Conclusion: The Afterlife of Victorian Typhoid

Summary

In the fall of 1937 typhoid again reared its ugly head, exploding to epidemic proportions in the south London town of Croydon. In a few months, local officials noted nearly three hundred typhoid cases, and by the end of the outbreak forty-three local residents had died of the disease. Early in November Croydon’s MOH, Oscar Holden, reached out to the Ministry of Health, who sent inspector Ernest T. Conybeare. Working with local officials, Conybeare plotted typhoid cases onto a map of the town’s water supply (supplied by five wells) and instantly saw that most of the early cases were supplied with water from the high-level supply from the Addington well. A few days later the supply was cut off. Subsequent sleuthing showed that prior to the outbreak the well in question was being worked on, chlorination had stopped, and one worker—a positive typhoid carrier—had contaminated the supply. While hardly the only or last fulminating outbreak of typhoid in twentieth-century Britain, Croydon became, as Anne Hardy has argued, “a cause célèbre in the preventive community.” In important ways the legacy of Victorian public health reformers like John Simon lived on; typhoid continued to serve as a litmus test of the “sanitary civilisation” of an area long after the disease had declined and the typhoid of the Victorians had been forgotten. We should rightly situate the Croydon outbreak, as some scholars have done, in the context of a specific set of interwar British public-health debates. These debates centered on the accidental contamination of water supplies, the question of whether local rate payers were due compensation for lapses in technical know-how, inadequate educational campaigns on personal hygiene, and the role played by chronic typhoid carriers. Yet, placed in the longer framework that stretches back to the Victorian period, the Croydon outbreak resonates with the major themes of this book: the growth and constraints of bureaucracy, the broader political attempts at preventive medicine, and the everyday practices of epidemiology.

The 1937 Croydon case, like scores of other localized outbreaks of typhoid in the twentieth century, reveals the historically contingent ways that epidemiological outbreak investigation persisted as a central feature of public health practice well into the twentieth century.