Cholera in the large towns of the West and East Ridings, 1848-1893.

This study discusses the three cholera epidemics in 1848-49, 1853-54 and 1865-66, focussing on how the disease was experienced and acted upon, as well as its impact in the four . large towns of the West and East Riding of Yorkshire (Bradford, Hull, Leeds and Sheffield). It does this comparatively and sets cholera outbreaks in the context of local social, administrative and geographical factors. The main thesis is that historians should not talk about the national experience of cholera for the period 1848-66, rather they should recognise different experiences and impacts between towns, through time and at different levels of society. A subsidiary argument, however, is that the scares which occurred in the 1870s, 1880s and 1890s can be considered at the national, even international level.In 1848-49 there were major differences in mortality between the four towns, with Hull and Sheffield at two ends of the spectrum nationally and regionally. In 1853-54 and 1865-66 none of the four towns experienced a major epidemic, though they did experience exceptional levels of public health activity, such that an 'epidemic consciousness' can be identified. While nationally there was an incremental fall in cholera mortality over the three later epidemics, in the four towns there was a single fall after 1849. As each threat passed there was growing confidence that cholera was controllable, though it never lost its power to 'shock'.In 1848-49 there were major differences between the towns in levels and forms of activity both to the approach and the containment of the epidemic. This was due to a number of variables: social relations and class attitudes, the role of the medical profession, theories of cholera's etiology (including the gradual adoption and adaptation of Snow's ideas), local reactions to relations with central government, the intensity of the mortality crisis and past experiences of epidemic diseases. The most striking feature in 1853-54 was the lack of variation in official actions across the towns. During and after the 1866 epidemic a two-tier approach was adopted, with cholera increasingly seen as a port disease.Was cholera the local sanitary reformers' best friend? The answer given is no, but this is qualified in several ways.The commonest middle class view of the later epidemics was that those who suffered were culpable, due to their ignorance and fecklessness.. In other words, the problem was not so much the disease as the people. Working class reactions to sanitary reform were not characterised, as is often said, by ignorance or hostility, rather they were varied and patterned. Actions were guided by a specific, usually local, understanding of urban disease ecology and of the wider determinants of health and disease. This knowledge of the local physical environment was linked to views on rights and responsibilities. The working class did not share the one dimensional environmentalism of the sanitarians; instead they contended that many other factors were determinants of health, not least wages and hours of work.