Ann Shelton: the index case

On August 29th 1854, a five-month old baby by the name of Frances Lewis developed symptoms of cholera, a disease that over the next few days would claim seventy lives within a few block radius of her home at 40 Broad Street in London’s Soho district. By September 3rd, John Snow, a young doctor who lived in the neighbourhood, had begun an investigation of this so-called ‘index case’ that would last until the day he died. Snow’s approach was revolutionary on two counts: first, it brought mapping to the study of infectious disease, making visual the number of deaths resulting from a single source of contamination – here Frances Lewis and the Broad Street water pump. Second, it identified the disease-carrying agent as water-borne, thus refuting the miasma (noxious gas) theory of disease that prevailed in Western medicine until the mid-nineteenth century. The effects of this investigation, though hotly debated, were vast and far-reaching, ushering in the birth of modern epidemiology and making a strong case for the establishment of modern sewerage systems in cities worldwide.

Photographer Ann Shelton’s night-and-day diptychs represent the approximate sites where the water pumps shown on Snow’s now-infamous map once stood. This series, 'the index case', functions on many levels, referring to, not only Frances Lewis, but also this first case of modern epidemiological practices.

The series, furthermore, conjures the possibility of an archive or index of the pumps, and also to the medium of photography itself, as an index of the real. By showing us the sites where Snow’s water pumps once stood, Shelton’s work evokes that which cannot be seen, a crucial history as well as the infrastructure of our water supply, a system whose maintenance still remains a matter of life and death.

Sarah Caylor
May 2012