121-583: William Farr CB (30 November 1807 – 14 April 1883) was a British epidemiologist , regarded as one of the founders of medical statistics . William Farr was born in Kenley, Shropshire , to poor parents. He was effectively adopted by a local squire, Joseph Pryce, when Farr and his family moved to Dorrington . In 1826 he took a job as a dresser (surgeon's assistant) in the Salop Infirmary in Shrewsbury and served
242-686: A Companionship of the Bath and the Gold Medal of the British Medical Association for his work in the field of biostatistics . In his last years, Farr's approach had become obsolescent. Bacteriology had changed the face of the medical issues, and statistics became an increasingly mathematic tool. Medical reformers, too, changed approach, expecting less from legislation and central government. Farr died aged 75 at his home in Maida Vale , London, and
363-529: A double-blind experiment . In the mid-19th century, Soho in London had a serious problem with filth due to the large influx of people and a lack of proper sanitary services: the London sewer system had not reached Soho. Cowsheds, slaughter houses and grease-boiling dens lined the streets and contributed animal droppings, rotting fluids and other contaminants to the primitive Soho sewer system. Many cellars had cesspools underneath their floorboards, which formed from
484-489: A 'morbid matter' which, passing from one patient in his evacuations, is accidentally swallowed by other persons as a pollution of food or water; that an increase of the swallowed germ of the disease takes place in the interior of the stomach and bowels, giving rise to the essential actions of cholera, as at first a local derangement; and that 'the morbid matter of cholera having the property of reproducing its own kind must necessarily have some sort of structure, most likely that of
605-460: A cell. Even though Simon understood Snow's theory, he questioned its relation to the cause of cholera. On 31 August 1854, after several other outbreaks had occurred elsewhere in the city, a major outbreak of cholera occurred in Soho. Snow later called it "the most terrible outbreak of cholera which ever occurred in this kingdom." Over the next three days, 127 people on or near Broad Street died. During
726-454: A daily allowance of beer, they did not consume water from the nearby well. During the brewing process, the wort (or un-fermented beer) is boiled in part so that hops can be added. This step killed the cholera bacteria in the water they had used to brew with, making it safe to drink. Snow showed that the Southwark and Vauxhall Waterworks Company was taking water from sewage-polluted sections of
847-443: A few days in that town, where the water was known to be clean, and there had been no previous outbreaks of cholera. Snow was informed that the water had recently turned impure. Residents were forced to let the water run for a while before using it, in order to let the sudsy, sewer-like water run until it was clear. Snow, finding that the water the residents were using was not different from the usual water from their pump, determined that
968-665: A letter to the Annual Report of the Registrar General of Births, Deaths and Marriages in England . In that letter, he applied mathematics to the records of deaths during a recent smallpox epidemic, proposing that: "If the latent cause of epidemics cannot be discovered, the mode in which it operates may be investigated. The laws of its action may be determined by observation, as well as the circumstances in which epidemics arise, or by which they may be controlled." He showed that during
1089-657: A medical practice in Fitzroy Square , London. He became involved in medical journalism and statistics. In 1837 the General Register Office (GRO) took on the responsibility for the United Kingdom Census 1841 . Farr was hired there, initially on a temporary basis to handle data from vital registration . Then, with a recommendation from Edwin Chadwick and backing from Neil Arnott , Farr secured another post in
1210-651: A nominal apprenticeship to an apothecary . Pryce died in November 1828, and left Farr £500 (equivalent to £54,100 in 2023), which allowed him to study medicine in France and Switzerland . In Paris he heard Pierre Charles Alexandre Louis lecture. Farr returned to England in 1831 and continued his studies at University College London , qualifying as a licentiate of the Society of Apothecaries in March 1832. He married in 1833 and started
1331-469: A noxious form of "bad air". The germ theory was not established at this point ( Louis Pasteur did not propose it until 1861). Snow did not understand the mechanism by which disease was transmitted, but the evidence led him to believe that it was not due to breathing foul air. Based on the pattern of illness among residents, Snow hypothesized that cholera was spread by an agent in contaminated water. He first published his theory in 1849, in an essay titled "On
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#17330941957661452-413: A poison already present in the subject's bloodstream. Popular medical practices, such as bloodletting, could not be effective in such a case. Snow also argued that cholera was not a product of Miasma. "There was nothing in the air to account for the spread of cholera". According to Snow, cholera was spread by persons ingesting a substance, not through atmospheric transmittal. The Reverend Henry Whitehead
1573-483: A recent holder of the office of Garter King of Arms, wrote of Anstis's motivations: It was Martin Leake's opinion that the trouble and opposition Anstis met with in establishing himself as Garter so embittered him against the heralds that when at last in 1718 he succeeded, he made it his prime object to aggrandise himself and his office at their expense. It is clear at least that he set out to make himself indispensable to
1694-509: A red ring bearing the motto of the Order in gold letters. The circle is flanked by two laurel branches , and is above a scroll bearing the words Ich dien (older German for 'I serve') in gold letters. Stylised versions of this are known as Bath stars , and are used as epaulette pips to indicate British Army officer ranks and for police ranks . The star for civil Knights and Dames Grand Cross consists of an eight-pointed silver star, without
1815-451: A scroll bearing the words Ich dien in gold letters. The civil badge is a plain gold oval, bearing three crowns on the obverse side, and a rose, a thistle and a shamrock , emanating from a sceptre on the reverse side; both emblems are surrounded by a ring bearing the motto of the Order. On certain ' collar days ' designated by the Sovereign, members attending formal events may wear
1936-464: A series of national life tables . The theory of zymotic disease was Farr's contribution to the debate on aetiology . He identified urbanisation and population density as public health issues. In terms of nosology he classed epidemic, endemic and contagious diseases as "zymotic", seen as diseases of filth and overcrowding. A selection of his statistical writings was published in 1885, edited by Noël Humphreys. In " The Sewer King ", an episode in
2057-618: A way that went beyond the original job description. In so doing he applied the techniques of the English actuary Benjamin Gompertz (the Gompertz curve ), and the closely allied statistical "law of mortality" of his fellow actuary Thomas Rowe Edmonds . Farr, by relying on the existing mathematical model of mortality, could use data sampling to cut back the required computation. From the GRO data he constructed
2178-408: Is a British order of chivalry founded by King George I on 18 May 1725. Recipients of the Order are usually senior military officers or senior civil servants , and the monarch awards it on the advice of His Majesty's Government. The name derives from an elaborate medieval ceremony for preparing a candidate to receive his knighthood , of which ritual bathing (as a symbol of purification )
2299-455: Is a gold Maltese Cross of eight points, enamelled in white. Each point of the cross is decorated by a small gold ball; each angle has a small figure of a lion. The centre of the cross bears three crowns on the obverse side, and a rose, a thistle and a shamrock , emanating from a sceptre on the reverse side. Both emblems are surrounded by a red circular ring bearing the motto of the Order, which are in turn flanked by two laurel branches, above
2420-461: Is in turn larger than the Companion's badge; however, these are all suspended on a crimson ribbon. Knights and Dames Grand Cross wear the badge on a riband or sash, passing from the right shoulder to the left hip. Knights Commander and male Companions wear the badge from a ribbon worn around the neck. Dames Commander and female Companions wear the badge from a bow on the left side: The military badge
2541-470: Is known for his influence on public health, which arose after his studies of the cholera epidemic. In attempting to figure out who was receiving impure water in each neighbourhood, what is now known as a double-blind experiment fell right into his lap. He describes the conditions of the situation in his essays: In many cases a single house has a supply different from that on either side. Each company supplies both rich and poor, both large houses and small; there
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#17330941957662662-437: Is made of black velvet ; it includes an upright plume of feathers . The collar , worn only by Knights and Dames Grand Cross, is made of gold and weighs 30 troy ounces (933 g) . It consists of depictions of nine imperial crowns and eight sets of flowers ( roses for England, thistles for Scotland, and shamrocks for Ireland), connected by seventeen silver knots. On lesser occasions, simpler insignia are used: The star
2783-419: Is no difference in the condition or occupation of the persons receiving the water of the different companies...As there is no difference whatever either in the houses or the people receiving the supply of the two Water Companies, or in any of the physical conditions with which they are surrounded, it is obvious that no experiment could have been devised which would more thoroughly test the effect of water supply on
2904-460: Is not entirely clear. The 'three joined in one' may be a reference to the kingdoms of England , Scotland , and either France or Ireland , which were held (or claimed in the case of France ) by English and, later, British monarchs. This would correspond to the three crowns in the badge. Another explanation of the motto is that it refers to the Holy Trinity . Nicolas quotes a source (although he
3025-467: Is now known as a Voronoi diagram . He mapped the locations of individual water pumps and generated cells which represented all the points on his map which were closest to each pump. The section of Snow's map representing areas in the city where the closest available source of water was the Broad Street pump included the highest incidence of cholera cases. Snow also performed a statistical comparison between
3146-452: Is sceptical of it) who claims that prior to James I the motto was Tria numina juncta in uno (three powers/gods joined in one), but from the reign of James I, the word numina was dropped, and the motto understood to mean Tria [regna] juncta in uno (three kingdoms joined in one). The prime mover in the establishment of the Order of the Bath was John Anstis , Garter King of Arms , England's highest heraldic officer. Sir Anthony Wagner ,
3267-584: Is the Great Master, of which there have been ten: Originally a Prince of the Blood Royal, as the Principal Knight Companion, ranked next after the sovereign. This position was joined to that of the Great Master in the statutes of 1847. The Great Master and Principal Knight is now either a descendant of George I or 'some other exalted personage'; the holder of the office has custody of the seal of
3388-426: Is used only by Knights and Dames Grand Cross and Knights and Dames Commander. Its style varies by rank and division; it is worn pinned to the left breast: The star for military Knights and Dames Grand Cross consists of a Maltese Cross on top of an eight-pointed silver star; the star for military Knights and Dames Commander is an eight-pointed silver cross pattée. Each bears in the centre three crowns surrounded by
3509-551: The Earl Marshal , which was not hard, their political principles being congruous and their friendship already established, but also to Sir Robert Walpole and the Whig ministry, which can by no means have been easy, considering his known attachment to the Pretender and the circumstances under which he came into office. ... The main object of Anstis's next move, the revival or institution of
3630-651: The Gulf War . A more controversial member of the Order was Robert Mugabe , whose honour was stripped by the Queen, on the advice of the Foreign Secretary , David Miliband , on 25 June 2008 "as a mark of revulsion at the abuse of human rights and abject disregard for the democratic process in Zimbabwe over which President Mugabe has presided." Honorary members do not count towards the numerical limits in each class. In addition,
3751-746: The London School of Hygiene & Tropical Medicine . Twenty-three names of public health and tropical medicine pioneers were chosen to appear on the School building in Keppel Street when it was constructed in 1926. In 1884, Farriolla , which is a genus of fungi in the Ascomycota phylum, was named in William Farr's honour. Order of the Bath The Most Honourable Order of the Bath
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3872-742: The Order of the Garter ). Foreign generals are also often given honorary appointments to the Order, for example: Marshal Ferdinand Foch and Marshal Joseph Joffre during the First World War ; Marshal Georgy Zhukov , King Abdul-Aziz of Saudi Arabia , General Dwight D. Eisenhower , General George C. Marshall , General Douglas MacArthur , and General George S. Patton Jr. during the Second World War ; and General Norman Schwarzkopf and General Colin Powell after
3993-531: The Southwark and Vauxhall Waterworks Company , and a waterworks at Seething Wells (owned by the Lambeth Waterworks Company ) that was further upriver and hence had cleaner water; he showed that houses supplied by the former had a cholera mortality rate 14 times that of those supplied by the latter. Regarding the decline in cases related to the Broad Street pump, Snow said: It will be observed that
4114-783: The Sovereign of the United Kingdom (currently King Charles III ), the Great Master (currently William, Prince of Wales ), and three Classes of members: Members belong to either the Civil Division or the Military Division. Knight Companion (KB), the order's only class prior to 1815, is no longer an option. Commonwealth citizens who are not subjects of the British monarch and foreign nationals may be made honorary members. The Order of
4235-480: The St James parish authorities to disable the well pump by removing its handle. Although this action has been popularly reported as ending the outbreak, the epidemic may have already been in rapid decline, as explained by Snow: There is no doubt that the mortality was much diminished, as I said before, by the flight of the population, which commenced soon after the outbreak; but the attacks had so far diminished before
4356-452: The coronation of Henry IV in 1399, the full ceremonies were restricted to major royal occasions, such as coronations, investitures of the Prince of Wales or royal dukes , and royal weddings, and the knights so created became known as Knights of the Bath . Knights Bachelor continued to be created with the simpler form of ceremony. The last occasion on which Knights of the Bath were created
4477-603: The "British Life Table". In 1862 Farr was paid £300 (equivalent to £35,400 in 2023) for producing a report on the Metropolitan Police Superannuation Fund, an early pension provision for that organisation. He also served as a commissioner in the 1871 census, retiring from the General Register Office in 1879 after he was not given the post of Registrar General , the position going to Sir Brydges Henniker. The same year, Farr received as honours
4598-405: The 1853-54 epidemic, Farr gathered more statistical evidence. During focused study of the 1854 Broad Street cholera outbreak , the physician John Snow used data supplied by the GRO and applied the (now accepted) mechanism for transmission he had proposed in 1849: people were infected by swallowing something, and it multiplied in the intestines . Snow also examined mortality statistics compiled by
4719-485: The 1854 epidemic to miasma. Dr Edwin Lankester was a physician on the local research conglomerate that studied the 1854 Broad Street Cholera Epidemic. In 1866, Lankester wrote about Snow's conclusion that the pump itself was the cause of the cholera outbreak. He agreed with Snow at the time; however, his opinion, like Snow's, was not publicly supported. Lankester subsequently closed the pump due to Snow's theory and data on
4840-434: The 1859 revision. Women were admitted to the Order in 1971. In the 1971 New Year Honours , Jean Nunn became the first woman admitted to the order. In 1975, Princess Alice, Duchess of Gloucester , an aunt of Elizabeth II , became the first woman to reach the highest rank, Dame Grand Cross. Princess Alice (née Douglas-Montagu-Scott) was a direct descendant of the Order's first Great Master, and her husband, who had died
4961-512: The 2003 British television documentary series Seven Wonders of the Industrial World , Farr was played by Norman Lovett . Farr's first wife, whom he married in 1833, had the surname Langford; she died of tuberculosis in 1837. He married Mary Elizabeth Whittal in 1842, and they had eight children. In 1880 a public testimonial was collected to provide for his daughters after he lost money through unwise investments. One daughter, Henrietta,
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5082-602: The Bath is the fourth most senior of the British orders of chivalry , after the Order of the Garter , the Order of the Thistle , and the (dormant) Order of St Patrick . In the Middle Ages , a knighthood was often conferred with elaborate ceremonies. These usually involved the knight-to-be taking a bath (possibly symbolic of spiritual purification ), during which he was instructed in the duties of knighthood by more senior knights. He
5203-701: The British monarch and foreigners may be made honorary members. Queen Elizabeth II established the custom of appointing visiting (republican) heads of state honorary GCBs, for example Gustav Heinemann and Josip Broz Tito (in 1972), Ronald Reagan (in 1989), Lech Wałęsa (in 1991), Censu Tabone (in 1992), Fernando Henrique Cardoso , George H. W. Bush (in 1993), Nicolas Sarkozy (in 2008), and Susilo Bambang Yudhoyono (in 2012), as well as Turkish President Abdullah Gül , Slovenian President Danilo Türk , Mexican President Felipe Calderón , and South African President Jacob Zuma (royal heads of state are instead usually made Stranger Knights and Ladies Companion of
5324-485: The Broad Street outbreak, as he noted that he hesitated to come to a conclusion based on a population that had predominantly fled the neighbourhood and redistributed itself. He feared throwing off results of the study. From a mathematics perspective, John Snow's innovation was focusing on death rates in areas served by two water companies which drew water from the River Thames, rather than basing it on data from victims of
5445-486: The Broad Street pump (which drew water from a well). Snow's work also led to a far greater health and safety impact than the removal of the Broad Street pump handle. Deactivating the pump "hardly made a dent in the citywide cholera epidemic, which went on to claim nearly 3,000 lives". Snow was sceptical of the prevailing miasma theory , which held that diseases such as cholera or the Black Death were caused by pollution or
5566-450: The Broad Street pump handle. They had responded only to the urgent threat posed to the population, and afterwards they rejected Snow's theory. To accept his proposal would have meant indirectly accepting the oral-faecal method of transmission of disease, which was too unpleasant for most of the public to contemplate. The Broad Street outbreak was an effect rather than a cause of the epidemic. Snow's conclusions were not predominantly based on
5687-418: The GRO as the first compiler of scientific abstracts (i.e. a statistician). Chadwick and Farr had an agenda, demography aimed at public health , and the support of the initial Registrar General Thomas Henry Lister . Lister worked with Farr on the census design, to forward the programme. Farr was responsible for the collection of official medical statistics in England and Wales. His most important contribution
5808-743: The GRO for people supplied with water from two companies in South London – the Southwark & Vauxhall Company (which drew contaminated water from low in the Thames basin) and the Lambeth Water Company (which drew cleaner water from further up the Thames) – and found Southwark & Vauxhall customers were especially likely to suffer. Farr took part in the General Board of Health 's 1854 Committee for Scientific Enquiries. The conventional explanation for cholera
5929-675: The Garter equivalent (the Gentleman Usher of the Black Rod ) perform any duties in the House of Lords . There were originally seven officers, each of whom was to receive fees from the Knights Companion both on appointment, and annually thereafter. The office of Messenger was abolished in 1859. The office of Genealogist was abolished at the same time, but revived in 1913. The offices of Registrar and Secretary were formally merged in 1859, although
6050-460: The Genealogist, Brunswick Herald of Arms to the Gentleman Usher, and Bath King of Arms was also made Gloucester King of Arms with heraldic jurisdiction over Wales. This was the result of a move by Anstis to give the holders of these sinecures greater security; the offices of the Order of the Bath were held at the pleasure of the Great Master, while appointments to the heraldic offices were made by
6171-621: The King under the Great Seal and were for life. Members of the Order wear elaborate uniforms on important occasions (such as its quadrennial installation ceremonies and coronations ), which vary by rank: The mantle , worn only by Knights and Dames Grand Cross, is made of crimson satin lined with white taffeta . On the left side is a representation of the star (see below). The mantle is bound with two large tassels. The hat , worn only by Knights and Dames Grand Cross and Knights and Dames Commander,
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#17330941957666292-512: The Knights of the Bath, as well as the colour of the riband and mantle , and the ceremony for creating a knight. The rest of the statutes were mostly based on those of the Order of the Garter, of which he was an officer (as Garter King of Arms). The Order was founded by letters patent under the Great Seal dated 18 May 1725 ; 299 years ago ( 1725-05-18 ) , and the statutes issued
6413-528: The Maltese cross; the star for civil Knights and Dames Commander is an eight-pointed silver cross pattée. The design of each is the same as the design of the military stars, except that the laurel branches and the words Ich dien are excluded. The badge varies in design, size, and manner of wearing by rank and division. The Knight and Dame Grand Cross' badge is larger than the Knight and Dame Commander's badge, which
6534-604: The Military Division, to Commissariat and Medical officers serving with the Army and Navy , including those serving with the East India Company . In 1859, a further edition of the Statutes was issued; the changes related mainly to the costs associated with the Order. Prior to this date, it had been the policy that the insignia (which were provided by the Crown) were to be returned on
6655-502: The Mode of Communication of Cholera". In 1855 he published a second edition, including a more elaborate investigation of the effect of the water supply in the 1854 Soho outbreak. The cholera epidemic of 1849–1854 was also related to the water supplied by companies in London at the time. The main players were the Southwark and Vauxhall Waterworks Company , and the Lambeth Waterworks Company . Both companies provided water to their customers that
6776-565: The Old Ford Reservoir in East London. Farr's work was then considered conclusive. In 1858, he performed a study on the correlation of health and marriage condition, and found that health decreases from the married to the unmarried to the widowed. In the period 1857–9 the Office ordered a difference engine , a model designed by Swedish followers of Charles Babbage . The intended application was
6897-461: The Order for members who had been appointed for the services in the recent war. The fees were abolished, and replaced with a salary of approximately the same average value. The offices of Genealogist and Messenger were abolished, and those of Registrar and Secretary combined. In 1910, after his accession to the throne, George V ordered the revival of the Installation ceremony, perhaps prompted by
7018-485: The Order of the Bath was probably that which it in fact secured, of ingratiating him with the all-powerful Prime Minister Sir Robert Walpole. The use of honours in the early eighteenth century differed considerably from the modern honours system , in which hundreds, if not thousands, of people each year receive honours on the basis of deserving accomplishments. The only honours available at that time were hereditary (not life) peerages and baronetcies , knighthoods , and
7139-399: The Order of the Garter (or the Order of the Thistle for Scots), none of which were awarded in large numbers (the Garter and the Thistle are limited to twenty-four and sixteen living members respectively). The political environment was also significantly different from today: The Sovereign still exercised a power to be reckoned with in the eighteenth century. The Court remained the centre of
7260-420: The Order were increasingly made for naval , military , or diplomatic achievements. This is partly due to the conflicts Britain was engaged in over this period. The Peninsular War resulted in so many deserving candidates for the Bath, that a statute was issued allowing the appointment of Extra Knights in time of war, who were to be additional to the numerical limits imposed by the statutes, and whose number
7381-625: The Order's collar over their military uniform or evening wear. When collars are worn (either on collar days or on formal occasions such as coronations), the badge is suspended from the collar. The collars and badges of Knights and Dames Grand Cross are returned to the Central Chancery of the Orders of Knighthood upon the decease of their owners. All other insignia may be retained by their owners. 1854 Broad Street cholera outbreak The Broad Street cholera outbreak (or Golden Square outbreak )
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#17330941957667502-518: The Thames Other companies, such as the New River Company and Chelsea Waterworks Company , were observed to have better filtered water; few deaths occurred in the neighbourhoods which they supplied. These two companies not only obtained their water from cleaner sources than the Thames, but they filtered the water and treated it until there were no obvious contaminants. As mentioned above, Snow
7623-507: The Thames and delivering it to homes, resulting in an increased incidence of cholera among its customers. Snow's study is part of the history of public health and health geography . It is regarded as the founding event of epidemiology . In Snow's own words: On proceeding to the spot, I found that nearly all the deaths had taken place within a short distance of the [Broad Street] pump. There were only ten deaths in houses situated decidedly nearer to another street-pump. In five of these cases
7744-455: The air (referred to as " miasma "). This discovery came to influence public health and the construction of improved sanitation facilities beginning in the mid-19th century. Later, the term " focus of infection " started to be used to describe sites, such as the Broad Street pump, in which conditions are favourable for transmission of an infection. Snow's endeavour to find the cause of the transmission of cholera caused him to unknowingly create
7865-422: The air and infect individuals, and thus cause cholera. Dr William Farr , the commissioner for the 1851 London census and a member of the General Register's Office, believed that miasma arose from the soil surrounding the River Thames. It contained decaying organic matter which contained miasmatic particles and was released into the London air. Miasma theorists believed in "cleansing and scouring, rather than through
7986-540: The causes of cholera in the human body: miasma theory and germ theory. The London medical community debated between these causes for the persistent cholera outbreaks in the city. The cholera-causing bacterium Vibrio cholerae was isolated in 1854, but the finding did not become well known and accepted until decades later. Miasma theorists concluded that cholera was caused by particles in the air, or "miasmata", which arose from decomposing matter or other dirty organic sources. "Miasma" particles were thought to travel through
8107-413: The death of the holder; the exception had been foreigners who had been awarded honorary membership. In addition, foreigners had usually been provided with stars made of silver and diamonds, whereas ordinary members had only embroidered stars. The decision was made to award silver stars to all members, and only require the return of the Collar . The Crown had also been paying the fees due to the officers of
8228-421: The deaths either very much diminished, or ceased altogether, at every point where it becomes decidedly nearer to send to another pump than to the one in Broad street. It may also be noticed that the deaths are most numerous near to the pump where the water could be more readily obtained. There was one significant anomaly—none of the workers in the nearby Broad Street brewery contracted cholera. As they were given
8349-419: The deceased persons used to drink the pump-water from Broad Street, either constantly or occasionally ... The result of the inquiry then was, that there had been no particular outbreak or prevalence of cholera in this part of London except among the persons who were in the habit of drinking the water of the above-mentioned pump-well. I had an interview with the Board of Guardians of St. James's parish, on
8470-461: The evening of Thursday, the 7th September, and represented the above circumstances to them. In consequence of what I said, the handle of the pump was removed on the following day. It was discovered later that this public well had been dug 3 feet (0.9 m) from an old cesspit that had begun to leak faecal bacteria. Waste water from washing nappies , used by a baby who had contracted cholera from another source, drained into this cesspit. Its opening
8591-426: The fact that the Bath was represented as a military Order, only a few military officers were among the initial appointments (see List of knights companion of the Order of the Bath ). They may be broken down into categories as follows (some are classified in more than one category): The majority of the new Knights Companions were knighted by the King, and invested with their ribands and badges on 27 May 1725. Although
8712-464: The families of the deceased persons informed me that they always sent to the pump in Broad Street, as they preferred the water to that of the pumps which were nearer. In three other cases, the deceased were children who went to school near the pump in Broad Street ;... With regard to the deaths occurring in the locality belonging to the pump, there were 61 instances in which I was informed that
8833-473: The first Installation ceremony of the more junior Order of St Michael and St George , held a few years earlier, and the building of a new chapel for the Order of the Thistle in 1911. The Installation ceremony took place on 22 July 1913 in the Henry VII Chapel , and Installations have been held at regular intervals since. Prior to the 1913 Installation, it was necessary to adapt the chapel to accommodate
8954-403: The following week. The Order initially consisted of the Sovereign, a Prince of the blood Royal as Principal Knight, a Great Master, and thirty-five Knights Companion. Seven officers (see below) were attached to the Order. These provided yet another opportunity for political patronage, as they were to be sinecures at the disposal of the Great Master, supported by fees from the knights. Despite
9075-406: The help of Reverend Henry Whitehead ), Snow identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street ) at Cambridge Street. Although Snow's chemical and microscope examination of a sample of the water from this Broad Street pump water did not conclusively prove its danger, his facts about the patterns of illness and death among residents in Soho persuaded
9196-407: The human body. Cholera did not affect either the circulatory or the nervous system and there was no "poison in the blood...in the consecutive fever...the blood became poisoned from urea getting into the circulation". According to Snow, this "urea" entered the blood through kidney failure. (Acute kidney failure is a complication of cholera.) Therefore, the fever was caused by kidney failure, not by
9317-493: The larger number of members. An appeal was made to the members of the Order, and following the Installation a surplus remained. A Committee was formed from the Officers to administer the 'Bath Chapel Fund', and over time this committee has come to consider other matters than purely financial ones. Another revision of the statutes of the Order was undertaken in 1925, to consolidate the 41 additional statutes which had been issued since
9438-404: The marks of distinction which they have so nobly earned. The Order was now to consist of three classes: Knights Grand Cross, Knights Commander, and Companions. At the same time, the large and small Naval Gold Medals were suspended, while the bearers became Knights Commander and Companions, respectively. The existing Knights Companion (of which there were 60) became Knight Grand Cross; this class
9559-467: The neck (with either a hand or a sword ), thus making him a knight. It was this accolade which was the essential act in creating a knight, and a simpler ceremony developed, conferring knighthood merely by striking or touching the knight-to-be on the shoulder with a sword, or 'dubbing' him, as is still done today. In the early medieval period, the difference seems to have been that the full ceremonies were used for men from more prominent families. From
9680-400: The new Order for Walpole was that it would provide a source of such favours to strengthen his political position. He made sure that most of the 36 new honorees were peers and MPs who would provide him with useful connections. George I having agreed to Walpole's proposal, Anstis was commissioned to draft statutes for the Order of the Bath. As noted above, he adopted the motto and badge used by
9801-509: The next week, three quarters of the residents had fled the area. By 10 September, more than 500 people had died and the mortality rate was 12.8 per thousand inhabitants in some parts of the city. By the end of the outbreak, 616 people had died. Many of the victims were taken to the Middlesex Hospital , where their treatment was superintended by Florence Nightingale , who briefly joined the hospital in early September in order to help with
9922-505: The occurrence of vibriones in air samples from various cholera wards and Hassall observed vibriones in water samples. Neither identified vibriones as the cause of cholera. As part of their investigation of the cholera epidemic, the Board of Health sent physicians to examine in detail the conditions of the Golden Square neighbourhood and its inhabitants. The Board of Health ultimately attributed
10043-476: The opportunity also taken to regularise the 1815 expansion of the Order. The 1847 statutes also abolished all the medieval ritual, but they did introduce a formal Investiture ceremony, conducted by the Sovereign wearing the Mantle and insignia of the Order, attended by the Officers and as many GCBs as possible, in their Mantles. In 1850, a special statute authorised appointments of Knight Commander and Companion, in
10164-458: The order and is responsible for enforcing the statutes. The statutes also provide for the following: Regular membership is limited to citizens of the United Kingdom and of other Commonwealth countries of which the British monarch is Sovereign. Appointees are usually officers of the armed forces or senior civil servants, such as permanent secretaries . Members appointed to the Civil Division must "by their personal services to [the] crown or by
10285-402: The outbreak must be caused by a leak in the pipes that allowed surrounding sewage and its contaminants to seep in to the water supply. This scenario was similar to that of the Broad Street outbreak. The incoming water was being contaminated by the increasing levels of sewage, coupled with the lack of proper and safe plumbing. After the cholera epidemic had subsided, government officials replaced
10406-451: The outbreak. According to a letter from Elizabeth Gaskell , "She herself [Nightingale] was up night and day from Friday afternoon (Sept. 1) to Sunday afternoon, receiving the poor creatures (chiefly fallen women of that neighbourhood - they had it the worst) who were being constantly brought in - - undressing them - putting on turpentine stupes, et cetera, doing it herself to as many as she could manage". By talking to local residents (with
10527-466: The pattern of infection, and infection rates dropped significantly. Lankester eventually was named the first medical officer of health for St James's parish in London, the same area where the pump was located. A replica pump was installed in 1992 at the site of the 1854 pump. Every year the John Snow Society holds "Pumphandle Lectures" on subjects of public health. Until August 2015, when the pump
10648-654: The performance of public duties have merited ... royal favour." Appointments to the Military Division are restricted by the minimum rank of the individual. GCBs hold the rank of admiral in the Royal Navy, general in the British Army or Royal Marines , or air chief marshal in the Royal Air Force . KCBs must at least hold the rank of vice admiral , lieutenant general in the Army or Marines, or air marshal . CBs tend be of
10769-522: The political world. The King was limited in that he had to choose Ministers who could command a majority in Parliament , but the choice remained his. The leader of an administration still had to command the King's personal confidence and approval. A strong following in Parliament depended on being able to supply places, pensions, and other marks of Royal favour to the government's supporters. The attraction of
10890-450: The prestige of the Order. In 1847, Queen Victoria issued new statutes eliminating all references to an exclusively military Order. As well as removing the word 'Military' from the full name of the Order, this opened up the grades of Knight Commander and Companion to civil appointments, and the Military and Civil Divisions of the Order were established. New numerical limits were imposed, and
11011-456: The previous year, had also held that office. The second Dame Grand Cross, Sally Davies , was appointed in the 2020 New Year Honours . The British Sovereign is the Sovereign of the Order of the Bath. As with all honours, except those in the Sovereign's personal gift, the Sovereign makes all appointments to the Order on the advice of the Government . The next-most senior member of the Order
11132-437: The progress of Cholera than this, which circumstances placed ready made before the observer. The experiment too, was on the grandest scale. No fewer than three hundred thousand people of both sexes, of every age and occupation, and of every rank and station, from gentlefolks down to the very poor, were divided into two groups without their choice, and, in most cases, without their knowledge; one group being supplied water containing
11253-546: The purer scientific approach of microbiology". Farr later agreed with Snow's germ theory following Snow's publications. In contrast, the germ theory held that the principal cause of cholera was a germ cell that had not yet been identified. Snow theorised that this unknown germ was transmitted from person to person by individuals ingesting water. John Simon , a pathologist and the lead medical officer for London, labelled Snow's germ theory as "peculiar". Excerpt from John Simon: This doctrine is, that cholera propagates itself by
11374-552: The rank of rear admiral , major general in the Army, Royal Navy or Royal Marines, or air vice marshal in the Royal Air Force, and in addition must have been Mentioned in Despatches for distinction in a command position in a combat situation, although the latter is no longer a requirement. Non-line officers (e.g. engineers , medics) may be appointed only for meritorious service in wartime. Commonwealth citizens not subjects of
11495-418: The sewage of London, and amongst it, whatever might have come from the cholera patients, the other group having water quite free from such impurity. Snow went on to study the water contents from each home through a test performed on each sample. In this way, it could be deduced from which supplier the home was receiving their water. He concluded that it was indeed impure water from the big companies that allowed
11616-519: The sewers and filth seeping in from the outside. Since the cesspools were overrunning, the London government decided to dump the waste into the River Thames , contaminating the water supply. London had already suffered from a "series of debilitating cholera outbreaks". These included outbreaks in 1832 and 1849 which killed a total of 14,137 people. Preceding the 1854 Broad Street cholera outbreak, physicians and scientists held two competing theories on
11737-400: The smallpox epidemic, a plot of the number of deaths per quarter followed a roughly bell-shaped or " normal curve ", and that recent epidemics of other diseases had followed a similar pattern. There was a major outbreak of cholera in London in 1849 which killed around 15,000 people. Early industrialisation had made London the most populous city in the world at the time, and the River Thames
11858-416: The spread of cholera to progress rapidly. He went on to prove his theory through the observation of prisons in London, finding that cholera ceased in these places only a few days after switching to cleaner water sources. Snow's analysis of cholera and cholera outbreaks extended past the closure of the Broad Street pump. He concluded that cholera was transmitted through and affected the alimentary canal within
11979-626: The statutes allow the Sovereign to exceed the limits in time of war or other exceptional circumstances. The office of Dean is held by the Dean of Westminster . The King of Arms, responsible for heraldry , is known as Bath King of Arms; he is not, however, a member of the College of Arms , like many heralds. The Order's Usher is known as the Gentleman Usher of the Scarlet Rod ; he does not, unlike his Order of
12100-405: The statutes set out the full medieval ceremony which was to be used for creating knights, this was not performed, and indeed, was possibly never intended to be, as the original statutes contained a provision allowing the Great Master to dispense Knights Companion from these requirements. The original knights were dispensed from all the medieval ceremonies with the exception of the Installation, which
12221-515: The two positions had been held concurrently for the previous century. An Officer of Arms and a Secretary for the Knights Commander and Companions were established in 1815, but abolished in 1847. The office of Deputy Secretary was created in 1925. Under the Hanoverian kings, certain of the officers also held heraldic office. The office of Blanc Coursier Herald of Arms was attached to that of
12342-406: The use of the water was stopped, that it is impossible to decide whether the well still contained the cholera poison in an active state, or whether, from some cause, the water had become free from it. Snow later used a dot map to illustrate how cases of cholera occurred around this pump. Snow's efforts to connect the incidence of cholera with potential geographic sources was based on creating what
12463-461: Was a severe outbreak of cholera that occurred in 1854 near Broad Street (now Broadwick Street ) in Soho , London , England , and occurred during the 1846–1860 cholera pandemic happening worldwide. This outbreak, which killed 616 people, is best known for the physician John Snow 's study of its causes and his hypothesis that germ-contaminated water was the source of cholera, rather than particles in
12584-582: Was also to appoint eight officers for this body. However, the statute was never invoked. In January 1815, after the end of the Peninsular War , the Prince Regent (later George IV ) expanded the Order of the Bath to the end that those Officers who have had the opportunities of signalising themselves by eminent services during the late war may share in the honours of the said Order, and that their names may be delivered down to remote posterity, accompanied by
12705-414: Was an assistant curate at St. Luke's church in Soho during the 1854 cholera outbreak. A former believer in the miasma theory of disease , Whitehead worked to disprove false theories. He was influenced by Snow's theory that cholera spreads by consumption of water contaminated by human waste. Snow's work, particularly his maps of the Soho area cholera victims, convinced Whitehead that the Broad Street pump
12826-426: Was an element. While not all knights went through such an elaborate ceremony, knights so created were known as "knights of the Bath". George I constituted the Knights of the Bath as a regular military order . He did not revive the order, which did not previously exist, in the sense of a body of knights governed by a set of statutes and whose numbers were replenished when vacancies occurred. The Order consists of
12947-623: Was buried in the churchyard at Holy Trinity, Bromley Common . In 1837 Farr wrote the chapter "Vital Statistics" for John Ramsey McCulloch 's Statistical Account of the British Empire . In January 1837 he established the British Annals of Medicine, Pharmacy, Vital Statistics, and General Science , discontinued in August of that year. He revised a book of James Fernandez Clarke on tuberculosis . Farr exploited his GRO post compiling abstracts in
13068-484: Was drawn from the River Thames, which was highly contaminated with visible and invisible products and bacteria. Dr Hassall examined the filtered water and found it contained animal hair, among other foul substances. He made the remark that: It will be observed, that the water of the companies of the Surrey Side of London, viz., the Southwark, Vauxhall, and Lambeth, is by far the worst of all those who take their supply from
13189-485: Was heavily polluted with untreated sewage. Farr subscribed to the conventional theory that cholera was carried by polluted air rather than water – the miasmic theory . In addition, through his analysis of several variables and their association with death from cholera, Farr held the belief that elevation was the major contributor to the occurrence of the disease. He also presented how topographical features are able to prevent certain diseases similarly to immunization. During
13310-456: Was limited to 72 members, of which twelve could be appointed for civil or diplomatic services. The military members had to be of the rank of at least major-general or rear admiral . The Knights Commander were limited to 180, exclusive of foreign nationals holding British commissions, up to ten of whom could be appointed as honorary Knights Commander. They had to be of the rank of lieutenant-colonel or post-captain . The number of Companions
13431-604: Was married to painter and illustrator Henry Marriott Paget , the older brother of illustrators Sidney and Walter Paget . Another daughter, Florence Farr , was also a painter and artist and a model of many famous art deco works of art. The Pagets as well as the Farr sisters lived and worked in Bedford Park , the famous artist's colony in West London. Farr's name features on the Frieze of
13552-517: Was not specified, but they had to have received a medal or been mentioned in despatches since the start of the war in 1803. A list of about 500 names was subsequently published. Two further officers were appointed, an 'Officer of arms attendant on the Knights Commanders and Companions', and a 'Secretary appertaining to the Knights Commanders and Companions'. The large increase in numbers caused some complaints that such an expansion would reduce
13673-427: Was not subject to any restrictions. Another statute, this one issued some 80 years earlier, had also added a military note to the Order. Each knight was required, under certain circumstances, to supply and support four men-at-arms for a period not exceeding 42 days in any year, to serve in any part of Great Britain. This company was to be captained by the Great Master, who had to supply four trumpeters , and
13794-464: Was performed in the Order's Chapel, the Henry VII Chapel in Westminster Abbey , on 17 June. This precedent was followed until 1812, after which the Installation was also dispensed with, until its revival in the twentieth century. The ceremonies however remained part of the Statutes until 1847. Although the initial appointments to the Order were largely political, from the 1770s, appointments to
13915-557: Was placed in charge of investigating the cholera outbreak. They were to study the atmospheric environment in London; however, they were also to examine samples of water from several water companies in London. The committee found that the most contaminated water supply came from the South London water companies, Southwark and Vauxhall. As part of the Committee for Scientific Inquiries, Richard Dundas Thomson and Arthur Hill Hassall examined what Thomson referred to as "vibriones". Thomson examined
14036-452: Was still multifactorial ; Snow's view of cholera as solely caused by a pathogen was not accepted, though his evidence was taken seriously. Farr's research was detailed and showed an inverse correlation of mortality and elevation. There was a further epidemic in 1866, by which time Snow had died, and Farr had accepted Snow's explanation. He produced a monograph which showed that mortality was extremely high for people who drew their water from
14157-434: Was the coronation of Charles II in 1661. From at least 1625, and possibly from the reign of James I , Knights of the Bath were using the motto Tria juncta in uno ( Latin for 'Three joined in one'), and wearing as a badge three crowns within a plain gold oval. These were both subsequently adopted by the Order of the Bath; a similar design of badge is still worn by members of the Civil Division. Their symbolism however
14278-411: Was the source of the local infections. Whitehead joined Snow in tracking the contamination to a faulty cesspool and the outbreak's index case (the baby with cholera). Whitehead's work with Snow combined demographic study with scientific observation, setting an important precedent for epidemiology. The Board of Health in London had several committees, of which the Committee for Scientific Inquiries
14399-424: Was then put to bed to dry. Clothed in a special robe, he was led with music to the chapel where he spent the night in a vigil . At dawn, he made confession and attended Mass , then retired to his bed to sleep until it was fully daylight. He was then brought before the King, who after instructing two senior knights to buckle the spurs to the knight-elect's heels, fastened a belt around his waist, then struck him on
14520-751: Was to set up a system for routinely recording the causes of death. For example, for the first time it allowed the mortality rates of different occupations to be compared. In 1839, Farr joined the Statistical Society , in which he played an active part as treasurer, vice-president and president over the years. In 1855 he was elected Fellow of the Royal Society . He was involved in the Social Science Association from its foundation in 1857, taking part in its Quarantine Committee and Committee on Trades' Societies and Strikes. In 1840, Farr submitted
14641-493: Was under a nearby house that had been rebuilt further away after a fire and a street widening. At the time there were cesspits under most homes. Most families tried to have their raw sewage collected and dumped in the Thames to prevent their cesspit from filling faster than the sewage could decompose into the soil. At the same time, an investigation of cholera transmission was being conducted in Deptford . Around 90 people died within
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