| Faction: Contagionist Ideological Reference: William Farr |
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You believe that Cholera is caused by many complicated factors, and you align closely with the broadly encompassing theory of William Farr, who describes four sub-categories of Cholera: the miasmatic, the enthetic or contagious, the dietetic, and the parasitic. You will take every opportunity to encourage consensus, since this theory is so general that even Anti-contagionists can agree with it. 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. |
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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://www.ncbi.nlm.nih.gov/pubmed/11582849
http://www.ncbi.nlm.nih.gov/pubmed/4572629
http://www.jstor.org/stable/2338305
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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.
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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 Chairman Frederick Crane, you will stand and offer your personal statement, making your arguments along the lines of Farr’s broadly encompassing theory of disease. You work in London’s General Register Office, the department responsible for recording births, deaths and marriages. Daily, you are involved in maintaining the public health system, set up by your supervisor William Farr, based on routinely recording causes of death. You admire Farr’s skill with medical statistics and know of Farr’s professional interactions with Dr. John Snow.
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.
Keep in mind that William Farr is a general miasmatist and believes that Snow’s science remains unsubstantiated.
CLASS SESSION II: DEBATE AND FINAL VOTING ON PROPOSED COURSES OF ACTION
Whenever necessary, you must strongly argue for the contagionist aspects of Farr’s theory as the causes of the current Cholera outbreak. You will not question the utility of removing the pump handle from the Broad Street pump unless the data convince you otherwise. While steadfast in your convictions, above all you are receptive to strong arguments that are made using scientific data, population surveys and statistics.
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“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 John Snow’s and William Farr’s contributions to understanding Cholera and rather steadfast in your convictions. Be prepared to influence the Indeterminates with solid arguments based on scientific data, and do your best to argue for the enhanced statistical examination of Cholera outbreaks. |
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SECRET OBJECTIVE Propose and have the Board vote on appointing an employee of the Vestry to provide detailed daily information of mortalities in the parish to the General Register Office in an effort to enable the strongest statistical study of Cholera to date. |