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MAKING THE MODERN WORLD
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module:Geography of health

Patterns of disease

page:John Snow and the Broad Street pump

Epidemiology is the study of the distribution, occurrence and spread of disease. It is thus closely related to geography, which examines humans and their relation to the environment.


The original Broad Street pump. picture zoom © Wellcome Library, London

The first comprehensive epidemiological study was undertaken by Dr John Snow, who analysed fatalities in the London cholera outbreak of 1854. By linking these to one water pump in Broad Street in Soho, London, he established that cholera was a water-borne disease. That summer had been hot and the people were drinking cold water rather than boiling it for tea, as was usual.

In this area of London there were 13 pumps supplying water from wells. The cholera outbreak happened very rapidly. The majority of those who died became violently ill on the night of 31 August and died one or two days later. People began to flee if they were able; 75 percent of the population left in just a few days.


Dr John Snow. picture zoom © Wellcome Library, London

At once, Snow investigated and mapped the locations of the homes of those who had died in this outbreak. The pump central to his map was in Broad Street. Of the 89 people who died, only 10 lived closer to another pump. What was curious was that the 535 inmates of the workhouse in Poland Street were unaffected, even though it was surrounded by fatalities.

The 70 Broad Street Brewery workers also escaped the disease. But one woman in Hampstead and her niece in Islington, both over eight kilometres away from the pump, also died.

ACTIVITY

 

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Illustration of the contents of a pail of water sourced from a cistern, around the time of the 1854 cholera epidemic in the UK. picture zoom © Wellcome Library, London

In addition, Snow found that the water coming from the pump was cloudy; people had reported that it smelt bad in the days preceding the outbreak. The well was nine metres deep, but a sewer only seven metres below ground was just above it. On 7 September, a week after the outbreak began, Snow got the authorities to remove the pump handle. The number of infections and deaths fell rapidly.

ACTIVITY

 

Text only version

Snow’s study had far-reaching consequences. One of them was the improvement in London’s sanitation, including the new sewerage system constructed in the 1880s by Joseph Bazalgette. Bazalgette's work was also partly a response to the ‘Great Stink’, when the noxious odours from a polluted Thames forced the windows in Parliament to remain closed – even through an unusually hot summer!

Explore the following scene to find out more about national initiatives responding to the catastrophes of urban ill health in this period:


STORY: Muck and brass: The industrial town
SCENE: Responses
launch scene


Appearance of a cholera victim after death. picture zoom © Wellcome Library, London


Resource Descriptions

The original Broad Street pump.
Dr John Snow.
Illustration of the contents of a pail of water sourced from a cistern, around the time of the 1854 cholera epidemic in the UK.
Appearance of a cholera victim after death.
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Person
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