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<h1>I Luv Urban History: BLog</h1>
<h3>Epidemics and the City: Cholera Pt. 1</h3>
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    <p>Germ theory had been floating around for some time but it came into its own in the last decades of the 19th century, roughly 1860 to 1900. Much like other revolutionary theories, germ theory was met with both excitement and resistance. It was an important advance in the history of medicine that led to a new understanding of the nature of disease.</p>
  
    <p>Cholera is thought to have originated in India in the delta of the Ganges and Brahmaputra Rivers. There had been an epidemic in India but it was unknown elsewhere until it burst onto the scene with the epidemic of 1817. Initially, cholera was trapped in India as it does not travel easily. That changed, however, when throughout the 19th century, people began to vastly increase their movement between India and the West. Once it got to the West the industrial revolution had created conditions that facilitated the disease. </p>
    
<img src="https://dencityhome.files.wordpress.com/2020/09/the_silent_highwayman.jpg?w=975" style="width:1000;height:auto;" class="center" />

    <p>Cholera thrived on the chaos of rapid growth and unplanned urbanization. Ubiquitous filth and overcrowded, substandard housing and a lack of adequate, secure water supply nor sewers made for ideal conditions for the spread of the disease. To give an idea of the level of pollution in industrial cities like London, during a heatwave in 1858, water levels in the Thames dropped leaving layers upon layer of fecal matter and other waste to ferment in the sun. The stench was so overwhelming they called it "The Great Stink." Miasma theory blamed the smell for the recent cholera outbreaks; germ theory blamed the water contamination. </p>
  
    <amp-fit-text layout="fixed-height" min-font-size="6" max-font-size="72" height="80"><blockquote class="wp-block-quote"><p>Gentility of speech is at an endâ€”it stinks, and whoso once inhales the stink can never forget it and can count himself lucky if he lives to remember it. </p><cite>City Press on the Great Stink</cite></blockquote></amp-fit-text>
  
<img src="https://dencityhome.files.wordpress.com/2020/09/cholera-hero-1.jpg" style="width:1000px;height:auto;" class="center" />

    <p>Cholera was (is) a terrible way to die. Symptoms could develop in a matter of hours after ingesting contaminated water. In most people, stomach acid would kill the bacterium. But if the number of bacterium ingested is overwhelming and for those who are compromised by some gastrointestinal disorder or chronic alcoholism it escapes the stomach and its acids into the small intestine. Once in the small intestine it reproduces and causes infection as it attaches to the mucous lining of the bowel. From there the body reacts by attacking the bacteria, killing it. This is where things go terribly wrong. </p>

    <p>When the bacteria dies it releases and enterotoxin, one of the most powerful poisons in nature. It effectively makes the intestine work in reverse, instead of allowing nutrients out into the bloodstream it allows blood plasma to move from the bloodstream into the intestine. This colorless liquid is then violently expelled from the body. The loss of plasma makes the blood thick and reduces circulation. The body's temperature falls and the massive amount of fluid loss makes the skin seem to shrivel and shrink leaving the person looking gaunt and cadaver-like. </p>
    
    <p>Then, in the second stage, people would appear to get better but it was not necessarily true. The duration of the first stage would determine the likelihood of surviving the second; the longer the first stage lasted the less likely they were to survive. Then, once deceased, the body had a habit of continuing to spasm and tremble. It was It is said that this process could be so swift that someone fine at lunch could be dead by dinner. Between 1831 and 1866, approximately 40,000 people&nbsp;died from cholera in London alone.</p>
    
    <p>Effective treatment for cholera took a long time to come by. Bloodletting was the initial go-to, it was used as a remedy for a great deal of things. The loss of blood plasma, however, made the blood thick and impeded circulation so traditional venesection was ineffective. Desperation led doctors to experiment with new treatments. One such treatment, conceived in the 1830s, involved administering fluids. However, not knowing how much fluid to give the patients they often overdosed. Plus, with germ theory not yet widely accepted, doctors didn't think to use sterile water and so it induced septicemia. It wasn't until 1908 when a British physician, Leonard Rogers, created the "cholera bed" to measure fluids lost by the patient paired with a drip of a distilled saline solution did the death toll of cholera drop. </p>
 
    <p>To be continued...</p>

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<h5>Content originally from Dencity.blog</h5>
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