Cholera and the Water Supply in the South Districts of London in 1854Snow, John
History
Cholera and the Water Supply in the South Districts of London in 1854
Snow, John
Cholera -- England -- London -- Epidemiology; Water-supply -- England -- London
I gave a copy of the first results of my inquiry to Dr. Farr, to whom I
was indebted for facilities very kindly afforded: and Dr. Farr being
much struck with these results, instituted a continuance of the inquiry
through the district registrars, who were requested to make a return of
the supply of water to each house in which a fatal attack of cholera
might occur in all the south districts of London. As the registrars
could not be expected to make a chemical analysis of the water, or to
seek out the landlord or agent in cases where the tenant was not
acquainted with the water supply, the question remained unanswered in a
considerable number of instances, but the return was obtained for more
than three-fourths of the deaths, and shows, no doubt, the correct
proportion. Dr. Farr’s inquiry commenced from the 27th of August, and
extended to the close of the epidemic; and as my inquiry extended to
August 26th, the water supply was obtained for the whole epidemic of
1854. It was only necessary to make a computation of the small number of
attacks occurring in houses supplied by pump wells or some other source,
in the three weeks—the 5th to the 7th inclusive—of the epidemic, in
Bermondsey and the other districts which do not receive the Lambeth
water. This computation was made according to the result ascertained in
the previous four weeks, and must approach very nearly to the truth.
In treating of the general results of this inquiry, it is desirable to
divide the epidemic into different periods, as the influence of the
water supply was found to diminish in relative intensity as the epidemic
progressed. In the first four weeks of the epidemic of 1854, that is,
from July 9th to August 5th inclusive, there were 334 deaths from
cholera in the districts to which the supply of the two water companies
we are considering extends. The water supply in every one of these
instances was made a matter of personal inquiry, and the result of each
case was published by me in detail in the Appendix to a work on Cholera.
In 286 instances the supply of the house in which the attack took place
was that of the Southwark and Vauxhall Company; in 14 instances it was
that of the Lambeth Company; in 4 cases the supply was from a pump well;
in 26 cases the water was drawn direct from the river, or a canal, or a
tidal ditch; and in 4 cases the supply could not be ascertained, owing
to the address of the deceased persons, prior to the fatal attack, not
being known. The number of houses supplied by the Southwark and Vauxhall
Company was 40,046, having a population estimated by the
Registrar-General[3] at 266,516, and the number of houses supplied by
the Lambeth Company was 26,107, with an estimated population of 173,748;
the mortality from cholera was, therefore, at the rate of 107 to each
100,000 inhabitants supplied by the former company, and 8 to each
100,000 supplied by the latter; in other words, the disease was between
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