REVEREND HENRY WHITEHEAD
11 Oct 2006
Although he had no formal medical education, the epidemiology of cholera intrigued Reverend Whitehead. So who was this religious leader and how did he get interested in cholera?
Reverend Henry Whitehead (1825-96), shown here in 1884 at age 59, was born on September 22,1825 in the seaside town of Ramsgate (middle center) in Kent by the Straits of Dover. His father was master at Chatham House, a small public school in the area. Henry was the eighth of ten children and grew up in the school, where later he became an assistant master. In 1847 at age 22, he left home and his potential teaching position to attend Lincoln College, University of Oxford (lower left). It was here that he made up his mind to enter the Anglican Church. After obtained his B.A. in 1850, he left for London to seek ordination.
His first employment was as assistant curate (i.e., junior priest) with the Vicar of St. Luke’s Church, Berwick Street(center right, labelled "ch" above King Street) in Soho, London, near the home of Dr. John Snow and the future site of the Broad Street pump outbreak (see red site in map). Saint Luke's had been completely rebuilt in a decorated Gothic style in 1838-9 and was popular in the parish that included Broad Street and its environs. Following his ordination as a deacon in 1851, Whitehead took up his duties among the residents of the crowded slums of the Berwick Street area and became a welcome visitor in the homes of his parishioners. His friendliness and social acceptance proved of great value to him in 1855 during the four months of his painstaking inquiry into Broad Street pump outbreak.
FEAR AMONG PARISHIONERS
After deducing the source of the Broad Street pump outbreak, Dr. John Snow had convinced the Board of Guardians to have the handle removed from the pump. This they did on September 8, 1854. The epidemic continued to decline, but greatly disrupted the community. A newspaper correspondent for the Times described on September 15, 1854 what he had seen.
The outbreak of cholera in the vicinity of Golden Square is now subsiding, but the passenger through the streets which compass that district will see many evidences of the alarming severity of the attack. Men and women in mourning are to be found in great numbers, and the chief topic of conversation is the recent epidemic. The shop windows are filled with placards relating to the subject. At every turn the instructions of the new Board of Health stare you in the face. In shop windows, on church and chapel doors, on dead walls, and at every available point appear parochial hand-bills directing the poor where to apply for gratuitous relief. An oil shop puts forth a large cask at its door, labeled in gigantic capitals "Chloride of Lime." The most remarkable evidence of all, however, and the most important, consists in the continual presence of lime in the roadways. The puddles are white and milky with it, the stones are smeared with it; great splashes of it lie about in the gutters, and the air is redolent with its strong and not very agreeable odor. The parish authorities have very wisely determined to wash all the streets of the tainted district with this powerful disinfectant; accordingly the purification takes place regularly every evening. The shopkeepers have dismal stories to tell—how they would hear in the evening that one of their neighbors whom they had been talking with in the morning had expired after a few hours of agony and torture. It has even been asserted that the number of corpses was so great that they were removed wholesale in dead-carts for want of sufficient hearses to convey them; but let us hope this is incorrect.
Whitehead was very troubled by the outbreak and its aftermath. He felt that many of the news reports were exaggerated and noted that even though the population of the area was decimated, there was "no panic which somewhat surprised [him] as [he] had always heard and read that great pestilences were invariably attended by wholesale demoralization of the population." Within a few weeks of the epidemic, Reverend Whitehead wrote his own account, entitled The Cholera in Berwick Street (1854). No mention was made of the Broad Street pump. He was 29 at the time.
While Whitehead was issuing his initial publication, John Snow was busy gathering data to test his hypothesis that the spread of cholera was attributed to the Broad Street pump. At the same time, the Medical Committee of the General Board of Health was carrying out a local inquiry of its own. This third group seemed to favor the initial report of Whitehead, describing him as the "exemplary and indefatigable curate of St. Luke's." Snow's explanation of the outbreak was considered by the Medical Committee, but was rejected outright.
The debate among Committee members continued, and eventually they decided to expand the inquiry by circulating a questionnaire to people in the area. The modest returns did not fulfill their expectation. The Committee then decided to seek information by personal interviews, but to this end needed more members. Among the eight new-comers were John Snow (then age 41) and Henry Whitehead. Thus with this one act, the three investigations into the cause of the cholera outbreak merged into one. Likely it was at such a Medical Committee meeting that Snow and Whitehead met for the first time. In January 1855, Snow completed his book On the Mode of Communication of Cholera. Shortly thereafter he gave a copy to the younger Reverend Whitehead.
Having read Snow's 1855 book, Whitehead remained unconvinced and wrote Snow of his critical thinking. He felt that an intensive inquiry would reveal the falsity of the Snow's hypothesis regarding the Broad Street pump. Having so forcefully expressed his opinion, Whitehead was determined to carryout such an inquiry. In the first half of 1855, he visited many people in the area, sometimes four or five times to confirm the facts he needed. For every person who had died of cholera he ascertained the:
At the end of his inquiry, Whitehead wrote in a June 1855 report Special Investigation of Broad Street, "Slowly and I may add reluctantly," the conclusion was reached "that the use of water [from the Broad Street pump] was connected with the continuation of the outburst."
The Medical Committee reviewed Snow's book and Whitehead's most recent report. While they did not accept Snow's hypothesis regarding the cause of cholera (many believed in the miasma theory), the Committee reached the conclusion on August 9, 1855 that "the sudden severe and concentrated outbreak beginning on August 31st  and lasting for the few early days in September was in some manner attributable to the use of the impure water of the well in Broad Street." The vote for and against this benign conclusion was split equally, requiring the Chairman of the Committee to cast the deciding affirmative vote.
Whitehead remained at St. Lukes until 1857, when he left to seek another curacy. In the ensuing years he served several London parishes and in addition to cholera, developed special interest and expertise in juvenile delinquency.
In 1865 when cholera again came to London, Whitehead turned his attention back to the disease. Dr. John Snow had died seven years earlier, leaving Whitehead as the main authority on the earlier Broad Street outbreak. Because of rising public alarm. Whitehead again published his observations, cautioning in December 1865 that public health lessons of the past should not be neglected. But to no avail. In the following year, cholera broke out in the crowded slums of East London and spread by contaminated water to thousands of homes. The Bishop of London called for volunteers from among the clergy who had previous experience with cholera, and Reverend Whitehead was among those who responded.
Following the East London epidemic, Whitehead took up a curacy in Stepney (bottom right). His two years there were followed by a short service in Hammersmith (upper right), after which he returned to the dock area as Vicar of St. John's Church in Limehouse (upper right). Another three years went by and he was offered a position in Brampton, (middle right) a small town in Cumberland, supported by the Earl of Carlisle. He accepted, leaving behind a legacy as vicar in several districts of London. Before leaving the grand city, his many friends and colleagues gave him a farewell dinner on January 16, 1874 at the Rainbow Tavern in Fleet Street.
In what many felt was the longest after-dinner speech on record, Whitehead at the Rainbow Tavern offered the following personal reminiscence of Dr. John Snow.
Yet for wholly exceptional reasons, I may say a few words about Dr. John Snow—as great a benefactor in my opinion to the human race as has appeared in the present century. Dr. Snow had long believed that he had discovered the mode in which cholera is propagated and fortunately he was at hand to direct an inquiry into the cause of the Broad Street outbreak, which inquiry resulted in a remarkable confirmation of his. hypothesis. The story of his researches and of this investigation in particular I have elsewhere related at some length and therefore I will not now go into the subject. What I chiefly wish to dwell upon is the calm prophetic way in which he would talk of the ultimate results of the doctrine which he laid down.
"You and I", he would say to me, "may not live to see the day, and my name may be forgotten when it comes, but the time will arrive when great outbreaks of cholera will be things of the past; and it is the knowledge of the way in which the disease is propagated which will cause them to disappear."
He died in 1858 and since his death we have seen a complete revolution in the mode of investigating the causes of cholera and typhoid, a revolution already fruitful in beneficial consequences and destined hereafter to achieve all the important results that he anticipated. He did not in his lifetime receive all the recognition which was due to his genius, though unstinted respect was paid to his character.
"Dr. Snow's views on cholera," said a medical friend to me in 1855 "are generally regarded in the profession as very unsound." "If that be the case," I replied, "heresy may be as good a thing in your profession as some of you are apt to suppose in mine."
A portrait of Dr. Snow hangs on my study wall and ever serves to remind me that in any profession the highest order of work is achieved not by fussy demand for "something to be done," but by patient study of the eternal laws.
Thereafter in March 1874, Whitehead started his ministry in Cumberland. By 1884 (click for photograph) Reverend Whitehead had become head of a small chapel in Newland, south of Carlisle in Cumberland. He remained in the Cumberland area until his death at age 70 on March 5, 1896. He left behind a widow and two unmarried daughters.
In his 1958 publication on Henry Whitehead, S.P.W. Chave wrote a summary that best describes the public health significance and importance of the man.
Henry Whitehead is remembered as a devoted pastor and as an enlightened worker for social improvement. But his endeavors in the epidemiological field were by no means negligible. The value of his work on cholera in no way detracts from that of John Snow, rather it is complementary to it. To Snow undoubtedly belongs the credit for having first elucidated the means whereby cholera is spread. In his lifetime his discovery was received with incredulity by the majority of the medical profession who were satisfied that the transmission of this and other epidemic diseases could be explained in terms of miasmata. Whitehead, entering into this controversy almost by chance, had no reason to doubt the truth of the prevailing doctrine. Snow’s indictment of the Broad Street pump seemed at the outset as unsatisfactory to him as it did to the medical inspectors of the Board of Health. It is, therefore, greatly to his credit that when the opportunity presented itself, he was not content to leave the issue undetermined. For him it was not sufficient to seek to refute Snow’s explanation by argument, but by demonstration. This he set out to do, and, in the event, his research constituted a remarkable confirmation of the hypothesis he had anticipated that it would refute. His discovery of the manner in which the well had become contaminated provided the final link in the chain of evidence which put the issue beyond reasonable doubt. It should not be forgotten that, but for Whitehead’s work, Snow’s explanation of the Soho epidemic would have remained presumptive.
Although without special training or knowledge in medical matters, Whitehead displayed the keen observation, the strict regard for objectivity and measurement and the ability to evaluate evidence which are the hall-marks of sound scientific inquiry. His studies, together with those of John Snow, provide an outstanding example of the fruitful combination of the intelligent layman and the medical specialist.
Whitehead’s work served both to confirm and underline the thesis that cholera is a water-borne disease, which, with his persistent efforts to bring this knowledge into practical use, made a signal contribution to the advancement of public health.
Chave, SPW. Medical History 11(2), 92-109, 1958.
Newsom, S.W.B., Journal of Hospital Infection 64(3), 210-216, 2006.
Rawnsley, H.D., Henry Whitehead, 1825-1896: A Memorial Sketch, 1898.
Thames, R. Soho Past, 1994.