The History of Medicine: A Very Short Introduction (Very Short Introductions) by William Bynum

Author:William Bynum [Bynum, William]
Language: eng
Format: epub, mobi
Publisher: Oxford University Press
Published: 2008-07-30T16:00:00+00:00

Throughout his long life, Chadwick never abandoned his notion of filth disease, nor of the healing power of cleanliness. He left office against his will, in 1854, despite the return of cholera. His dictatorial style made too many enemies, and he wanted compulsory legislation to enter through the front door. It came, piecemeal and gradually, through the back one.

In the meantime, the nature of filth diseases was being reconceptualized. Only in hindsight did people realize that the Italian microscopist Filippo Pacini (1812–83) had described during the 1854 pandemic the causative organism of cholera. Of equal moment, the London anaesthetist, epidemiologist, and general practitioner John Snow (1813–58) demonstrated that cholera is not air but water borne. Snow was a medical apprentice during the original cholera outbreak in 1831–2, and studied the disease as an established and ambitious practitioner during the 1848 and 1854 London epidemics. He provided good evidence from the 1848 epidemic that the disease was transmitted through water contaminated by faeces; he nailed his case through two classic community experiments during 1854. The Broad Street Pump is the most famous – the stuff of legends. This pump, in Soho, central London (the street is now called Broadwick Street), served many houses, most of which had no direct access to running water. By systematically investigating house to house the cases that occurred in the area of a single water pump, and tracing cases further afield from people who had drunk water from the pump, he incriminated it as the source of the disease. An open sewer drained into it. The dramatic removal of the pump handle was more symbolic than effective, since the epidemic was already on the wane, but the incident attracted a good deal of attention.

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