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Cholera and the Broad Street Pump

You are John George French

Faction: Contagionist
Ideological Reference: John Snow

You currently serve as the medical officer of the Poland Street Workhouse. You are distinguished in your discipline, having been granted Fellowship in the Royal College of Surgeons – your field’s highest qualification. At every opportunity you will argue in strong support of your colleague, John Snow, that Cholera is transmitted via contaminated food and water.


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.


•    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).


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?


The Special Committee convenes on the evening of Thursday, 7 September 1854. As one of the medical officers active in the Parish, your opening statement will make your colleagues aware of your function and your observations from daily practice. Throughout the meeting, you have a primary responsibility to intervene in discussion of specific issues that have a medical origin or relevance, including the options for treating those with Cholera. At the end of Session I, you will announce to everyone that Dr. John Snow wishes to hold audience with the committee, and you will make a brief and direct appeal to have him heard.

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.

Whenever necessary, you will argue that contagion and contaminated food and water is 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 argue against the perceived “inconvenience” that this will cause to Parish residents that frequent that pump for water. Most importantly, you are steadfast in your convictions and training as a medical professional, and you will be most swayed by particularly strong arguments and/or sound use of scientific data.


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 reputation and steadfast in your convictions. Be prepared to influence the Indeterminates with solid arguments based on scientific data from John Snow and William Farr, as needed.

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

At the end of Session, you strongly urge the Board to vote in favor of having Dr. Snow testify in front of the  committee (at  the“Interlude”). Also propose and have the Board vote on additional rooms in the Church being arranged to receive any new Cholera cases and that Nurses be appointed to handle these patient.