49 pages • 1 hour read
Deborah HopkinsonThe Great Trouble
Fiction | Novel | Middle Grade | Published in 2013A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
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Historical Context: The 1854 Broad Street Cholera Epidemic
The 1854 Broad Street cholera epidemic was a severe outbreak of cholera that led to the deaths of 616 people. It was part of a global cholera pandemic that lasted from 1846 to 1860. The outbreak was investigated by the English physician John Snow, who discovered that cholera is caused by contaminated water, rather than by air, as the previous “miasma theory” held. The Broad Street outbreak, which arose on August 31, 1854, was the most severe of several other concurrent outbreaks of cholera in London. Many of the victims of the Broad Street outbreak were taken to Middlesex Hospital, where their care was overseen by the famed nurse and reformer, Florence Nightingale.
Snow historically charted the outbreak to the Broad Street water pump by conducting interviews with the help of Reverend Henry Whitehead. By mapping the results of these interviews, they were able to determine that all of the afflicted had contact with a Broad Street source. The miasma theory was further challenged by the realization that none of the employees of a nearby brewery contracted the disease; they were given a daily allotment of beer, so they were far less likely to drink water from the nearby well. Because boiling the water is a standard part of the beer-making process, the cholera in the water was effectively eliminated. As a result of Snow’s discoveries, the handle to the Broad Street pump was removed. As the epidemic waned, the source of the contamination was identified; a nearby cesspool had become infected when an ill baby’s diapers were rinsed. Snow continued to work in public health after the outbreak. In 1992, a replica water pump was placed on the site of the original Broad Street pump to commemorate the significance of Snow’s findings during the epidemic.
Social Context: Public Health and Societal Impact
Per the US Centers for Disease Control and Prevention, public health is “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals” (“Introduction to Public Health.” Centers for Disease Control and Prevention). The notion of public health has evolved with contemporary understandings of diseases and their causes. Examples of public health attitudes that are now known to be incorrect include the “miasma theory” (as discussed in The Great Trouble) which led “plague doctors” to wear masks with fragrant herbs tucked inside during outbreaks of the bubonic plague, as these masks were believed to nullify miasmas. While the miasma theory proved inaccurate, the notion that diseases are transmissible between people and can therefore be contained by quarantine dates back to the 14th century.
The “germ theory” of illness, which holds that specific pathogens cause specific illnesses, was introduced by Louis Pasteur in 1861 (after the events of The Great Trouble). Efforts by John Snow and Pasteur led to further reform in the latter half of the 19th century, and their work had a notable effect on promoting the idea that governmental organizations should be responsible for maintaining public health.
In the 20th and 21st centuries, public health became a collaboration between the institutional and the individual levels, and with the advent of mass media, physicians saw an unprecedented opportunity to “manage the masses” during the 1918 influenza pandemic (also known as the “Spanish Flu”). However, most contemporary doctors felt that the efforts made to implement social distancing during the outbreak were insufficient (Tomes, Nancy. “‘Destroyer and Teacher’: Managing the Masses During the 1918–1919 Influenza Pandemic.” Public Health Reports, vol. 125, no. 3, Apr. 2010, pp. 48-62). Similar efforts were undertaken during the COVID-19 pandemic that began in 2020.
