City was pioneer during 1866 cholera outbreak

EARLIER in these columns I wrote about cholera and the catastrophic outbreak of the disease in 1832 that killed more than 3000 citizens of Glasgow, the majority of them female.

I said I would have to write about cholera again and the time has come to do so, not least because of COP26 happening here just now.

Just as cholera was devastating for Glasgow in the 19th century, so climate change threatens annihilation for large parts of the planet and its supposedly most intelligent occupant species, ie us, humans.

I fail to understand why COP26 does not see the United Nations declare a full-on global health emergency for climate change as they have done for the coronavirus pandemic.

After all, the UN itself says climate change is set to cause at least 250,000 extra deaths per year, every year. But being forced to react to a world health emergency will not be welcome in some countries.

They should take a lesson from the host city of COP26, because it was here in Glasgow that the authorities took action to stop the scourge of cholera, and in doing so laid down the sanitary policies and preventive practices which have vastly improved public health across the globe.

Even as Glasgow was booming, the old enemy of cholera came calling.

As we have seen, the 1832 outbreak was not as bad as that of 1848 which first led the city fathers to consider the Loch Katrine water scheme, with the 1854 outbreak confirming the wisdom of that project.

After that outbreak, it should be emphasised, English doctor John Snow demonstrated the link between cholera and contaminated water.

That evidence was widely accepted by the medical profession by the year 1866.

Seven years after the water supply started to come from Loch

Katrine, Glasgow’s health was generally much improved, but still cholera struck – typhus fever, it should be said, was ever-present.

Katrine water was pure but there remained a huge problem, and that was housing. According to Professor William Tennant Gairdner (1824-1907) of Glasgow University in a paper about the 1866 outbreak delivered to the Association of American Physicians, the city was insanitary because of massive overcrowding, particularly of the “operative classes”, ie the workers.

He wrote: “This large mass of wretchedly housed persons was also densely packed upon ground space smaller in reference to the numbers of population than in any city of Great Britain and Ireland, save Liverpool.”

Gairdner at that point was the part-time medical health officer of the city of Glasgow and it was largely due to his successes that such officers were made full-time and became a legal requirement of cities in the Public Health Act of 1872.

In some areas of Glasgow in 1866, population density was 1000 to an acre. Plans were already under way by the city council to clear up the streets and improve sanitation, but cholera got there first.

It had spread across Europe and the medical experts such as Gairdner knew it would come to Glasgow, which it did.

Gairdner had known Dr James Burn Russell at the university and turned to his friend for assistance in preparing the city for an epidemic of cholera.

Russell duly became one of the towering figures of the history of Glasgow and a pioneer of public health across the globe.

Russell had been born in Rutherglen in 1837, and according to his biography at Glasgow University’s website, he received his early education at the High School of Glasgow.

The biography states: “After completing his Arts degree at the University of Glasgow in 1858, he acted as assistant to his former teacher Lord Kelvin.

“Russell assisted Kelvin with laying the first Atlantic cable. He then moved from electrical engineering to the study of medicine, graduating from the University of Glasgow MDCM in 1862.

“After completing his studies, Russell worked as a resident assistant at the fever wards of the Glasgow Royal Infirmary, gaining experience in the treatment of infectious disease.

“During the typhoid outbreak of 1864-1865, Russell was appointed as Physician Superintendent of Glasgow’s first fever hospital.”

His experiences there taught Russell that prevention and careful preparation of treatment was the key to dealing with infectious diseases.

When cholera duly arrived in the city in 1866, Russell sprang into action.

Among other facilities he proposed and got was 24 hour opening of pharmacies and surgeries, and

His 1888 pamphlet has been credited with starting the movement that led to council housing

also four emergency hospitals, one of them on Glasgow Green – just like the Nightingale hospitals of our own time, they were hardly needed.

That’s because Gairdner came up with a revolutionary concept involving Christian churches of all denominations – volunteer health visitors.

They numbered in excess of 3000 and were recruited and instructed by Russell in record time and bravely went from door to door, educating the Glasgow public all about cholera and how to prevent it by sanitary measures such as avoiding dirty water and frequent hand washing – sound familiar?

For the first time a civic population did not panic in the face of cholera, and the results of the Gairdner-Russell “disinfecting” and educating approach were quite simply amazing.

Expecting a death toll in the hundreds or thousands, disinfected Glasgow suffered just 53 deaths – a third of the number who died in Edinburgh from cholera that year.

Gairdner was able to report that the epidemic was over by Ne’erday 1867, and Glasgow breathed again.

After, Russell was made the Medical Officer of Health following the Public Health Act of 1872 and he developed sanitation and hygiene policies which greatly reduced Glasgow’s death rate from all diseases.

Reforms developed by Russell included the compulsory notification of infectious diseases, as well as increased training of nurses.

He persuaded often reluctant councillors to improve public sanitation and clear slums, and over 26 years he fought with land and housing owners to make sure they kept their properties clean.

His 1888 pamphlet Life In One Room has been credited with starting the movement that led to council housing and his works on diet and the links between poverty and ill-health were hugely influential.

Russell died in 1904, his reputation as a public health pioneer confirmed.