Cholera epidemics in Spain

The successive pandemics that the country suffered caused an economic recession, as well as an opportunity for profound change in health and hygiene in Spain.

It was not free of controversy, both for the use of the vaccines created by Jaime Ferrán y Clúa and for the ways of combating the disease, as well as for the policies used to deal with it.

The then very recent death of Ferdinand VII after the Ominous Decade left a weak and conflict-ridden state, the first outbreaks occurred during what would become the First Carlist War that was taking place in northern Spain.

In 1884, Robert Koch discovered the origin of the disease in the form of a bacillus; the fight against its advance already had a scientific sense from that year on, however epidemic outbreaks appeared throughout the world.

The patients show a syndrome based on vomiting and excessive diarrhea (called cholerine) with watery stools with little or no fever, after an incubation period of one or two days.

When the outbreak becomes established in a population, it is the abundant stools (more than thirty times a day) that easily contaminate drinking water sources and the clothes of the affected persons.

After Koch's discovery, Dr. Jaime Ferrán y Clúa tested a vaccine in Spain a year later, which was widely criticized by scientists and politicians.

Cholera disease seems to have disappeared in Europe and America at the end of the 19th century, and since 1950 only sporadic outbreaks have occurred in India and nearby countries such as Bangladesh.

One of the characteristics of the initial evolution of cholera is that each infected country tried to solve the problem on its own, without requesting help from the rest and without taking any joint action or providing any information to other nations.

Cholera affected in its various outbreaks mainly the eastern half of the Iberian Peninsula, and particularly the densely populated urban centers on the coast and some of them also in the interior.

Dr. Pedro Castelló obtained from Fernando VII the authorization to send, in February 1832, a medical commission composed of Pedro María Rubio, Lorenzo Sánchez Núñez and Francisco Paula y Folch, in order to study the effects of cholera in cities such as Paris, Vienna and Munich.

Some of the measures were based on the creation of sanitary cordons, quarantines in the lazarettos, sectorized isolation of the population, and the establishment of hospitals.

At this time in the 19th century, cholera was considered an epidemic disease, not at all contagious, and therefore it was thought that the best course of action was to have good hygiene in order not to get it.

One of the doctors who stood out in the first outbreaks was the hygienist Mateo Seoane Sobral, who published several articles on the evolution of pandemics in Europe, compiling the experiences of other countries in the treatment of the disease.

The outbreak started due to the landing of combat troops from the Portuguese War of Succession; it is possible that they were responsible for their arrival in Spain, and it was in Andalusia where the most deadly cases occurred in the summer of that same year.

Other stories mention that the disease came aboard the steamship Isabel la Católica, which came from Greece; in it, three sick people were traveling and were isolated in the corresponding lazaretto.

The outbreak in southern Spain was more virulent, and spread with great force due to environmental conditions, reaching Madrid, Toledo, Guadalajara, Soria, Avila, Burgos and Cuenca.

One of the causes was the French ship Triton, which had left Toulon with soldiers of the foreign legion on a long voyage that included Oran and Algiers.

The ship and its crew remained in quarantine in the lazaretto on the island of San Simón, from where the pathology gradually spread throughout the Rías Bajas.

All this despite the fact that the modes of transmission of the infection among the population were already beginning to be suspected and an incipient international network of health posts was being coordinated to provide regular information on the evolution and situation of the disease.

It arrived preceded by some catastrophic phenomena, such as earthquakes and torrential rains, which created the ground for the epidemic to develop.

Although the first case was registered in Jaén on August 13, a month earlier there were deaths caused by enterocolitis, a diagnosis that can be interpreted as a euphemism for cholera when the disease is not declared.

On October 11 of that year, the Italian ship Remo docked in Santa Cruz de Tenerife; it arrived from Rio Grande, on its way to Genoa.

Religious rogatory processions were carried out through the streets of the city, such as the Señor de las Tribulaciones (Lord of Tribulations).

In spite of everything, there was an epidemic outbreak of cholera in the middle of Franco's regime, and the focus was located on the banks of the Jalón river; this occurred in July 1971.

The multitude of ways of pretending to cure the disease depended fundamentally on the etiopathogenic doctrines held by the physicians of the time.

As a prophylactic, quinine sulfate, camphor, and benzoic acid were recommended; other remedies were cinnabar cigar, a mineral rich in mercury, and charcoal smoke.

Prior to these epidemics, cemeteries in Spain were located in the center of cities, sometimes near the hospitals themselves, and sometimes people were buried inside churches.