Getting Started

During my teaching career, I frequently used a newspaper article to introduce a new unit, particularly in courses where many students thought doing history meant memorizing and regurgitating information, period. The following article could be used to introduce the two exercises I’m developing on the cholera outbreak in St. James, Westminster, metropolitan London during September 1854.

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In a 28 December 2014 article in the New York Times, Michael Kimmelman described two, medical clinics under construction in Haiti. They are “open-air, modest in size and cost, designed to tackle diseases that can be as insidious and deadly as Ebola, but are also more common: cholera and tuberculosis. . . .  Instead of constructing hermetic shields in the form of airtight, inflexible hospital buildings, the architects took advantage of Haiti’s Caribbean environment, exploiting island cross breezes to heal patients and aid caregivers. . . .  Windows are placed on walls directly opposite one another to promote cross ventilation. . . . The idea harks back to colonial hospitals in the developing world, which were open-air buildings constructed around courtyards.” (Click here for a PDF containing the text, only, of this article.)

The open-air plan in colonial hospitals was an adaptation to local circumstances of principles already in use on Nightingale wards in Europe and the United States, beginning in the second half of the nineteenth century. A conventional historical interpretation is that Florence Nightingale, the “lady with the lamp” in the Crimea from 1854 until 1856, initiated the same open-air, hospital reforms on her return to England that she had successfully employed to reduce horrific mortality from cholera and wounds at British army hospitals abroad.

If so, how did Florence Nightingale come up with the idea that healing is promoted when patients are placed in large, open spaces with plenty of cross-ventilation? One year as superintendent of a London institute offering respite care to indigent “gentlewomen” in a converted house in Upper Harley Street is unlikely to have sparked that thought. Could she have drawn on what she learned during a brief nursing stint at the Middlesex Hospital during an astoundingly horrid cholera outbreak in September 1854, just prior to her departure for the Crimea that October?

Nightingale & Cholera offers suggestions and materials for a history workshop examining these two questions.

As the NYT article states, one of the new Haitian clinics is being purpose-built to treat cholera victims, after “cholera arrived here by way of Nepalese peacekeeping troops after the earthquake and ran amok through contaminated water.” So, 160 years after the infamous Broad Street outbreak, cholera may appear wherever sanitation measures are inadequate to contain this disease. In 1854, however, the majority of sanitarian-minded people focused their reform efforts on housing, ventilation (like Nightingale), street-cleaning, and assorted nuisance-trades rather than water purity.

Snow & the pump handle offers suggestions and materials for a history workshop examining the investigation undertaken by the man whose findings convinced the parish authorities to disable the Broad Street pump.