Travel and Quarantine in the 19th Century

Amongst the many impacts of COVID-19 has been the devastation of the travel industry, and its knock-on effects on the global economy. We are all having to think carefully about the ways we travel, not only internationally, but even around our own countries and communities. At the moment, a summer holiday in the sun seems like a long way off.

In Britain, one of the solutions being put in place as we tentatively begin to consider heading out again, is to impose a two-week quarantine on incoming travelers and tourists, in attempts to limit the spread or import of the virus. It all feels very odd in an age where we have become so used to travel that it has become easy, routine and even mundane. But it’s worth remembering that these issues and restrictions are not new, and that the dangers of epidemics have actually shaped travel, and affected individual travelers, for centuries. What was it like to be quarantined in the past? In 1892, a letter was sent to the Coventry Herald newspaper from a Mr W.H. Grant, a traveller to America, who found himself quarantined on a Canadian island in the midst of a deadly outbreak of Typhoid fever.

(Image of a ‘Beaver Line’ ship from WWW.NorwayHeritage.com/Gallery – creative commons licence)

Grant was headed for New York but, due to overcrowding on direct sailings, due to a cholera scare, he elected instead to go on one of the Beaver Line’s ships via Montreal, and finish his journey to NY by rail. Things immediately began to go wrong. The ship he boarded at Liverpool, the ‘SS Lake Huron’, was itself badly overcrowded and ‘taxed to its utmost capacity’, and they departed in bad weather and heavy seas. The ship had not even got as far as New Brighton, in Merseyside, when “a sort of mutiny occurred on board, culminating in a free fight between six or eight of the seamen and officers”. The ship was forced to anchor whilst a tug took the offenders away.

(Image of SS Lake Huron from WWW.NorwayHeritage.com/Gallery –  creative commons licence)

But worse was to come. It rapidly became clear that a serious infectious disease had broken out aboard the ‘Lake Huron’. This was initially “hushed up” and Grant reported that the crew were seen throwing dead bodies overboard with no ceremony when they thought “the act could not be observed by passengers”. When a steward came down with Typhoid fever, it was no longer possible to conceal the truth, and it became clear that the vessel would not be welcomed in port.

(Image ‘Man with Typhoid’ copyright Wellcome Trust, Wellcome Images)

On arrival in Quebec the SS Lake Huron was put into quarantine off an island in the St Lawrence River – “a veritable forest with rocks, valleys, mountains, bays and the most magnificent scenery imaginable”. After two days the passengers were ordered ashore “taking whatever baggage and things we should require” whilst the ship was disinfected. Hopes of a comfortable quarantine looked doubtful though. On landing, all sick passengers were transported to a hospital some distance away, whilst the rest of the passengers were led to clearing in a forest, occupied by whitewashed, one-story buildings, with no locks on the doors, nor separate areas for men and women. They were also dismayed to see nearby a “lonely graveyard in a swamp, where 5420 people were buried twenty-five years ago, within a few months having died of ship fever and cholera”.

With true Victorian efficiency, the passengers of the SS Lake Huron quickly took control of the situation and formed a management committee. Also, true to form though, this was not some egalitarian or Utopian commune, but strictly class divided, with all first- and second-class passengers having their own ‘shed’, subdivided into areas for men and women and children, and those from steerage in another “some distance off”. No need to have the poor near the posh!

Eager to restore some sense of ‘normality’ though, working parties of able men were quickly set up, who rigged up hammocks, cut down trees and even decorated the buildings with ferns and shrubs. Bonfires were made up to cook food, and dinner was served every evening at six o clock by the two cooks from the ship. In this version of ‘lockdown’ passengers soon began to make their own entertainment too. After two days Grant reported that people were busy rambling, exploring, hunting, swimming, and even organizing hill-climbing competitions. A variety of animals were captured including squirrels, snakes and titmice, providing diversion for the youngsters.

The threat of the disease remained, and three families from the steerage buildings were taken to hospital, but after a couple of weeks, Grant was hopeful of returning to the ship and onward to his destination. Here his letter ended, and it is not clear what happened next. (It’s also worth noting that this wasn’t to be the last time this particular ship was quarantined at Quebec: in 1899 an outbreak of smallpox on the ship caused a similar situation.) But whilst the detail and context of his story are unique, they still resonate. Even in unfamiliar circumstances, surrounded by the threat of contagion, and uncertain of the future, people still found a way to preserve some sense of ‘normality’.

(Image ‘Passengers on board ship undergoing quarantine examination, 1883’ copyright Wellcome Trust/Wellcome Images)

And this, without trying to sound glib, is where history IS useful – not necessarily so much in terms of particular approaches or responses, (and hopefully not in terms of the prospects for modern quarantine!) but more in reminding us that what we are experiencing now is not new. The past is strewn with epidemics. We routinely teach children about the Bubonic Plague: our very language is shot through with references to it…e.g. things we should avoid ‘like the plague’. Smallpox. Typhoid. Spanish Flu. Each obviously has its own context, its own effects and symptoms, and each leaves its mark in the collective memory. The important thing to remember, though, is that in time they pass. It might not feel like it at the moment, and the media love their ‘things will never be the same again’ headline-grabbers, but we will come out of the other side of this, hopefully stronger and better prepared for the next one.

BBC Free Thinking Feature: Bamburgh Castle Surgery, c. 1770-1800

Over the past few years I’ve been working on the records of a unique eighteenth-century medical institution. The eighteenth century saw the rise of institutional medicine, first in the form of hospitals and infirmaries, and later dispensaries. The former were large, imposing buildings in a town landscape, housing inpatients and treating surgical cases, as well as other conditions. Dispensaries were smaller, sometimes occupying existing buildings, but generally acted as outpatient services where the poor could be given medicines, patched up if necessary, and sent on their way.

Both hospitals and dispensaries were funded by subscription. Subscribers were invited to pledge an annual sum of money, put towards the building, running and upkeep of the institution. In return, subscribers had the right to recommend patients for treatment, according to the size of their donation. Unlike today, patients could not simply turn up at the doors, unless in absolute emergency. Instead, they required a certificate of permission, signed by a subscriber and, as such, could be difficult to access at times.

Image from Wikimedia Commons

Also, institutions were firmly urban in nature. They were closely bound up with the civic ambitions of Georgian towns. A hospital could be a strong statement about a town’s importance and beneficence to the poor. ‘See how kindly we look upon our poor objects’.

Unsurprisingly demand for these facilities was high. Even outside London, annual admissions could number in the thousands. Especially in the crowded and often unsanitary conditions of towns, conditions like epidemic fevers were rife.

But one medical institution stood apart – both literally and notionally – from the rest. In the 1770s, Dr John Sharp, Archdeacon of Northumberland, philanthropist, and member of a family which included a prominent surgeon and famous anti-slavery campaigner (Granville Sharp) was a trustee of a large charitable fund established by the late Nathaniel Lord Crewe. Crewe had set aside large amounts of money from land revenues, stipulating in his will that these were to be put to charitable use.

Image from Wikimedia Commons

One of the properties was the dilapidated medieval Leviathan of Bamburgh Castle. Undertaking a massive programme of restoration, Dr John Sharp adapted the castle to a variety of charitable uses, including a school, corn charity, home for shipwrecked sailors and the surgery/infirmary.

With his brother’s advice (a surgeon at St Bartholomew’s hospital in London), Sharp equipped Bamburgh with the very latest in medical technologies, including an ‘electrical machine’ for literally electrocuting patients back to health, a full stock of medicines and equipment, and other modern apparatus such as the ‘machine for the recovery of the apparently dead’ – used to try and revive the recently-drowned.

Last year I visited Bamburgh and made a short radio programme for BBC Radio 3, which is now available online.

Click on the link and then the ‘play’ icon in the new page to access the programme

For more about Bamburgh and its facilities, you can also click here for my ‘History Today’ article about Dr Sharp and his medical charity.

Norovirus and the reporting of epidemics through history

This winter has already witnessed an unprecedented increase in cases of Norovirus – the so-called ‘winter vomiting bug’. For some reason, across the globe, the infection has spread with increasing virulence and also lingered longer than normal in parts of the world now moving from spring to summer.  Norovirus is an especially durable and adaptable virus. It is perfectly suited to what it does; spreading from person to person either through airborne contact with minute particles of vomit, or through surface contact with the virus…on some surfaces it can last for up to two weeks. Given that I have a pathological phobia of vomiting, this one is the stuff of nightmares!

In Britain, the Health Protection Agency is the public face of public health and is charged with providing a virtual barometer of sickness. Their website contains a list of the current maladies doing the rounds and, in the case of flu and norovirus, weekly updates on the numbers of the stricken. The site also contains tips on how to prevent the spread of the virus and some advice (if little comfort) to those who have already succumbed.

To my mind, the information on the HPA website is extremely reminiscent of the information disseminated to the public in past times of epidemic disease – say the seventeenth-century plagues. It strikes me that authorities throughout history have had to balance the need to provide practical details of encroaching sickness with the need to avoid spreading panic. The language of sickness reporting in fact has a long history, and show remarkably similar patterns.

The reporting of the numbers of sufferers, for example, is something that was certainly an important element in the way the Great Plague of 1665 was reported. In seventeenth-century London, the so-called ‘Bills of Mortality’ gave a weekly update on deaths in the city, in the form of a published pamphlet. Information for these pamphlets was gleaned from the ‘searchers of the dead’ – people (often women) who were employed to examine fresh corpses to discern the cause of their demise. Their diagnoses were diverse. In one bill dating from 1629, the causes range from predictable conditions such as measles, cold and cough and gout to other, stranger, ones such as ‘teeth and worms’, ‘excessive drinking’ and ‘suddenly’!

As the plague increased though, the Bills of Mortality became rapidly dominated by these numbers, and Londoners pored over the pages every week to gauge the seriousness of the situation. News of the contagion was a regular topic of conversation and people were eager to learn if things were getting better or worse. The newly burgeoning cheap presses of the mid seventeenth century went into action, with everything from treatises on the causes of the plague to ‘strange newes’ about the latest outbreaks or figures and even popular cures.

The authorities were clearly worried about the danger of epidemic sickness, and took measures to try and limit its spread. One of these was to try and restrict popular gatherings such as fairs, to try and prevent the disease running rampant. This Royal proclamation from 1637, for example, entreated people not to attend the popular Sturbridge Fair that year, the king ‘Forseeing the danger that might arise to his subjects in generall”.

So, the authorities published the numbers of sufferers, took preventative measures against the spread of contagion and, in general, maintained a dialogue with the public, updating them on disease types, currency and potential ways to avoid them. The popular press also served to stir up fears, however, and perpetuated public dialogue about infection. Disease and health have always been topics of conversation but, in times of contagion, they tend to become more concentrated, and people become more engaged in dialogue about them.

Fast forward to 2013 and it is remarkable how similar the situation still is. The HPA website, for example, gives a weekly update on numbers of norovirus sufferers, not only in terms of clinically-reported cases, but of an assumption that for every reported case there are a further 288 or so unreported cases – people who simply decide to stay home and self-medicate. Indeed, at the present time, people are being actively discouraged from attending doctors’ surgeries, and hospital wards are being closed to the public. The impression is one of a wave of contagion breaking over the British Isles and, for me at least, one that is coming to get me!

There is indeed a fine line to tread between reporting facts and sparking panic. When SARS first emerged, there was a great deal of information (and misinformation), with various ‘experts’ calling it variously a massive threat to humanity, or simply the latest in the processional line of epidemics to afflict humankind.  A few years ago, a virtual global panic was instigated by the apparent mutation of avian flu, or bird flu. This outbreak made ‘pandemic’ the buzzword of the late 2000s and, again, much space was devoted (and indeed still is to some degree) on educating people on what it is, who has got it, and how to avoid it. In 2005, a UN health official warned that bird flu was capable of killing 150 million people worldwide. According to Dr David Nabarro, speaking to the BBC at the time “”It’s like a combination of global warming and HIV/Aids 10 times faster than it’s running at the moment,”. The World Health Organization, perhaps seeing the potential panic that this could cause, immediately distanced itself from the comment. The fact that the outbreak was ultimately relatively mild emphasises the problem that epidemic disease causes for health officials. How to alert people without scaring them?

None of this is helped by the press who, like their seventeenth-century counterparts, are keen to give the largest mortality figures, or emphasize the spread of diseases. In June 2012, for example, Reuters were still warning that a global bird flu pandemic could happen at any moment.  http://www.reuters.com/article/2012/06/21/us-birdflu-pandemic-potential-idUSBRE85K1ES20120621

The same pattern is now happening with the norovirus – although clearly this does not carry the same levels of danger. Here we are talking about contagion, rather than mortality.  Let’s take the headline on the Western Mail newspaper of 20^th December though: “Norovirus: Now more wards are closing as hospitals in Wales hit”. The breathy style of this banner line emphasises its rapidity, not just a straight report, “NOW” it’s coming. What purpose do these reports ultimately serve? Put another way, why do we need to be told? Logically, if preventative measures are possible then it makes sense to tell as many people as possible. But often this is not the purpose of newspaper copy in times of sickness which, to me, almost seems at times to be deliberately provocative.

The answer seems to be a deeply-set human interest in sickness, ultimately linked to our own mortality. Even in this apparently scientific and modern age of medicine, there are still many things which are incurable, and many diseases which have the ability to wipe us out at a stroke. It is this uncomfortable reality which perhaps continues to fascinate and frighten us. We live in an age of control, but some things are still beyond our control, and it is perhaps this innate fear of disease – of our own transience – which makes these headlines ultimately so compelling.