Cholera, Typhoid and Typhus
The cholera germ enters the body via the mouth, usually in contaminated water or food, and sets up an infection in the small intestine. The incubation period is short, never longer than five days and sometimes less than one.
The disease usually developed in three relatively well-defined stages; the stage of evacuation, the stage of collapse and the stage of reaction. The onset was invariably abrupt and characterised by a purging diarrhoea and copious vomiting, which emptied the stomach and was followed by exhausting retching and hiccuping. As the body became dehydrated, agonising cramps afflicted legs, arms, abdomen and back.
As the patient passed into the stage of collapse his physical appearance changed completely - his skin became lax, wrinkled, cold and clammy to touch, his eyes sunken, his cheeks hollow, and there was blueness about the eyes and lips. The voice became husky, the expression anxious and apathetic. His blood pressure fell and he was unable to urinate. At this stage death could occur from circulatory failure or failure of bodily functions.
If the patient was lucky, he survived the second stage; his blood pressure was restored, his urine flow was restored and he slowly recovered, though heart failure could still follow the slightest exertion.
Typhoid and Typhus
The typhoid germ enters the body through the mouth, usually in contaminated food and water. Drinking water taken from contaminated wells was a common source of infection. The patient suffered headache and nose-bleeding, general body aches, a feeling of tiredness and persistent fever which may have lasted up to three weeks. He developed a rash, called 'rose spot' and relapsed into delirium and mental confusion. Bronchitis and pneumonia were secondary and frequently fatal effects.
The typhus germ is transmitted by the bite of the body louse; so the disease was directly connected with filth and overcrowded unwashed clothes and shared beds. In various circumstances it was called 'putrid fever', 'ship fever', 'jail fever' and 'camp fever' and was particularly virulent in cold weather, when poorer people would tend to wear every ragged stitch they possessed and when their vitality, through lack of warmth and nourishment, was at its lowest ebb. The symptoms are very similar to those of typhoid: headache and general pains, chills and fevers, lassitude and delirium. In crowded conditions typhus could be a real killer. In 1833 P. Gaskell published The Manufacturing Population of England, and identified common lodging houses as a particular problem:
[Common lodging houses] are occupied indiscrimately by persons of both sexes, strangers perhaps to each other, except a few of the regular occupants. Young men and young women; men, wives and their children - all lying in a noisome atmosphere swarming with vermin, and often intoxicated. [p. 142]
The following extract does not relate to Nottingham, but is typical of habits of the poorer working class folk in any industrial city in the 1830s, and illustrates that some were so poor they had to share clothes:
We saw half-dressed wretches crowding together to be warm; and in one bed, although the middle of the day, several women were imprisoned under a blanket, because as many others who had on their backs all the articles of dress that belonged to the party were then out of doors in the streets.
[Extract from Reports on the Sanitary Condition of the Labouring Population of Scotland, in Consequence of an Inquiry Directed to be Made by the Poor Law Commissioners, p. 9; 1842 (008)]
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