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Cholera and the Broad Street Pump

You are Benjamin Cox

Faction: Contagionist
Ideological Reference: Edward Oke Spooner

You are well versed on the evidence supporting the view that Cholera is caused by contagion. In particular, you are very familiar and articulate on the infection theories postulated by Edward Oke Spooner of Blandford, who was strongly committed to the idea of inhalation as a principal means of infection. You believe that the policies of London’s Board of Health and Sanitary Commissioners defy both common sense and scientific observation.


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://collections.nlm.nih.gov/muradora/objectView.action?pid=nlm:nlmuid-64750940R-bk

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2551835/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2487696/

YOU ARE IN THE “Contagionist” FACTION.

You and your fellow 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 a relatively short distance, through the atmosphere.

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

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 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 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 learn 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. When invited by the Chairman and Senior Churchwarden Frederick Crane, you will stand and offer your personal statement, and you will point out Spooner’s observation that the 1817 Cholera epidemic followed well-established trade and travel routes, advancing no quicker than humans could travel. You may also openly mock the miasmatists. By the end of Session I, you should make specific proposals that will be addressed by the Committee in Session II, being debated and brought to a final vote at the end of the discussion.

INTERLUDE: JOHN SNOW GIVES HIS TESTIMONY AND RECOMMENDATION

Between the two class sessions, Dr. John Snow 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 must strongly argue for contagion as the cause of the current Cholera outbreak. You will not question the utility of removing the pump handle from the Broad Street pump, and you will point out the evidence that Dr. Snow has presented as being consistent with a reasonable explanation of Cholera communication.

“Contagionist” FACTION STRATEGY

Your faction, the Contagionists, may disagree as to the specific nature of contagion, but you will likely vote for Dr. Snow’s recommendation. Personally, you believe that Snow’s arguments will lead to the committee taking relevant, decisive action at minimal expense to the Parish, and you will do everything possible provide supporting arguments once debate continues in Session II. You might also argue that the current “Anti-contagionist” approach of widespread limewashing of buildings throughout London has done little to stem Cholera outbreaks. Of course, you anticipate opposition but are also confident in your understanding of E.O. Spooner’s theories and steadfast in your convictions. Be prepared to influence the Indeterminates with solid arguments based on scientific data.

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

Propose and have the Board vote on the implementation of widespread zones of quarantine around all houses, privies and streets that have been touched by the Cholera.