Margaret Pelling

Research: My earliest work was on history of epidemiology and public health in 19th-century England, with reference to the Benthamite sanitarians, William Farr of the Registrar General’s Department, and the pioneering epidemiologists John Snow and William Budd.  I sought to particularise the thinking of the time in relation to cholera (epidemic) and forms of fever (endemic) in order to show, first, that the latter rather than the former was the main engine of sanitary reform; secondly, that it is inaccurate to see the controversies over disease causation in terms of the binary miasmatic/contagious, which is still so often referred to; and thirdly, that those contributing to these debates prior to the “bacteriological revolution” were, with considerable justification, committed to  a multifactorial rather than “exclusive” approach, based on a sophisticated hierarchy of causation making sense of changes both inside and outside the body. John Snow adopted an “exclusive” view, but even he can be shown to have participated fully in this climate of opinion. In doing justice to this formative period, we may gain a better understanding of the present. In spite of the increasing predominance of the degenerative diseases in the prosperous west, we are still culturally wedded to a simplified model of disease causation derived from the bacteriological revolution which leads to equally simplified expectations of treatment and control. Endemic disease is neglected in favour of the drama of epidemic rise and fall, such that conditions like obesity and drug dependency are continually described as epidemics. One indication of the enduring nature of this outlook is the frequent mention of John Snow in accounts of Covid-19. This is less about his methodology, as in his mapping of the effects of different water supplies, and more about the drama of his removing a parish pump and thereby ending a plague. It seems worthwhile to ask again, how justified is this afterlife of Snow?

See https://www.hsmt.ox.ac.uk/people/dr-margaret-pelling for more information.

Relevant publications include:

Cholera, Fever and English Medicine, 1825-1865 (Oxford, OUP, 1978)