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If the many social changes that occurred during the Victorian age, public health reform is widely agreed to be one of the most significant. In the early Victorian era the vast majority of Britons drank water from murky ponds and rivers, carried to their dwellings in buckets; and their excrement was deposited into the streets and paths outside their houses. By the end of the century however, piped water from wells or lakes was widespread in all but the most rural areas, as was the disposal of urine and faeces by comprehensive systems of sewage pipes.
The success of these reforms was reflected in the pattern of infectious diseases which affected the population of Britain. Typhus, typhoid, cholera, gastro-enteritis, smallpox and tuberculosis all caused huge mortality in the early decades of the nineteenth century; but by the 1890s the mortality had fallen dramatically. In particular cholera had disappeared, and typhus and typhoid were almost gone. As well as these medical improvements, the associated engineering achievement was considerable; there are few households in the United Kingdom whose dwellings are not to this day serviced by water pipes and sewers built in the mid-Victorian period.
Of all the infective diseases feared by the Victorians, cholera was without doubt the greatest. It was a dramatic dehydrating diarrhoeal illness which spread around the country (and indeed the western world) in major epidemics. Though its effect on overall death rates was not great, many historians believe that its sudden epidemic nature made the disease a major instigator of public health reform.'
Though the cause of cholera, and its mode of transmission remained unknown for much of the nineteenth century its association with filth and squalor were well known (the `Court for King Cholera' see illustration on page 11 ). In 1849, The Times published a letter from a group of fifty-six poor people from a deprived area of London, describing their plight. To the credit of the newspaper, they printed the letter exactly as it was written, and the following is an abstract:
`We live in muck and filth... we got no priviz, no dust bins, no drains, no water splies, and no drain or suer in the hole place...we all of us us suffer, and numbes are ill, and...