More graphically than other epidemics, it demonstrated the helplessness of traditional patterns of authority to meet the challenge posed by the social and environmental consequences of rapid industrial and urban growth, while revealing the structures of social inequality, the operations of political power, and the attitudes and habits of mind of different classes and groups in society with a cold and pitiless clarity.
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These institutional weaknesses and habits of mind might have had less tragic results during the crisis of 1892 if there had been a determined and united medical profession capable of making the government face up to realities. But the doctors were slow in winning the confidence of the ruling classes in Hamburg, who were suspicious of their claim to a monopoly in the health market and their attempt to strengthen hygienic and sanitary regulations, and who were in any case, as one doctor wrote in 1863, prone to “a scarcely believable ignorance and indifference…with regard to what one might call public health care.”
Typical of the disregard of medical advice is the fact that decades after the introduction of compulsory vaccination against smallpox in the rest of Germany, Hamburg’s government continued to rely on voluntary methods of prevention, and when the medical profession pressed for legislation on the subject in the 1860s, and again in 1871, this was rejected by the Citizens’ Assembly, with the argument on the latter occasion that compulsory vaccination “encroaches upon personal freedom and liberty, and upon the most basic right of the individual, that of the freedom to dispose of his body as he wishes.” Later in the year, soldiers returning from the war against France brought the smallpox virus with them. Four thousand and fifty-three inhabitants of Hamburg died of the disease, more victims than in any local outbreak of typhoid or cholera in the nineteenth century, including the epidemic of 1892.
