The stricken died quickly, sometimes within hours.
Others hung on a few days, but they were so dehydrated they no longer looked like themselves, but rather like skin stretched taut over bones and tendons. Their brains still worked, even as their bodies died all around them.
People passed one another in the street without greeting, fearful that their friends and neighbors would contaminate them. Orphaned children wandered the streets, seeking food and shelter from strangers. Those with means fled to the countryside.
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No. Cholera in Lexington — in summer 1833.
Terry Foody, a public health nurse who has lectured about cholera for the Kentucky Humanities Council for the past decade, has written a book about the 1833 epidemic in Lexington: The Pie Seller, The Drunk, and The Lady: Heroes of the 1833 Cholera Epidemic in Lexington, Kentucky (Self-published; $18.33).
The book combines novel-like anecdotes with historical research about the epidemic that devastated Lexington just as it was struggling to make the leap to frontier city.
The pie seller was a free black woman called Aunt Charlotte, who made a meager living selling savory and fruit pies. The drunk was William "King" Solomon, who buried many of the dead; his portrait still hangs in the Bodley-Bullock House, showing a kindly face on an unkempt person. The lady was Maria Cecil Gist Gratz, who founded an orphanage for the children left behind by cholera and persuaded her neighbors to finance it.
Cholera is a waterborne infectious disease that attacks the small intestine via water that is contaminated with the Vibrio cholerae microbe, and the Lexington of 1833 was the perfect reservoir of filth to nurture it. The outbreak killed 501 people of a city population of about 6,000.
Doctors, what few there were who did not fall to the disease themselves, were stumped on how to treat patients. They gave them doses of calomel (mercury), a purgative, which made the ill vomit in addition to their diarrhea. The idea was that the sick were suffering from poisoning, and vomiting would relieve them of their toxins. Unfortunately, that only added to their dehydration.
The disease had made its way from the Orient to Russia to London to New York and finally to Lexington, where pigs and cows ran the streets of the still-settling town. With no organized waste collection, the detritus of households and manufacturers was tossed into the streets. Outdoor privies overflowed during flooding.
Because of Lexington's porous underground system of limestone caves and sinkholes, the area is uniquely suited for all that nastiness to fall into the city's water system. Residents used a series of water pumps, Foody said, and some favored a particular pump because they thought its water tasted better. A single bucket of water could contaminate an entire household, Foody writes.
The first cholera outbreak was at Captain John Postlethwaite's tavern between Water and Main streets, where Phoenix Plaza now sits.
An 1872 history of early Lexington written by George Ranck described the town: "Business houses were closed, factories stopped, and men passed their most intimate friends in silence and afar off, staring like lunatics, for fear the contagion was upon them."
So many died so quickly that there was no one to bury them. Solomon took on the chore. No one is really certain why he did. He surely needed money, but many of those buried did not have families flush with cash. City government was loosely organized, and Solomon had done some previous work for the city and its leading citizens, including the digging of privies.
Maybe it was simply kindness. Solomon, his organs long bathed in rivers of alcohol, did not seem to be affected by cholera.
When confronted with the corpses, Foody said, "He wasn't afraid of them. He felt a kinship with them."
No one living in Lexington at the time knew what was bringing the sickness to them. Was it the miasma, a mysterious condition of "bad air" that could have floated in as an ill wind from Maysville? Was it contagious? Why did some people die in the same household where others lived?
In 1854, English physician John Snow figured out that water carried a cholera outbreak in London's Soho by pinpointing the locations affected. Even then, he could not isolate the microbe under a microscope. The microbe was identified in 1883.
Foody's book includes thoughts on how global health is affected by a disease whose appearance is sudden, lethal and mysterious, such as cholera.
Recently, Foody talked about how today's response to sudden acute respiratory syndrome and Ebola mirrors the early response to cholera. SARS and Ebola are contagious — spread person to person — while cholera is infectious, meaning it is spread from tainted water to a person. Cholera could not be spread person to person, although no one knew that at the time — hence the friends who ignored one another on the streets.
Why some people remained in town yet avoided cholera is unknown. Maria Gratz's mother died from the disease, although Gratz and her husband, businessman Benjamin Gratz, lived. Seven of the Gratz servants died.
Cholera epidemics spurred the development of the public health movement in the United States, Foody said, and that yielded a host of improvements in city sanitation. Although the disease is largely nonexistent in developed areas with reliably clean water supplies and antibiotic and rehydration treatment, it still pops up.
The World Health Organization estimates that 100,000 people a year die of cholera.