Finding Cholera

By 1817, Britain was feeling pretty tired. The long war against Napoleon was finally won, but it had been terribly expensive and had required tiny Britain to recruit large armies and build a huge navy. The economy was a shambles.

Still, the future looked bright, especially overseas. Almost by accident, Britain had acquired a huge empire which would soon become a market for all the consumer goods the Industrial Revolution was beginning to produce in such vast quantities.

The heart of that empire, the one that glowed brightest with wealth for the future, was India.

What had once been a dizzying patchwork of little tribal areas, kingdoms, and principalities had been united into a huge proto-nation. Weirdly, it was ruled by a private company, the British East India Company. It was the Company’s troops that conquered and it was the Company’s bureaucrats who made the laws and enforced them. To become a Company man and travel to India was to live a live of luxury and return a very rich man.

Providing, of course, you survived.

Because India was alien, rich, gaudy, and deadly. From the western world’s point of view, the perennial sweep of plagues across India was a pretty minor matter. Unless your brother or son was one of those caught in the latest pestilence, it was just something that happened to little brown people in a far distant place.

It was news. Safely-confined-to-India news.

Until, that is, 1817. Britain and the western culture had brought disciplined armies that criss-crossed the sub-continent. It brought steam engines that connected India the rest of the world. In short, it brought multiple pathways for disease to venture out of its home base.

In that year, an unusually severe outbreak of cholera sprang up in Bengal. It didn’t stay there. British troops carried it up into Afghanistan and Nepal. British ships carried it east to Ceylon, Indonesia, China, and all the way to Japan. It traveled west to southern Arabia and up into the Persian Gulf and all the way to the Caspian Sea.

There it stopped. So, for the British at home, it was still just news. Thousands died, of course, but the India-born disease was still safely remote.

Until, that is, 1826. Once again a severe strain of cholera erupted in Bengal. But this time it not only traveled east and west. From the Caspian, it continued traveling north. By 1830, it had reached St. Petersburg. By the time it burned itself out, 100,000 Russians were dead. This might still be just news, but it was getting uncomfortably close. By 1831 it was burning brightly in Hamburg and any British sense of the invulnerability of distance was gone. It became a matter of waiting and praying. By October, it appeared up in northern England, in Sunderland. Then, by February, 1832, it reached London.

Cholera was terrifying in many ways. First, to Europe at least, it was a brand new disease. Secondly, it could kill in a matter of hours. Thirdly, the manner of its spread was novel and mysterious. But the worst of it was that the symptoms were so unfamiliar and so deadly.

A perfectly healthy person might suddenly collapse. Then diarrhea set in, often accompanied by vomiting. Even when the insides were completely cleaned out, the diarrhea continued, odorless and nearly clear, with flakes of what looked like rice in it. The body seemed to shrivel away, all the flesh drawing back to the bones. The heartbeat slowed, the body turned blue, and then death came. Most horribly, the victim seemed to stay conscious right to the end.

And it was so unpredictable. A whole family might go down at once, or a single person might be spared. A wife, tending her sick husband and children might not get the disease, but the person in the room upstairs might. It struck the poor especially hard, but some of the wealthy fell too. Doctors could do nothing except mutter about how it was all caused by a miasma in the atmosphere, created by all the rotting trash of the Victorian city. [Remember that this was in the time before the “Germ Theory” was part of the medical debate.]

Cholera seemed to simply defy normal logic. Was it contagious? You could nurse a cholera patient and be perfectly safe. But in some odd sense it must be infectious, because it devastated whole neighborhoods. But it might skip right over the next block. Over the next fifty years, cholera would return to Europe in waves, killing in the tens and hundreds of thousands.

It was not till 1883 that the mystery was solved. A German scientist named Robert Koch took a team to Egypt and India where they isolated a comma-shaped bacillus called Vibrio Cholerae and declared it to be the cause of cholera.

This discovery put Koch right up there in the medical pantheon with Jenner, Lister, and Pasteur. He had many other accomplishments, of course, but this one sealed his place in history. He was skilled, persistent, and wonderfully intuitive.

But it helps to be lucky.

Koch was incredibly fortunate to identify what you might call the real deal: the particular bacillus that caused the genuine, raging cholera that killed as many as 50% of its victims.

He was fortunate because it turns out that there are actually something like 200 strains of Vibrio Cholerae. They are found in warm waters around the world, happily causing no problems at all. Few of them bring disease. And of the ones that do, most cause a more or less severe form of gastroenteritis. Finding one of them in the water supply or even in diarrheal stool is hardly rare. But the strain that Koch identified and vigorously defended happened to be the right one.

So you could say he was awfully lucky.

But he’s not alone. One of the oddest things about studying those great minds that go down in history is their uncanny talent for being in the right place at the right time. And, more than that, for recognizing the right solution out of all the others when it comes along and then clinging to it like grim death.

Maybe it’s a talent, or maybe it’s just luck. But, his great rival Pasteur said, “Le hasard ne favorise que les esprits préparés.” Fortune only favors the prepared mind.

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