Guest blogger Charlotte Orr provides a brief insight into her MLitt dissertation on the links between the 1831-1832 British cholera pandemic and the professionalisation of medicine and its relevance today.

Doctors rightly have a serious amount of cultural cachet: COVID-19 ‘clap for our carers’ has given us all a chance, for a short time on a Thursday evening, to acknowledge their fundamental hard work to keep us safe. This blog briefly examines how historical pandemics have altered our perception of ‘healthcare heroes’.

Today, if you want to be a doctor you must be the crème of the crop intellectually: those accepted to medicine at university are some of the brightest sparks. However, before the Medical Act of 1858, doctors were not legally required to have qualifications. During the 1831-1832 British cholera pandemic then, anyone could declare themselves a doctor. As if that wasn’t enough to make Victorians wary of doctors, just two years before cholera arrived the infamous duo Burke and Hare were slaying people in Edinburgh and selling the bodies to Dr Knox for research. Contempt for medicine was standard in the early nineteenth century, but some doctors wanted that to change and cholera was their chance.

In 1823 Thomas Wakley founded the Lancet medical journal, naming it after ‘a sharp instrument used to puncture a boil’ in the hope that it would reveal the diseased wound present in the medical profession. [1]^[2] The Lancet is a key source for understanding the changing dynamics of the medical profession during the cholera pandemic because it was the first weekly medical periodical, allowing contributors to share their knowledge relatively frequently. It was also the most widely read medical journal, ‘with a circulation of over four thousand’.[3]

So, what did Victorian doctors say in the Lancet? Well, the first article on cholera is a forty-four page long ‘history of the rise, progress [and] ravages of the blue cholera of India’.[4] The word ‘cholera’ is first mentioned a page in, after being referred to as a ‘pestilence’, a ‘visitation’, ‘a new and terrible disorder’.[5] Arguments over the framing of the disease continued throughout the pandemic, evident in the cautious title of a March 1832 article: ‘Observations tending to prove the identity of the disease now present in London, with that which prevailed in the North of England, on the Continent of Europe, and in India’. Much as we have heard from non-medical sources recently about the ‘Chinese virus’, and the ‘Wuhan Virus’, the Lancet regularly referred to the ‘Asiatic cholera’ and ‘Indian cholera’. This disease frame problematically insinuated that cholera was not present in Britain, would never be present in Britain, and could never be Britain’s problem: the pandemic eventually killed 32,000 people living in Britain.

Similarly, the military rhetoric that we’re hearing from presidents, prime ministers, and the press today resonates with the framing of cholera during the 1831-1832 pandemic. The Lancet personifies cholera, imagining the disease battling with British colonial troops in India:

Salvos of artillery and peals of musketry roared from the rising to the setting sun, loud shouts were raised by united thousands […]; but the unrelenting progress of the pestilence soon showed in the inefficacy of this clamour, and the crash of ordnance and martial music gave place to the shrieks and melancholy wailings of the dying and bereaved.[6]

In the commanding editorial of 25 February 1832, the writer complains that ‘[n]ever […] in the whole chronology of epidemics, were erroneous opinions more violently, more dogmatically, pressed upon the public.[7] The Lancet makes explicit that a ‘war’ against cholera has in turn created a war for authority: the pandemic created an opportunity for doctors to assert themselves as the ultimate health authority. In a 10 March 1832 article, the writer aims to solidify doctors’ control over the disease: ‘the vehement manner in which an influential portion of the non-medical press has inculcated the opinion that no new or malignant disease reigns amongst us [is] deserving [of] particular attention.[8] Due to the medical expertise of their writers then, the Lancet will dissect, analyse, and share the failures of the press: doctors are, by the end of the pandemic, not only medical but also moral authorities for the public.

The link between the professionalisation of medicine and the cholera pandemic filtered into fictive work. In Harriet Martineau’s Deerbrook (1839) the village doctor, aptly named Hope, becomes a hero because of his perseverance during the cholera outbreak. He disregards fearmongering newspapers, and stoically forgives villagers who once claimed he was a ‘burker’.[9] In the end, secure in his professional status, Hope is able to morally and medically rescue the villagers and witness the deaths of those who refused to admit their immorality.

During this pandemic, we’ve seen evidence of the reassuring figure of the doctor: Boris Johnson and Nicola Sturgeon have regularly been flanked by chief medical officers and other public health officials in press briefings to legitimise their comments on the virus. Perhaps then, as with cholera, doctors may harness this newly reinforced fashioning as essential ‘frontline’ workers, as ‘healthcare heroes’, in order to ensure fundamental positive change for the NHS.

References

[1] Michael Durey, The Return of the Plague (Dublin: Macmillan Ltd, 1979), p. 103.

[2] Martin Hutchinson, ‘How the Lancet made medical history’ (3 October 2003) URL: http://news.bbc.co.uk/1/hi/health/3168608.stm  [Accessed: 13 June 2016].

[3] Michael Brown, Performing Medicine: Medical Culture and Identity in Provincial England 1760-1850 (Manchester: Manchester University Press, 2011), p. 159.

[4] Anonymous, ‘History of the Rise, Progress, Ravages, etc. of the Blue Cholera of India’, Lancet, 17 (429), (19 November 1831), p. 241.

[5] Ibid., p. 241.

[6] Ibid., p. 241.

[7] Anonymous, ‘The Lancet: The Cholera in London’, The Lancet, 17 (443), (25 February 1832), p. 774.

[8] P. H. Green, ‘Observations tending to prove the Identity of the disease now present in London, with that which prevailed in the North of England, on the Continent of Europe, and in India’, The Lancet, 17 (445), (10 March 1832), p. 824.

[9] ‘Burker’ was the title given to those suspected of conducting crimes similar to those of William Burke (i.e. murdering people to use their bodies as medical cadavers).

About the Author

Charlotte Orr is a final year Medical Humanities PhD candidate at the University of Glasgow. Her thesis interrogates the literary self-fashioning of medico-scientific researcher Sir Ronald Ross (1857-1932).

Banner Image Credit: Blue stage of the spasmodic Cholera of a girl who died in Sunderland, November 1831. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)