Porträt einer Cholera-Präservativ Frau (Portrait of a Cholera-Protected Woman), according to Moritz Gottlieb Saphir (1795-1858), etching by Peter Carl Geissler (1802-1872), 1831. NML Medical Museum, Visual Art Collection, MG 367

Object of the Month: September 2020

A Woman Protected from Cholera

A copper patch on the chest over flannel bandages, a bodice made of elastic rubber. Above the dress a belt of small bricks, with wax taffeta bow flying towards the back. Lower leg clothes triple garnished with herb bags at the foot. Shoes and overshoes with hot water bottles. In her large, round leg-o’-mutton sleeves she wears towels, flannel wool, brushes, sandbags, etc. all wrapped up. A necklace made of salt stones and peppercorns around the neck. In the three braids of hair she has placed vinegar bottles, chlorinated lime, pots and soup bowls. At the top of her head a small windmill to purify the air. Pendants of onions and small garlic in her ears, at the front a bottle of camphor as a Sevigné brooch. A ribbon of juniper berries and perfume bottles tied under the chin. In one hand a basket with an economic stove, bricks, water jugs, etc. In the other hand an open parasol with a juniper branch, small sacks of chlorinated lime hanging from the whalebone ribs, an emergency bell attached to the top. Her little dog runs behind, a cholera band around its body, tail adorned with lilac branches and feet dressed in socks. In its mouth it carries a beam with a lavement apparatus and a wash basin hanging from each end. Around the neck it wears a copper plate with the inscription: Do not fear!

Pandemics of centuries past and the all-embracing fear that accompanied them induced hunger for guaranteed means of protection

This 1840s travel kit includes cholera tincture drops (Cholera Tropfen). NML Medical Museum, PH 512.

against disease and remedies certain to restore those affected. News of such preservatives and cures spread by the word of mouth as well as the printed page. No later than during 19 century cholera epidemics, mass media became the main source of more or less reliable guidance on protection from the plague. Even in 2020, in the public space affected by COVID 19, it is no easy task to distinguish evidence based procedures from untested conceptions, alternative practice and outright quackery. Two hundred years ago, the required information was much scarcer and the critical discourse more limited than it is – we can only hope – today.

The first cholera pandemic that afflicted Europe and North America struck in the early 1830s. In the course of ten years, „the Asian Cholera“ spread from India through Central Asia and Russia. In Europe, the disease claimed several hundred thousand victims, with Russia, Hungary and France among the worst affected countries. Mortality in Central Europe was lower at the end: of the 300 000 residents of Vienna, about 2000 died of the disease, the toll in Berlin (with a quarter million people) and Prague (ca. 100 000) was about 1500. This could not, however, ease the prevailing fright. The victims within days or weeks of severe diarrhea and vomiting and resulting dehydration. The bacteria disseminated freely through contaminated water and food, especially in the narrow, congested streets of poor inner cities, close to the river and the mouths of the sewers. Quickly formed cholera hospitals were not trusted by the ill and their families and did not have enough beds in any case. Home care by relatives only contributed to the spread of the disease.

Medicine of the 1830s had no truly effective instruments to stop the epidemic. Quarantine projects – whether it closed a border, such as the Austrian sanitary cordon in the east, or individual neighborhoods and houses – could not suffice if a single person could carry the infection into a city or a country. The role of drinking water and sewage in spreading cholera was established by John Snow (1813-1858) only in 1854, during the next pandemic, and his discovery took even longer to take hold. Moreover, following hygienic procedures protects others above all: fearing death, people sought ways to rescue themselves and their families.

Warmth and cleanliness were considered crucial both to protect the healthy and to heal the ill: in environments where the disease spread most quickly, both were very difficult to provide. Warm binds – the „cholera belts“ of wool or flannel, worn under the shirt, wound around the belly and the waist – were trusted as protectives; the sanative properties of heat and cleansing inspired sweating treatments, steam baths and other water cures. Enemas, using liquids or tobacco smoke, mild emetics were also widespread. Such drastic methods risked further dehydrating the patient and may have boosted the popularity of gentler homeopathic treatments. Counterirritants used included camphor, wine vinegar, mustard bandages, pepper, sulfur or chloride of lime and their combinations. The growing panic multiplied the „guaranteed“ procedures and newly introduced compounds intended both as preservatives and as cures.

The “Volta Kreuz” succeeded magnetic belts in the 1890s. NML Medical Museum, P 242

Period newspapers and popular brochures introduced hundreds of guaranteed treatment methods, including immunization with plant extracts, various disinfectant salts, medicinal plants, wines and spirits. „Cholera drops“ recommended by the Posen physician Carl Julius Leviseur (1794-1874) included camphor, 80% ethanol, ethyl acetate (aether aceticus) and Mynsicht’s elixir (acidic aromatic tincture), a spirituous solution of fragrant herbs and sulfuric acid. Another patented recipe was advertised – without listing the contents – by the Czech surgeon František Čížek (1814-1884) from Bystřice u Benešova. Advertisements for „magnetic chains“ to be worn around the neck, originally against rheumatism, promised protection from cholera in newspapers across Germany, Austria and the Czech Lands. Electricity and magnetism offered their healing powers to all those who trusted the wonders of modern science. Other cures, such as fumigation with juniper berries, alluded, by contrast, to preventive medicine of antiquity.

This plethora of tools of prophylaxis and therapy, boasting their novelty or their ancient origin, became the object of ridicule in Moritz Gottlieb Saphir‘s (1795-1884) caricature and satirical paragraph published in the Munich journal Der deutsche Horizont he edited in 1831, at the climax of the cholera epidemic. Saphir was famous for his blistering satire, whose pungency chased him out of several cities and countries and occasionally into jail. The „Women Protected from Cholera“ (and the parallel cartoon of no less well established man) does not, however, target the fear that grasped cities possessed by the epidemic: it mocks the naive faith of frightened people that protection from disease is available by mail order and the corresponding eagerness of merchants to offer them ever new wares. Indeed, there is no limit to the number of things that might protect us against disease.