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He compared annual death rates from cholera in people drinking water from different sources and found that the risk was 14 times greater (relative risk 14) in those who drank water which was extracted from the Thames in London where there was heavy sewage contamination. He concluded that cholera was spread from person to person via morbid material from the alimentary canal of the sufferer that was then swallowed by other people and had the power of multiplication in the body of the person it attacked.