This episode is brought to you by Wondrium.
Brew: London, England.
While many of us today may see it as a quaint old-timey city,
or a potential future vacation destination, there was a time
where you wouldn’t have wanted to step near the city proper.
Quiz: Because of all the smog?
I know that there was so much pollution
there during the Industrial Revolution.
Brew: Well, not quite..
See, in the 19th century, London was famed
as the capital of the largest empire on
Earth— and a truly disgusting place to live.
Mud and filth caked the streets, sooty smog choked the
air, and sewage was dumped straight into the Thames River.
In fact, the Thames was so notoriously gross
that one hot, summer day in 1858 the smell from
it alone forced politicians to vacate their
buildings in an event known as “The Great Stink”.
And unfortunately for everyone, water companies also
used the Thames River to bottle water and sell it.
But in the midst of all this filth, how exactly
did a used diaper cause a local pandemic?
And more importantly, how did beer save
a building full of workers from it?
Today’s episode deals with a widespread and
fatal disease, and may include descriptions
of the symptoms, causes, and effects of it.
Viewer discretion is advised.
And, with that out of the way, let’s get into it.
Before we get into the 1858 cholera outbreak,
what exactly is cholera and how does it spread?
Well, according to the Centre for Disease Control, Cholera is,
“an acute, diarrheal illness caused by
infection of the intestine with the toxigenic
bacterium Vibrio cholerae serogroup O1 or O139.
An estimated 2.9 million cases and 95,000
deaths occur each year around the world.
The infection is often mild or
without symptoms, but can be severe.”
If severe symptoms should arise, then cholera
can prove fatal within a few short hours.
And the way it goes is… unpleasant, to say the very least.
Cholera causes infected individuals to
become dehydrated through the… uncontrollable
evacuation of their bodily fluids, shall we say.
The proper treatment for cholera is rehydration - not just
drinking water mind you, but specific rehydration solution
that has a balanced level of water, electrolytes, and sugar.
Grill: So the cure is some sports drank?
Quiz: Eh, close enough.
Brew: Or products such as pedialyte.
Though the World Health Organization has a specific
drink called the “New Oral Rehydration Solution”.
In particularly severe cases, patients
may need intravenous fluid replacement.
Thankfully, with quick and proper treatment, the CDC
reports that less than 1% of cholera cases prove fatal.
But that’s with modern technology.
Let’s take a step back into the leading
medical minds of the early 1800s.
For centuries it has been understood that disease
is caused and spread via the dreaded miasma, a fancy
word which here means, “an oppressive or unpleasant
atmosphere which surrounds or emanates from something.”
Chill: Oh miasma, that’s like concentrated bad vibes, right?
Brew: Kind of.
This miasma was released from filth and decay, with the
resulting foul odors or smells causing the spread of disease.
Quiz: Fun fact, Miasma theory is actually why plague
doctors have their distinctive bird-beak masks!
They would fill the beak full of dried flowers,
herbs, and spices to counteract the “bad air”!
Brew: Belief in miasma was quite attractive to English
sanitary reformers, since it explained why epidemics broke
out so often among the poor, filthy, unwashed masses.
There were other theories on how
disease was spread, of course.
Like “blood generation theory”, which stated that disease
was spontaneously created in blood, and “germ theory”,
which stated that organisms too small for the human
eye to see were responsible for the spread of disease.
Germ theory grew in popularity after the invention of
the microscope in 1676 and the mind-blowing revelation
that a small world existed in even a drop of water.
But even by the 1800s, there were many that held fast to the
conventional wisdom of miasma being the origin of disease.
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Now back to our story!
Enter John Snow—
Chill: You know nothing John Snooo-oh.
Brew: No, not that one.
That’s a stale joke even for me.
She is our queen.
Ah it still hurts.
Doctor John Snow was born on March 15, 1813 in York, England
as the eldest of nine children to a labourer in a coal yard.
At the age of 14, he left school to pursue three separate
medical apprenticeships in Yorkshire and soon had his first
encounter with cholera when visiting coal miners in 1831.
Throughout his career, Snow would learn to be a master
anaesthesiologist— to the point where Queen Victoria herself
entrusted him with the administration of chloroform during the
birth of Prince Leopold in 1853 and Princess Beatrice in 1857.
More importantly to this tale, he was a proponent
of germ theory and he was a co-founder of
the London Epidemiological Society in 1850.
Snow had recently investigated another epidemic and
published a much-ignored paper, citing contaminated
water as the source of cholera outbreaks.
One of Snow’s great works came in 1854, when
cholera gripped the region of Soho within London.
Within days, there were over 127
fatalities around Broad Street.
Shortly after that, the body count rose to over 500.
Within a week, the only people who
hadn’t left were the poor and the dead.
By a stroke of luck, Dr.
Snow lived nearby and began
patrolling the region from day one.
This was the result of his “grand experiment” as
it is known today, in which he mapped out instances
of cholera and cross referenced homes suffering the
disease to companies supplying contaminated water.
Using his experience in epidemiology, he quickly deduced
that the culprit was a hand pump that many victims had
gathered drinking water from or lived close to leading
up to the outbreak - though there were some exceptions.
Among them, the Broad Street Brewery which
boasted zero cases among its 70 workers.
There were exceptions in the opposite direction
too, like Susannah Eley and her niece, two
women who lived quite a distance from the
Broad Street pump yet died of cholera anyways.
Travelling to their estate, Snow interviewed her son and
learned that not only had Eley once lived around Broad Street,
but she had enjoyed the taste of the water there so much
she sent a servant to collect water from the pump every day.
While Snow had not managed to prove that
cholera wasn’t transmitted through miasma, he
was certain that the pump had been infected.
He brought his case to the local authorities and had
them remove the Broad Street pump’s handle to prevent
others from collecting water from the contaminated
supply, and cases immediately began to drop.
But what had caused the outbreak
of cholera in the first place?
And how did those workers manage to evade it?
Any guesses?
Chill: They had good enough vibes to ward off the bad feels.
Grill: What kind of business did you say this was?
Quiz: It was a brewery.
Grill: Lemme guess, they didn’t drink the water.
They drank all the booze.
Brew: That’s… exactly right, actually.
The workers at the brewery didn’t drink the
contaminated water because they were all drinking beer.
Specifically the beer that they were brewing as
management gave the troops a free allowance on the stuff.
But the investigation didn’t end there.
At first it seemed as though the well
could not have been contaminated by sewage.
A cursory inspection found no leakage in the
brick lining of the well, and the sewer was
ten feet away and dug deeper into the earth.
Reverend Henry Whitehead, a priest who had also responded
to the outbreak and consoled those struck by the
disease, joined John Snow on the Medical Committee of
the General Board of Health in searching for the cause,
though Whitehead disagreed with Snow’s conclusions.
Whitehead spoke to families four or five times each
to confirm the facts and found himself reluctantly
concluding that the cause was, in fact, the water pump.
And while reviewing the facts, he
found what may have been patient zero.
A young child, still in diapers, had died of cholera
symptoms days after the outbreak on Broad Street.
Whitehead elected to interview the mother, and learned that
she had been washing the baby’s dirty diapers in a pail,
and dumping the water into a cesspit, directly in front of
the Broad Street pump that happened to have a leak in it.
Whitehead and Snow had found their culprit.
Quiz: So the workers avoided the disease
because they weren’t drinking the water, and the
outbreak was caused by a poorly made cesspit?
Grill: But this Snow guy, I’m sure he lived a long,
cushy life after solving a big pandemic like this?
Seems like the kind of thing a
doctor would get a reputation from.
Brew: Well he might have, but he unfortunately
passed away from a stroke in 1858 - only
four years after the cholera outbreak.
But for his work, Snow has since become
known as the “father of modern epidemiology”.
And as for beer… well, you’d be surprised
at the history it has with humanity.
It’s a lot to drink in.