Mode of Communication of Cholera, which posited the theory of the water-borne transmission of disease, rather than the miasma theory; little attention was paid to the paper. Following the third cholera outbreak in 1854, Snow published an update to his treatise, after he focused on the effects in Broad Street, Soho. Snow had removed the handle from the local water pump, thus preventing access to the contaminated water, with a resulting fall in deaths. It was later established that a leaking sewer ran near the well from which the water was drawn. Local government The civic infrastructure overseeing the management of London's sewers had gone through several changes in the 19th century. In 1848 the Metropolitan Commission of Sewers (MCS) was established at the urging of the social reformer Edwin Chadwick and a Royal Commission. The Commission superseded seven of the eight authorities that had managed London's sewers since the time of Henry VIII; it was the first time that a unitary power had full control over the capital's sanitation facilities. The Building Act 1844 had ensured that all new buildings had to be connected to a sewer, not a cesspool, and the commission set about connecting cesspools to sewers, or removing them altogether. Because of the fear that the miasma from the sewers would cause the spread of disease, Chadwick and his successor, the pathologist John Simon, ensured that the sewers were regularly flushed through, a policy that resulted in more sewage being discharged into the Thames. In August 1849 the MCS appointed Joseph Bazalgette to the position of assistant surveyor. He had been working as a consultant engineer in the railway industry until overwork had brought about a serious breakdown in his health; his appointment to the commission was his first position on his return to employment. Working under the chief engineer, Frank Foster, he began to develop a more systematic plan for the city's sewers. The stress of the position was too much for Foster and he died in 1852; Bazalgette was promoted into his position, and continued refining and developing the plans for the development of the sewerage system. The Metropolis Management Act 1855 replaced the commission with the Metropolitan Board of Works (MBW), which took control of the sewers. By June 1856 Bazalgette completed his definitive plans, which provided for small, local sewers about in diameter to feed into a series of larger sewers until