Good evening! I'm your host for the week, @khowaga, and I'm about to ruin your dinner! (1/18)

#tweetistorian #histmed #twitterstorian #epitwitter
You see, I've mentioned #cholera a few times, but I need to take a deep dive into what it was and why it was one of the great international health crises of the 19th century.

Apologies for doing the "Lost" thing where we devote an entire episode to a new character. (2/18)
Cholera--as it became understood in the 19th century, the illness that was proven in 1884 to be caused by the bacterium Vibrio cholerae--first appeared in Bengal in 1817. (3/18)
The question of why Bengal, and why 1817, has been hotly debated ever since. There is one school of thought that V. cholerae was a newly mutated virus that appeared in the floodwaters of the Ganges Delta. (4/18)
There is another theory that V. cholerae had existed in its post-1817 form, but that it was extremely localized, and the introduction of new transportation technology, aided by British colonization of the subcontinent, caused it to spread. (5/18)
There was yet a third theory--now largely unpopular--that cholera had always existed in India, but that pre-1817 sources are unreliable because, since the disease was ubiquitous, none of the Indian medical texts went into very much detail since "everyone knew." (6/18)
The last theory fell out of fashion because it was based primarily on the premise that only European accounts could be trusted. This, despite the existence of ancient medical texts and the Ayurvedic medical tradition with an extensive corpus of literature. (7/18)
One of the pieces of evidence used to support the idea that cholera existed in India much earlier was the discovery of a shrine at a temple in Kolkata dedicated to Oladevi, the goddess of cholera (pictured). That there was a Vedic goddess of cholera was seen as proof. (8/18)
A few decades later, it was discovered that Oladevi only started being worshipped as the goddess of cholera around ... you guessed it, 1817 ... and that the newly arrived official who foud the shrine didn't realize how quickly statues erode in the damp climate. (9/18)
Anyway, I tend toward the first theory, myself (new mutation). The disease spreads too easily and kills too quickly to have gone unremarked upon, imo.

Here's the part you might want to skip if you're about to eat. (10/18)
V. cholerae enters the body through the ingestion of tainted water. For some reason, when I was doing work on the 1883 outbreak, this conversation always seemed to happen at a dinner party.

Someone would ask how you get cholera. "You ingest tainted water," I would say. (11/18)
"Tainted with what?" they would ask, innocently, apparently not seeing where this was going. And I would have to figure out how to answer "fecal matter" in a socially acceptable manner.

But, yes, this is how it spread. (12/18)
V. cholerae would pass through the system, follow the wastewater, the wastewater would come into contact with "clean" water and be drunk, or used to wash fruits or vegetables that were eaten raw, ingested, lather, rinse, repeat. (13/18)
Cholera was an effective killer, terrifyingly so.

When Frances Hodgson Burnett had the protagonist of "The Secret Garden" sent off to bed before her parents throw a party, only to wake up to find everyone has died overnight from cholera, this wasn't an exaggeration. (14/18)
The death was horrible.

Victims expelled all of the fluid from their systems (I will not go into detail, you can imagine), and often turned a purplish-blue before expiring from shock and systemic organ failure. (15/18)
And, given the way the disease spread, quarantine was useless to prevent it--once the ground water was contaminated, that was it. The disease would eventually burn itself out, but not before killing tens of thousands of people. (16/18)
No effective vaccine was ever produced (there are some on the market, but their efficacy is around 50-60%). Eventually, it was discovered that rapid rehydration can prevent death, and today cholera is considered manageable. (17/18)
But during the era of imperialism, no disease was more terrifying than cholera. And its arrival in Egypt in 1883 was a master class in all of the reasons why this was. (/fin)

~csr
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