London, 1854. The most populous city in Europe is almost literally an open sewer. So bad is the waste disposal system that “night-soil men” are paid to unclog the unmentionably horrific material causing backup in the city’s sewers. Unfortunately, their means of disposal involves merely transporting that material to the farthest reaches of the city. But that isn’t where it all winds up. Scavengers picking through the transported sewer clogs can also get in on the revenue of waste disposal by selling whatever they find of worth.
On August 28, Sarah Lewis called for a doctor for help with her infant baby who was terribly ill with noxious emissions existing from both ends. She took one of the soiled diapers, walked down to her cellar and casually turned the clothe into a disposable diaper by tossing it into the cesspool there. The 1854 cholera outbreak in London had begun.
From that point on, the story essentially becomes a tale of two men and a conflict between two opposing theories: miasma versus contagion. One is a priest living near the Soho neighborhood of Lewis. Whitehead is known and respected within the community because of his religious position, but also because of his interest and work in trying to nail down the cause and effect which results in the spread of cholera. He adopts and becomes the leading proponent of the miasma theory which assumes transmission through airborne contamination resulting from the
John Snow, meanwhile, had made his way from a simple working-class existence to the cream of the crop of London’s medical world. He was already a groundbreaking anesthesiologist who had been compiling information about cholera since an outbreak in 1848. He is the figurehead for the revolutionary theory that explains the spread of cholera through contagion. The idea of transmission from one person to another is, at the time, not merely revolutionary, but considered an affront to common sense.
Snow, convinced his contagion theory was correct based on all the research he’d conducted and the findings his collected, found himself going up against a brick wall in the form of Edwin Chadwick, head of London’s General Board of Health and, as a result, one of the most influential men in the city on all matters regarding science and sickness. Support for the miasma theory—which seems ludicrous to people now—actually fit in with the long accepted though egregiously misguided belief that foul odors naturally had an inextricable connection to the cause of bad health. That fact that this belief also contributed to class distinctions which unfairly targeted the poor did not even enter in the intellectual calculus. Intellectually speaking, however, Chadwick’s prejudicial insistence upon connecting bad odors with bad health actually resulted in even more bad health when his solution to addressing the problem led to the “night-soil men” and the transportation of untold tons of sewer waste directly into the Thames.
Snow and Whitehead, meanwhile, were both visiting homes in Soho to gain more information and the more Snow learned, the more convinced he became that the primary source of cholera could be narrowed down to one single water pump on Broad Street which everybody was mistakenly assuming was actually a source for clean water. In reality, it had been contaminated.
An emergency meeting off community officials was held at which Snow presented his findings along with the recommendation to remove the Broad Street water pump. Surprisingly, the board of governors agreed—though not without some fair amount of trepidation—with the result being an greater reduction in the number of new cases which had, admittedly, already been slowing. Within months, Sir Benjamin Hall announced to the public that the General Board of Health had formed a special committee to conduct further intensive study into the cause of the cholera outbreak. Hall, however, was also a solid member of the brick wall supporting the miasma theory and disregarding Snow’s contagion explanation. As a result, the investigation commence upon an unsound premise which naturally led to corrupted results.
Meanwhile, Henry Whitehead had also been called upon to investigate the cause of the epidemic. Working for St. James Vestry, Whitehead initially launched his study still completely in full opposition to Snow. In fact, Whitehead had even been among those who were not mere feeling trepidation about removing the Broad Street water pump, but actively opposed the measure. His visits to Soho homes and families suffering from the disease had come to a very different conclusion: those who had consumed water from it actually attributed their recovery to the Broad Street pump. As he conducted his investigation at the behest of St. James, however, Whitehead found that the evidence kept pointing to Snow having been right all along. He also pinpointed that diaper Sarah Lewis tossed into the cesspool—as well as all the diapers she’d been throwing into it—as quite possibly the point of origination for the entire Soho epidemic.
At the same time that Whitehead was transforming into a powerfully influential supporter, John Snow’s further investigations has disclosed the story of two siblings in Soho whose mother died of cholera shortly after they had sent her drinking water pumped from Broad Street. Even more tellingly, Snow had discovered the smoking gun: the evidence strongly suggested that cholera was unknown among Soho residents who had never drank water from the Broad Street pump. This was all that was needed to shift Whitehead firmly onto Team Snow: both men now supported the contagion theory and dismissed the miasma explanation.
Despite the evidence and despite the backing of such a respected and influential member of the community as Whitehead, the world was no different in 1855 than it had been in 1854. Hall and Chadwick remained just as stubbornly convinced of the miasma explanation as ever and actually became even more pronounced in their opposition to contagion theory. Chadwick would openly denounce the entire theory as illogical and from there the attacks by others on Snow became personal and offensive. In 1858, Snow would die as the result of a stroke at the age of 45. As a result, he would not live to see his theories finally gain acceptance and policy changes put into place. This would not happen until 1866 when another cholera outbreak finally stimulated nearly unanimous acceptance of Snow’s theory and the first emergency order issued by the government to avoid drinking any water which had not first been boiled.
