With his medical knowledge, Robert Koch helps the people of Hamburg fight the cholera epidemic.
"I forget that I am in Europe." Robert Koch, director of the Prussian Institute for Infectious Diseases, delivers this damning verdict on conditions in Hamburg when he visits the Hanseatic city during the cholera epidemic in the summer of 1892. It is the last major outbreak of this disease in Germany.
Hot summer, low water level
The summer of 1892 is exceptionally hot. In August, temperatures in Hamburg are around 30 degrees Celsius. The water levels of the Elbe and the canals are low, the water is warm and thus ideal for the multiplication of germs. The Altona physician Dr. Hugo Simon expresses already on 14. August in a patient suspected of cholera. The canal worker named Sahling suffers from severe vomiting diarrhea. Dies shortly after admission to hospital. In the coming days, the cases of diarrhea with vomiting, as most doctors call the clinical picture in their files, will accumulate.
Robert Koch quickly recognizes that the catastrophic hygienic conditions, especially in the poorer districts of Hamburg, offer the best conditions for the spread of the cholera pathogen. "I have never encountered such unhealthy housing, plague dens and breeding grounds for every contagious germ as in the so-called corridor quarters I have been shown, on the harbor, Steinstrasse, Spitalerstrasse or Niedernstrasse."
Unimaginable misery in the gangway districts
Many Hamburg residents live in deplorable conditions in the corridor quarters. For the construction of the Speicherstadt numerous inhabitants have been displaced from the harbor area -. Have affordable housing in the apartment buildings around the churches St. Michaelis. St. Jacobi found. Jacobi found. Narrow alleys, dirty and dark backyards, damp basement apartments and inadequate sanitary facilities provide an ideal breeding ground for disease.
Eels from the water pipe
Another weak point in the Hanseatic city: drinking water is taken unpurified from the Elbe River. The construction of a filtration plant – already suggested in 1872 – is postponed for cost reasons and is only in the initial stages in 1892. The extraction point is only two kilometers upstream at Rothenburgsort, so that the polluted harbor water is taken in at high tide. Not only the dirty Elbe water runs through the pipes. Numerous animals, including eels, come out of the water pipes. Conditions in neighboring Altona are quite different. A sand filtration plant near Blankenese has been purifying drinking water since 1859. The benefits soon become apparent: Only a few people die of cholera in Altona.
Warning comes too late
Robert Koch proves the cholera bacterium for the first time in 1884 and shows that it is transmitted by water.
After the first cases, appropriate measures to contain the disease initially fail to materialize. For those in charge hesitate for a long time to announce the outbreak of cholera. They fear economic losses more than the epidemic. In addition, many Hamburg physicians are not familiar with the latest scientific findings. Thus, Medical Councillor Johann Caspar Theodor Kraus asks the head of Eppendorf Hospital, Dr. Theodor Rumpf, not to cause a stir. Rumpf, who is a follower of the bacteriologist Koch, initially fails to prove the cholera pathogen.
Finally, on 22. August Dr. Eugen Fraenkel isolates the bacterial culture. Although there is now scientific proof of cholera, Senator Gerhard Hachmann continues to speak only of a suspicion. He even ares U.S. Vice Consul Charles Burke that there is no cholera in Hamburg. Accordingly, the emigrant ships initially continue to sail to New York. Only on 23. August 1892 the Hanseatic city reports the outbreak of the epidemic to the Imperial Health Office in Berlin. The following day, Koch, as a representative of the Reich government, confirms the news on the spot.
Disease control and reactions to the epidemic
People stand in line at a drinking water distribution point. Drawing by Karl Muller on the cholera epidemic in Hamburg in 1892.
While many wealthy Hamburgers leave the city, the poor try to protect themselves as best they can. But the cramped, unhygienic living conditions and lack of education make it difficult to combat cholera effectively. The medical authorities distribute leaflets with rules of conduct, barrel trucks distribute boiled water, and cookshops offer bacteria-free meals in public places. On Koch's orders, the schools are closed. Trade and traffic come to a standstill. The Hanseatic city that likes to call itself the gateway to the world is isolated.
Gravediggers in constant use
The dockworkers, now unemployed, find employment in the cemetery or with disinfection crews. They disinfect streets and houses with various chemicals such as chlorinated lime, carbolic acid, lysol and creoline. Day and night, 125 workers dig new graves in the Ohlsdorf cemetery. Often the dead are buried in mass graves. On 27. August alone, 441 cholera patients die. The epidemic rages for ten weeks. Isolated deaths still occur until February 1893. A total of 16 people fall ill in Hamburg.596 people, 8.605 of them die. Although there are cases of cholera elsewhere in Germany, no epidemic is as dramatic as the one in Hamburg. Because in other cities the hygienic conditions are much better. And the authorities also take rigorous countermeasures when the first cases become known.
Germ presumably arrives in Hamburg from Russia
In Ballinstadt, emigrants wait for their onward journey to America – here a photo from 1909.
Politicians blame the cholera outbreak on Eastern Europeans who emigrate in large numbers to America via Hamburg. In Russia in particular, the 19th century saw. In the twenty-first century, cholera outbreaks occur again and again. Now the Eastern European emigrants are forbidden to enter Prussian soil. Hamburg's borders are also closed, and Russians are not allowed to leave the emigrant barracks on Amerikakai. The Hapag shipping company, which earns a fortune from the emigrant ships, presses for a rapid resumption of transit traffic. From 1893, the Senate once again permits the entry of Eastern European emigrants to Hamburg. However, medical checks and disinfection measures are now already taking place at the borders.
Senate takes measures
In addition to the death of many people, the city suffered losses of millions in the economy. Politicians draw the consequences and take numerous measures to prevent a new epidemic. This is how the filtration plant of the Hamburg waterworks on the Elbe island of Kaltehofe near Rothenburgsort was completed in 1893. In the same year, a waste incineration plant goes into operation. The Gangeviertel are redeveloped. In addition, the city enacts new building laws to promote more hygienic living conditions. Conditions for emigrants also improve. In 1906, the new emigrant halls on Veddel replace the old barracks on Amerikakai. They offer more space. Better hygiene.
Bernhard Nocht becomes harbor doctor
The physician Bernhard Nocht devotes himself to researching tropical diseases. The Hamburg Tropical Institute is named after him.
Bernhard Nocht resigns on 1. In April 1893, the poor take up the newly created post of harbor doctor. The student of Robert Koch should pay attention to the observance of hygienic precautions and, if necessary, raise the alarm at an early stage. In October 1900, the tropical physician takes over as director and chief physician at the newly founded Institute for Ship and Tropical Diseases. Today, the Bernhard Nocht Institute is one of the world's leading institutions in the field of tropical medicine.
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