Cholera and the water supply in the south districts of London in 1854 / John Snow.

  • Snow, John (Bailiff of Stockbridge)
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: Cholera and the water supply in the south districts of London in 1854 / John Snow. Source: Wellcome Collection.

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    SANITARY INQUIRY. vaccination, measures against and during epidemics, etc.; the inspection of articles of food and medicine; all these and other duties, properly performed, would occupy the en¬ tire time of a skilled and experienced superintending officer,* who ought most certainly to be debarred from private pro¬ fessional engagements, and thus be rendered independent of those local influences which are known to be adverse to an unflinching and uncompromising discharge of public duty. Such an officer would be analogous to the Krcis-physicus of the German States, whose scientific reports and preventive duties are of great value, and would doubtless lead to more important practical results, if laid before an English commu¬ nity with its practical tendencies and its ample pecuniary resources. 18. ffhe questions involved in the territorial distribution of the population are of the largest importance to society; but I must now close these remarks by a brief recapitulation. l. The physical geography of the district, and the general character of its population, should be the main facts upon which any revision of the areas of sanitary inquiry and juris¬ diction should be founded. ii. Areas for statistical returns should be co-extensive with those for sanitary management. hi. 1 lie extent of these areas-should be large enough to provide satisfactorily for the amalgamation of existing smaller jurisdictions. iv. ihe superior sanitary districts should also be large enough to secure, ■with economy, the appointment of a higher and more useful class of sanitary officers. All these changes might be judiciously carried into effect, I believe, without any reckless or offensive sacrifice of exist¬ ing interests, or any violation of justly established rights. be desirable to divide these functions among two or three officers, »uh diderent utles and qualifications. (Kssa)s on State Medicine, pp. 50-1.) THE WATER SUPPLY, ETC. 239 CI10LERA AND THE WATER SUPPLY IN TnE SOUTH DISTRICTS OF LONDON, IN 1854. By .JOHNfSNOW, M.D. In the summer of 1849, I published certain conclusions at which I have arrived with regard to Asiatic cholera, and the facts and reasonings which had led to them. The following is a very brief outline of these views. The cholera com¬ mences as an affection of the alimentary canal, and not with general illness; there is no evidence of poisoning of the blood in this disease, except in some cases where secondary fever occurs ; there is conclusive evidence that cholera may be communicated from person to person, and it follows, therefore, that the morbid matter which produces the disease is applied to the interior of the alimentary canal, where it increases and multiplies during the period of so-called incu¬ bation, and passes off, during the attack, to cause fresh cases when suitable opportunities occur. Various circumstances connected with the propagation of cholera seemed in accord¬ ance with the above view of its pathology. Thus, it was observed to pass frequently from person to person in the crowded habitations of the poor, who cat, drink, cook, and sleep in the same apartment, and pay little or no regard to cleanliness, who live, in fact, under circumstances where the sudden and copious evacuations of cholera, soiling the bed and body linen, would not fail to contaminate the hands of the patient and his attendants, and be thence transferred to any food they might touch. The absence of colour and odour in the evacuations could not help to favour this re¬ sult. The social visitor who came to see tire poor patient, or attend his funeral, frequently suffered, whilst the medical man, and others who partook of no food in the apartment, and who washed their hands when requisite, escaped. The mining districts of this country have suffered excessively from cholera in each epidemic, an event which might be explained by the following circumstances when taken in connexion with the above view of the cause of the disease. The miners stay eight or nine hours at a time in the pits, and take food with them, which they eat invariably with unwashed hands, and without knife and fork, whilst the pits are without privies, and are generally extremely foul and dirty. The entire absence of daylight must also cause the workmen to take much more dirt with their food than they aware of. It occurred to me, as soon as I began to entertain the above opinions, that if the cholera excreta could reproduce the .3 . (V>Jo A ■&