the premises and always filled from the Broad Street pump. Among these employees eighteen died of cholera. Similar facts were elicited for other factories on the same street, all tending to show that in general those who drank the water from the Broad Street pump well suffered either from cholera or diarrhoea, while those who did not drink that water escaped. The whole chain of evidence was made absolutely conclusive by several remarkable and striking cases, like the following: ‘‘A gentleman in delicate health was sent for from Brighton to see his brother at No. 6 Poland Street, who was attacked by cholera and died in twelve hours, on the ist of September. The gentleman arrived after his brother’s death, and did not see the body. He only stayed about twenty minutes in the house, where he took a hasty and scanty luncheon of rump steak, taking with it a small tumbler of cold brandy and water, the water being from Broad Street pump. He went to Pentonville, was attacked with cholera on the evening of the following day, Septem- ber 2d, and died the next evening. The death of Mrs. E. and her niece, who drank the 98 HISTORY OF SANITATION water from Broad Street at the West End, Hampstead, deserves especially to be noticed. I was informed by Mrs. E.’s son that his mother had not been in the neighborhood of Broad Street for many months. <Callout type="important" title="Important">A cart went from Broad Street to West End every day, and it was the cus- tom to take out a large bottle of the water from the pump in Broad Street, as she preferred it. The water was taken out on Thursday, the 31st of August, and she drank of it in the evening and also on Friday. She was seized with cholera on the evening of the latter day, and died on Saturday. A niece who was on a visit to this lady also drank of the water. She returned to her residence, a high and healthy part of Islington, was attacked with cholera, and died also. There was no cholera at this time either at West End or in the neighborhood where the niece died. Besides these two persons only one servant partook of the water at West End, Hampstead, and she did not suffer, at least not severely. She had diarrhea.” Dr. Snow’s inquiry into the cases of cholera which were nearer other pumps showed that in most the victims had preferred, or had access to, the water of the Broad Street well, and in only a few cases was it impossible to trace any connection with the pump. Finally, Dr. Snow made a statistical statement of great value which is here given in its original form: THe Broap STREET, LONDON, WELL AND DeEATHS FROM ASIATIC CHOLERA NEAR If IN 1854 Date ei Deaths August 19 1 1 August 20 1 0 August 21 1 2 August 22 0 0 August 23 1 0 August 24 1 2 August 25 0 0 August 26 1 0 August 27 1 1 August 28 1 0 HISTORY OF SANITATION 99 Number of Fatal Attacks August 29 A : : 1 1 August 30 ; i : 8 2 August Bl : ‘ : 56 4 September 1 : ‘ ‘ 148 70 September 2 : , ‘ 116 127 September 38 : ; ‘ 54 76 September 4 : ‘ : 46 71 September 5 é ; . 36 45 September 6 : : 2 20 37 September 7 28 382 September 8 : ; : 12 30 September 9 : : : 11 24 September 10 : : ; 5 18 September 11 9) 15 September 12 1 6 September 13 3 13 September 14 0 6 September 15 1 8 September 16 a 6 September 17 2 5 September 18 3 2 September 19 0 3 September 20 0 0 September 21 2 0 September 22 1 2 September 23 1 3 September 24 il 0 September 25 1 0 September 26 i 2 September 27 1 0 September 28 0 2 September 29 0 0 September 30 0 0 Date unknown 45 0 616 616 In addition to the original and general inquiry con- ducted from the time of the outbreak by Dr. Snow, the Rev. H. Whitehead, M. A., curate of St. Luke’s in Ber- wick Street, and like Dr. Snow, a member of the Cholera Inquiry Committee, whose knowledge of the district both before and during the epidemic, owing to his official posi- tion, gave him unusual advantages, made a most elaborate and painstaking house-to-house investigation of one of the principal streets affected, viz., Broad Street itself. The Rev. H. Whitehead’s report, like that of Dr. Snow, 100 HISTORY OF SANITATION is a model of careful and extended observation and study, cautious generalizing and rigid verification. It is an excel- lent instance of inductive scientific inquiry by a layman in sanitation. Mr. Whitehead found the number of houses on Broad Street 49; the resident householders 35; the total number of resident inhabitants 896; the total number of deaths among these 90. Deaths among non-residents (workmen, etc.) belonging to the street, 28. Total deaths chargeable to this street alone, 118. Only ro houses out of 49 were free from cholera. The dates of attack of the fatal cases resident in this single street were as follows: * Number of Date of Attack Fatal Attacks August 12 August 28 August 30 August 381 September 1 September 2 September 3 September 4 September 5 September 6 September 7 September 8 September 9 ® 0 KHWwWoOowInwmdwokkaarrr (lo) Ss Mr. Whitehead’s detailed investigation was not made until the spring of 1855, but in spite of this fact it supplied most interesting and important confirmatory evidence of Dr. Snow’s theory that the Broad Street well was the source of the epidemic. Mr. Whitehead, moreover, went further than Dr. Snow, and endeavored to find out how the well came to be infected, why its infectious condition was so limited, as it appeared to have been, and to answer various other questions which occurred in the course of his inquiry. As a result, he concluded that the well must have been most infected on August 31st, that for some HISTORY OF SANITATION 101 reason unknown a partial purification began on September 2d, and thereafter proceeded rapidly. There was some evidence that on August 3oth the water was much less infected than on the 31st, so that its dangerous condition was apparently temporary only. He further discovered that in the house No. 40 Broad Street, which was the nearest house to the well, there had been not only four fatal cases of cholera contemporaneous with the epidemic, but certain earlier cases of an obscure nature, which might have been cholera, and that dejecta from these had been thrown without disinfection into a cesspool very near the well. On his reporting these facts in April, 1855, to the main committee, Mini Y OFKS Secs retary and_= sur- veyor to the com- mittee, was in- structed to survey the locality and examine the well, cess poo l-and drains at No. 4o Broad Street. Mr. York s-report, ‘re- vealed a startling Comdition of affairs. The well was circular in sec- tion, 28 feet 10 inches deep, 6 feet Line oF FRonr — ASIATIC CHOLERA —AND— THE BROAD STREET WELL. LONDON 1854. in diameter, lined eS eras OF HOUSE No.40. with brick. and V'anoV__CELLARS UNDER STREET. ii, C_—=CESS POOL. when examined P___ Privy. (AFTER MR.YORKS ORIGINAL DRAWINGS.) contained 7 feet 6 inches of water. It was arched in at the top, dome fashion, and tightly closed at a level 3 feet 6 inches be- low the street by a cover occupying the crest of the dome. The bottom of the main drain of the house No. 40 Broad 102 HISTORY OF SANITATION Street, lay 9 feet 2 inches above the water level, and one of its sides was distant from the brick lining of the well only 2 feet 8 inches. It was constructed on the old fash- ioned plan of a flat bottom, 12 inches wide, with brick sides rising about 12 inches high, and covered with old stones. As this drain had but a small fall or inclination outward to the main sewer, the bottom was covered with an accumula- tion of soil deposit about 2 inches thick, and upon clearing this soil away the mortar joints of the old stone bottom were found to be perished, as was also all the jointing of the brick sides, which had brought the brickwork into the condition of a sieve, and through which the house drainage water must have percolated for a considerable period. After opening back the main drain, a cesspool, in- tended for a trap but misconstructed, was found in the area, 3 feet 8 inches long by 2 feet 6 inches wide and 3 feet deep, and upon or over a part of this cesspool a common open privy, without water supply, for the use of the house, was erected, the cesspool being fully charged with soil. This privy was formed across the east end of the area, and upon removing the soil the brickwork of the cesspool was found to be in the same decayed condition as the drain, and which may be better comprehended by stating that the bricks were easily lifted from their beds without the least force, so that any fluid could readily pass through the work, or as was the case when first opened, over the top course of bricks of the trap into the earth or made ground, immediately under and adjoining the end wall eastward, this surface drainage being caused by the accu- mulation of soil in, and the misconstruction of, the cess- pool. Thus, therefore, from the charged condition of the cesspool, the defective state of its brickwork and also that of the drain, no doubt remains in my mind that constant percolation for a considerable period had been conveying fluid matter from the drains into the well; but lest any doubt should arise on this subject hereafter, I had two spaces of the brick stemming, 2 feet square each, taken out HISTORY OF SANITATION 103 of the inside of the well, the first 13 feet deep from the level of the street paving, the second 18 feet deep, and a third was afterward opened still lower, when the washed appearance of the ground and gravel fully corroborated the assumption. In addition thereto, the ground was dug out between the cesspool and the well to 3 feet below the bottom of the former, and its black, saturated, swampy condition clearly demonstrated the fact, as did also the small furrowed appearance of the underlying gravel observed from the inside of the well, from which the fine sand had been washed away during the process of filtration. It was thus established as clearly as can be done by circum- stantial evidence, that the great epidemic in St. James’ Parish, Westminster, London, in 1854, was caused by the polluted water of the Broad Street well, which for a very few days was probably infected with cholera germs. It is much less clear how the well became infected, but it seems probable that the dejecta of a cholera patient found tolera- bly direct access to the well from the cesspool or drain of a house nearby. There is no evidence whatever that the germs multiplied in the well, but rather much evidence that they rapidly died out. It is repeatedly stated in the report that the water was preferred for drinking because it was cold, z. ¢., colder than the cistern water derived from public water supply and this condition would probably favor such dying out. That the water had long been polluted there can be no doubt. There was evidence of this, and also some evidence that it was worse than usual at the time when it was probably infected. One consumer spoke of it as having been at the time offensive in taste and odor. It is instructive to note that mere pollution seems to have done no obvious harm. Specific infection, however, pro- duced Asiatic cholera. Mr. Whitehead in his singularly fair and candid report raises an interesting question, viz: Why, if an early and unrecognized case in the house in question brought about infection of the well, should not the four severer cases of 104 HISTORY. OF SANITATION undoubted cholera subsequently in the same house, with no known change in the drainage, have produced even greater disaster? This question remains unanswered, ex- cept that after the removal of the pump handle on the 8th of September access to the well was shut off, and during the intermediate week the well may have been avoided by the frightened people; or owing to illness less water may have been used in No. 4o Broad Street, so that the cess- pool did not overflow, or some other condition unknown may have been changed.”’ Following closely on the heels of the report of the Cholera Inquiry Commission came an event, which, though fraught with no danger, nevertheless did more to call attention of people in general and lawmakers in particular to the necessity for sanitary surroundings and the danger of polluted water supply, than had all the epidemics of cholera and typhoid fever which had preceded. This event was one of the most famous stinks recorded, if not the most famous, and arose from the Thames in London in 1858 and 1859. The following account of this historic stink is by Der Budd:* ‘‘The need of some radical modification in the view commonly taken of the relation which subsists between typhoid fever and sewage was placed in a very striking light by the state of the public health in London during the hot months of 1858 and 1859, when the Thames stank so badly. The late Dr. McWilliam pointed out at the time, in fitting and emphatic terms, the utter inconsistency of the facts with the received notion of the subject. Never before had nature laid down the data for the solution of a problem of this kind in terms so large, or wrought them out to so decisive an issue. As the lesson then taught us seems to be already well nigh forgotten, I may perhaps be allowed to recall some of its most salient points. The occasion, indeed, as has already been hinted, was no common one. An extreme case, a gigantic scale in the phenomena, and perfect accuracy in the registration of the * Typhoid Fever, tts Nature, Mode of Spreading and Prevention. HISTORY OF SANITATION 105 results—three of the best of all the guarantees against fal- lacy—were combined to make the inductions sure. For the first time in the history of man, the sewage of nearly three millions of people had been brought to seethe and ferment under a burning sun, in one vast open cloaca lying in their midst. The result we all know. Stench so foul we may well believe had never before ascended to pollute this lower air. Never before at least had a stink risen to the height of an historic event. Even ancient fable failed to furnish figures adequate to convey a conception of its thrice-Augean foulness. For many weeks the atmosphere of Parliamentary committee rooms was only rendered barely tolerable by the suspension before every window of blinds saturated with chloride of lime, and by the lavish use of this and other disinfectants. More than once, in spite of similar precautions, the law courts were suddenly broken -up by an insupportable invasion of the noxious vapor. The river steamers lost their accustomed traffic, and travelers pressed for time often made circuit of many miles rather than cross one of the city bridges. For months together the topic almost monopolized the public prints. Day after day, week after week, the 770s teemed with letters filled with complaint, prophetic of calamity or suggesting remedies. Here and there a more than commonly passionate appeal showed how intensely the evil was felt by those who were condemned to dwell on the Stygian banks. At home and abroad the state of the chief river was felt to be a national reproach. ‘‘India is in Revolt, and the Thames Stinks,” were the two great facts coupled together by a distinguished foreign writer to mark the climax of a national humiliation. But more sig- nificant still of the magnitude of the nuisance was the fact that five million pounds in money were cheerfully voted by a heavily-taxed community to provide the means for its abatement. With the popular views as to the connection between epidemic disease and putrescent gases, this state of things naturally gave rise to the worst forebodings. Members of Parliament and noble lords, dabblers in 106 HISTORY OF SANITATION sanitary science, vied with professional sanitarians in pre- dicting pestilence. If London should happily be spared the cholera, decimation by fever was at least a certainty. The occurrence of a case of malignant cholera in the person of a Thames waterman, early in the summer, was more than once cited to give point to these warnings, and as fore- shadowing what was to come. Meanwhile the hot weather passed away; the returns of sickness and mortality were made up, and, strange to relate, the result showed not only a death rate below the average, but as the leading peculiarity of the season, a remarkable diminution in the prevalence of fever, diarrhoea and the other forms of disease commonly ascribed to putrid emanations.” While the historical stink of the Thames was without apparent effect on the public health, the nuisance caused was so great and the fear engendered was so real, that much good was the immediate result. One of the most lasting and far reaching benefits was the appointment by Parliament of a Rivers Pollution Commission, to study into and devise ways for the prevention
Key Takeaways
- The Broad Street pump well in London was identified as the source of a cholera outbreak.
- Dr. Snow’s investigation provided critical evidence linking contaminated water to cholera cases.
- The Thames stink event highlighted the dangers of untreated sewage and spurred legislative action.
Practical Tips
- Always ensure your drinking water is clean and free from contaminants, especially in areas with a history of waterborne diseases.
- Install water filters at home to remove potential pathogens before consumption.
- Be aware of signs of contaminated water sources such as unusual odors or colors.
Warnings & Risks
- Do not assume that cold water is safe; it can still contain harmful bacteria and viruses.
- Avoid using water from questionable sources, especially during outbreaks of waterborne illnesses.
- Regularly check and maintain your water filtration systems to ensure they are functioning properly.
Modern Application
While the specific techniques used in the 19th century have been improved upon, the fundamental principles of clean water and proper sanitation remain crucial. Modern water treatment plants and filtration systems can prevent many of the same issues that plagued London during the cholera outbreaks. Understanding these historical lessons helps us appreciate the importance of modern public health measures.
Frequently Asked Questions
Q: How did Dr. Snow identify the Broad Street pump as the source of the cholera outbreak?
Dr. Snow identified the Broad Street pump by analyzing patterns in cholera cases, noting that those who drank water from this particular pump were more likely to contract cholera. He also used statistical evidence and case studies, such as the death of a gentleman who consumed water from the pump before falling ill.
Q: What was the significance of the Thames stink event in 1858-1859?
The Thames stink event highlighted the dangers of untreated sewage and spurred legislative action. Despite the foul smell, there was a remarkable decrease in disease rates that year, which challenged prevailing theories about the connection between putrescent gases and epidemic diseases.
Q: What evidence did Dr. Snow provide to support his theory about the Broad Street pump?
Dr. Snow provided statistical evidence showing that those who drank water from the Broad Street pump were more likely to contract cholera. He also used case studies, such as a gentleman who consumed water from the pump before falling ill, and detailed investigations of the well's condition.