Cholera outbreak at Theydon Bois cont.

Martyn’s account of this outbreak is of considerable interest, not least in the light of the present-day uncertainties caused by the Covid pandemic. Further information from the Theydon Bois outbreak can be gleaned from newspaper reports that appeared in numerous publications across the country, indicating the level of nationwide concern about the disease at that period. Many of the London newspapers carried reassuring articles written by Thomas Forshall, a surgeon who had investigated the Theydon outbreak, and had even been unwise enough to sample some of the farm’s well water which he found to have ‘an unpleasant odour and a nauseous taste’.

Asiatic cholera was a dramatic illness which caused considerable public alarm. It apparently came out of nowhere and could kill with considerable rapidity, usually within 24 hours of onset, though sometimes a previously fit person would be dead within a few hours. With better treatment available in the 1920s, the mortality rate was between 25 and 50%. In the 1860s, it was probably significantly high. It was then widely believed to be caused by ‘noxious effluvia’, an invisible miasma arising from drains and poor sanitation.

More than decade earlier, the pioneer epidemiologist, Dr John Snow, had plotted the incidence of cholera in London on a map, and had clearly linked the outbreak to the consumption of water drawn from one particular pump in Broad Street. He famously took direct action to end the outbreak by removing the pump handle. But in spite of Snow’s detective work, the local press accounts of the 1865 outbreak at Little Gregories, Theydon Bois, show that the belief that ‘noxious effluvia’ caused cholera outbreaks was still well embedded. The press blamed the practice of spreading London’s manure as a fertiliser on local fields, and also reported that quicklime was being thrown onto fresh dung on the streets of Stratford in an attempt to prevent local outbreaks in the metropolis. The Epping magistrates went down a similar path by issuing a directive to disinfect ‘any place … producing bad smells’, and threatened the ‘full penalties of the law’ for anyone who failed to do so after due notification.

Cholera, of course, is a highly infectious disease, principally caused by contamination of drinking water with sewage, though it could also be spread by poor hygiene after person-to-person contact, as is suggested by the death from the disease of Dr McNab senior who succumbed soon after attending the Groombridge family. Person-to-person contact may also have caused the death of the poor woman who was responsible for laying-out the corpse of the Groombridge’s farm labourer, though it might have resulted from accepting food or drink at the house after completing her grim task. The farm labourer himself is more likely to have been infected by drinking water from the farm’s well.

Subsequent investigation revealed that the farmhouse water closet, as well as the kitchen sink waste, had been leaking into the communal well, the water from which was heavily contaminated with hydrogen sulphide. What is less clear is how the disease had found its way to this rather isolated farm. Initially it was attributed to Mr Groombridge’s recent holiday in Weymouth, a suggestion serious enough to result in a visit by a government inspector to that seaside resort, though no evidence was found to confirm this. The source of the Theydon outbreak was never established, though it is interesting that Mr Groombridge himself was reported to have been significantly unwell for many months, raising the possibility that he might have been a carrier who had unknowingly contaminated the farm’s water supply. This could explain why the outbreak was limited to members of that household and their employees, and why it had failed to spread elsewhere in the district.

As already mentioned, cholera was an illness of dramatic onset and high mortality, causing a high fever and rapid dehydration, with circulatory and renal failure. Treatment in the mid nineteenth century included large doses of calomel (mercuric choride), sugar of lead (lead acetate), opium, starch enemas and castor oil, suggesting to a modern observer that, even if cholera did not kill the patient, it was quite likely that the treatment would succeed!