On the mode of communication of cholera — John Shaqi
On the mode of communication of choleraSnow, John
History
On the mode of communication of cholera
Snow, John
Cholera
There were a few cases of cholera in the neighbourhood of Broad Street,
Golden Square, in the latter part of August; and the so-called outbreak,
which commenced in the night between the 31st August and the 1st
September, was, as in all similar instances, only a violent increase of
the malady. As soon as I became acquainted with the situation and extent
of this irruption of cholera, I suspected some contamination of the
water of the much-frequented street pump in Broad Street, near the end
of Cambridge Street; but on examining the water, on the evening of the
3rd September, I found so little impurity in it of an organic nature,
that I hesitated to come to a conclusion. Further inquiry, however,
showed me that there was no other circumstance or agent common to the
circumscribed locality in which this sudden increase of cholera
occurred, and not extending beyond it, except the water of the above
mentioned pump. I found, moreover, that the water varied, during the
next two days, in the amount of organic impurity, visible to the naked
eye, on close inspection, in the form of small white, flocculent
particles; and I concluded that, at the commencement of the outbreak, it
might possibly have been still more impure. I requested permission,
therefore, to take a list, at the General Register Office, of the deaths
from cholera, registered during the week ending 2nd September, in the
sub-districts of Golden Square, Berwick Street, and St. Ann’s, Soho,
which was kindly granted. Eighty-nine deaths from cholera were
registered, during the week, in the three sub-districts. Of these, only
six occurred in the four first days of the week; four occurred on
Thursday, the 31st August; and the remaining seventy-nine on Friday and
Saturday. I considered, therefore, that the outbreak commenced on the
Thursday; and I made inquiry, in detail, respecting the eighty-three
deaths registered as having taken place during the last three days of
the week.
On proceeding to the spot, I found that nearly all the deaths had taken
place within a short distance of the pump. There were only ten deaths in
houses situated decidedly nearer to another street pump. In five of
these cases the families of the deceased persons informed me that they
always sent to the pump in Broad Street, as they preferred the water to
that of the pump which was nearer. In three other cases, the deceased
were children who went to school near the pump in Broad Street. Two of
them were known to drink the water; and the parents of the third think
it probable that it did so. The other two deaths, beyond the district
which this pump supplies, represent only the amount of mortality from
cholera that was occurring before the irruption took place.
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