History of Infectious Disease Pandemics in Urban Societies by Hardt Mark D

Author:Hardt, Mark D.
Language: eng
Format: epub
Tags: undefined
Publisher: Lexington Books, a division of Rowman & Littlefield Publishers, Inc.
Published: 2012-02-15T16:00:00+00:00

Paradigmatic Resistance:

The Ossification of the Past

Snow presented his finding to local officials who subsequently had the pump handle removed. Shortly thereafter the epidemic subsided. His efforts were met with three counterarguments. First, the epidemic had already appeared to be slowing before the removal of the pump handle. Thus his critics dismissed his hypothesis on that ground. Second, his hypothesis was the very antithesis of the prevailing miasma theory. Accordingly, miasma proponents and Snow opponents found the hypothesis to make little, if any, sense. Third, his theory did not include any microscopic support. Parenthetically, this is an argument the tobacco industry later made (that microcausation of cancer by tobacco could not be proved). This third counterargument illuminates the difference between deterministic research, more common in the biological sciences, and probabilistic research that is more common among the social sciences.

In an effort to establish validity and reliability for his hypothesis that sewage-contaminated drinking water is the cause of cholera, Snow conducted a carefully controlled test the following year. In this test, he collected data on cholera mortality among three hundred thousand people in an area of London whose water supplies could be identified. In doing so, he relied on improvements to the Bills of Mortality established by William Farr. Snow then went door to door asking for the names of water suppliers. His results, matching population to water sources, demonstrated that the cholera mortality rates were far higher in households receiving water from suppliers with contaminated sources than were the rates in households receiving water from cleaner sources. Despite the strength and thoroughness of his evidence, the miasma weltanschauung remained so ingrained that the medical establishment once again rejected his findings. Nevertheless his approach to conducting research and his data collection technique of going door to door—now dubbed shoe leather epidemiology—establish John Snow as one of the founders of modern epidemiology.

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