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On the cover: Skeleton in bottle of water. 1879. (British: published in Punch magazine, October 11, 1879) The Bridgeman Art Library, New York. Reproduced with permission.

In the last quarter of the 19th century, London witnessed a remarkable decline of the epidemics for which the city was so infamous in the first half of that century. While typhoid and cholera would still evade elimination, no longer were they the public health dangers they once posed.

Two significant advances played major roles in this transformation: the adoption of gas-powered buses and the linking of indoor toilets to public sewer systems.

By the late 1800s, 11 000 hansom cabs and several thousand horse-drawn buses generated over 500 tons of manure daily, providing an enormous breeding ground for flies capable of spreading typhoid. Petrol-based buses and delivery vehicles vanquished the threat of disease from the “street mud” overnight.

Water closets introduced in the mid-1800s were originally connected to the backyard cesspools, a practice that led to overflow due to the large volume of flushing water. Connecting the WC to a public sewer system led to the elimination of enteric epidemics in neighborhoods that could afford such improvements.

Despite these breakthroughs, pockets of disease remained, as evidenced by the warning depicted on the cover: an admonition to the patrons of a London pub frequented by German-speakers, that typhoid still lurked in the water supply.

(Mary & Michael Grizzard, Cover Art Editors)

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