Urban famine or urban crisis? Typhus in the Victorian city.

There were four horsemen of the Apocalypse: War, Famine, Disease and Death, a historic association which has continued into modern times. For most of history, the disease most commonly linked with this awful partnership has been typhus, and typhus has become known as the archetypal famine fever. The aetiology of the disease has, however, rarely been examined in its historical context; as a result, historians have often misinterpreted its significance. In one recent article, for example, the disease was treated as an indicator of urban famine, of the extent to which the nutritional status of the Lancashire textile operatives was reduced by the Cotton Famine of the 1 860s. 1 In the nineteenth century, however, epidemics of typhus occurred in both times of stress and times of prosperity: unlike its cousin, relapsing fever, typhus is not a primary indicator of "true, nutritional famine". Why did typhus disappear as a significant cause of death in the late nineteenth century? The disease was almost certainly endemic in pockets of cities across Britain in the eighteenth and early nineteenth centuries; from time to time there were epidemic outbreaks. What were the different factors that permitted the survival of the disease, stimulated epidemics, and finally led to its virtual disappearance in the 1870s? The commonly-assumed causal link between typhus and famine, or at least malnutrition, raises the question of dearth and living standards in the nineteenth century. The harvest-related subsistence crisis had vanished by the late eighteenth century; but do typhus epidemics indicate periods of dearth in nineteenth-century cities? Or was typhus's survival rather a question of hygiene? For the urban historian H. J. Dyos, typhus was an indicator of "dirt and destitution"; for Thomas McKeown, of malnutrition and low levels ofpersonal hygiene.2 The answer is perhaps more complex: in a recent analysis ofthe European subsistence crisis of 1740 John Post has argued that the links between food shortages and disease are more social than nutritional, that typhus is not an indicator of famine per se, but the consequence of social dislocation