Man is an intelligence in servitude to his organs.
Aldous Huxley (1894-1963)
In the summer of 1858, the Members of Parliament abandoned their beautiful waterfront building in London and fled to Oxford. Why? No political upheaval was brewing. No angry mob pounded on the doors. No deadly natural disaster threatened the capital. No terrorist plot was uncovered. No extraordinary criminal activity frightened people away. In fact, in that unusually hot summer, the stench of the River Thames simply became so offensive that spending the day in Westminster was absolutely unbearable.
For much of the nineteenth century, the Thames was essentially an open sewer, alternately sloshing and stagnating its slimy way through London. The river was (and still is) very tidal; its unpleasant contents tended to drift back and forth repeatedly before finally flowing out to sea. And what were those contents, exactly?
It was sort of like that, except without all the filtration in the middle. With drinking water like that, who needs sewage?
It’s no wonder, then, that epidemics of “filth diseases” (as they were called) like cholera and typhus ransacked London periodically. Although poverty increased the risk of contracting such a disease, nobody of any social status was safe – even Prince Albert, Queen Victoria’s beloved husband, died of typhoid after drinking contaminated water. Of course, the water wasn’t blamed at the time; widespread acceptance of germ theory was still decades away. In fact, part of what made the filth diseases so terrifying was complete ignorance of their origins. Some believed that cholera was proof of God’s judgment – a disease caused more by moral filth than physical filth – and responded with religious treatments rather than medical ones, such as a National Day of Fasting and Prayer for Cholera held in February 1832. Others believed that “miasmas,” foul-smelling airs, carried disease, and so combated aromatic filth with deodorizers. Luckily, some of these deodorizers actually turned out to be effective against disease for reasons unknown at the time; for example, carbolic acid was used to remove the stench from sewage even before its antiseptic properties were understood. Prayer and caustic deodorants weren’t the only options for warding off cholera – the epidemics supported a booming trade in patent medicines of dubious efficacy. Mainstream medicine, however, offered no more help than quack apothecaries: there was no effective treatment for cholera once it was contracted.
It wasn’t the doctors who eventually ended cholera’s reign of terror; it was the engineers. Even before germ theory explained why contaminated water was deadly, people wanted things cleaned up. The city smelled terrible, from the open sewer called the Thames to the streets covered in horse manure to the slaughterhouses slick with spilt blood to the tanneries filled with urine to the factories spitting coal smoke. The popular miasma theory said that bad smells meant bad health, so in the effort to eradicate filth fevers, anything that stunk had to go. Besides, politicians like Edwin Chadwick had crunched the numbers and realized that people who lived in filth died younger than those who could afford to get out of the slums. Thus, Chadwick and others made it their mission to clean up the city – get the sewage out to sea, keep the narrow streets of the slums from choking up with refuse, and deodorize everything. And so public health was born.
Now, before the cockles of your heart get too warm, let me clarify that Edwin Chadwick could give a crap about the poor of London. He was not a philanthropist; he was a politician. Again, he crunched the numbers (as he was wont to do) and determined just how much it cost the government to support the diseased paupers. The answer was a lot. When people were too ill to work, they became a burden on the taxpayers by sucking up welfare money. Chadwick figured it would be more cost-effective to finance the improvement of their living conditions just enough to keep them sufficiently healthy to earn their own keep. (Not surprisingly, Chadwick was also one of the brains behind the Poor Law reform of 1834, which established workhouses on the principle that people would try harder not to end up on welfare if the experience was made as unpleasant as possible.)
Whatever the reasons, though, the results were beneficial. Joseph Bazalgette, a civil engineer, undertook the enormous project of creating an underground sewer system for the entire city of London – one which would carry the waste far enough outside the city to ensure that it flowed into the sea instead of washing back up with the tides of the Thames. In deciding how big the main sewer would need to be, he estimated the maximum amount of sewage it could ever possibly have to contain, allowing for all imaginable population expansion…then, just for good measure, he doubled his estimate. Thanks to that last step, his sewer in still in use today; if he hadn’t doubled the size, it would have overflowed in the 1960’s.
Bazalgette’s masterpiece did its job, and the incidence of filth diseases dropped. It’s still worth noting that economics, not compassion, was the driving force behind such reforms. According to an exhibit at London’s Science Museum, “Public health reform movements in England from the 1830s onwards were prompted by the cost of supporting the sick poor, the need for a healthier labour force, fear of the spread of disease, and Christian traditions of charitable work.” It’s no coincidence that charity comes last in that list, preceded by cost, need for labour, and fear.
All politics aside, though, I’m certainly glad sanitation came into vogue, however unsavory the story behind it. Thanks in part to science and in part to selfishness, I get to see signs everywhere of the continuing campaign for sanitation and public health.
[Originally posted 7/22/10]