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Cholera and the Broad Street Pump

You are Charles Abbott

Faction: Anti-contagionist
Ideological Reference: Thomas Sydenham

Your views on the causes of Cholera are consistent with  the historical arguments of Thomas Sydenham, who argued that an ‘epidemic constitution’ results from fluctuating atmospheric conditions and changes in season. This epidemic constitution acts upon an individual’s internal humoral condition, and the influence of the two ultimately determines whether someone falls ill or not.


GENERAL DIRECTIVE:

You are a member of the special Sanitary Committee of the Board of Governors and Directors of the Poor of St. James Parish. On 14 August 1854, you and your colleagues on the General Board of Governors and Directors of the Poor voted to forgo standard meeting protocols and form this special emergency response committee to address any threat of Malignant Cholera throughout the parish. Collectively, you wield the power and financial backing to make whatever arrangements you deem necessary regarding administrative courses of action, medical responses, future meetings, etc.


REQUIRED READINGS

•    Chapter 1 of The Ghost Map by Steven Johnson (2006).
•    Chapters 2 and 10 of Disease Maps: Epidemics on the Ground by Tom Koch (2011).
•    Anticontagionism between 1821 and 1867 by Erwin Ackerknecht (1948).


CHARACTER-SPECIFIC ONLINE RESOURCES

http://archive.org/details/worksofthomassyd02sydeiala

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2066736/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1933874/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2101773/

YOU ARE IN THE “Anti-contagionist” FACTION.

You and the other Anti-contagionist members of the Board believe that the Cholera outbreak may be explained by a number of physical, chemical and social factors, including: classic Hippocratic epidemic constitution, atmospheric influences, elevation above sea level, miasmas arising from exposure to decaying  animal or vegetable matter, diet, lifestyle and socioeconomic status. No human-to-human transmission is involved.

The Contagionist members of the  Board believe  that Cholera is transmitted by the direct passage  of some chemical, physical or biological agent originating  from  a sick person and transmitted to a susceptible victim by contact or fomites or, for relatively short distances, through the atmosphere.

The Indeterminate members of  the Board do not have fixed opinions as to the  origins of Cholera. As such, sound scientific arguments made by members of the  other factions may sway the opinion of these Board members.

PLEASE  NOTE: Although you and your faction colleagues may agree as to the general Anti-contagionist notions of disease, your specific beliefs may be quite   different. Over the course of our debate, and even outside of class, you may (and should) consult with  one another to  identify those issues  upon which  you can agree as well as those upon which you disagree. For the purposes of final voting on any measures of remediation and prevention, some degree of consensus is required; it is particularly clear that you cannot advance the Anti-contagionist agenda without soliciting the support of other, dissenting Board members. So, it will be important to develop arguments that will be convincing to Indeterminate Board members, whose votes will allow you to champion your own beliefs. Once you identify who are the Indeterminates, wisely use you time during the debate sessions and outside of class, via emails and in person as necessary, to compel them to join your cause.

SPECIFIC INSTRUCTIONS: The format of the meeting is divided into two class sessions. For Session I, you will prepare a short (< 1 page) written statement that introduces your character and your ideologies on Cholera. You will deliver this statement as a speech of roughly 1-2 minutes, detailing your position and making specific suggestions that can be debated and brought to a vote in Session II. You should address three questions: What is the source of the outbreak? How is Cholera communicated from person to person? And, what steps should be taken to contain the outbreak?

MEETING AGENDA

CLASS SESSION I: OPENING STATEMENTS AND PROPOSED RESPONSES
The Special Committee convenes on the evening of Thursday, 7 September 1854. In the course of your research, you should familiarize yourself with what has occurred over the past week. When invited by Chairman Frederick Crane, you will stand and deliver your personal statement. Also, listen intently and take notes as your colleagues make their presentations. Be sure to propose any specific remedial actions by the end of Session I so that these issues may be debated and brought to a final vote at the end of Session II.

 

INTERLUDE: JOHN SNOW GIVES HIS TESTIMONY AND RECOMMENDATION
Between the two class sessions, Dr. John Snow has requested to be heard by the Board and has testified that the Cholera outbreak is being driven by contaminated water originating from the pump located on Broad Street. He has recommended that the Board remove the handle from the Broad Street pump immediately, so as to interrupt public access to what he considers as a tainted water supply. In preparation for Session II, use the online Cholera Data Manager to examine closely the data upon which Dr. Snow bases his arguments. Also consult Dr. Snow’s map and the accompanying Excel spreadsheets to conduct your own analyses of these data and raise further questions and/or support for your arguments. You should also examine William Farr’s data and figures and utilize them similarly.

 

CLASS SESSION II: DEBATE AND FINAL VOTING ON PROPOSED COURSES OF ACTION
Whenever necessary, you will argue strongly for Anti-contagionist causes of the current Cholera outbreak.  
Question the utility of removing the pump handle from the Broad Street pump, and point out that this will be a significant inconvenience Parish residents. Also, be sure to coordinate your perspectives with your fellow Anti-contagionists so that, together, you can gain the support of the Indeterminates and defeat the Contagionist agenda. Keep in mind that there are inconsistencies in the various Contagionist arguments you will hear over the course of the debate. Counter these with logical rebuttals and any compelling quantitative data that you can gather.

 

“Anti-contagionist” FACTION STRATEGY

Your faction, the Anti-contagionists, will likely vote against Dr. Snow’s recommendation, but you may be swayed by any particularly strong arguments or data that are presented. Consider the different perspectives of Thomas Sydenham, T. Southwood Smith, William Farr and the Rev. Henry Whitehead (from internet sources and fellow Board members). You are generally supportive of any remedial or preventive measure that was widely in use at the time (e.g. the use of chlorine or chloride of lime for washing). You are also in favor of persistent communication with Parish residents about the virtues of pure air, cleanliness of person, of house and of premises, and temperance with respect to the consumption of spirituous liquors. You should endorse that the Board recirculate among Parish residents handbills with language to this effect. In your arguments, make specific references to existing language in the draft handbill that has been circulated among Board members and suggest any changes to the handbill language that you feel are warranted.

SECRET OBJECTIVE
To earn bonus credit for this role-playing activity, you must also achieve your secret objective:

When it is announced that Dr. John Snow wishes to address the committee, propose and have the Board vote against having Dr. John Snow testify. As far as you are concerned, Dr. Snow’s ideas about the communication of Cholera are not founded in the prevalent thinking of the day and should be dismissed outright.