In 1846 Dr. Ignaz Semmelweis was an assistant doctor at Vienna General Hospital which had two maternity wards 1 with interns being trained, & the other midwives are trained. Many pregnant women were dying at child birth due to ‘puerperal fever’ or childbed fever & the popular belief was this was caused by miasma or poisonous air. During this time the sewerage system had not yet formed well & there was always dirt all around. So belief was that this poisonous air was causing the problem. Semmelweis collected data and in 6 months noticed difference among the 2 wards. The death rate in the ward run by interns was almost 10% & that run by midwives was about 2.9%. He tried identifying differences in these 2 wards but nothing worked. The ‘Aha’ moment came with the unfortunate death of his friend in the hospital, Dr. Kolletschka, the pathologist. He had cut himself during one of his daily autopsies & by evening he had picked fevers. Semmelweis saw symptoms similar with the pregnant women when they contracted childbed fever. The very next day Kolletschka died, & Semmelweis told the administrators that he would like to do the autopsy on his friend. The pathology of Kolletschka’s body was similar to the pathology of the pregnant women who died of childbed fever. He had also noticed that the interns used to train in the morning in the autopsy chamber & in the afternoon go to the maternity wards & train there. Semmelweis concluded that these doctors were picking up death particles during the autopsy which went into the maternity ward. He instituted a very stringent hand wash process with lime & chlorine. Immediately the mortality rate at the maternity ward of the interns came down to as close to the ones managed by the midwives. When some of the interns were bypassing the instructions & he became much stricter. The next 2 months there were 0 deaths in the clinic. With this data he rushed to the hospital administration & declared that the death particles were causing childbed fever, not Miasma. They laughed & objected his theory. As he was sacked, instantly the hand wash process was disregarded, & death rates shot up. In 1848 London was reeling from bouts of cholera where 10 to 20,000 people lost their lives in each outbreak. The popular theory among doctors during that time was that Cholera was caused by Miasma or poisonous air. Indeed there was a perpetual stink that hung over most over-crowded cities in those times, including London. Without proper sewerage systems most houses had cesspools in their backyard & all human waste was collected in them. Rudimentary piping system carried waste from these cesspools to the Thames river causing a perpetual stench hanging over the city of London making the miasma theory about a believable one. After interning all his teenage years, Dr. John Snow developed a different belief about Cholera’s cause. He believed it was waterborne as he saw a sailor at an inn die of cholera & was the only one who was infected, poisonous air would have infected everybody. He talked to people in the medical community but no one believed him. In 1848 he collected data. He went around London where people had died, tried to identify any link to water. In one locality with row of houses on both sides of the street, 8 out of 10 houses on 1 side of the street had seen death by cholera but only 1 of the 10 houses on the other side. John studied the cesspits & sewerage pipes & saw that the pipes on both side of the street ran in the same direction. However, the well from where people took the water on the side of the street with more deaths were upstream & the well on the side with only one death was downstream. Clearly, the water in the well downstream to the sewage pipe must have gotten contaminated as these pipes weren’t watertight & there was always some seepage. This didn’t happen on the other side as the well was upstream. Even now his claims that cholera is waterborne were rejected. In 1854, the breakout was concentrated at Broad Street with 80% deaths in the first few days. John used a map of the area to mark death with a “-” & hand-pumps with “x”. This famous John Snow Map of Cholera was perhaps the 1st fabulous attempt at data visualization. He found out that most of the deaths had occurred close to the water pump at 40 Broad street. On further investigation he found out that at 39 Broad street, a baby had somehow contracted cholera, & dysentery nappies had been dropped into the cess pool. He realized that this must have caused the water to cause cholera when people drank it. Now the municipality believed him. They took off the handle of the hand pump there, immediately Cholera almost stopped. Dr. John Snow had a story to support his data. The doctors in London & Vienna had a belief that Miasma caused the disease, they had a story in their head & you can never beat a story with facts. You can only replace it with a more powerful story. #Cholera #PowerOfStorytelling #stories #London #Vienna
