The first outbreak of cholera occurred in Sunderland in the autumn of 1831. There had been an outbreak in Germany earlier in the year which had alerted the government to the danger. District boards were set up to segregate the sick. Infected towns were to be isolated by troops and police and a period of quarantine was imposed by the health boards on ships arriving from the North. A day of national fasting and penance was arranged but four days afterwards on the tenth of February cholera appeared at Rotherhithe and spread along the banks of the Thames

The filthy overcrowded conditions in which so many people lived ensured the rapid spread of Cholera. Contact with human excrement and flies which had themselves been in contact with human excrement was inevitable. The worst source however was contaminated water. Cholera attacked with terrible suddeness and victims could die within a few hours, or after a few days of violent pain and diarrhoea. Where transmission was by contact whole households died, but where it was waterborne whole streets and areas were affected. There was no effective treatment and one in two of those infected died , The Life and Times of Sir Edwin Chadwick (1952), S.E.Finer, from London 1808-1870: The Infernal Wen, Francis Sheppard, 1971. It was the more terrifying because it was not initially understood that it was waterborne, so it appeared to move and jump from one area to another at random. Nor was cholera the only danger. Typhus was almost as virulent. A good part of the problem was that sewers were regarded primarily as the means of discharging water. Cesspools were the usual way of dealing with household drainage, but the huge increase in population made this impossible. Cesspools constantly overflowed, often because emptying them was prohibitively expensive. some were even open to the elements. It was reported by a surveyor in Whitechapel that there were no sewers and consequently it was, 'the filthiest place you can imagine'. In Manchester, in common with elsewhere, it was customary to empty raw sewage into the rivers. While the overcrowded poor were in the most obvious danger the middle classes were not exempt precisely because the infection was waterborne.

River Irwell in Manchester flowing under Regent Road. The scum on the water is the consequence of the rivers being used as sewers, Mancester Public Libraries, fromThe Victorian City, Images and Realities, Dyos and Wolff (1973)

In the preface of the fifth edition of Oliver Twist Dickens explains that,

I am convinced that nothing effectual can be done for the elevation of the the poor in England until their dwelling places are made decent and wholesome. This reform must proceed all other social reforms, without it those classes of the people which increase the fastest, must become so desperate and be made so miserable, as to bear within themselves the certain seeds of ruin to the whole community.

Contemporary novelists drew attention to the appalling conditions in London; Dickens, Kingsely, Mrs Gaskell and George Gissing among others. There were official reports and the journalist Henry Mayhew's famous London Labour and the London Poor. They all testified to the dreadful conditions in which the lowest levels of society lived, 'a class of people whose misery, ignorance and vice, amidst all the immense wealth and great knowledge of "the first city in the world", is to say the very least, a national disgrace', The London Doré Saw, Eric de Maré (1973).

Housing for the poor was the worst problem and it constantly grew worse still. It seems likely that two thirds of the London population was composed of families living in one room. Irish immigrants in particular were crowded together in the 'rookeries' - 'so called', as Thomas Beames explained in 1850 from, an analogy

' between these pauper colonies and the nests of birds. Other birds are broken up into separate families - occupy separate nests; rooks seem to know no distinction'.

Dickens's description in Bleak House of Tom-All-Alone's, a rookery in St Giles, east of Charing Cross Road serves as an example,

'It is a black, dilapidated street, avoided by all decent people...these tumbling tenements contain, by night a swarm of misery. As, on the ruined human wretch, vermin parasites appear, so these ruined shelters have bred a crowd of foul existence that crawls in and out of gaps in walls and boards; and coils itself to sleep, in magggot numbers, where the rain drips in ; and comes and goes, fetching and carrying fever, and sowing more evil in its every footprint...'

Low lodging house, St Giles's. Graphic (1872), from The London Doré Saw, Eric de Maré (1973). Conditions in such poor people's hotels were controlled to some degree by Shaftesbury's Common Lodging-House Act of 1851.

This is illustrative of the conditions that many people who migrated to London in mid century were apt to find.

Jacob's Island Bermondsey. Watercolour by J.L.Stewart (1887) London Museum, from 1870. London 1808-1870, The Infernal Wen, Francis Sheppard (1971

This was the place which Dickens called 'the filthiest, the strangest, the most extraordinary of the many localities that are hidden in London'. He spoke of the 'maze of close, narrow, and muddy streets, thronged by the roughest and poorest of waterside people. Coal-whippers, brazen women, ragged children, and the very raff and refuse of the river'. Oliver Twist.

'That wretched woman with the infant in her arms, round whose meagre form the remnant of her own scanty shawl is carefully wrapped, has been attempting to sing some popular ballad, in the hope of wringing a few pence from the compassionate passer-by. The weak tremulous voice tells a fearful tale of want and famishing; and the feeble singer of this roaring song may turn away, only to die of cold and hunger'. Sketches by Boz

Before becoming too censorious about Victorian neglect however we ought to bear in mind those sleeping in the doorways of London's shops a hundred years after Victoria's death. Those not absolutely destitute might find a bed in a 'doss house' or might hire it for eight hours or so. These were the haunts of tramps, crossing-sweepers, costermongers and clerks. The parish Boards of Guardians organized the Unions of Workhouses but the conditions in them were rather worse than those obtained in the prisons. As Punch observed in 1844,

'The poor being at once sent to GAOL, and the FELONS consigned to the WORKHOUSE. The alteration may bear rather hard upon the thief; but that cannot be helped.'

They were the last resort; the destitute and pregnant Fanny Robins dies in such a place in Hardy's Far from the Madding Crowd.