Introduction to Water - A Historical Perspective Water, Sanitation and Health - Part I
In today's lecture we're going to look at water and health. We're going to look at three case studies that helped us understand the historical context of how we first learned about the importance of water as it relates to health. One of those in the mid- 1800 in london, a second we'll look at chicago in the late 1800, and then we'll fast-forward to 1993 in milwaukee. In each of these case studies, we'll see how the connection between water and health first became apparent, and how it's even very much still an issue in more recent times.
We'll start in london in the mid- 1800. We didn't yet understand why disease was transmitted from one person to another, from one location to another. It was an outbreak of cholera in london that really helped to highlight these issues. At this time it was thought that poison somehow transferred around through the atmosphere or through the soil or somehow. But it didn't quite fit with the transfer of the disease, and so it was in 1854 that john snow, a medical doctor in london, did a systematic study to try and understand what was the cause of this spread of disease. And what dr. Snow did was he did a survey of the people that died from cholera, and he asked those people that knew them, where did they live, where did they work, where did they get their food, where did they go to church where did they get their water, and just a long list of questions.
And in the process of this study, what dr. Snow realized is the one thing that all the victims had in common was they got their water from the same well, a public well. At this point in time there was a community well in the center of the town area in the so ho district of london and the people would come and they would pump the handle on the well and they would get their water. And the one thing that all the victims had in common was they had gotten their drinking water from this same source. So famously dr. Snow went down and he took the handle off that pump, and that helped to curb the spread of the epidemic of cholera in london at that time.
It turned out that the the cause was identified as a a diaper an infant diaper, that had been disposed in a cesspool, this is a cement block tank below ground. And the cesspool leaked, and it leaked water into the ground. Then that water ended up in the wells, and so people would drink the water, they would get sick, and then that cycle would continue. Now as dr. Snow studied the deaths over time, what began to appear is a trend: a a few cholera deaths and then those numbers picked up. And so you can see a graph of time on the X-axis and cholera deaths on the Y-axis. You see a slow increase and then all of a sudden a rapid increase. And then as the intervention happened, as the handle was removed from the pump, as people began to remove away from that area, the number of deaths began to drop off.
And this is a classical diagram that's used in public health to understand the occurrence and and the decline of an epidemic. The interesting thing about this is, in studying the people that died of the cholera, some of the people didn't necessarily live right in that area. There was one person that lived several kilometers away. Well, it turned out this person used to live in that area of london, and they really liked the water from that well, and so they would periodically get water from that well and take it to their home. And so unfortunately this person was impacted by the cholera even though they no longer lived in that area.
So dr. Snow, john snow has become known as the father of epidemiology. Epidemiology is the study, systematic study of disease and how disease spreads, and his systematic study was the first example of this type of approach to studying public health. He's also known as the father of water treatment because he was the first to recognize that disease, cholera in this case, could be spread through the water. And so all of a sudden the importance of treating the water and making the water safe became paramount. And so we know him in these two respects.
If you visit london, as I did on my first trip to london, one of the places I most wanted to go in london was to the broad street well and to see where this famous episode occurred. And you can go there today, and there's a a pump in tribute to this great discovery, and there's actually no handle on the pump. Ceremonially the handle is removed from that pump to demonstrate what dr. Snow did back in the 1850. And you can also go right next to this, and there's a plaque on the side of the john snow pub. So you can do as I did, go in and have a brew in honor of john snow and the major discovery that he made. So cholera is a a major source of disease.
It's something that we don't know so much in the US anymore or in london as we did in former times. There's two movies that help to depict the the devastating effect of cholera. One movie is horese man on the roof, and this movie depicts france in the middle 1800s. And it's a it's a love story of sorts, but it's set in the backdrop of a major cholera epidemic in france, showing that france at that time was very vulnerable to the spread of cholera. And the second movie, the painted veil, depicts china in the 1900, and again shows the devastating affects of cholera and also shows in that movie the realization that the cholera was being spread through the water.
So these are two popular movies that you could watch to see a depiction of cholera in former times. But let's move forward now to chicago in the late 1800. Chicago on lake michigan was impacted not by cholera in this case, but by typhoid fever. The people got their drinking water from lake michigan, but as it turned out, their waste also would flow into lake michigan. And so as the people would get sick and that would go into lake michigan, that waste, and then people would bring their water from the lake, and they would the cycle would continue. And so we see again a graph of typhoid death, deaths due to typhoid favor, versus time in chicago.
We'll start in london in the mid- 1800. We didn't yet understand why disease was transmitted from one person to another, from one location to another. It was an outbreak of cholera in london that really helped to highlight these issues. At this time it was thought that poison somehow transferred around through the atmosphere or through the soil or somehow. But it didn't quite fit with the transfer of the disease, and so it was in 1854 that john snow, a medical doctor in london, did a systematic study to try and understand what was the cause of this spread of disease. And what dr. Snow did was he did a survey of the people that died from cholera, and he asked those people that knew them, where did they live, where did they work, where did they get their food, where did they go to church where did they get their water, and just a long list of questions.
And in the process of this study, what dr. Snow realized is the one thing that all the victims had in common was they got their water from the same well, a public well. At this point in time there was a community well in the center of the town area in the so ho district of london and the people would come and they would pump the handle on the well and they would get their water. And the one thing that all the victims had in common was they had gotten their drinking water from this same source. So famously dr. Snow went down and he took the handle off that pump, and that helped to curb the spread of the epidemic of cholera in london at that time.
It turned out that the the cause was identified as a a diaper an infant diaper, that had been disposed in a cesspool, this is a cement block tank below ground. And the cesspool leaked, and it leaked water into the ground. Then that water ended up in the wells, and so people would drink the water, they would get sick, and then that cycle would continue. Now as dr. Snow studied the deaths over time, what began to appear is a trend: a a few cholera deaths and then those numbers picked up. And so you can see a graph of time on the X-axis and cholera deaths on the Y-axis. You see a slow increase and then all of a sudden a rapid increase. And then as the intervention happened, as the handle was removed from the pump, as people began to remove away from that area, the number of deaths began to drop off.
And this is a classical diagram that's used in public health to understand the occurrence and and the decline of an epidemic. The interesting thing about this is, in studying the people that died of the cholera, some of the people didn't necessarily live right in that area. There was one person that lived several kilometers away. Well, it turned out this person used to live in that area of london, and they really liked the water from that well, and so they would periodically get water from that well and take it to their home. And so unfortunately this person was impacted by the cholera even though they no longer lived in that area.
So dr. Snow, john snow has become known as the father of epidemiology. Epidemiology is the study, systematic study of disease and how disease spreads, and his systematic study was the first example of this type of approach to studying public health. He's also known as the father of water treatment because he was the first to recognize that disease, cholera in this case, could be spread through the water. And so all of a sudden the importance of treating the water and making the water safe became paramount. And so we know him in these two respects.
If you visit london, as I did on my first trip to london, one of the places I most wanted to go in london was to the broad street well and to see where this famous episode occurred. And you can go there today, and there's a a pump in tribute to this great discovery, and there's actually no handle on the pump. Ceremonially the handle is removed from that pump to demonstrate what dr. Snow did back in the 1850. And you can also go right next to this, and there's a plaque on the side of the john snow pub. So you can do as I did, go in and have a brew in honor of john snow and the major discovery that he made. So cholera is a a major source of disease.
It's something that we don't know so much in the US anymore or in london as we did in former times. There's two movies that help to depict the the devastating effect of cholera. One movie is horese man on the roof, and this movie depicts france in the middle 1800s. And it's a it's a love story of sorts, but it's set in the backdrop of a major cholera epidemic in france, showing that france at that time was very vulnerable to the spread of cholera. And the second movie, the painted veil, depicts china in the 1900, and again shows the devastating affects of cholera and also shows in that movie the realization that the cholera was being spread through the water.
So these are two popular movies that you could watch to see a depiction of cholera in former times. But let's move forward now to chicago in the late 1800. Chicago on lake michigan was impacted not by cholera in this case, but by typhoid fever. The people got their drinking water from lake michigan, but as it turned out, their waste also would flow into lake michigan. And so as the people would get sick and that would go into lake michigan, that waste, and then people would bring their water from the lake, and they would the cycle would continue. And so we see again a graph of typhoid death, deaths due to typhoid favor, versus time in chicago.
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