Descripción
"All Smell is Disease" Folding lithograph plan. Rare epidemiological plan of Soho that accompanied the General Board of Health's exhaustive report into the, 1854, Broad Street cholera outbreak. Cholera is a contagious disease caused by the bacterium vibrio cholerae. The bacteria lives in warm, salty stagnant waters, and is contracted when an individual ingests water or food contaminated with the bacteria. In the most severe strains the bacteria multiplies dramatically within the individual's gut, causing the intestine to release increasing amounts of water, leading to severe diarrhoea, vomiting and rapid loss of the fluids, and can, if untreated, lead to death within 24 hours. The majority of epidemics are caused when the faecal matter of an infected individual contaminates the water supply. It has been estimated that, since the beginning of the nineteenth century, cholera has been responsible for some 50 million deaths, and although relatively simple rehydration treatments are now readily available, according to the World Health Organisation some 120,000 people a year still die from the disease. The Broad Street outbreak The London epidemic of 1853-54, was part of the larger 1846-1860 cholera pandemic - the third such pandemic to occur since 1817 - and the second time that the disease had spread to British shores. The Broad Street outbreak, which was to be traced by Dr John Snow to a contaminated water pump outside number 40 Broad Street, was a particularly virulent strain, and would result in the deaths of 500 people, over a period of just ten days; by the end of the outbreak a total of 619 people would have succumbed to cholera, leading the Observer newspaper to note that, "such mortality in so short a time is almost unparalleled in this country". The Broad Street outbreak led to the publication of two reports and a monograph: The General Board of Health (BoH), The Report… on the Cholera Epidemic of 1854 (1855); The Cholera Inquiry Committee (1855), set up by the Parish of St James's; and Doctor John Snow, On the Mode and Communication of Cholera (2nd edition, 1855). Although Snow's work is now seen as one of the foundation stones of epidemiology, its argument - that cholera was a waterborne disease - was not widely held by the Victorian medical establishment, with prominent people such as Edwin Chadwick, head of the first General Board of Health, expounding the view that cholera was an airborne disease, brought about by foul odours caused by unsanitary conditions. Although Snow was to prove, that the airborne hypothesis was erroneous, the 'miasmatic' theory, with its instance that "all smell is disease", would be the catalyst for many of the great municipal sanitary improvements - such as Bazalgette's great sewer - carried out during the Victorian era. Formation of the General Board of Health In 1848, Parliament passed the Public Health Act, which instituted the Board of Health for a period of five years, with powers to sanction expenditure for sanitary improvements requested by local government, and in the event of an epidemic to provide guidance to the government's response. The board was headed by, and was the brainchild of, Edwin Chadwick, whose 1842 General report on the Sanitary condition of the Labouring Population of Great Britain, has been called the, "fundamental document on modern public health" (Rosen). "The creation of the Board of Health was a high point of the great Victorian enterprise of sanitary reform, whose central idea was that environmental circumstances particularly pollution of the air and water, defective sanitation, dampness, filth and overcrowding were causes of disease, particularly epidemic disease, and these diseases often killed the wage earners, left poor working families impoverished, pushed widows and orphans into workhouses, and undermined the moral fibre of the working classes" (Paneth). Although the Board was successful in enacting a great many sanitary improvements over the next fi. N° de ref. del artículo 16264
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