An 1802 cartoon of Edward Jenner’s cowpox-derived smallpox vaccine
During the 19th century, three previously encountered diseases and one emerging infectious disease, cholera, reached epidemic proportions.
1 Medical responses
5 Yellow fever
Epidemics of the 19th century were faced without the medical advances that made 20th-century epidemics much more rare and less lethal. Micro-organisms (viruses and bacteria) had been discovered in the 18th century, but it was not until the late 19th century that the experiments of Lazzaro Spallanzani and Louis Pasteur disproved spontaneous generation conclusively, allowing germ theory and Robert Koch’s discovery of micro-organisms as the cause of disease transmission. Thus throughout the majority of the 19th century, there was only the most basic, common sense understanding of the causes, amelioration and treatment of epidemic disease.
The late 19th century was the beginning of widespread use of vaccines. The cholera bacterium was isolated in 1854 by Italian anatomist Filippo Pacini, and a vaccine, the first to immunize humans against a bacterial disease, was developed by Spanish physician Jaume Ferran i Clua in 1885, and by Russian-Jewish bacteriologist Waldemar Haffkine in July 1892.
Antibiotic drugs did not appear until the middle of the 20th century. Sulfonamides did not appear until 1935, and penicillin, discovered in 1928, was not available as a treatment until 1950.
Hand bill from the New York City Board of Health, 1832—the outdated public health advice demonstrates the lack of understanding of the disease and its actual causative factors
During the second cholera pandemic of 1816-1851, the scientific community varied in its beliefs about its causes. In France doctors believed cholera was associated with the poverty of certain communities or poor environment. Russians believed the disease was contagious and quarantined their citizens. The United States believed that cholera was brought by recent immigrants, specifically the Irish. Lastly, some British thought the disease might rise from divine intervention.
During the third pandemic, Tunisia, which had not been affected by the two previous pandemics, thought Europeans had brought the disease. They blamed their sanitation practices. The prevalence of the disease in the South in areas of black populations convinced United States scientists that cholera