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Throughout the nineteenth century, cholera was a global scourge against human populations. Practitioners had little success in mitigating the symptoms of the disease, and its causes were bitterly disputed. What experts did agree on was that the environment played a crucial role in the sites where outbreaks occurred. In this book, Michael Zeheter offers a probing case study of the environmental changes made to fight cholera in two markedly different British colonies: Madras in India and Quebec City in Canada.The colonial state in Quebec aimed to emulate British precedent and develop similar institutions that allowed authorities to prevent cholera by imposing quarantines and controlling the disease through comprehensive change to the urban environment and sanitary improvements. In Madras, however, the provincial government sought to exploit the colony for profit and was reluctant to commit its resources to measures against cholera that would alienate the city's inhabitants. It was only in 1857, after concern rose in Britain over the health of its troops in India, that a civilizing mission of sanitary improvement was begun. As Zeheter shows, complex political and economic factors came to bear on the reshaping of each colony's environment and the urgency placed on disease control.

The cholera epidemics that plagued London in the nineteenth century were a turning point in the science of epidemiology and public health, and the use of maps to pinpoint the source of the disease initiated an explosion of medical and social mapping not only in London but throughout the British Empire as well. Mapping the Victorian Social Body explores the impact of such maps on Victorian and, ultimately, present-day perceptions of space. Tracing the development of cholera mapping from the early sanitary period to the later “medical” period of which John Snow’s work was a key example, the book explores how maps of cholera outbreaks, residents’ responses to those maps, and the novels of Charles Dickens, who drew heavily on this material, contributed to an emerging vision of London as a metropolis. The book then turns to India, the metropole’s colonial other and the perceived source of the disease. In India, the book argues, imperial politics took cholera mapping in a wholly different direction and contributed to Britons’ perceptions of Indian space as quite different from that of home. The book concludes by tracing the persistence of Victorian themes in current discourse, particularly in terms of the identification of large cities with cancerous growth and of Africa with AIDS.

Explanations for the genesis and propagation of cholera pandemics since 1817 have remained elusive. Evolutionary pathogen change is presumed to have been a dominant factor behind the 7th \"El Tor\" pandemic, but little is known to support this hypothesis for preceding pandemics. The role of anomalous climate in facilitating strain replacements has never been assessed. The question is of relevance to guide the understanding of infectious disease emergence today and in the context of climate change. We investigate the roles of climate and putative strain variation for the 6th cholera pandemic (1899-1923) using newly assembled historical records for climate variables and cholera deaths in provinces of former British India. We compare this historical pandemic with the 7th (El Tor) one and with the temporary emergence of the O139 strain in Bangladesh and globally. With statistical methods for nonlinear time series analysis, we examine the regional synchrony of outbreaks and associations of the disease with regional temperature and rainfall, and with the El Niño Southern Oscillation (ENSO). To establish future expectations and evaluate climate anomalies accompanying historical strain replacements, climate projections are generated with multi-model climate simulations for different 50-year periods. The 6th cholera pandemic featured the striking synchronisation of cholera outbreaks over Bengal during the El Niño event of 1904-07, following the invasion of the Bombay Presidency with a delay of a few years. Accompanying anomalous weather conditions are similar to those related to ENSO during strain replacements and pandemic expansions into Africa and South America in the late 20th century. Rainfall anomalies of 1904-05 at the beginning of the large cholera anomaly fall in the 99th percentile of simulated changes for the regional climate. Evolutionary pathogen change can act synergistically with climatic conditions in the emergence and propagation of cholera strains. Increased climate variability and extremes under global warming provide windows of opportunity for emerging pathogens.

This article reconstructs the first outbreak of epidemic dropsy recorded in documentary evidence, which occurred in Calcutta, Mauritius, and northeastern India and Bengal in 1877–80. It uses current medical knowledge and investigations into the wider historical contexts in which the epidemic occurred to re-read the colonial medical literature of the period. It shows that colonial policies and structures in the context of variable enviro-climatic conditions increased the likelihood that an epidemic would break out, while also increasing the vulnerability of certain populations to infection and mortality. Additionally, it shows how the trans-regional nature of the epidemic contributed to varying understandings of the disease between two colonial medical establishments, which influenced each other in contradictory ways. The article’s core contributions are to recent trans-regional perspectives on disease transmission and colonial medical knowledge production in the Indian Ocean World.

Using case studies of cholera, plague, malaria, and yellow fever, this book analyzes how factors such as public health diplomacy, trade, imperial governance, medical technologies, and cultural norms operated within global and colonial conceptions of political and epidemiological risk to shape infectious disease policies in colonial India.

The 50-year commemoration of S.N. De's seminal 1959 publication in Nature provides an opportunity to reflect on scientific discovery, recognition, and public health. De's paper marked the first major conceptual advance in cholera research since 1884, when Robert Koch definitively identified Der Kommabazillus as the aetiological agent of cholera. Unfortunately, Koch reported that systemic toxinosis and multi-organ failure led to severe dehydrating diarrhoea, thereby mistaking cause for effect. As a consequence, while work on other microbial pathogens advanced into the development of vaccines and therapeutics, cholera research languished as scientists injected animals parenterally in decades of futile effort to develop an animal model of diarrhoea. This fundamental misconception in cholera pathogenesis was swept away when S.N. De used ligated loops of rabbit ileum to demonstrate lumenal fluid accumulation in the presence of Vibrio cholerae culture filtrates. After some delay, De's observation of a diarrhoeagenic exotoxin became the founding principle of modern cholera research, vaccination, and treatment; and a burst of discovery saw V. cholerae transformed into the enteric pathogen best understood at the molecular level. The scientific basis for orally administering vaccines to induce mucosal immunity was established, and the success of oral rehydration, what has been described as one of the 20 th century's most important medical advances, was explained. Nobel laureate Joshua Lederberg wrote of De's iconoclastic creativity, experimental skill, and observational mastery, and many other leaders in the field concurred. De was nominated for the Nobel Prize in Physiology or Medicine more than once. But despite the passage of half a century from De's work, cholera remains a frustrating problem: we are clearly missing something. In reviewing the scientific and programmatic impact of S.N. De on cholera, it is clear that a defining victory against the disease is achievable, but only if basic scientific discoveries are relentlessly driven towards progress in public health.

From the mid-19th to the early 20th centuries, the forces unleashed by the age of European imperialism and its rapid encroachment on dār al-Islām increasingly brought the hajj under the scrutiny and regulation of non-Muslim powers. The driving force behind these dramatic changes in administration of the hajj was the expansion of the British Empire. As Britain's power in the Indian subcontinent grew, so too did its maritime supremacy throughout the Indian Ocean basin. Looking to secure its access to India, ward off its European competitors, and expand its commercial interests in southwestern Arabia, the Red Sea, and the Gulf of Aden, Britain's role in the region was intensified by the transit opportunities that emerged with the development of regular steamship routes between the Mediterranean and India from the 1830s to the 1860s and the eventual opening of the Suez Canal in 1869. With the exponential growth of maritime traffic that accompanied these technological advances came a similarly dramatic rise in the oceangoing pilgrim traffic from and through British India. Owing to this expansion in the number of seaborne pilgrims, the hajj soon came to be recognized as the primary conduit for the globalization of epidemic diseases, such as cholera and plague.

From the 1850s to the 1890s, Tanta, the largest city in the Egyptian delta appeared in print media throughout the world as an epicenter of cholera. Medical journals, periodicals, and missionary tracts reproduced the death tolls from the 1848 cholera epidemic that killed three thousand people in Tanta. Collectively, colonial administrators, missionaries, and physicians pigeon-holed Tanta as an epicenter of cholera that threatened to spread westward. This article uses Tanta's emergence into the global discourse of public medicine as a vehicle to understand the dynamic relationship between global and local engagements. It argues that the 1848 outbreak took on new meaning over the second half of the nineteenth century as it played into larger debates about germ theory, colonialism, and global trade. It shows that Tanta's engagement with the global discourse reflects the inherently symbiotic relationship between world and local histories.

This paper will try to give new insight into the Cholera Controversy, which occurred 125 years ago. The majority of papers already written on the topic have emphasised the role of Robert Koch who described the comma bacillus as the cause of cholera epidemics. At the same time they have marginalised the role of Emanuel Edward Klein by stating that he was wrong when he objected to Robert Koch's statement, because as an employee of the British government he was politically motivated. Moreover, they have paid barely any attention to Klein's writings on the subject. In this paper I will try to approach his attitudes from the scientific, not political, perspective and try to explain the reasons why he challenged Koch.

In 1959–1961, two major international centers for the study of cholera were established in Calcutta and in Dacca, Bangladesh. As the result of collaborative work in these centers, a simple effective oral therapy for cholera, using ingredients available in virtually every part of the world, was defined. Through the well-coordinated efforts of the World Health Organization (WHO), knowledge of how to prepare and administer oral rehydration therapy has now been disseminated throughout most of the world. With this background, when Peru was attacked in 1991 by a massive and totally unanticipated outbreak of cholera, a remarkably well-organized national response to the epidemic achieved a survival rate > 99% in > 300,000 cholera patients during the first year of the epidemic. Thus the results of clinical research on the Indian subcontinent, widely disseminated through educational programs by the WHO, have resulted in unparalleled success in the treatment of the largest epidemic outbreak of cholera in the 20th century.