BLUE DEATH IN BENGAL - Tambora: The Eruption that Changed the World - page 50

Russia. Medical historians disagree on what happened next: whether the 1817 cholera merely
slowed before gaining renewed strength in 1829 when it reached Moscow, or whether a new
epidemic began in Bengal in 1826, reaching the Russian capital three years later. Either way,
on an implacable westward march that inspired as much fear in those awaiting its coming as
misery in those already afflicted, cholera reached Paris in 1830, England in 1831, and finally
American shores the following year.
Figure 4.6. Map showing the global spread of epidemic cholera out of Bengal post-1816, in what has since
been termed the first cholera “pandemic.” Epidemiologists have identified six subsequent pandemics, the
most recent, and ongoing, originating in Indonesia in 1961. (Adapted from John Barber, An Account of the
Rise and Progress of the Indian Spasmodic Cholera … Illustrated by a Map Showing the Route and Progress of
the Disease from Jessore, Near the Ganges, in 1817, to Great Britain, in 1831 [New Haven, 1832].)
The eerie predictability of cholera's progress, because of its perfect alignment with the
global web of human commerce, “created panic on a scale not seen since the great plague epi-
demics of the seventeenth century.” 28 For all the anticipation, however, cholera's first strike
was always shockingly sudden. In April 1832, the poet and journalist Heinrich Heine wrote
about his experience at a masquerade ball in Paris at which a guest, dressed as a harlequin,
suddenly collapsed on the dance floor. Panic ensued. Dozens of other victims fell to the floor
until the ballroom resembled a battlefield. These fresh cholera victims, who had begun their
evening dancing at a carnival ball, ended it rudely tossed into makeshift graves still dressed
in their masquerade costumes.
The fact of cholera's essential mystery and resistance to treatment only amplified its power
over the nineteenth-century imagination. An extraordinary number of speeches were given,
orders issued, and weighty words written giving voice to these universal anxieties. Cholera is
accordingly the best-reported disease in history and boasts a vast medical and popular literat-
ure. In the twentieth century only AIDS approaches cholera in terms of the volume of research
and public opinion produced. As part of this same cultural phenomenon, cholera was the first
disease to come under modern public health surveillance and gave rise to entire new bureau-
cracies across the European nation-states. Cholera operated, historian Christopher Hamlin has
suggested, “like the conscience of the nineteenth century,” drawing the plight of the newly
urbanized European poor into stark focus and helping bring into being the modern apparatus
of professionalized public health. 29 The first British Board of Health was established in 1831
in response to the cholera epidemic, while in 1851 the first International Sanitary Conference
was held in Paris—cholera its sole subject. By century's end, the modern sciences of microbi-
ology and epidemiology had formed around the iconic image of a white-coated cholera sci-
entist peering through his microscope in a laboratory, while sanitarianism assumed its status
as the global orthodoxy of disease prevention, which it still holds today.