Treat the cause not the symptom

Many attempts at problem-solving fail because people address the symptoms rather than the cause.

There’s a brown-walled pub in the Soho area of London called the John Snow.

It’s not named after the character from A Game of Thrones (whose first name is spelt ‘Jon’, incidentally), but after a 19th-century doctor who is recognised as the founding father of epidemiology.  

Whilst there hasn’t been a single case of cholera originating in England in more than 100 years, outbreaks were once common and, in 1854, one outbreak in Soho caused widespread panic.

People were dying in significant numbers - over 600 in total.

Our understanding of the transmission of disease was still in its infancy back then and the most popular theory among medical professionals was that disease was transmitted in the form of smells or miasma (In fact the origin of the name ‘malaria’ is the Italian for ‘bad air’ because people hadn’t then identified the cause as mosquitoes and assumed that the smell from stagnant ponds and marshes caused the disease).

You can understand why people thought that way; after all, food that smells bad is probably going to make you ill if you eat it. And infected wounds will soon start to smell.

But Dr Snow wasn’t convinced. For a start, he was visiting houses and breathing the same bad air and wasn’t catching the disease. He was also finding fit and healthy people living among the dead and dying. It seemed to him that the air wasn’t the issue. He therefore set out to identify another possible cause.

He painstakingly mapped the area where the infections were reported. This quickly revealed a pattern to the transmission of the disease; everyone who got their water from the public hand pump in Broad Street (now known as Broadwick Street) was getting ill.

Meanwhile, people in the same area who got their water from the pump in nearby Golden Square weren’t getting ill. And the people who worked in the breweries (in the area now called Brewer Street) also weren’t getting sick because they drank beer rather than water.

From this, he deduced that the disease was most likely spreading from the contaminated well of the Broad Street pump. To fix the problem, he removed the handle from the water pump, and people stopped dying.  

This is a famous example of when treating the symptoms rather than the cause doesn’t solve the problem. In fact, because cholera causes severe life-threatening dehydration, the existing cure had been to give people plenty of water. This, of course, had accelerated the effect by re-infecting people.

By treating the symptoms, doctors had actually made things worse, but by simply removing a handle at the root of the problem, John Snow saved lives.