International Journal of Epidemiology 2002;31:915-919
© International Epidemiological Association 2002
Reprints and Reflections |
Commentary: John Sutherland’s Epidemiology of Constitutions
University of Notre Dame, Department of History, Notre Dame, IN 46556, USA.
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To a modern epidemiologist, these extracts from John Sutherland’s Report to the General Board of Health on the Epidemic of Cholera of 1848 and 1849 will likely seem both familiar and strange.1 Sutherland plots and counts cases; he is interested in cholera in time and space, searches for empirical generalizations (‘fixed laws’), and will suggest effective measures to respond to the epidemic. In particular, his discussion in section three of the effects of ‘unwholesome water’ may seem intriguing in light of John Snow’s concurrent and rightly celebrated demonstrations of the waterborne character of cholera.
And yet Sutherland fails to take much interest in his findings with regard to water. He relegates impure water to the status of predisposing cause, and seems uninterested in analysing the phenomena of the epidemic to exclude plausible cholera causes. Here I explore the unfamiliar in Sutherland’s epidemiology, and consider how the familiar fits into it.
Sutherland and the Chadwickian Project
Constitution and localization
The epidemiologist as clinician
Cholera as moral failing
Cholera from ‘a social point of view’
Bad water
Overdetermination and sanitary reform
Conclusion
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