By the middle of the 19th century Glasgow  had become one of the largest and most productive industrial cities in Europe and its population had swollen to nearly 500,000; but beyond the sandstone palaces of the Merchant  City 
In 1832 a new and genuinely frightening disease arrived into the city: Cholera. Originating in India , the disease spread quickly through the Middle East to Egypt , and then by ship to most of the industrial cities of northern Europe . Not since the days of the plague was there such a trail of death and panic. This first epidemic took over 3100 lives; and when it visited Glasgow 
In the 1850s the City of Glasgow Southern Highlands  flowed through 35 miles of pipeline to the masses. It was an incredible achievement, and once again modern ingenuity and science tackled a deadly disease and reduced it to insignificant. The unseen hand of disease and our reaction to it is an underlying part of the Scottish story.
Disease, whether endemic or epidemic has always been part of the human condition: it affects population growth, debilities the labour force, causes widespread misery and fear, and alters the course of history. We know little about the epidemiological history of early Scotland Mediterranean . 
Although Scotland  was not really part of the Roman Empire, it was still strongly affected by it, and its collapse would have severe implications for the political development of the British Isles . In 165AD a new and devastating disease, probably Smallpox, hit the Mediterranean ports and spread quickly through the provinces. Mortality was high, and it cut a swathe through the main administrative centres. The epidemic lasted for 15 years and was a severe blow; then in 251 another serious outbreak hit the Roman world. This time the culprit was Measles, and with its arrival into Europe  the consequences were truly horrific. 
Between the two outbreaks the death toll exceeded five million, and it almost certainly led to a breakdown in order; one that was never fully recovered and with Malaria rampant it proved too much and in the 5th century the house of cards came tumbling down. The Romans were forced to import Germanic peoples to provide manpower for farming and military service. It wasn’t enough and the Empire failed; the inheritors would be these same tribes and peoples, and they would shape the Europe  to come.
Smallpox and Measles probably entered the Scottish population as well, and wreaked havoc among the countryside; but, it was the influx of the Anglo-Saxons into Britain  on the back of the collapse of Roman authority, and the formation of England  that would shape Scotland Scotland ’s principal market disappeared and this seems to have initiated a more aggressive, warlike age among the various tribes and kingdoms north of Hadrian’s Wall .
Across Europe  these two diseases would erupt over 40 times from 600 to 1000AD and more than certainly contributed to the poor productivity, high mortality and increase in brutality associated with the so called Dark Ages. It would also appear that Malaria gained a stronghold across Europe  at this time. The mosquito that carried the disease can only thrive in warm climates, and there is enough reason to suggest that southern Scotland 
The Plague of Justinian (542-43) all but annihilated the populations of the Mediterranean, and is the first identifiable outbreak of the Bubonic Plague in Europe . With a death toll of over 25 million it was the beginning of the end of the Byzantine Empire of Constantinople and the true harbinger of the Dark Ages. Its devastation however was confined to the Mediterranean and Danube: northern Europe  was left unscathed. The reason being that the black rat, which carries the flea, which hosts the disease, Yersinia Pestis, being a native of India Europe  shift irrevocably to the north. Rome 
The Bubonic and Pneumonic (airborne version) plagues are extremely contagious and extremely deadly. The disease originates in the southern Himalayas , and was spread by increases in trade and inter-continental warfare. The Black Death which hit Europe certainly came from Asia , and arrived into the Mediterranean ports in 1346. This time however, with the black rat firmly established it would hit an entire continent. By the time it had run its course, over a third, and probably nearer a half of Europe was dead; and Scotland , which had just gone through a series of bloody wars with England 
That said, pre-plague populations were high and initially the social implications weren’t too severe. However, it came back again, and again, with monotonous regularity throughout the 14th and 15th centuries and this did lead to a severe and lasting reduction in population (the low point is estimated around 1450). This in turn led to a shortage of labour, which means the economy becomes a sellers’ market. Serfdom vanishes, some peasants have opportunities to become land owners or merchants and a middle class begins to emerge; central government takes the opportunity to eliminate rivals; and religious unrest ultimately leads to the Reformation. It was a gloomy time, and both art and gravestone decoration often depict the so called ‘Dance of Death’. And death was an ever contestant part of life, on a scale and prevalence we’d find hard to fathom today.
 The Dance of Death Artwork
While Scotland 
As the country began to recover from recurrent visitations of the plague, and disease like smallpox developed into childhood illnesses, the likes of typhoid and dysentery took hold in the very unsanitary cities that were emerging. Plague too found a home in these rat infested warrens. However, following the infamous outbreak of 1665 it simply vanishes from Britain  and most of Europe north of the Alps  – never to return: a true epidemiological mystery. In all probability the disease mutated to cope better with the increased cooling associated with the ‘Little Ice Age’ and that this new version happened to be non-lethal (it isn’t in the bacteria’s interest to kill off 100% of a population anyway, so this may have accelerated the mutated form’s success). Also, improvements in house building, including the move away from timber and thatch to stone and slate widened the ‘distance’ between rat and man; thus, breaking the chain of contagion. 
By around 1700 Scottish society was beginning to emerge from the shadow of the great killers; fear was replaced by optimism and it would have a profound affect. Across Britain , including Scotland 
 Dry Stane Dyke - Field Enclosure Revolution
All of this led to a huge rise in cattle numbers, which had the unexpected effect of eradicating malaria from the British Isles – our mosquito (found in the south east of Scotland 
This dramatic rise in agricultural output meant that cities like Glasgow , Edinburgh  and Dundee  could feed and clothe its rapidly growing population. Greater efficiency in the countryside also meant less labour was required, which provided these cities with much needed manpower. Disease in the industrial slums kept mortality rates high, and death rates far exceeded birth rates – thus migration from the surrounding countryside was vital. By 1801 Scotland Highlands  and led to large-scale, voluntary emigration. 
One disease still haunted the imagination of the country at large – Smallpox. It is a scary looking illness, mostly contracted in childhood and while it has a relatively high mortality most people lived. It did leave people scarred for life though, with at least a third left blinded. There is no doubt that had an impact on society. An English doctor, Edward Jenner observed that milkmaids bore none of the scarring, and were essentially immune; the result of contracting the far less lethal cowpox. This would lead first to inoculations and ultimately vaccinations. The fight against the infectious and often mortal illnesses had begun. 
Without the agricultural revolution there could have been no industrial revolution and certainly not enough people to make it happen. Death control was winning in the age-old battle. Other European countries were slow to implement vaccination programmes, improve their sanitation and failed to enclose the pastureland. Only in Britain America , Canada  and Australia , and provided people for the ever growing British Empire . 
How disease was actually transmitted, and indeed what they were, was one of the great leaps forward of the late 18th century; allowing science to create vaccinations, and governments to improve living conditions. Cholera, diphtheria and many others could now be battled on several fronts. It would have been impossible to have so many men entrenched in such confined and poor conditions as was experienced in the First World War had it not been for such advances – typhoid would simply have wiped them out, as it had done Napoleon’s Grand Army a hundred years early.
By this time, with improved sanitation, vaccinations, cures and ultimately the arrival of penicillin for the first time in Scotland 
From this distance in time we are really oblivious to the danger that disease posed to our ancestors: it could come out of nowhere, and no-one was safe. Life expectancy rates were in the mid 30s, and death was commonplace. It debilitated the labour force, affected political decision-making and held the people in a thrall. It plays a huge part in the story of the Scottish people, and the changes that occurred from 1700 to 1900 altered the landscape, created our cities and built modern Scotland 
 



 

