Name: Roll No:

Grade: 9 Div: A
Subject: ESL WS No: 1
Topic: Note-Making
WS Issue Date: 12-01-2024 Submission Date: 16-01-2024

Read the passage which was published on the 150th anniversary of a major
epidemic spread in Britain carefully, and then complete the notes below.

Mapping disease: John Snow and Cholera

09 Dec 2016
Fahema Begum

Cholera was one of the deadliest diseases to affect Britain in the nineteenth century and this
summer marked the 150th anniversary of the fourth and final pandemic in London in 1866.

In the nineteenth century it was believed that the disease was transmitted and spread by a
‘bad air’ or ‘bad smells’ from rotting organic matter. This thinking dominated official medical
and government statements and the recently created General Board of Health was amongst
those that believed in this theory. But it was not until 1854 that the physician John
Snow (1813-1858) made a major contribution to fighting cholera when he was able to
demonstrate a link between cholera and the contaminated drinking water through his
pioneering studies.

John Snow was born in York on 15 March 1813. He went to Newcastle upon Tyne at the age
of 14 to work as an apprentice for the surgeon William Hardcastle. He then went on to study
at the Newcastle Infirmary. During the 1831 outbreak of cholera in the North East, he
attended to sufferers in the Killingworth Colliery. The excellent observations he made on the
disease at this time formed the basis for his later work.

The page above is from the volume titled "Cholera", which contains Thomas Egerton
Bryant’s notes of cases of cholera from April 1832. The cases include the name of the patient,
symptoms, treatment and result.

Between 1833 and 1836, Snow was an assistant in practice in County Durham and North
Yorkshire. In 1836 he moved to London to study at the Hunterian School of Medicine. He

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began hospital practice in October 1837 at the Westminster Hospital and became a member
of the Royal College of Surgeons of England in 1838. He graduated from the University of
London in 1844 with a degree in medicine and in 1850 was admitted as a member of the
Royal College of Physicians.

A major outbreak of cholera reached the district of Soho, London, in August 1854. This was
the third cholera outbreak in London, having previously occurred in 1832 and 1849. In the
mid-19th century, Soho had a serious problem with filth due to the large influx of people and
a lack of proper sanitary services: the London sewer system had not reached Soho at this
point and drainage was poor throughout London. It was common at the time to have a cesspit
under most homes.

By talking to local residents Snow identified the source of the outbreak as the contaminated
public water pump on Broad Street. He did this by mapping the deaths from cholera, and
noted that they were mostly people whose nearest access to water was the Broad Street
pump. His studies of the pattern of the disease were convincing enough to persuade the local
council to disable the well pump by removing its handle. This action has been credited with
contributing significantly to the containment of the disease in the area. It was later discovered
that the water for the pump was polluted by sewage contaminated with cholera from a
nearby cesspit.

However, Snow’s theory was not new in 1854. He had argued earlier that it was not an
airborne disease in his published essay, On the Mode of Communication of Cholera, in 1849.
The germ theory was not developed at this point, so Snow was unaware of the mechanism
by which the disease was transmitted, but evidence led him to deduce in 1854 that it was not
due to breathing in foul air. In 1855 a second edition was published, incorporating the results
of his investigation of the Soho epidemic of 1854.

Hand pumps like that on Broad Street were not the only source of Londoners’ water, or
Snow’s only object of study during the 1854 cholera outbreak. The Lambeth Water
Company and the Southwark and Vauxhall Water Company were both supplying
mechanically-pumped water to residents of South London. Snow recorded cholera attacks in
this area, alongside information about the water supply to the houses affected. He showed
that the Southwark and Vauxhall Waterworks Company was taking water from sewage-
polluted sections of the Thames and delivering the water to homes, leading to an increased
incidence of cholera.

His findings were not immediately accepted but, despite this, they influenced changes in
public health and the construction of improved sanitation facilities.

Snow’s study was an important event in the history of epidemiology and public health. Map
lovers can enjoy his application of cartography which allowed geographic visualisation of the

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 data. His use of detailed statistical analysis also proved to be an efficient way of showing the
correlation between the quality of the water source and cholera cases.

Note Making.

Make notes based on John Snow's Contribution to Cholera Understanding.

Background:

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Key Contributions;

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Impact:

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Make notes based on Methodology and Findings of John Snow's Study

Methodology:

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Findings:

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[Marks:12]

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