By the middle of the 19th century Glasgow had become one of the largest industrial cities in Europe and its population had swollen to nearly 500,000; but beyond the sandstone palaces of the Merchant City it was a filth ridden slum. In places like the Gorbals people were often forced to sleep 14 to a room; sanitation was all but non-existent and clean water was a luxury. Diseases like dysentery and typhoid were rife; but worse was coming.
In 1832 a new and genuinely frightening disease arrived into the city: Cholera. Originating in India, it spread quickly through the Middle East to Egypt, and then by ship to most of the industrial cities of northern Europe. Not since the days of the plague was there such a trail of death and panic. This first epidemic took over 3100 lives; and when it visited Glasgow again in 1848 another 3800 succumbed. It is a horrible illness, comes out of nowhere, and often kills within hours. Yet, in 1865 when cholera came to Britain once more the death toll in Glasgow had dropped to a mere 53: and the reason was a marvel of the Victorian age.
In the 1850s the City of Glasgow Corporation constructed an aqueduct system from Loch Katrine in the Trossachs. Queen Victoria herself switched the system on and from 1859 the clean, fresh water of the Southern Highlands flowed through 35 miles of pipeline to the masses. It was an incredible achievement, and once again modern ingenuity and science tackled a deadly disease and reduced it to insignificant. The unseen hand of disease and our reaction to it is an underlying part of the Scottish story.
Disease in Scotland
Disease, whether endemic or epidemic has always been part of the human condition: it affects population growth, debilities the labour force, causes widespread misery and fear, and alters the course of history. We know little about the epidemiological history of early Scotland, except to say that there would have been disease: although few big killers due to the climate. The same could not be said for the Mediterranean.
Although Scotland was not part of the Roman Empire, it was still strongly affected by it, and its collapse would have severe implications for the political development of the British Isles. In 165AD a new and devastating disease, probably Smallpox hit the Mediterranean ports and spread quickly through the provinces. Mortality was high, and it cut a swathe through the main administrative centres. The epidemic lasted 15 years and was a severe blow; then in 251 another serious outbreak hit the Roman world. This time the culprit was Measles, and with its arrival the results were truly horrific.
Between the two outbreaks the death toll exceeded five million, and it almost certainly led to a breakdown in order that was never fully recovered; and with Malaria rampant it proved too much and in the 5th century the house of cards came tumbling down. The Romans were forced to import Germanic peoples to provide manpower for farming and military service. It wasn’t enough and the Empire failed; the inheritors would be these same tribes and peoples, and they would shape the Europe to come.
Smallpox and Measles probably entered the Scottish population as well, and wreaked havoc among the countryside; but, it was the influx of the Anglo-Saxons into Britain on the back of the collapse of Roman authority, and the formation of England that would shape Scotland’s future for centuries to come. It also meant that Scotland’s principal market disappeared and this seems to have initiated a more aggressive, warlike age among the various tribes and kingdoms north of Hadrian’s Wall.
Across Europet hese two diseases would erupt over 40 times from 600 to 1000AD and more than certainly contributed to the poor productivity, high mortality and increase in brutality associated with the so called Dark Ages. It would also appear that Malaria gained a stronghold across Europe at this time as well. The mosquito that carried the disease can only thrive in warm climates, and there is enough reason to suggest that southern Scotland was affected as well – a staggering thought today. Things though were about to get a whole lot worse.
The Plague of Justinian (542-43) all but annihilated the population of the Mediterranean, and is the first identifiable outbreak of the Bubonic Plague in Europe. With a death toll of over 25 million it was the beginning of the end of the Byzantine Empire of Constantinople and the true harbinger of the Dark Ages. Its devastation however was confined to the Mediterranean and Danube: northern Europe was left unscathed. The reason being that the black rat, which carries the flea, which hosts the disease, Yersinia Pestis, being a native of India had not made it that far. This saw the balance of power in Europe shift irrevocably to the north. Rome, once a city of over a million was reduced to a town of 25,000. The second visitation of the Plague in the 14th century would be even more catastrophic.
The Bubonic and Pneumonic (airborne version) plagues are extremely contagious and extremely deadly. The disease originated in the southern Himalayas, and was spread by increases in trade and inter-continental warfare. The Black Death which hit Europe certainly came from Asia, and arrived into the Mediterranean ports in 1346. This time however, with the black rat firmly established it would hit an entire continent. By the time it had run its course, over a third, and probably nearer a half of Europe was dead; and Scotland, which had just gone through a series of bloody wars with England wasn’t spared. The population was scythed from a million to around 600,000 by 1360.
And it came back again, and again, with monotonous regularity throughout the 14th and 15th centuries leading to a severe and lasting reduction in population (the low point is estimated around 1450). This in turn led to a shortage of labour, which means the economy becomes a sellers’ market. Serfdom vanishes, some peasants took opportunities to become land owners or merchants and a middle class begins to emerge; central government takes the chance to eliminate rivals; and religious unrest ultimately leads to the Reformation. It was a gloomy time, and both art and gravestone decoration often depict the so called ‘Dance of Death’. And death was an ever contestant part of life, on a scale and prevalence we’d find hard to fathom today.
While Scotland was dealing with one epidemic after another, the population was acclimatising to other diseases such as mumps and whooping cough; and this in itself allowed the population to rebound. Leprosy also vanished; probably due to the arrival of Tuberculosis (a bacteria similar to leprosy but much more contagious and lethal).
As the country began to recover from recurrent visitations of the plague, and disease like measles developed into childhood illnesses, the likes of typhoid and dysentery took hold in the very unsanitary cities that were emerging. Plague too found a home in these rat infested warrens. However, following the infamous outbreak of 1665 it simply vanishes from Britain and most of Europe north of the Alps– never to return: a true epidemiological mystery. In all probability the disease mutated to cope better with the increased cooling associated with the ‘Little Ice Age’ and this new version happened to be non-lethal. Also, improvements in house building, including the change from timber and thatch to stone and slate widened the ‘distance’ between rat and man; thus, breaking the chain of contagion.
By around 1700 Scottish society was beginning to emerge from the shadow of the great killers; fear was replaced by optimism and it would have a profound affect. Across Britain, including Scotland, money was invested in emerging industries and innovative techniques. As the population began to rise, more food was required to feed the masses and this led to an agricultural revolution in the countryside, increasing yields. Also, a huge programme of walled enclosures for cattle and sheep was instigated by landlords, which improved the health of the livestock.
All of this led to a huge rise in cattle numbers, which had the unexpected effect of eradicating malaria from the British Isles – our mosquito (found in the south east ofScotland) prefers cattle to humans, but the malaria plasmodium doesn’t. It was the end of the road for a chronic disease which was known as ague. More cattle also meant more meat and milk on the menu, which in turn meant a higher protein diet. This allows the body to manufacture more antibodies, and so become more resistant to infection and illness. Better storage also meant that any meat or produce could be transported further. It was a striking transformation and led to a population boom.
This dramatic rise in agricultural output meant that cities like Glasgow, Edinburgh and Dundee could feed and clothe its rapidly growing population, and fuel the industrial revolution. Greater efficiency in the countryside also meant less labour was required, which provided the cities with much needed manpower. Disease in the industrial slums kept mortality rates high, and death rates far exceeded birth rates – thus migration from the surrounding countryside was vital. By 1801 Scotland’s population had risen to 1,600,000, within 50 years it had nearly doubled to 2,900,000.
One disease still haunted the imagination of the country at large – Smallpox. It is a scary looking illness, mostly contracted in childhood and while it has a relatively high mortality most people lived. It did leave people scarred for life though and there is no doubt that it had an impact on society. An English doctor, Edward Jenner observed that milkmaids bore none of the scarring, and were essentially immune; the result of contracting the far less lethal cowpox. This would lead first to inoculations and ultimately vaccinations. The fight against the infectious and often mortal illnesses had begun.
Other European countries were slow to implement vaccination programmes, improve their sanitation and failed to enclose the pastureland. Only in Britain was the advancement possible; and thus British, and by that, Scottish wealth and influence grew. And with this advancement, the population continued to soar, reaching 4,500,000 by 1900. A three-fold rise in less than a century must by its very nature alter society and politics; and it also fuelled the huge emigrations to America, Canada and Australia; and provided people for the ever growing British Empire.
How disease was actually transmitted, and indeed what they were, was one of the great leaps forward of the late 18th century; allowing science to create vaccinations, and governments to improve living conditions. Cholera, diphtheria and many others could now be battled on several fronts. It would have been impossible to have so many men entrenched in such confined and poor conditions as was experienced in the First World War had it not been for such advances – typhoid would simply have wiped them out, as it had done Napoleon’s Grand Army a hundred years early.
By this time, with improved sanitation, vaccinations, cures and ultimately the discovery of penicillin for the first time in Scotland’s history the birth rate exceeded the death rate in her cities. The industrial base meant that there was still work for both migrant and city born; and when decline set in, families had significantly reduced the number of children they were having.
From this distance in time we are really oblivious to the danger that disease posed to our forefathers: it could come out of nowhere, and no-one was safe. Life expectancy rates were in the mid 30s, and death was commonplace. It debilitated the labour force, affected political decision-making and held the people in a thrall. It plays a huge part in the story of the Scottish people, and the changes that occurred from 1700 to 1900 altered the landscape, created our cities and built modern Scotland.
This article was written by David McNicoll, who runs Vacation Scotland – a travel company specialising in planning tours and vacations to Scotland. For more info – www.vacationscotland.biz