WEBVTT - John Snow's Ghost Map

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<v Speaker 1>Welcome to Stuff You Missed in History Class from how

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<v Speaker 1>Stuff Works dot Com. Hello and welcome to the podcast.

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<v Speaker 1>I'm Katie Lamberg, joined by Sarah Dowdy. How are you, Sarah?

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<v Speaker 1>I'm great, Katie, How are you? He won't be as

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<v Speaker 1>great once we start talking about what we're talking about.

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<v Speaker 1>Which was a listener request Janie from d C wanted

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<v Speaker 1>to hear all about John Snow and the cholera outbreak

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<v Speaker 1>in Victorian London. I don't know. I'm kind of a

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<v Speaker 1>fan of slummy Victorian London, so I think I'm going

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<v Speaker 1>to enjoy this one. John Snow was born in eighteen

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<v Speaker 1>thirteen in Yorkshire, England, and he was actually the son

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<v Speaker 1>of a coal yard laborer, but quickly gets into the

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<v Speaker 1>medical field at fourteen, when he starts three consecutive apprenticeships

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<v Speaker 1>and first encounters cholera. Not that long after, while visiting

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<v Speaker 1>coal miners in eighteen thirty one, he gets, you know,

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<v Speaker 1>his first exposure to contagious disease. He doesn't begin his

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<v Speaker 1>formal medical education until eighteen thirty six, but he gets

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<v Speaker 1>his m d in eighteen forty four from the University

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<v Speaker 1>of London and by eighteen forty nine He is a

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<v Speaker 1>licensed specialist of the Royal College of Physicians of London,

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<v Speaker 1>which was a really elite organization. Yeah, this guy gets

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<v Speaker 1>big fast. Um. He kind of enters the realm of

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<v Speaker 1>what today we'd probably call a celebrity doctor, especially when

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<v Speaker 1>he treats Queen Victoria. That's because he learned about ether

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<v Speaker 1>being used in America but pioneered how it was dispensed. Right,

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<v Speaker 1>So he helps Queen Victoria through her childbirth, on the

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<v Speaker 1>birth of Prince Leopold and Princess Beatrice, and makes the

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<v Speaker 1>public more accepting of the process at all if Victoria

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<v Speaker 1>is into it, whether it's Christmas trees or big white

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<v Speaker 1>weddings or ether. The Kingdom likes to trends center Victoria.

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<v Speaker 1>But we don't think of him today for his work

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<v Speaker 1>in anesthesia. We think about him for is pioneering work

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<v Speaker 1>in germ theory. And to do that will give a

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<v Speaker 1>little background first about Victorian London, which was really disgustingly dirty.

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<v Speaker 1>The life expectancy for a gentleman in Victorian London was

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<v Speaker 1>forty five, but if you were a tradesman it was

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<v Speaker 1>your mid twenties. So I would be killed off by now,

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<v Speaker 1>and so would you say, and London was really really stinky,

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<v Speaker 1>like known worldwide for being stinky. It was the biggest

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<v Speaker 1>city in the world. But sewage was just piled up everywhere.

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<v Speaker 1>Toilets drained into basement sesspits, so there would just be

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<v Speaker 1>piles and piles of sewage in your basement, stinking too

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<v Speaker 1>high heaven, and the sus pits were flushed into the

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<v Speaker 1>river if they were cleaned, which of course is where

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<v Speaker 1>everyone got their water. Maybe you can see where this

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<v Speaker 1>is going. So needless to say, London, overcrowded, dirty, stinky,

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<v Speaker 1>a good place for diseases to spread. And at the time,

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<v Speaker 1>it was thought of that diseases came from my asthma

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<v Speaker 1>or bad air from decayed organic matter, so bad smells

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<v Speaker 1>meant disease, and when the entire city stinks, people thought

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<v Speaker 1>you were getting sick from the sewage. There's also a

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<v Speaker 1>moral element to the whole myasthma theory, uh that stinky

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<v Speaker 1>people were you know, unclean and more prone to disease,

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<v Speaker 1>not just because they were poor and destitute and living

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<v Speaker 1>in overcrowded pubbles. They were morally unsound, so too bad

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<v Speaker 1>for you poor people to Victoria in London, everyone thought

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<v Speaker 1>your illness was your own darn fault. So Snow doesn't

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<v Speaker 1>buy this though. He thinks that diseases are caused by

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<v Speaker 1>some agent, not by a smell, right, So they started

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<v Speaker 1>calling that germ theory. And so we've got these two

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<v Speaker 1>philosophies that are kind of going head to head, and

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<v Speaker 1>they go head to head for for decades, surprisingly enough

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<v Speaker 1>to to us, who you know, my asthma sounds like

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<v Speaker 1>such a bad idea, um, But people aren't quick to

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<v Speaker 1>buy germ theory. So there have been a few outbreaks

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<v Speaker 1>of cholera in London. The eighteen forty eighteen forty nine

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<v Speaker 1>Color outbreak killed fifty thousand people. And this is where

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<v Speaker 1>John Snow wants to figure out how this is happening.

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<v Speaker 1>Color is not a pretty disease. You die from basically

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<v Speaker 1>diarrhea that's unstoppable, and various digestive ills. You die from

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<v Speaker 1>dehydration because your body doesn't have any fluid left, and

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<v Speaker 1>you can die really quickly, like within a day. So

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<v Speaker 1>John Snow wants to figure out this germ theory and

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<v Speaker 1>see if he can prove it. But in that particular outbreak,

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<v Speaker 1>there weren't a public death records and he couldn't figure

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<v Speaker 1>out who was giving water to witch households, so this

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<v Speaker 1>wasn't a good test case for him. And in the

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<v Speaker 1>summer of eighteen fifty four, another collar outbreak happens. Seven

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<v Speaker 1>people are dead in two weeks, and this is when

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<v Speaker 1>he starts his experimentation and runs around testing water and

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<v Speaker 1>interviewing people and trying to figure out where this is

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<v Speaker 1>coming from so he can stop it. And he performed

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<v Speaker 1>two classic experiments during this eighteen fifty four outbreak UM.

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<v Speaker 1>The first was the Broad Street Pump outbreak experiment, which

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<v Speaker 1>is my favorite. He's like Sherlock Holmes of medicine and

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<v Speaker 1>it's pretty amazing. So UM, in the Soho district of London,

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<v Speaker 1>where he's actually based his medical offices are actually based,

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<v Speaker 1>there is a sudden case of cholera. Seventy fatalities within

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<v Speaker 1>a twenty four hour period, most of them within five

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<v Speaker 1>square blocks UM, and all of these fatalities are based

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<v Speaker 1>around the Broad Street Pump, which is a free water

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<v Speaker 1>pump for the poor. It draws the water from a

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<v Speaker 1>well underneath the Golden Square, which has some of London's porous,

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<v Speaker 1>most overcrowded people. So in the last week of August

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<v Speaker 1>eighteen fifty four, all the residents of Golden Square start dying.

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<v Speaker 1>And it starts with an upset stomach and then goes

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<v Speaker 1>to vomiting and severe cramps in the gut, and then

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<v Speaker 1>to diarrhea and thirst, and then, like we said, death

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<v Speaker 1>from dehydration, and it's fast to kill. Some people are

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<v Speaker 1>dying within twelve hours after it starts, and it's really

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<v Speaker 1>fast to spread. So the medical authorities are pretty quick

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<v Speaker 1>to identify this as cholera, and Snow moves in to

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<v Speaker 1>start studying what's happening, and he takes a really multidiscipline approach.

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<v Speaker 1>He looks at water samples and sees, you know, what

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<v Speaker 1>he can find in the water, but he also starts

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<v Speaker 1>looking at the maps of London dead or the weekly

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<v Speaker 1>statistics about who's dying of cholera in London, looking for

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<v Speaker 1>geographical patterns, and he draws a ghost map that showed

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<v Speaker 1>a correlation between cholera cases in this neighbor hood and

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<v Speaker 1>the Broad Street pump. Basically, if you lived within walking

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<v Speaker 1>distance of the Broad Street pump, if that was your

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<v Speaker 1>nearest water source, you were very likely to come down

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<v Speaker 1>with cholera. And it's really intense. You can find a

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<v Speaker 1>bunch of them online, of the ghost maps, but they're

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<v Speaker 1>just black lines everywhere showing people. They're very disturbing, little

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<v Speaker 1>stacks of black lines. And you'll see the pump location

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<v Speaker 1>in the houses immediately adjacent to the pump just have

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<v Speaker 1>these huge stacks of black lines coming from them. And

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<v Speaker 1>this is part of the reason he's called the father

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<v Speaker 1>of modern epidemiology and starts right here. Um So, after

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<v Speaker 1>about a week he goes to the local Board of

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<v Speaker 1>Guardians of St. James Parish with his findings with this

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<v Speaker 1>ghost map, and Um convinces them to shut down the

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<v Speaker 1>Broad Street pump, to take the literally take the handle

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<v Speaker 1>off the pump so people can't use it. And they're

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<v Speaker 1>not totally into it, though, are They know, they're still

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<v Speaker 1>thinking about the whole myasthma thing. So they're engaged in

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<v Speaker 1>this pursuit to spread lime all over the streets because

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<v Speaker 1>that'll kill the snows. That will kill it. But they decide, okay,

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<v Speaker 1>so let's go ahead and take the pump handle off,

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<v Speaker 1>and surprise, surprise, the outbreak ends. But what's so great

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<v Speaker 1>about Snow's experiment here is he doesn't just look at

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<v Speaker 1>the overwhelming evidence on the side of if you, you know,

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<v Speaker 1>drink this water, you very well might get sick. He

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<v Speaker 1>looks at kind of the statistical outliers. Yes, he's very thorough.

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<v Speaker 1>I love this. Yeah he um. There's some school children

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<v Speaker 1>who don't live near the pump who end up dying.

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<v Speaker 1>He reasons that they passed by the pump on their

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<v Speaker 1>way to school. And my favorite, there's a widow in

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<v Speaker 1>West End Hampstead and her niece in Isilington and they

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<v Speaker 1>got sick, but neither of them had been anywhere near

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<v Speaker 1>so how So he did some investigation, did some interviewing

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<v Speaker 1>and discovered that the widow had once lived on Broad

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<v Speaker 1>Street and liked the taste of the well water so

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<v Speaker 1>much that she had a servant go to Soho every

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<v Speaker 1>day and bring her back a bottle of it to drink.

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<v Speaker 1>It's like when you go to Florida, South Georgia and

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<v Speaker 1>you like, bring your Atlanta water. Um. So yeah, And

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<v Speaker 1>he actually finds the last bottle of water that the

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<v Speaker 1>widow had gotten was from August thirty one, which is

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<v Speaker 1>the start of the epidemics, So bad bad timing there.

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<v Speaker 1>There's also an army officer living in St. John's Woods,

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<v Speaker 1>who dies after dining in Water Street where he had

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<v Speaker 1>drunk in a glass of water from the Broad Street well.

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<v Speaker 1>And he also, in his thoroughness looks at the people

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<v Speaker 1>who didn't get sick. So the people at the Poland

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<v Speaker 1>Street workhouse are just around the corner from the Broad

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<v Speaker 1>Street pumps. So I mean, if you're thinking about it,

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<v Speaker 1>they should have been sick, but they weren't. And so

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<v Speaker 1>he went and looked into that. And that's because the

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<v Speaker 1>workhouse had its very own water source. They weren't using

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<v Speaker 1>a Broad Street pimp. And that's also a good case

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<v Speaker 1>against the maas a theory. These people are in the workhouse,

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<v Speaker 1>they're dirty, they're more likely to be morally corrupt, but

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<v Speaker 1>here they are, you know, safe from cholera. Also, the

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<v Speaker 1>Broad Street Brewery, which you know, right down the street

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<v Speaker 1>from the pump um no deaths because the workers are

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<v Speaker 1>given a daily beer allowance, so they don't need to

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<v Speaker 1>drink water. I feel like there's a lesson in there

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<v Speaker 1>somewhere for my bosses. He also has the help of

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<v Speaker 1>Reverend Henry Whitehead, who's the vicar of St. Luke's Church,

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<v Speaker 1>and Whitehead actually wasn't originally on his side. He thought

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<v Speaker 1>the outbreak was caused by God's intervention, and he started

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<v Speaker 1>a report to prove it, but it actually only ended

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<v Speaker 1>up confirming John Snow's study. But he was man enough

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<v Speaker 1>to come to a minute to Snow and admit, you know,

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<v Speaker 1>my research is the same as years, and he actually

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<v Speaker 1>helps Snow track down the source of the local outbreak

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<v Speaker 1>of sick child at number four the broad Street, right

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<v Speaker 1>near the pump um had had his diapers washed and

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<v Speaker 1>the water was dumped into a cesspool. It's only a

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<v Speaker 1>few feet away from the well, and after the child died,

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<v Speaker 1>no more diaper pail water had been dropped in that

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<v Speaker 1>cesspitse so people stopped getting sick. So later in the

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<v Speaker 1>year our Sherlock Holmes John Snow conducts a grand experiment

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<v Speaker 1>and he compares the London neighborhoods who are receiving water

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<v Speaker 1>from two different companies, and one company uses water that

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<v Speaker 1>comes from the Upper Thames and the other uses water

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<v Speaker 1>that comes from the heart of London. And interestingly, Parliament

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<v Speaker 1>had actually required the Metropolitan water companies to improve the

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<v Speaker 1>quality of their intake, but not all of them had complied.

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<v Speaker 1>And of course sewage is being dumped into the Thames.

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<v Speaker 1>The sanitation commissioner named Edwin Chadwick believed in the miasma thing,

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<v Speaker 1>and he thought that if you dumped sewage in the river,

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<v Speaker 1>you were keeping bat air away from people. So he

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<v Speaker 1>thought what he was doing was actually really good. But

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<v Speaker 1>of course he's dumping sewage into water that's then getting

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<v Speaker 1>turned into drinking water. But this dual water company thing

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<v Speaker 1>kind of presents the perfect opportunity for an experiment for

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<v Speaker 1>Snow because the companies were rivals and it had at

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<v Speaker 1>one point competed head to head. So some houses had

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<v Speaker 1>mans from one company while their next door neighbor had

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<v Speaker 1>a man from the other company. So essentially you had

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<v Speaker 1>this controlled experiment. Everything was the same in this neighborhood

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<v Speaker 1>except for the water where they got their water from.

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<v Speaker 1>And it turned out for people who got the London

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<v Speaker 1>sourced water, they had a much higher chance of contracting cholera.

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<v Speaker 1>And Snow is overjoyed because he thinks, wow, he's finally

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<v Speaker 1>proved it. The ratio of people who died from one

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<v Speaker 1>source of water versus the other was something ridiculous like

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<v Speaker 1>seventy five to five. I mean, if that's not proof,

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<v Speaker 1>you know, what is, and he suggests intervention strategies to

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<v Speaker 1>control epidemics extend. He's thinks that he's proven that contaminated

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<v Speaker 1>water is what gets people, but it didn't seem to stick. No,

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<v Speaker 1>people are still stuck on the miasma theory and it's

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<v Speaker 1>not sadly, it's not really until the eighteen eighties when

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<v Speaker 1>germ theory is, you know, golden people, people go with

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<v Speaker 1>that when the causative organism of cholera fabrio cholera is

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<v Speaker 1>actually finally understood. So when John Snow died in eighteen

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<v Speaker 1>fifty eight, people still thought it was my asthma, and

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<v Speaker 1>no one accepted all the things he'd worked out so hard.

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<v Speaker 1>Chadwick was still suggesting ridiculous things. At one point he

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<v Speaker 1>was quoted as saying, all smell is if it be intense,

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<v Speaker 1>immediate acute disease. And in the eighteen nineties he suggested

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<v Speaker 1>bringing down fresh air from places like the Eiffel Tower

0:13:55.200 --> 0:14:00.400
<v Speaker 1>and distributing it. We're discussing how that would actually be done,

0:14:00.800 --> 0:14:03.080
<v Speaker 1>Like how how do you get to the air and

0:14:03.120 --> 0:14:09.320
<v Speaker 1>then distribute it. I can't ask Mr Chadwick. The Great

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<v Speaker 1>Stink of eighteen fifty eight, which is my favorite name

0:14:12.720 --> 0:14:15.920
<v Speaker 1>of anything that has ever happened. Ever is what starts

0:14:15.960 --> 0:14:21.280
<v Speaker 1>to change things. Because this summer was incredibly hot and

0:14:21.400 --> 0:14:25.080
<v Speaker 1>sewage was everywhere in London. The flush toilets were overflowing

0:14:25.080 --> 0:14:27.880
<v Speaker 1>the basement cesspits which are going into the street drains,

0:14:28.800 --> 0:14:30.680
<v Speaker 1>and I mean it was so bad. No one wanted

0:14:30.720 --> 0:14:33.360
<v Speaker 1>to be in the city. It was so horrible. The

0:14:33.400 --> 0:14:36.400
<v Speaker 1>people in the House of Commons were draping their curtains

0:14:36.440 --> 0:14:39.600
<v Speaker 1>and soaking them in cloride of lime just so they

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<v Speaker 1>wouldn't be smelling the sewage. And so a committee was

0:14:43.040 --> 0:14:44.880
<v Speaker 1>set up to figure out how to fix the stink.

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<v Speaker 1>And this is where the modernization of the sewage system

0:14:47.760 --> 0:14:52.360
<v Speaker 1>in London started to happen. So even though sanitation is

0:14:52.560 --> 0:14:56.440
<v Speaker 1>much better in London today, it's still a problem in

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<v Speaker 1>a lot of places in the world, and cholera is

0:14:59.200 --> 0:15:03.880
<v Speaker 1>actually still causing a lot of deaths. Diarrhea is one

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<v Speaker 1>of the leading causes of death for kids in the

0:15:06.160 --> 0:15:10.400
<v Speaker 1>developing world. There's a treatment for it today, oral rehydration salts,

0:15:10.520 --> 0:15:14.520
<v Speaker 1>which you know, basically keep you from dying of dehydration

0:15:14.640 --> 0:15:19.040
<v Speaker 1>in twelve hours twenty four hours, and it's um it's

0:15:19.200 --> 0:15:24.200
<v Speaker 1>estimated that it's prevented forty million death since nineteen So

0:15:24.240 --> 0:15:26.720
<v Speaker 1>today we'd like to give thanks to John's Snow and

0:15:26.880 --> 0:15:30.320
<v Speaker 1>his amazing investigative work, and we recommend the book The

0:15:30.320 --> 0:15:33.200
<v Speaker 1>Ghost Map if you hadn't picked it up. And if

0:15:33.200 --> 0:15:36.480
<v Speaker 1>you'd like to learn more about infectious diseases and safe

0:15:36.480 --> 0:15:39.760
<v Speaker 1>water supply, come to how stuff Works and also check

0:15:39.800 --> 0:15:42.440
<v Speaker 1>out the blog on our homepage at www dot how

0:15:42.480 --> 0:15:46.200
<v Speaker 1>stuff works dot com. For more on this and thousands

0:15:46.200 --> 0:15:49.760
<v Speaker 1>of other topics, visit how stuff works dot com. Let

0:15:49.840 --> 0:15:52.480
<v Speaker 1>us know what you think. Send an email to podcast

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<v Speaker 1>and how stuff works dot com and be sure to

0:15:55.040 --> 0:15:57.160
<v Speaker 1>check out the stuff you missed in History Glass blog

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<v Speaker 1>on the how stuff works dot com home page