On the pathology and mode of communication of cholera / by John Snow.

  • Snow, John, 1813-1858.
Date:
[1849]
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and mode of communication of cholera / by John Snow. Source: Wellcome Collection.

    5/16
    these houses there were twenty-five cases of cholera, and fourteen deaths ; one of the houses had a pump railed off, to which the inhabitants of the other houses had no access, and there was but one case in that house. The people in Rotherhithe, where the rnor- lality from cholera has been greater than in any other part of the metropo¬ lis, are supplied with water to a great extent from certain tidal ditches com¬ municating with the Thames, and re¬ ceiving besides the refuse of the houses in the neighbourhood ; and Dr. Lloyd informs me that a line may be drawn between the places where ditch- water is used, and those supplied from the Water Works, and that the cholera has been many times more prevalent in the first-mentioned places ; although, in my opinion, the water supplied from the water works is itself not free from suspicion of having conveyed cholera poison, being obtained from the Thames. Rotiierhithe is less densely populated than many parts of the metropolis which have been compara¬ tively free from cholera, and those ditches, it should be remembered, are not very offensive to the smell; being only Thames water rendered a little richer in manure ; being, in short, probably equal to what Thames water would be if certain of our sanitary advisers could succeed in having the contents of ail the cesspools washed into the river. In Bermondsey, the I district in which next to Rotherhithe the cholera has been most fatal, the people also have to drink ditch water to a great extent. The Registrar-General has very ably pointed out the connection be¬ tween the higher rate of mortality from cholera on the south side of the Thames, and the lowmr level of the ground; but when this division of the metropolis is examined in detail, and compared with certain other parts of London, it will be found that the re¬ lation IS not one simply of level, or of the State of the air in connection with it, but that it depends altogether on the water used by the people. Not j because the water carries the poison to 3 every individual case, but because it { supplies a number of scattered cases i which diffuse the disease more gene- i rally. The water works supplying the i south of London take water from the Thames mostly at places near which the chief sewers run into it. More¬ over, the wells in this part of London are very liable to be contaminated by the contents of cesspools. Mr. Quick, engineer of the Southwark w'aterwmrks, in his evidence before the Sanitary Com¬ missioners in 1844, said* that in the south side of the 'I'hames the wells are often so contaminated owing to the cesspools and the wells being often about the same depth—viz. from eight to twelve feet, whilst on the north of the Thames the wells require to be from thirty to seventy, or eighty feet deep. These, together with the water from the ditches mentioned above, are the chief sources of the high mortality on the south of the Thames, and where they are not in operation there has been compara¬ tive immunity from the disease. Beth- lem Hospital is very copiously supplied with water from an Artesian well on the premises, and 1 am informed that that there have been but two or three cases of cholera out of a population of about seven hundred. Mr. Morton, Surgeon to the Queen’s Prison, in¬ forms me that, although there has been a good deal of diarrhoea, there have been but two cases of cholera in that establishment, containing a population, with the officers and attendants, of 300 and upwards, and one of the cases (the only fatal one) occurred in a patient who had been about a week in the prison, had suffered from an attack of cholera just before he entered, and had lost some members of his family by it. Now, the Queen’s Prison is supplied with very good water from various wells within the walls. Bethlem Hos¬ pital is situated in Lambeth, wheie one in every eighty-eight of the popu¬ lation have been carried off by cho¬ lera ; and the Queen’s Prison in South¬ wark, where one in every sixty per¬ sons have died of it: and the latter establishment is closely surrounded by houses, in numbers of which the cho¬ lera has been very fatal. In another institution in London, situated at the same elevation as those just mentioned, there has been, together with a differ¬ ence of water, a difference in the rela¬ tive prevalence and fatklity of cholera amongst its inmates and the surround¬ ing population j but here it has been against the institution and in favour of * First Report, p. 396.