Tag Archives: cholera

September 26, 1994: Tucson Shuts off CAP Supply; 1908: First Chlorine Use in US; 1855: Handle Put Back on Broad Street Pump

September 26, 1994:  Tucson Shuts off Direct Delivery of Central Arizona Project Water Supply. Corrosive water destroying pipes in a major American city preceded the events in Flint, Michigan by over two decades. On November 4, 1992, the water department for Tucson, Arizona, (Tucson Water or TW) began delivery of a new water supply: treated surface water from the Central Arizona Project (CAP)—primarily Colorado River water. Putting treated CAP water into the TW distribution system caused a corrosion problem that resulted in colored water (e.g., rusty, red, orange, yellow and brown) flowing from customer taps. Tucson’s introduction of CAP water is a story of mistakes committed at all levels of the utility and by the Tucson City Council.

Technical mistakes included not preparing the distribution system to receive a more complex surface water supply. TW was a groundwater utility that relied on about 200 wells distributed throughout the system. Recognizing their lack of experience with treating surface water, they hired treatment plant operators from other utilities to run the new $80 million leading-edge-technology treatment plant. Unfortunately, the same level of focus and preparation was not applied to the aging distribution system, which received, literally overnight, a chloraminated supply to half its customers from a single point of entry.

One of the biggest mistakes was not testing the impact of treated CAP water on corroded galvanized steel pipes. There were about 200 miles of this 2-inch substandard pipe in the system. When treated CAP water hit these pipes, the iron corrosion deposits inside the pipes were stripped away causing colored water, taste and odor problems, and damage to home plumbing, appliances and property due to flooding.

There was a rush to deliver CAP water and to hold down costs to the detriment of needed studies, which would have shown that raising the treated water pH for corrosion control was the proper approach.

Also high on the list of pre-delivery problems was a lack of political will to replace the substandard galvanized and reline the old cast iron street mains. The presence of these substandard pipes made the TW distribution system ripe for a catastrophic corrosion problem due to unsound corrosion control practices.

Delivery of CAP water was terminated on September 26, 1994, because of the inability of TW to control the colored water problem and the resulting political uproar. The $80 million treatment plant was shut down and has not been used since.

After a series of management resignations and firings over several years, Tucson hired David Modeer as the Director of TW. Modeer and his management team put the utility on the road to recovery. Along with a carefully planned technical program to select the correct corrosion treatment and deal with the taste and odor problems, an innovative public information campaign that also included a public apology for the CAP debacle, began to restore the credibility of TW. Customers were invited to actively participate in determining the future use, treatment and quality of CAP water via such methods as consumer preference research and participation in an extensive bottled water program.

After the voters defeated a proposition in 1999 that would have severely limited the ability to use CAP water in the future, TW completed an aquifer storage and recovery project in the nearby Avra Valley. The Central Avra Valley Storage and Recovery Project (CAVSARP) allowed the utility to fully use its CAP allotment and serve a recovered groundwater/recharged CAP water mix that was accepted by TW customers. Tucson Water turned around a disaster into a singular success. Because of its ability to conjunctively use CAP water and groundwater, Tucson is now one of the more drought-resistant communities in the Southwest.

Commentary:  Marie Pearthree and I finished our book about what happened in Tucson before, during and after the corrosion problem doomed their new water supply, entitled:  Tucson Water Turnaround:  Crisis to Success. A wealth of material reveals previously unknown information related to TW’s problems. The results of these efforts are much-needed lessons for water utilities on how to avoid TW’s mistakes and how to successfully introduce a new water supply.

Here is a review of our book published in the Arizona Daily Star on September 6, 2020.

“’Tucson Water Turnaround: Crisis to Success’

by Michael J. McGuire and Marie S. Pearthree

American Water Works Assoc. $31.76; $33 Kindle

‘Whiskey’s for drinking, and water’s for fighting over.’ So the saying goes, and it neatly sums up the situation in Tucson in the early 1990s when the attempt was made to switch from groundwater to CAP (Central Arizona Project) water. As longtime Tucsonans will recall, the CAP rollout was an epic failure. The water smelled bad and ran from faucets in a rainbow of unsightly colors from yellow to dark brown. It ruined clothes, damaged appliances and ate through pipes that flooded homes. The populace was in an uproar, the politicians were in a frenzy, and the water company was, well, ineffectual. Finally, the city opted to take CAP back offline, but that didn’t solve the Old Pueblo’s crisis of dwindling groundwater resources; plus, Tucson’s non-participation threatened to bankrupt the CAP.

Into this existential crisis came authors Mike Mc-Guire and Marie Pearthree, civil and environmental engineers and water utility professionals who were part of the coalition that reversed the transition’s death spiral and turned it into a success. But this is not a belated victory lap. Rather, the authors’ intent is to understand and document, nearly 30 years later, exactly what transpired from start to finish.

With this scrupulously researched, well-organized, and highly readable book, they do just that. Beginning with a historical overview of water delivery in the Tucson basin, the authors explore the perfect storm of aging infrastructure, technical failures, and toxic management culture that resulted in a public relations nightmare, and the subsequent remediation that produced a functioning water system. Perhaps most importantly, they provide a fascinating examination of how public trust is destroyed and rebuilt. Municipalities confronting water delivery issues will benefit from this object lesson and Tucsonans, particularly old-timers who experienced the CAP debacle firsthand as Pearthree did, will be fascinated by what actually went down.”

Building on the right housed the chloride of lime feed facility at Boonton Reservoir

September 26, 1908:  110th anniversary of the first day of operation of the chlorination facility at Boonton Reservoir for Jersey City, NJ.  This was the first continuous use of chlorine in the U.S. for drinking water disinfection.

In the field of water supply, there were big moves afoot in the state of New Jersey at the turn of the 20th century. Jersey City had suffered with a contaminated water supply for decades causing tens of thousands of deaths from typhoid fever and diarrheal diseases. In 1899, the City contracted with the Jersey City Water Supply Company to build a dam on the Rockaway River and provide a new water supply. The dam created Boonton Reservoir, which had a storage capacity of over seven billion gallons. One of the company’s employees, Dr. John L. Leal, would have an enormous impact on this water supply and the history of water treatment. Leal was a physician, public health professional and water quality expert. Leal’s job with the company was to remove sources of contamination in the Rockaway River watershed above the reservoir. Water from the project was served to the City beginning on May 23, 1904.

When it came time for Jersey City to pay the company for the new water supply, they balked. The price tag was steep—over $175 million in current dollars. Using newly developed bacteriological methods, consultants for the City claimed that the water was not “pure and wholesome,” and they filed suit against the company to get a reduced purchase price. The trial that resulted pitted the water quality experts of the day against one another in a battle of expert witnesses.

The opinion of the judge was published on May 1, 1909. In that opinion, Vice Chancellor Frederic W. Stevens said that Boonton Reservoir did a good job on average of reducing the bacteria concentrations in the water provided. However, he noted that two to three times per year, especially after intense rainstorms, the reservoir short-circuited and relatively high bacteria levels resulted.

Rather than build expensive sewers that would deal with only part of the bacteria contamination problem (an early recognition of non-point source pollution) Leal and the company attorney argued to install “other plans or devices” that would do a better job. The judge agreed and gave them a little over three months to prove their idea. Leal had decided in May 1908 that it was time to add a chemical disinfectant to drinking water. He was all too familiar with the suffering and death caused by typhoid fever and diarrheal diseases. He knew of some successful instances of using forms of chlorine in Europe, but nothing had been attempted in the U.S. on such a large-scale basis.

Leal was convinced that adding a disinfectant to the Jersey City water supply was the best course. He had done laboratory studies that convinced him that a fraction of a ppm of chlorine would kill disease-causing bacteria. In the face of the certain disapproval of his peers and possible condemnation by the public, he moved forward.

However, no chlorine feed system treating 40 million gallons per day had ever been designed or built and if the feed system failed to operate reliably, all of the courage of his convictions would not have amounted to much. He needed the best engineer in the country to do the work. He needed George Warren Fuller. In 1908, Fuller was famous for his work in filtration. He had designed an aluminum sulfate feed system treating 30 million gallons per day for the Little Falls treatment plant. On July 19, 1908, Leal left his attorney’s office in Jersey City and took the ferry to Manhattan. In Fuller’s office at 170 Broadway, he hired the famous engineer (undoubtedly on the basis of a handshake) and told him that the bad news was that he needed the work done in a little over three months.

Ninety-nine days later, the chlorine feed system was built and operational. Calcium hypochlorite (known then as chloride of lime or bleaching powder) was made into a concentrated solution, diluted with water and fed through a calibrated orifice to the water before it traveled by gravity to Jersey City. The feed system worked flawlessly from day one and continued to operate successfully for all of the following days. Liquid chlorine eventually replaced chloride of lime, but September 26, 2013, marks the 105th anniversary of the first continuous use of chlorine on a water supply—the longest period of water disinfection anywhere in the world.

Reference:  McGuire, Michael J. 2013. The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Broadwick [formerly, Broad] Street showing the John Snow memorial and public house.

September 26, 1855:  The St. James Board of Commissioners of Paving voted 10 to 2 to reopen the Broad Street pump at the urging of local residents.  Dr. John Snow had prevailed upon them a year earlier to remove the pump handle after he presented his evidence that cholera deaths were geographically clustered around the well site.

Reference: Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. Cholera, Chloroform, and the Science of Medicine. New York:Oxford University, 2003, 310.

September 8, 1854: Removal of Broad Street Pump Handle; 1900: Galveston Devastated by Hurricane of the Century

Dr. John Snow

September 8, 1854:  On this day, the pump handle was actually removed from the Broad Street pump.  History does not record who actually took the handle off, but we know it was not Dr. John Snow.  After all, the removal of the pump handle was the job of the St. James Board of Commissioners of Paving.  Incredibly, public protests resulted in the replacement of the pump handle on September 26, 1855.  The Broad Street well was not permanently taken out of service until the cholera epidemic of 1866.

Reference:  Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. Cholera, Chloroform, and the Science of Medicine. New York:Oxford University, 2003, 292-4, 310, 316-317.

Reconstruction of the 1900 Hurricane making landfall at Galveston

September 8, 1900: On this date, a Category Four hurricane struck Galveston, Texas, and destroyed, among other things, the drinking water system for the city.  The storm surge killed between 6,000 and 12,000 people, making it the deadliest natural disaster ever to hit the United States. Basic water service was not restored until September 12, 1900.

Commentary:  If you ever visit Galveston, go to the museum devoted to the hurricane. It is hard to comprehend the devastation and loss of life caused by this natural disaster.

September 7, 1854: Dr. John Snow Convinces Board to Remove Pump Handle

Broadwick [formerly, Broad] Street showing the John Snow memorial and public house.

September 7, 1854:  The St. James Board of Governors and Directors of the Poor was convinced by Dr. John Snow that the Broad Street pump was the source of a cholera epidemic in a London neighborhood.  The Board ordered the removal of the pump handle preventing a continuation of the epidemic.  Incredibly, public protests resulted in the replacement of the pump handle on September 26, 1855.  The Broad Street well was not permanently taken out of service until the cholera epidemic of 1866.

Reference:  Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. Cholera, Chloroform, and the Science of Medicine. New York:Oxford University, 2003, 292-4, 310, 316-317.

August 7, 1837: Death of Chester Averill

Chester Averill

August 7, 1837:  Death of Chester Averill who was Professor of Chemistry at Union College in Schenectady, New York.  Averill is known for a letter that he wrote to the Mayor of Schenectady, New York during the 1832 cholera epidemic which praised the disinfecting properties of chloride of lime (chlorine).  The treatise quoted many learned men of the time who demonstrated that chloride of lime eliminated the spread of contagious diseases by attacking the miasmas associated with them.  The letter also made reference to the destruction of certain “viruses” that may have been responsible for transmission of the diseases.

Commentary:  Averill’s letter is an extraordinary document that is worth reading. He was far ahead of his time. Indeed, he preceded Dr. John Snow’s conclusions about cholera transmission (1849) by 17 years.

July 18, 1911: Death by Cholera in the U.S.; 1908: Irrigating the Nile Valley

Quarantine in NYC Harbor in 1879

July 18, 1911:  Cholera Kills Boy; Eighth Death Here. New York Times Headline. “The sixth death from cholera since the arrival in this port from Naples of the steamship Moltke, thirteen days ago, occurred yesterday at Swineburne Island. The victim was Francesco Frando 14 years old.

Dr. A.H. Doty, the Health Officer for the Port of New York stated, “The great thing in fighting cholera is to isolate each case as soon as it is suspected, and, secondly, to take care that there is no local infection, like the contamination of the water supply, in the place where the suspected cases are isolated. That is why I detained all the passengers of the Moltke, although at the time there were no absolute cases of cholera among them. I let the crew take the vessel back to Europe, but refused to allow any of them to come ashore.”

Commentary:  Quarantine was the best weapon against cholera in the late 19th and early 20th century. Obviously, chlorination of drinking water had not taken hold across the U.S. by 1911.  A few short years later and it would be used as treatment in the majority of U.S. municipal water supplies. Doty was an interesting historical character. His obituary can be found at http://freepages.genealogy.rootsweb.ancestry.com/~quarantine/dotyobit.htm.

Update July 18, 2018:  Note the care and attention given to eight deaths from cholera at the New York port of entry near the turn of the 20th century. Today, the world shrugs off the news that there have been over 1,000,000 cases of cholera in Yemen and 10,000 deaths from cholera in Haiti. What has happened to our humanity?

Nile River Irrigation

July 18, 1908:  Engineering Record article. The Nile Irrigation Question. “The Nile Valley, from the great lakes of Central Africa on the south to the Mediterranean Sea on the north, is throughout, if watered, an essentially cotton country, and having in view the threatened shortage in the world’s future supply of one of its great necessities, and the large share of America in its provision in the past, it will be interesting to note what has been done and is being proposed in Egypt and the Sudan by means of irrigation to supplement the present supply of cotton and to meet the growing demand. In Egypt, at present, nearly all other cultivation is gradually yielding to that of cotton, notwithstanding the greater amount of hard work which the latter requires among a race to which it is by no means congenial.

The Nile system consists of the White Nile, which originates in the larger group of Central African lakes, the Victoria Nyanza, the Choga, the Albert Edward and the Albert Nyanza; and the Blue Nile, which is the largest source of supply, draining the mountains of Abyssinia. These two meet at Khartoum, the river thence flowing to the north being the Nile proper. It is on the latter that the principal conservation works have been and are now being erected, while on the White and Blue Niles, especially on the former, the work of the future will no doubt be chiefly concentrated.

As upper and lower Egypt, most of which is practically rainless, are dependent on the branches for their water, the Nile proper being merely a channel for its conveyance, and as much of the water is lost by spills and evaporation on the White Nile, it is a fortunate circumstance that Great Britain, with its large Indian irrigation experience, has even a greater control over the Sudan and the upper country through which the river flows than over Egypt itself. Hence not only will the former be benefited by direct irrigation on now unprofitable lands, but the latter will also receive more water by works undertaken under British initiation and financial help, on the White Nile.”

Commentary:  Note the reference to “lazy” Egyptian farmers and how wonderful it was that British innovation was helping to save their less fortunate and inferior brethren. Racism and colonialism were dominant themes in some engineering writings from this period.

July 4, 1961: Revolutionary Pipe Joint Patent; 1832: Letter from Chester Averill about Cholera; 2013: Natural Immunity from Cholera

Fastite Joint

July 4, 1961:  On this date, Patent Number 2,991,092 was issued to Mr. J. W. MacKay of the American Cast Iron Pipe Company in Birmingham, Alabama, for the Fastite push-on-rubber gasket joint for iron pipe.  The Fastite gasket uses a dual-durometer gasket having a stiff rubber ring to hold the gasket in place against insertion loads and a softer, fatter section to provide the leak-free seal.  The push-on gasket soon supplanted the bolted mechanical joint for virtually all underground pipe-to-pipe connections and is part of ANSI/AWWA C111/A21.11, Rubber-Gasket Joints for Ductile-Iron Pressure Pipe and Fittings. In 2014, Mr. MacKay is alive and well at age 104. He was inducted into the state of Alabama Engineering Hall of Fame in 2011.

Source:  Maury D. Gaston, American Cast Iron Pipe Company.

Chester Averill

July 4, 1832:  Date of letter from Chester Averill (Professor of Chemistry, Union College) to the Mayor of Schenectady, New York during the middle of a cholera epidemic which praised the disinfecting properties of chloride of lime (chlorine).  The treatise quoted many learned men of the time who demonstrated that chloride of lime eliminated the spread of contagious diseases by attacking the miasmas associated with them.  The letter also made reference to the destruction of certain “viruses” that may have been responsible for transmission of the diseases. The germ theory of disease would not be espoused by Louis Pasteur for another 30-40 years. However, Averill, like many others in the early 19th century suspected that something other than “bad air” caused disease. What follows is a small extract from his treatise.

“‘Chlorine is by far the most powerful agent hitherto discovered to counteract contagion and all kinds of noxious effluvia and its sanative powers appear equally extraordinary.’ Dr. Sillimaii’s Chem. vol. 2, p. 68.

I have here quoted the opinions of eminently scientific men, at least three of whom are M.D.’s. and all of whom, it may be thought, do not deserve to be styled empyrics. But what weight ought these opinions to have in this discussion? Surely no more than those of any other person even much less eminent, unless they are better substantiated by facts. It was thought advisable, however, to quote them, since they may serve to correct any bias which entirely opposite opinions, proceeding from no higher source, may have occasioned.”

Reference:  Averill, Chester. Facts Regarding the Disinfecting Powers of Chlorine:  With an Explanation of the Mode in Which it Operates and with Directions How it Should be Applied for Disinfecting Purposes. Letter to John I. DeGraff, Mayor of Schenectady. Private printing. 1832.

Bathing in the Ganges River

July 4, 2013:  In today’s New York Times (July 4, 2013), there was an extraordinary article that summarized recent research findings on human genetic adaptation to killer cholera. A few quotes give a summary of the findings:  “People living in the Ganges Delta, where cholera is an ancient, endemic and often lethal disease, have adapted genetically to the scourge through variations in about 300 genes, say researchers who have scanned their genomes for the fingerprints of evolution.

The researchers also found unexpected changes in genes that protect against arsenic, suggesting that arsenic exposure in Bangladesh is not just a modern problem associated with deep tube wells but may have ancient roots.

These instances of natural selection probably took place within the last 5,000 to 30,000 years, the researchers say, and show how evolution has continued to mold human populations through the relatively recent past…. People with blood group O are particularly susceptible to cholera, and indeed few Bengalis have blood group O. John Mekalanos, a cholera expert at the Harvard Medical School, said the new finding was one of several that ‘are starting to give a strong impression that the human genome has been dramatically shaped by responses to microorganisms.’”

Reference:  Wade, Nicholas. 2013. “Gene Sleuths Find How Some Naturally Resist Cholera.” New York Times. July 4, 2013.

June 16, 1858: Death of Dr. John Snow

Dr. John Snow

June 16, 1858:  Death of Dr. John Snow. Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

Medallion on John Snow Memorial, York, England (Photo Credit: Joe and Barbara Davis)

John Snow Memorial in York, England (Photo Credit: Joe and Barbara Davis)

May 7, 1848: Public Health Act, England

Edwin Chadwick

May 7, 1848:  “Public Health Act is passed by a reluctant Parliament fearful of spread of cholera. National Board of Health is formed and leads local boards to regulate water supply, sewerage, offensive trades.”

“The first local boards [of health] were created under the Public Health Act 1848 (11 & 12 Vict. c.63). The aim of the act was to improve the sanitary condition of towns and populous places in England and Wales by placing the supply of water, sewerage, drainage, cleansing and paving under a single local body. The act could be applied to any place in England and Wales except the City of London and some other areas in the Metropolis already under the control of sewer commissioners. The Act was passed by the incoming Liberal government, under Prime Minister Lord John Russell, in response to urgings by Edwin Chadwick.”

March 16, 1802: Corps of Engineers Established; 1804: Birth of Chester Averill

March 16, 1802:  President Jefferson authorized to establish the Corps of Engineers.“The history of United States Army Corps of Engineers can be traced back to 16 June 1775, when the Continental Congress organized an army with a chief engineer and two assistants. Colonel Richard Gridley became General George Washington’s first chief engineer; however, it was not until 1779 that Congress created a separate Corps of Engineers. One of its first tasks was to build fortifications near Boston at Bunker Hill. The first Corps was mostly composed of French subjects, who had been hired by General Washington from the service of Louis XVI.

The Corps of Engineers as it is known today came into being on 16 March 1802, when President Thomas Jefferson was authorized to ‘organize and establish a Corps of Engineers … that the said Corps … shall be stationed at West Point in the State of New York and shall constitute a Military Academy.’ Until 1866, the superintendent of the United States Military Academy was always an engineer officer. During the first half of the 19th century, West Point was the major and, for a while, the only engineering school in the country. The Corps’s authority over river works in the United States began with its fortification of New Orleans after the War of 1812.”

Chester Averill

March 16, 1804:  Birth of Chester Averill who became a Professor of Chemistry at Union College in Schenectady, New York.  Averill is known for a letter that he wrote to the Mayor of Schenectady, New Yorkduring the 1832 cholera epidemic which praised the disinfecting properties of chloride of lime (chlorine).  The treatise quoted many learned men of the time who demonstrated that chloride of lime eliminated the spread of contagious diseases by attacking the miasmas associated with them.  The letter also made reference to the destruction of certain “viruses” that may have been responsible for transmission of the diseases.

Commentary:  Averill’s letter is an extraordinary document that is worth reading. He was far ahead of his time. Indeed, he preceded Dr. John Snow’s conclusions about cholera transmission (1849) by 17 years.

March 15, 1813: Birth of Dr. John Snow

John Snow Memorial in York, England (Photo Credit: Joe and Barbara Davis)

March 15, 1813:  Birth of John Snow. Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Medallion on John Snow Memorial, York, England (Photo Credit: Joe and Barbara Davis)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

Commentary:  In 2013, we had a great time celebrating the 200thanniversary of his birth.

Photos from York:  The attached photos from York were taken by my friends, Joe and Barbra Davis, while they were on vacation in 2019. I had no idea that there was a memorial to John Snow in the city of his birth.