Edwin Snow’s discussion of the 1854 cholera appeared first in a presentation to the Providence Medical Association, which was delivered on February 5, 1855 and then published as a City Document entitled “Statistics and Causes of Asiatic Cholera as it Prevailed in Providence in the Summer of 1854.” On December 30, 1857, Snow delivered another lecture on the subject to the Rhode Island Historical Society, which was then published a day later in the Providence Journal as “History of the Asiatic Cholera in Providence.” Both papers can now be accessed online at the National Library of Medicine.
As documented in these two reports, cholera reached Providence in spring 1854, with the first death reported on May 16. The death totals remained low in June, rose in early July, reached a peak during the first two weeks of August, and then declined almost as quickly, with no deaths reported after September 29. A chart based on the 1857 report shows the trajectory of the outbreak and the proportion of the 159 total deaths in each time segment.
After citing statistical evidence about cholera deaths, Snow’s report draws a direct connection between understanding causes of death in the most recent outbreak and taking effective preventive measures against future outbreaks: “What are these causes? Why is it that one hundred and fifty-nine persons, mostly in the full vigor of life and health, have been so suddenly cut off by cholera? Did they die from causes which it was possible to remove, and is there any way to prevent the ravages of this disease in the future? These are questions of no small importance, and the duty of answering them, and of taking such action as may be necessary in future, most certainly belongs to the city authorities. They cannot escape the responsibility. If those persons, or any portion of them, died from causes which might have been prevented or removed by the city authorities, those authorities are responsible for such deaths. If the cholera shall visit our city again, and those causes shall still be in existence, those authorities will be doubly responsible.”
Snow then amplifies this statement by drawing on evidence from the cholera outbreak and his own professional expertise: “After a careful examination of the Reports in the City Clerk’s office, and considerable personal knowledge of the disease during its prevalence among us, I am confidently of the opinion, that nine tenths of the deaths from cholera in this city were from preventable causes, and that more than one half of those deaths were from causes which might have been, and which should have been, removed by the city authorities.”