This book has largely been about individual aspects of urban life: how changing ways of living have affected our distribution, density and diseases. For the final example of how city living has gotten into our very bones, we will look at the culmination of 15,000 years of creeping urbanisation: the birth of the modern city. Instead of going death-by-death through the global history of modern cities, this chapter will try to walk through the last few hundred years of urban history using the capital city of a small and standoffish island to see what there is to see: a history of population explosion, of global trade and local politics, of pollution and medicine, and all of the push–pull factors that have delivered the people of this city to the graves of paupers and of kings. With a wealth of history and an embarrassment of historians, archaeologists and archives, we will turn to the story of early modern London, and how the city described by Tacitus as a town somewhere below the rank of a proper Roman settlement became the city described by Dickens as a mountain heap of misery.
I love London, in the abstract way that only a child who grew up in a world where ‘old’ things date to the 1960s can. It’s also the city I know best, having lived here for more than a decade. London was at the heart of my PhD research, and I’m forever grateful for the kindness of historian Vanessa Harding in letting me audit her MA courses on early modern history; much of what I know about the city is inflected by the court rolls, wills and other historical accounts she exposed me to. I’m in constant awe of historians; I’m not sure how you could come up with a coherent narrative about anything when the details of history are so delightfully revealing. Even in the process of composing this chapter, I got distracted by an account of a session of the Middlesex Magistrates’ Court of one Mr Wotton, who in 1585 was running a school for pickpockets and cutpurses in the back of a pub near Billingsgate Market. He’d rigged a purse with bells all over and even created a graduated hierarchy of skills with titles for those boys who passed his tests; it’s such a strangely detailed thing to know about someone dead 400 years – and it’s distracting us from our story.
Despite their diverting character it’s precisely these detailed, written and, most critically, preserved minutiae that allow us to reconstruct the history of the city so clearly. History, however, is a liar and a cheat when it suits; there is a reason that there are no glorious stone obelisks set about the temples of Mesopotamia carved with commemorative images of the time the Mesoptamian king was ignominiously defeated in battle. It’s axiomatic that history is the past as told by the winning side. Only the dead never lie, but, as we’ve seen in the rest of this book, they certainly can mislead. I will attempt to pull together some of the endless bureaucratic details of the last few centuries, the little lives caught in their margins and the more human stories writ in the vast numbers of bones under London’s streets, buildings, parks and homes. This should show us in a microcosm all that we need to know about life (and death) in the city: the how many, who, what, why, when and where that the issue of urban life throws out.
The foundations of London lie far beyond the early modern period we want to get at here, but merit some mention. London sits astride (it used to be aside) the mighty Thames, at a convenient point where the river is wide enough to get back out to sea but narrow enough to cross. Quite a larger number of early island inhabitants did cross it: there are footprints up in Happisburgh1 on the northeast coast of Norfolk that have been dated to one of our hominin relatives more than 800,000 years ago. Britain itself is attached to the continent of Europe through the (now underwater) region of Doggerland,2 which only appears when large parts of the planet’s water have been taken up as glacial ice sheets. While it’s hard to imagine today, my house sits on the edge of the vast glaciers of the last ice age that once stretched all the way into North London. A Britain covered in ice is actually a bit easier to contemplate than one covered in savanna, but just down the hall from my office in the Natural History Museum we have an entire cupboard full of fossil fauna dug out of Trafalgar Square in the 1950s – and it’s full of lions and hippos that once roamed central London.
So it’s fair to say that London has seen considerable change, even before modern Homo sapiens arrived. Geoffrey of Monmouth, who dedicated himself to writing a very detailed, very imaginary history of Britain, recounts the foundation of London as a story of the defeat of the giant Gogmagog by a misplaced Trojan. Archaeology has yet to uncover the remains of any giants, however, so the origins of the city are traditionally ascribed to the Romans at the start of their incursion into the British Isles. This is a bit unfair on the rather older evidence of occupation – or at least human presence – that archaeologists have turned up, particularly along the banks of the Thames, but the story of London as a city really does begin with the answer to Monty Python’s question in the movie Life of Brian: ‘What have the Romans ever done for us?’ For the next 2,000 years, there were raids, razings, reconstructions and revolutions, leaving an extraordinary trail in the archaeological record. The city we want to speak about, however, is the city of the last few centuries: a city that has burst its banks and taken over both sides of the river, overflowing its walls to establish suburbs all the way from Westminster to the Tower of London. This is a city that was decimated by plague, going from possibly around 80,000 inhabitants at the start of the fourteenth century to little more than half that by the end.
The re-peopling of London after the Black Death was not a simple case of the production of more London babies by more London parents, as the eminent historian Paul Slack has demonstrated; he cites a variety of factors that kept the number of Londoners down after the catastrophic mortality of the plague. The factors he cites are interesting for how modern they sound to twentieth-century ears. Migration was a factor, with pilgrims, dissidents and others upping sticks and crossing seas, but the major brakes on the endogamous reproduction of the population are all attributes of urban life. There are the usual suspects in those diseases that flourish in dense, close-living urban conditions, but there are also social factors in reproducing urban life that resulted, not just from poor living conditions in London, but also from better living conditions.
The nature of work and the city, heavily influenced by patterns of migration, contributed to later ages at marriage than you would expect from the past; the average age at which men and women married and started families was in the mid-to-late 20s. From my research with Andrew Bevan into the demographic history of a rural community on a rather different island some thousands of miles and several cultural steps away (the goat-ridden paradise of Antikythera in Greece we visited in Chapter 3), I can see clear evidence that family formation was something that started much younger for the units of reproduction (i.e. women) in rural3 agricultural communities. It’s clear that the simple expectation that people in the past universally lived fast and died young is misplaced; then as now, circumstances dictate human choices on when and how to reproduce. In London, specialised employment in specific trades followed a system of apprenticeship that more or less took people off the marriage market for years at a time. Even for those who weren’t overtly specialised into one of the established trades, the presence of waged work in the city was too great an opportunity to be missed, even if it meant delaying marriage and starting a family. The great financial draw of working in London brought in migrants from all around the country and even beyond, but they came either as young men who would need seven years to become their own master in the traditional guild system of tradesmen, or as domestic servants, particularly women in the latter part of the period, putting off marriage and starting a family for the surety of hard cash.
All this cash is one of the key features of the modern city. Wages – earnable, transferrable wages – operate in a system of exchange that recognises no difference between luxuries and necessities – they all have a price tag. Abandoning this cash economy and living off the land in London is not an option.4 The urban economy is fully moneterised, made of credit, capital and, most of all, cash and the ability to earn, raise or steal the same.5 Repeating a refrain that was still current at least the last time I spoke to my grandparents, contemporaries of the early modern period deplored the ‘spirit of madness running abroad, and possessing men against marrying’. Even more pertinent to the modern participant in the cash economy, the seventeenth century describes the plight of the potential parent ‘afraid they shall not be able to maintain the children they shall beget’. Anyone who has ever looked at the price of a pram will understand the dilemma.6 The engines of global capitalism may have been running on timber, coal or steam, but the fug of money problems they emitted into the urban world seem not so very different to those of today.
There is of course a final factor in holding population numbers down in the early modern period, and that is death. I think the fact that we’re not surrounded by 200,000-year-old hunter-gatherers is reasonable proof that death is not the exclusive province of the city. But the rather fantastic thing is that sometime in the 1500s history begins to record what previously only the bones themselves had. Bureaucratic compilations of births, marriages and deaths were recorded by an officious and jealous Church slowly supplanted by an interventionist state. And this habit of keeping vital registers of the population was further extended to keep an eye on denizens even as they departed this world. These are the Bills of Mortality, and they’re the reason we know so much about mortality in early modern London.
The rather macabre collection of statistics embodied in the Bills has been mentioned briefly before, but they are remarkable documents. The point of them was to record plague deaths and act as a sort of early warning system for the powers that be if an epidemic approached; they were used in many European cities in the early modern period. Plague was still very much a threat at this time, cycling through Europe and causing catastrophic mortality until the last major outbreak in Marseille in the 1720s (another big, connected city at the height of its commercial clout). However, as the Bills themselves record, plague was certainly not the only thing to die of in the early modern city. The best-known collection of Bills records the plague year of 1665, the one that Samuel Pepys found so very pleasant. The conditions recorded require some flexibility with the facts of modern medicine – who dies of ‘horseshoe head’? – but they reflect contemporary attitudes towards disease. For just the week of 7 March 1665, various causes of death are recorded, such as: ‘aged’, ‘cancer’ and ‘childbed’, though ‘consumption’ is there as well as the ‘King’s Evil’ (aka scrofula, see Chapter 9). ‘Mother’ is also down as causing a death, and there is someone ‘mouldfallen’. ‘Rising of the lights’ appears to have taken off nine souls, and scurvy and rickets also do their worst. The ‘French pox’ is indicted in four deaths, in contrast to the small one that carried off 16. Sometimes the Bills give a very clear cause of death – ‘killed by a cart by St Martin-in-the-Fields’ – while others are touchingly esoteric: someone in London, in the week of 7 March 1665, died of ‘grief’.
They also reflect the medical knowledge of those who recorded them, a group so disparaged by the male medical establishment that we will have to take a moment to wade through the disdain to try to get at how accurate these causes of death might be. In the sixteenth century, the tradition of parish churches employing ‘searchers of the dead’ was instituted. These searchers were, quite literally, employed to search for the dead: to visit the same houses as Death and to ascertain what form it had taken. They were almost always elderly, indigent and female, which meant that they had all of the criteria to take on a job that, on the surface, sounds relatively undesirable. As poor women, they would have become dependents of the parish and been obliged to take what employment there was. No doubt having survived to old age, there was a good likelihood that they would survive future contagion, and even if not, there were plenty of other little old ladies around.7 The very early epidemiologist John Graunt, who pulled together many of the Bills of Mortality in order to make one of the first use of statistics in the understanding of disease, described them as ‘antient matrons, sworn to their office’, but later historians were even less kind. Popular perception seems to have been that the searchers were uneducated illiterates without the wit to put together cause of death. An anonymous correspondent to The Gentleman’s Magazine in 1799 reports that in at least two parishes of his knowledge, ‘the searchers cannot write; the mistakes they make are numberless in the spelling of Christian and surnames, for, they trust to memory till they get home; then, child or neighbour writes what they suppose it to be’.
Still, you wouldn’t want to be on the bad side of the searchers. Cause of death matters to the living relatives and associates of the deceased, not least in times of plague. If the searchers declared a plague death, quarantine and restrictions would fall on the household; the economic and social consequences were harsh. But how much reliable information can be got from causes of death that seem to be a collection of euphemisms for diseases that don’t even really exist? More than might be thought on initial reading. I’ve already mentioned in Chapter 10 the peculiar case of ‘rising of the lights’ being much more comprehensible when you realise that ‘lights’ are ‘lungs’.8 The searchers may have reported in the vernacular, but almost all diseases were vernacular in the early modern world. Take for instance our baffling case of ‘mouldfallen’. This is probably linked with diseases, recorded on the same line elsewhere in the Bills, such as ‘mouldhead’ or ‘horseshoe head’: forms of hydrocephaly. Hydrocephaly – water on the brain – causes a type of cranial swelling that would have been noticeable to even a lay person, and hydrocephaly in London was more than likely to have resulted from infection of the central nervous system with our old friend Mycobacterium tuberculosis. Death by ‘spleen’, however, shows that the opposite can also occur; what sounds like a practical appraisal of an anatomically limited problem is in fact likely to indicate a choleric distemper (more antique words implying medical diagnoses) – in other words, depression.
Without germ theory, Londoners lived in a pall of disease caused by all sorts of things. Worms in teeth were at the root of tooth decay, an idea that has been with us since the Babylonians. But above all, the environment was responsible for all manner of evil. The idea of humours had not gone out of medical fashion, and the climate, the temperature, the disposition of land and the fabric of buildings were all blamed for causing different ailments. The streets were thoroughfares of filth, and it must say something for the early modern conception of hygiene that the water running down roadside ditches was considered for use as both toilet and watering hole – something we actually know obliquely from two unfortunates who died in the same open sewer (or urban stream, if you like), but at the very different purposes of making and retrieving water. The air itself was not to be trusted, being full of vapours and, worst of all, the dreaded miasma.
But how bad was this brave new urban world? How dirty was it, compared to all of that skulking about in caves for all those hundreds of thousands of years9 before cities? Let us start with the filth on the ground before raising our eyes to the skies. Despite most of us holding a general perception of the past as a more bucolic place, full of greenery, wild animals and fluffy clouds, we seem to only ever imagine the cities of the past as potentially dank and polluted places. Picture the scene changes of any knights-in-armour type film and you’ll see what I mean – rolling hills transition through a portcullis to wretched filth within the city. There may even be ragged lepers for effect. Really, only the insightful work of Monty Python has dared contest this seemingly inbuilt urban prejudice. Their ‘mud farmers’ scene in the film Monty Python and the Holy Grail manages to get right down into the muck of rural life while taking pot shots at the social processes that put people there.10 As we discussed in Chapter 3, there are pollution risks associated with close-living livestock that can lead to increased disease transmission; these might be expected in contexts where people cohabit with their goats, but those contexts may or may not be urban. Agro-pastoralists, professional herders who also do a bit of farming, may have constant close contact with animals but are hardly urban dwellers. And in the space-conscious city, there just isn’t the room to keep that herd of goats with you at all times.
What cities do manage to do with the evocatively pastoral pollution of the animal world is build it up into terrifying quantities. Cities are aggregators – of people, things and animals; and until the advent of modern refrigerated transport, if you wanted to eat an animal, the animal had to come to you. Awkwardly, as cities got larger, if you wanted to get the animal, you increasingly had to get other animals to take you there. Animals have been present in the urban world since before it was properly urban; we can think of those goats and sheep at Aşıklı Höyük huddled in close some 10,000 years ago. The intensification of animal stockherding that really took off in the last 3,000 or 4,000 years in some places was never abandoned, leading to entire cultures of mobile pastoralists.
Alternately, we see a long tradition of herders so integrated with a sedentary lifestyle that we don’t view our pastoralist pasts as being separate from the story. If you ever find yourself at a loss for something to do in the French Pyrenees for a few days, I can highly recommend reading the strange story of Montaillou and seeing what an odd but not uncommon blend of nomadic and settled life looks like in practice. Montaillou was (and is, you can visit) a very small town on the fringes of France, about 40 kilometres (25 miles) from Andorra and just over the ridge from Spain. As a result of a scheming village priest, some unfortunate love affairs and an incredibly meticulous Inquisitor, the testimony of more or less the entire village was taken during the tail-end of the Cathar Inquisition in the years between AD 1318 and 1325. One Pierre Maury recounts his life as just such an agro-pastoralist, somewhat tainted by his association with the heretical Gnostic beliefs of the Cathars. His response comes to us in incredible detail thanks to the lead investigator (and future Pope of Avignon) Jacques Fournier’s idiosyncratic method of going about quashing heresy by basically just asking an insane number of questions and writing down all the answers, a fairly unique take on Inquisition in a movement with a reputation for inventive tortures. Pierre’s life as an illiterate shepherd 700 years ago is full of unexpected drama,11 but it’s also full of mobility and the breadth of experience is striking. He wanders through all the Occitan lands, which today cover at least three countries; he lives for months with Muslim workmates, visits cities big and small and quits his jobs whenever he feels like it, everywhere taking sheep to and from hills to shearing. Life in the city seems stultifyingly stationary compared to his experience, whether you were the human or the sheep.
Pierre’s story touches on an aspect of urban life that appears in the Neolithic but then slowly mutates as populations become denser and work more specialised: animals. Despite many urban dwellers maintaining a small personal menagerie, contact with living animals was probably more limited than in rural, pastoral contexts, with the potential exception of experimental early villages just developing the domestication process, like those at Aşıklı Höyük. Nonetheless, the big urban cities of the past still drew in meat to market. For millennia, drovers moved their flocks through cities, letting the animals do the work of marching on to their deaths and giving city dwellers the opportunity to eat. There are specific routes that were used by stockbreeders going to market still riddling the modern world; even cosmopolitan London has an archaic statute on the books granting the Worshipful Company of Woolmen, the ancient guild of sheep keepers, shearers and wool sellers, to drive their sheep across London Bridge, a right they rather surreally exercise once a year, much to the bemusement of tourists.12
Today in many parts of the world this is still an important practice; I will not soon forget spending Eid al-Adha amid the crumbling colonial facades of half a dozen empires in the undeniably Mediterranean but defiantly Egyptian port city of Alexandria. Eid al-Adha is the Islamic Feast of Sacrifice, commemorating the biblical story of Abraham, who, asked by God to sacrifice his only son, is rewarded for his homicidal piety with a miraculous kid–ram switcheroo. This is generally celebrated by acquiring or choosing a sheep in the preceding week, moving it in, getting the family and especially small children to love and pet it, and then slaughtering it in front of everyone.13 In Alexandria, like in many modern cities, people live in apartment towers and blocks, and sheep keeping is slightly out of reach,14 so enterprising herders bring their sheep to town. For convenience, they will also do the slaughtering for you, which is very considerate until you realise that bleeding out an average of about 30 sheep on every third street corner quite literally makes the streets run red with blood.15
The thoroughfare of animals in cities might more habitually leave behind animal excreta, but butchery too makes for a good source of animal pollution. By far and away the biggest contributor to animal pollution in the city, however, is the excreta of our transport animals. At one point in 1907 the American city of Milwaukee was producing 120 tonnes of horse manure scraped off its streets every day. Many enterprising cities invited farmers to come and collect the deposited wealth of urban animals; a hundred years earlier, New York City had sold 29,000 dollars of horse manure to farmers. London too had an active ‘nightsoil’ industry, supplying outlying agricultural areas and the tanneries on the eastern and southern fringes of the early modern city.
Casting our eyes away from the filth under our feet, we have at some point got to consider the air. Certainly, Londoners always did. They were convinced that the air was the source of every contagion, every cough and fever. It was an established medical fact in the early modern period that disease was caused by ‘miasma’, a pestilence spread through the air, and that miasmas hovered in fens, marshes and other low wet ground. London being full of such places, it was little wonder that disease stalked its citizens. The early modern belief that miasma in the air had to be kept out may have been connected to the presence of a terrible fever that presided over the then-marshlands of the eastern coast of England. It affected places like Essex so badly that Daniel Defoe, another keen diarist of the seventeenth century, was told by a group of ‘marsh men’ with straight faces of varying degrees of believability that anyone born outside the marshes was likely to die shortly after moving in. This led to the happy situation that a marsh man might expect to have five or six wives over the course of things if they brought wives in from ‘the uplands’. In fact, the English had their very own form of the French aguë, which we know today as malaria. The identification of the source of the disease – the word miasma means, literally, ‘bad air’ – was only half wrong; it’s generally agreed that plasmodium bacteria carried by mosquitoes were at one point endemic to these shores. Destroying the heart of the fens may have wreaked havoc on the ecosystem, but it did have the notable benefit of ridding England of a pestilent home for mosquitoes in the malarial swamplands just to the north of London (and depriving Essex men of their opportunity for new wives). Of course, at the time, it was the miasma that was considered vanquished, because everyone knew diseases lived only in the air.
It turns out that it might not have only been disease wafting around the streets of London. All those people, all those houses, all that industry, created an extraordinary amount of air pollution. People think of the ‘pea soupers’, the great fogs of particulate matter that used to turn day into night in the coal-burning capital of the mid-twentieth century, but smoky domestic fires of wood, peat and animal dung have been with us from the very beginning. In Chapter 2 we saw what happened if you try to occupy your new-build Neolithic dugout house without properly checking the ventilation: hordes of archaeologists choking and running for the exit. Actually, smoke inhalation seems to be one of the primary dangers of experimental archaeology; experiments at Çatalhöyük and Aşıklı Höyük in reconstructing the hearths of their ceiling-entry dwellings seem to have suggested that people and fires could not very easily coexist indoors.16 It’s not clear that Neolithic housing was all that much of an improvement on living in caves, air-quality-wise. While it’s difficult to reconstruct air pollution factors from tens of thousands of years ago, especially if you only have an archaeologist’s floor plan to work from, one of the interesting suggestions made by bioarchaeologists has been that we might be able to pick out signs of aggravated snuffling due to poor air quality from subtle changes in bones. The nose and mouth are where the human body takes in air,17 and these are lined with delicate tissues designed to protect the even-more-delicate tissues further down the line by responding floridly to threats both real18 and perceived.19
Constant irritation and inflammation can cause sinusitis – infection of the sinuses – and sufficiently irritate the flimsy bones that surround the nasal passage and sinuses so that they develop porosity on their surfaces, just as in any other inflammatory response. Noting shifts in levels of sniffles through time by collecting bioarchaeological evidence of inflammatory response on these bones has been argued to be one of the few ways we can reconstruct the quality (or lack thereof) of our housing, from cave to condo. The pioneering physical anthropologist Calvin Wells extended his investigation of palaeopathology to the sinuses of the upper jaw, sticking an endoscope up the noses of medieval British skeletons. Subsequent work by a group of British bioarchaeologists including Mary Lewis, Charlotte Roberts and Keith Manchester has produced a synthetic picture of air pollution in the British Isles over time. Roberts has compared the experience of air pollution across several widely spread groups stretching from North American hunter-gatherers to nineteenth-century London. She found that outside of the city, women had higher levels of sinusitis than men, but that urban living equalised each sex’s exposure to irritants, and also led to more exposure overall. If the home, urban or not, can be a source of pollution, then the elevated levels of sinusitis in non-urban females compared to males that we see in both archaeological and modern evidence might directly relate to the division of labour between the sexes. This pattern kicks in well before the Industrial Revolution, suggesting that the background levels of urban air pollution are of greater antiquity than those blights of modern air quality we point the finger at today: industrial manufacturing, power generation and transit. They stretch to the first urban agglomerations, suggesting that something about urban life – potentially the concentration of air pollution in homes or in city streets – is responsible for declining air quality. Certainly by the early modern period there were a number of industrial practices at work in the city that might have added their own particular flavours to the pall of smoke over the capital, including tanning, brewing and lime burning.
The pattern does not seem to be overly strong, however, suggesting that there might be a number of confounding factors between actual air pollution and the bony response bioarchaeologists can see. A study of pre-state agro-pastoralists and medieval Indian skeletons suggests that males were more likely to have sinusitis, but the pathology occurs so infrequently it’s hard to draw a conclusion as to what that might mean; the authors suggest that dental health and other infections have as much to do with sinusitis as air pollution. It’s a pity that larger samples were not available from the agro-pastoralists, as I would suspect that a life spent that close to animals would be tough on the schnozz in many ways, particularly reliance on animal dung for fires that then release industrial quantities of pollution into the home.
There is one further element in the story of London pollution that we have not yet covered: water. It’s not that it’s entirely unremarked on in contemporary times, but it seems to have been subject to a much lower threshold of purity than might be expected – recall the bodies found in the ditched streams running along main thoroughfares. The water of London was, simply, filthy. It’s a wet city at the best of times, surmounting a larger river and burying several smaller ones under the foundations and basements of the city. These were not the only channels coursing under the early modern city, however. The Romans had brought plumbing with them, giving London nearly two millennia to develop a functioning hydrological system, including options for temperature control,20 and riddling the city’s substrata with sewers. Alas, by the medieval period, the Roman sewers had gone the way of the Roman temples and markets: lost underground, unseen and unsuspected. By the early modern period, access to water for the vast majority of the population was through wells and public pumps, or straight from the river itself. This would have been fine, of course, if only the majority of human waste produced in the city of London did not drain right back into these sources.
This brings us to the final example of death in the city that we will cover: a story that starts with death and destruction and ends with, well, destruction. But with this destruction nevertheless comes some signs of hope for our urban world. It starts in India. The bacteria Vibrio cholerae, which seems to have been endemic to the subcontinent since the beginnings of medical writing, burst onto the global scene in the early nineteenth century. The infection can cause no symptoms or many. Cholera is characterised by an extreme diarrhoeal response; obviously this is in its favour, as the main mechanism of spread is in water contaminated by human faeces. The disease is particularly dangerous in children and other less immunocompetent people, and before the advent of rehydration solution, the loss of fluid could prove fatal. As with our other epidemic diseases, it’s the cities that sustain and circulate the disease, and cholera arrived in London in 1832. This being the nearly modern world, its arrival was announced in the newspapers: there had been cholera in Moscow for a year, and there were reports of earlier outbreaks in India.
The response of the good people of London was the same as in every other epidemic terror: a great deal of public verbiage was expended on the threat, inadequate amounts of money were promised to the cause and everyone avoided everyone else like, well, the plague. On the occasion of the 1832 outbreak in London, one noble gentleman refused to come out at all, and made deliverymen chuck everything to him from the street. Some 3,000 people died in the outbreak, and while the consequences for them were of course quite permanent, there were no major shifts in the political or environmental response to the disease. After all, everyone knew that diseases came from the air. There were plenty of diseases that caused diarrhoea, many of which could even kill you. Typhoid, for instance, was another disease out of the subcontinent that could kill you in a similar way, but with the occasional addition of a red-spotted rash on the chest. Typhoid, however, was a known threat of considerable antiquity – recent (though contested) ancient DNA work has suggested that it may even have been responsible for the plague of Athens in the fifth century BC. The one thing that everybody knew in the 1830s, from the uneducated coal pickers to the august and learned physicians, was that diseases came from foul smells and noxious vapours; and these were the sources of any scourge. Prevention of disease could be achieved by cleaning the filth from the streets, or setting fires on street corners to counteract epidemic airs. This was an attitude almost totally unchanged from the days of the Black Death, where it was thought that handfuls of herbs might keep away that most dreadful of visitations. The alternative theory was that disease came, if not the air, then from people themselves; the proponents of the ‘contagion’ theory saw disease as spread by touch, like flu. Both theories were voraciously expounded in the medical and quack-medical arenas, and as the miasmists and the contagionists set to in the press and in the lecture theatres, people continued to die.
The periodic outbreaks of cholera in London were watched over by a promising young medic by the name of John Snow. A meticulous sort of man, he pored over the details of each outbreak, slowly compiling evidence to support a theory that had taken up residence. Snow was convinced that cholera spread not by air, not contact, but by water. He mapped the deaths of an 1848 outbreak and found there were more deaths in those neighbourhoods that were supplied with water from the most polluted part of the Thames. In 1849 he published this revolutionary idea, to which the general response of the learned community of miasmists and contagionists was that he knew nothing. At the very least, he needed to prove beyond a doubt that water carried the disease.
It would be five years, but Snow would get his chance. In 1854 the neighbourhood around Broad Street (which is now Broadwick Street) formed the epicentre for a cholera outbreak that was remarkable for its virulence. In just one night, 70 people perished in between a handful of streets. Entire families died, shuttered into their houses, not to be found until the smell gave them away. Snow, who lived relatively near the outbreak, trotted around collecting samples of water from the community pumps in the area. He also turned to his maps. He carefully plotted 578 cholera deaths on a map of the neighbourhood, tallying blocky lines at the doors of each of the houses to represent the dead within.
He noticed two things that were enough to sway him and the tide of history. First, the destitute inhabitants of the nearby workhouse were largely unaffected by the outbreak. Since it’s usually the poor who suffer most from the burden of infectious disease, this was remarkable. However, the workhouse had its own well, and for once it was a blessing to be interned there while death stalked the more prosperous families all around. The other clue was the robust health of the brewery workers who lived towards the east edge of the radius of deaths. They failed to sicken because they took their drink in the form of beer, made locally at the brewery, and most importantly, boiled past the point of Vibrio cholerae survival in the process. Snow had his evidence, and went to the Board of Guardians of St James’s Parish with it. The next day, they took the handle off the pump at Broad Street, and the epidemic was quelled.
This was a triumph. A triumph for science, and of course for Snow, but also in the role of the city in setting and demanding standards of hygiene and behaviour. In the aftermath of Snow’s proof, the entirety of London’s water supply was thrown into doubt. The sewerage and piping systems were rebuilt to standards that would have impressed even the Romans. I live in a house built in 1898. The pipes that run out of my sink and my bath and my toilet all run into a beautiful Victorian tile-lined sewer, and thence onwards to the great sewer system the city was forced to build. And that is the crux of the thing. We have looked long and hard at the changes cities have made in us, but in the last hundred years, we have changed cities. The open sewers have become waste-treatment plants. The carts of muck that roamed London’s nighttime streets are replaced by two cheerful dudes in maroon uniforms who come around on a terrifying truck every Tuesday and tell me off if I put tin cans into the recycling. This house was built for the health of the Victorian worker, and despite the lack of tepid water and the constant threat of damp, it’s surrounded by green spaces, connected by footpaths and public transport that doesn’t poo directly on the street, and has yet to give me consumption, typhoid, cholera plague or smallpox.
I am a little worried about the sinusitis, though.
1 This is pronounced ‘hays-burrow’. Place names in England exist for the sole purpose of tormenting non-local speakers. I mean, really – where did the p’s go?
2 The etymology of which I’m sure is fascinating.
3 Very rural. Four-hours-by-boat-to-the-next-island rural.
4 Which is not to say that people haven’t tried. I recently had lunch in a converted skip on the construction site around King’s Cross station right next to the plants that had been denuded for my salad.
5 Again, there is opportunity to get lost in the assize (court) records here; part of their charm might derive from the fact that at least some of the sessions were held in the Mermaid Tavern, infamous drinking den of the Elizabethan era, which used to be somewhere near modern Bread Street and Cannon Street. Justice in the pub sounds more fun in general, though it did seem to end in death very frequently, so perhaps not for all.
6 Seriously. You could buy a car for less. I certainly have.
7 This would be the extreme version of ‘workfare’: take anyone living off the parish and see if they survive visiting plague houses.
8 So no, punching someone’s lights out does not mean what you think it does.
9 There were non-cave moments in between.
10 This scene also works as a critique of feudalism and/or mysticism; in the words of the ‘male’ character: ‘Strange women lying in ponds distributing swords is no basis for a system of government! Supreme executive power derives from a mandate from the masses, not from some farcical aquatic ceremony!’
11 There are paternity issues and complaints about getting girls to come up to the pastures for the night.
12 It is rather fantastic: https://sheepdrive.london.
13 We could have an entire subchapter here on traumatic experiences of Eid al-Adha (or Kurban Bayram in Turkish), but I think we’re sufficiently off-topic for now.
14 Though Cairo seems to be home to a particular breed of solely roof-dwelling caprids.
15 The only time in my life I have regretted wearing Converse. The white band at the bottom turned bright pink.
16 Sadly I never got to see many of the experimental reconstructions of either Aşıklı Höyük or Çatalhöyük, though I was treated to a live re-enactment of the highlight reel on one of the Çatal party nights.
17 Unless something has gone horribly wrong.
18 Microbes, pathogens.
19 Cats.
20 Something that has, bafflingly, never returned. Why must UK taps be limited to one hot, one cold? Can there be no middle ground of pleasantly warm water, as there is in other countries? This is a key source of vexation for the expat, alongside more tolerable cultural idiosyncrasies like the language and food.