Counting and mapping disease

Lesson plan

3 class periods of about 45 minutes.

1. Day 1 · 45 min

   Snow's pump

   1. 5 minutes: From the History tab of The Pump in Broad Street, 1854, students note that most doctors then blamed cholera on corrupted air, while John Snow argued it was passed on in something swallowed, most often water. The encyclopedia article Corrupted air (miasma) gives more background.
   2. 15 minutes: Read passages 2 to 5 together. Students list each kind of evidence Snow gathers: the water itself, the death register, and questions asked house by house.
   3. 15 minutes: Students find on Snow's map, on the source page, the pump in Broad Street, the other pumps, the workhouse and the brewery. They mark where the deaths crowd thickest and where there are few.
   4. 10 minutes: Read passage 6. Pairs write one sentence on what Snow told the Board of Guardians and what they did the next day.

2. Day 2 · 45 min

   Cases that do not fit

   1. 15 minutes: Read passages 9, 10, 13 and 14: the workhouse, the brewery and the widow in Hampstead. For each, students write how Snow uses it to support his argument.
   2. 10 minutes: Read passages 16 and 17. Students say what Snow's own figures show about the attacks before and after September 8, and what he admits he cannot decide.
   3. 10 minutes: Pairs write a short note to the Board of Guardians, using only the evidence on the map to argue for or against removing the pump handle. (Snow made his case to the Board in person on September 7, 1854.)
   4. 10 minutes: Discuss the limits of Snow's evidence from the History tab: much of it came from relatives and neighbors, and many people who could have answered had died or fled.

3. Day 3 · 45 min

   Advice for a whole country

   1. 10 minutes: Read passages 13 to 15 of The Government Explains the Flu, 1918, by the U.S. Public Health Service. Students note that the pamphlet does not know which germ is to blame, and find what it says about how the disease spreads.
   2. 15 minutes: Students turn passages 17 to 20 and 24 to 27 into a one-page public notice for a town in October 1918, keeping only advice the pamphlet gives. Beside each piece of advice they note the observation or belief of 1918 it rests on.
   3. 10 minutes: Compare Snow and the pamphlet under three headings. Impact: what action followed each one's evidence. Influence: whom each tried to persuade: Snow, the parish board and, in his book, other doctors; the pamphlet, a whole country. Change: what each asked people to do differently.
   4. 10 minutes: Each student writes a paragraph answering the unit question with evidence from both sources, including one place where the evidence was not enough to be certain.

Read these sources

In this order. Each opens in Hearth Library with the original beside plain English, and a History tab on who made it and how far to trust it.

1. 1

   The Pump in Broad Street, 1854

   John Snow, 1854–1855. Moderate.

   Long Victorian sentences and some medical words (irruption, flocculent, consecutive fever), but the argument is easy to follow, and the map helps.

   Questions, key terms and an activity

   outbreak

   a sudden rise in cases of a disease in one place

   mortality

   the number of deaths

   General Register Office

   the government office that recorded births, marriages and deaths

   Board of Guardians

   the local board that ran help for the poor, including the workhouse

   workhouse

   a building where poor people who could not support themselves lived and worked

   organic

   coming from living things, such as plants, animals or waste

   1. Comprehension What did Snow find when he compared the places where people died with the pumps they used? Give two of his cases.
   2. Analysis The workhouse inmates and the brewery workers lived or worked close to the pump, yet few of them died. How does Snow use them to support his argument?
   3. Analysis (reliability) Much of Snow’s evidence came from relatives and neighbors, and many people had died or fled. He also says the attacks had already fallen before the pump handle was removed. How do these limits affect how far we can trust his conclusion?
   4. Connection Read The Government Explains the Flu, 1918. Neither Snow nor the Public Health Service could see the germ they were dealing with. Compare the evidence each uses and the action each asks people or officials to take.

   Activity Students plot Snow’s cases on a copy of his map (the pump, the workhouse, the brewery, the children at school, the widow in Hampstead). In pairs, they write a short note to the Board of Guardians, as Snow did on September 7, 1854, using only the evidence on the map to argue for or against removing the pump handle, and then discuss what Snow’s own figures for the days after September 8 show.

   For teachers · Worksheet for this source

2. 2

   The Government Explains the Flu, 1918

   U.S. Public Health Service, 1918. Accessible.

   Plain question-and-answer format with mostly common words; pneumonia and meningitis are in the vocabulary list, and white corpuscles and Pfeiffer’s bacillus are explained in the footnotes.

   Questions, key terms and an activity

   epidemic

   an outbreak of disease that spreads quickly through many people at once

   pneumonia

   an infection of the lungs

   meningitis

   inflammation of the coverings of the brain and spinal cord

   complication

   a second illness that develops during or after the first one

   germ

   a tiny living thing that can cause disease

   bacteriologist

   a scientist who studies bacteria

   sputum

   mucus coughed up from the lungs

   patent medicine

   a ready-made remedy sold under a brand name, often with secret ingredients

   1. Comprehension According to the pamphlet, how does influenza spread, and what should a sick person and the family do?
   2. Analysis The pamphlet admits that no one knows which germ causes the epidemic. How can it still give advice? What evidence about how the disease spreads does that advice rest on?
   3. Analysis (reliability) This is the government speaking to the whole country while the epidemic was spreading and the nation was at war. What does it say, and leave unsaid, about the chance of dying? Why might it choose its words this way?
   4. Connection Read The Pump in Broad Street, 1854. John Snow named a single pump as the source of an outbreak, while this pamphlet asks millions of people to change everyday habits. Compare the kind of evidence behind each and the kind of action each asks for.

   Activity Students turn the pamphlet into a one-page public notice for a town in October 1918, keeping only advice the pamphlet gives. In a second column they note, for each piece of advice, what observation or belief of 1918 it rests on, then compare their notices with the closing rhyme and discuss why the government ended with it.

   For teachers · Worksheet for this source

To finish

Come back to the question: How did gathering evidence change what people did about disease? Ask students to answer it with evidence from at least two of the sources, and to say which source they trust most and why.

Standards

Students plot Snow's cases on his map and argue for removing the pump handle, then turn the 1918 pamphlet into a public notice and name the observation or belief behind each piece of advice.

Go further

Other units

From inoculation to vaccine · Imagining space travel · New ways to travel, eat and shop · Fixing the calendar

Encyclopedia

Corrupted air (miasma)

Collection

Every source in Innovation in History