Having spent countless hours studying maps of disease for a chapter in Mapping Society, I was intrigued by a recent episode of the LRB’s Talking Politics podcast, with David Runciman interviewing historian Professor Sir Richard Evans, author of the superbly researched Death in Hamburg. Professor Evans was drawing out the parallels between cholera epidemics of the 19th century and the present-day coronavirus epidemic, though he highlights an important distinction between the 19th century, which was a period when science was used to investigate the causes of diseases, and the 20/21st centuries, when the focus is on finding cures.
The Map of Cholera in 1832 in Hamburg shown below illustrates the disproportionate impact on people living in poverty in the city at the time. As is so often the case, this was due to contaminated water supplies and substandard living conditions.
The cholera epidemic of Hamburg in 1870 was at a critical point in time for the development of epidemiology as a science. Despite John Snow’s discoveries in 1850s London that cholera was a water-borne disease, as well as Pasteur and others pioneering germ theories of the 1860s, miasmatism (the belief that disease was spread through bad air) continued well into the latter quarter of the century. The persistent lack of confidence in science was coupled, in the case of Hamburg, with pressures from the mercantile elite for whom accepting the germ theory would have led to, as Attila Tárnok has stated, “consequences of … substantial investments in the city’s infrastructure, including water cleaning, sewage treatment, quarantine, and other measures” (Tárnok, 2020).
The reemergence of the disease in 1870 came as a surprise. The same issues of overcrowding and insanitary living conditions in low-lying areas of the city (though the correlation was somewhat the wrong way around: the poor were more likely to live in low-lying areas) as revealed by the myriad maps of cholera drawn up through the century coincided in this instance with a lack of political will, Evans maintains, that meant that the city suffered disproportionately badly from a disease that was, even in the best of cases, devastating. In Hamburg, trade was a critical aspect of its identity: a city effectively run by its merchants, who preferred to ignore those medics who supported a disease theory that might suppress trade through quarantine. By the 1890s the spread of disease was at its worst due to wider geopolitical conditions, and consequential population movements, alongside the development of the railways.
The impact of both political and societal structures during that period is telling. Professor Evans emphasises the negative effects of the lassez-faire attitude of local business people and administrative incompetence, but also broader societal differences that stemmed from the city’s relatively autonomous status within Germany, as well as its outlook as an economic centre. As we see today, even among democratic governments, different approaches to controlling contagion tend to coincide with differing levels of acceptability among local societies. While one hesitates to draw conclusions from the current data, it is hoped that we won’t need to wait another century before we draw lessons from the decisions made over the past few months.
Evans RJ. Death in Hamburg: Society and politics in the cholera years. United Kingdom: Penguin Books; 1830‐1910.
Tárnok, A. (2020), “The Cholera Epidemics in Hamburg and What to Learn for COVID‐19 (SARS‐CoV‐2)”. Cytometry, 97: 337-339. DOI:10.1002/cyto.a.23999
Vaughan, L. (2018), Chapter 2 Disease, health and housing (pp. 24-60) in Mapping Society: The Spatial Dimensions of Social Cartography. London: UCL Press. DOI: 10.2307/j.ctv550dcj.7