Subtitles section Play video Print subtitles See this guy? He is afraid for his life. This drawing is an 1832 joke - it's a riff on how nobody knew how to prevent cholera. You might suspend acorus over your masked mouth, or wear a copper breastplate, and tie pitchers of water behind your calves. Anything to keep the disease away. Starting in the 1830s, cholera pandemics swept the United Kingdom. Nobody knew how the disease was transmitted. Germs weren't an established idea. One London doctor — John Snow — tried to find out how the diseases spread, and today, one of his investigations is iconic in the field of epidemiology. And it all centered on a pump. This is a map John Snow made to prove his solution to the cholera mystery in London. It also shows the confusion and the problems he was up against. Each of these bars represents a death from cholera. The disease often killed half the people who got it — it caused vomiting and diarrhea. The rapid loss of fluids was fatal. At the time, a lot of people believed cholera was transmitted in a “miasma” — imagine an evil cholera cloud. This typical map from the 1840s shows a cholera “mist” that was blamed for transmission. Snow suspected a different source. At the time, people usually didn't get water directly in their homes. It came from a neighborhood pump connected to one of the few water companies in the city. John Snow mapped different water company's service areas in London. You can see how they are occasionally separate, and occasionally overlap. If a common pump was contaminated at any point — at the source or near the pump — Snow believed the water could kill. In 1849, he wrote that his study of symptoms and specific cases had led him to suspect 'the emptying of sewers into the drinking water of the community," caused outbreaks — not a miasma. Five years later, he had a chance to prove it — and stop a fresh outbreak in the process. In August 1854, 20 people lived here at 40 Broad Street, including an infant who died of cholera. After her death, Snow started to investigate the outbreak. He didn't think the original water source was the problem, but he thought something might be wrong down the line, at the pump. He took samples of the water. They seemed clean. But he wasn't satisfied, because more people were getting sick. He asked questions up and down the street, where one man had noticed a bad smell from his water. Snow asked the registrar for a list of people who'd died. He started going house by house to interview the survivors - and many of the dead had taken water from the pump. He became convinced the Broad Street Pump was the common link among the dead. He wrote, “I had an interview with the Board of Guardians of St. James's Parish on the evening of Thursday, 7th September, and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day.” People stopped using the water. But Snow had not won yet. Newspapers reported the streets were covered in lime — the city was using it as “a powerful disinfectant” on the streets. That showed they weren't fully convinced the pump was the problem. They still suspected miasma. So Snow bolstered his case through investigation and recording. He learned the 18 workers who died at this factory had drunk from big barrels of water drawn from the pump. At the same time, unlikely survivors could serve as proof of Snow's theory. According to the miasma theory, this place would've been covered in cholera clouds, affecting all workers. But Snow learned the workhouse had its own well — no bad water got in. The same went for this brewery. That's because Snow learned the workers there drank from the brewery's water supply or, more likely, only drank the free malt liquor they got on the job. That's right, drinking on the job saved their lives. Snow strengthened his argument and his map. He adjusted the location of the pump to show how close it was to 40 Broad Street and drew a dotted line - he showed a zone where it would be closest to walk to the Broad Street pump, rather than another one. That zone is where most people died. He tabulated every death, by date, to do it. This was paired with a local Reverend's similar data-driven investigations. A local surveyor looked at the plumbing at 40 Broad Street, where the infant had died. He learned that the cesspool, where sewage collected, was poorly designed and lined with decaying bricks. When the infant's diapers had been washed, the cholera-carrying water had leaked into the Broad Street pump's supply. John Snow died in 1858. His obituary read, “Dr John Snow: This well-known physician died at noon, on the 16th instant, at his house in Sackville Street, from an attack of apoplexy. His researches on chloroform and other anaesthetics were appreciated by the profession.” At the time, Snow was more famous for stuff like a chloroform inhaler than a map. It took years for the “investigation of John Snow” to become an example for subsequent outbreaks and epidemiology textbooks, and it slowly, eventually, helped end the miasma myth. That's because Snow didn't just make a map of a city. It's a map of his process and the field it shaped. It gave direction to a world where disease didn't have to be hidden in a cloud. Instead, it could start at a pump. OK, so the best book about John Snow is Cholera, Chloroform, and the Science of Medicine. It features an amazing story, which is that John Snow gave chloroform to Queen Victoria while she was giving birth.
B1 Vox cholera pump water john map The 1850s map that changed how we fight outbreaks 14 0 林宜悉 posted on 2020/08/14 More Share Save Report Video vocabulary