Modern Sanitary Sewer Practices Ushered in by Epidemics

Lest we forget, as the article demonstrates, we haven't come that far, when all is said and done.  And today, in the United States, we are facing 100 plus year old sanitary sewer systems and even older water delivery systems - and, even before the Great Recession, there was no money in municipal and state budgets to fix the ever-burgeoning repairs that must be done just to try to maintain the status quo.

Article from the English language French website rfi.fr:

1832 - The deadly epidemic that helped shape today's Paris
Hidden Paris - Article published the Thursday 18 November 2010
By Molly Guinness

At the end of March 1832 Paris’s Hôtel Dieu hospital began to receive a steady stream of patients. They had a wide range of symptoms – apoplexy, fever, chest pains, vomiting, headaches. Most of them were dead within a day or two. A six-month cholera epidemic, which was to claim 7,000 lives in the next two weeks and 19,000 in total, had begun.

A trawl through the Hôtel Dieu’s records, housed today in city’s medical archives, reveals death grimly marching through the disease-struck city. The rare modern-day reader must peer at microfilm records to find a glimpse of thousands of brief lives and agonising deaths.

The first victims came from outside the city walls – from Oise, Meaux and the north – but within a couple of days, the Hôtel Dieu was receiving patients from almost every arrondissement.

The 12th, the ninth and the seventh arrondissements are the first to enter the records; but by 29 March almost every admission is for cholera and almost no one is discharged.

A 49-year-old man from the fifth arrondissement with heart problems, a cobbler with a fever, a lacemaker from the ninth arrondissement all die soon after admission.

By April, the whole city exuded a sepulchral odour, and the streets were crawling with hearses.

Doctors were perplexed by the range of symptoms; cholera could come upon its victims by gradual degrees or very suddenly.

The disease even disrupted a society ball recorded by German poet Heinrich Heine. A group of harlequins was part of the entertainment.

"Suddenly the merriest of the harlequins felt a chill in his legs, took off his mask, and to the amazement of all revealed a violet-blue face,” Heine recorded in his diary.

At first the crowd thought the performance was part of the entertainment. But soon “several wagonloads were driven directly from the ball to the Hôtel-Dieu, where they arrived in their gaudy fancy dress and promptly died, too.”

Victims were said to look like corpses days before they died, and some had ice-cold tongues.

The recognised cures for the disease seem a bit like clutching at straws – a hot bath infused with vinegar, salt and mustard, some lime tea and a sensible diet?

“With these precautions, we need not worry about an epidemic,” an official declared with wild optimism in August 1832.

While cholera swept through the city, there was little to be done, but afterwards Paris’s town planners did their best to make sure the disaster was not repeated.

Paris’s insalubrious housing and ancient public hygiene system, where people threw sewage into gutters running down the middle of the street, allowed the disease to rip through the city at an alarming rate.

The lessons of the outbreak shaped the city we know today.

“Cholera became an important factor in urban planning,” says historian Oleg Kobtzeff. “The idea of wider streets and sidewalks came as a result of cholera, as well as having a proper sewage system.”

Paris had an underground sewage system by the beginning of the 19th century.

Sidewalks were introduced and the gutters were moved to the side of the street. In most cases, at least - you can still see some streets in the Latin Quarter and the 13th arrondissement where the gutter runs down the middle of the road.

When Baron Haussmann became prefect in 1853, the hygienist movement had become the major element in town planning.

Getting rid of the labyrinths of slums was, of course, also useful for crowd control, especially in a city that had experienced 50 years of riots and revolts.

So Paris, like London, owes its drainage system and, in part, its broad and beautiful boulevards to a devastating outbreak of a deadly disease.