John Snow - a historical giant in epidemiology





 

 

This site is devoted to the life and times of Dr. John Snow (1813-1858), a legendary figure in the history of public health, epidemiology and anesthesiology.

Click with your left mouse key to see and hear the material or and to see the material. The maps and narrations present the Snow story in place and time.

 

The following articles describe the intent of the John Snow site and comment about his life.

"Pioneer..." Chronicle of Higher Education

"Cyber Sleuths" UCLA Magazine

"History, maps..." SoC Bulletin (PDF)

"When Cholera Met its Match" Science

"John Snow" BBC Online

"The Handle" UAB School of Public Health Magazine

"Popularity of Epi site grows" UCLA School of Public Health Magazine

"Beyond Google. The great internet search engine is still no match for the expertise of a wise human being." Discover (PDF)

"Own your Own Words" New York Times

 ENCYCLOPEDIA ENTRY ON JOHN SNOW

Providing a summary of John Snow's life in Encyclopedia Britannica is UCLA Professor Emeritus Ralph R. Frerichs, author of this site. Frerichs' description is a good starting point for exploring the extensive material on the life and times of John Snow that are here presented.

SIGHT AND SOUND

Sight and sound animation describing the life and accomplishments of John Snow.

  Instructions and test of system 

  Part 1: The Early Years 

  Part 2: Broad Street Pump Outbreak 

          The U North Carolina Version 

Part 3: The Grand Experiment (under consideration)

 THE FATHER OF MODERN EPIDEMIOLOGY

In an article in Old News, David Vachon writes of John Snow's life and achievements, and concludes: "For his persistent efforts to determine how cholera was spread and for the statistical mapping methods he initiated, John Snow is widely considered to be the father of [modern] epidemiology."

 THE JOHN SNOW MEDAL

In 1971 a bronze medal of John Snow was created by the prominent medallic artist and sculpture Abram Belskie. In addition to Snow, Belskie created nine more medals of distinguished leaders of historical medicine as part of his Great Men of Medicine Series. Dr. John Snow was considered an appropriate member of this prominent nineteenth century group.

THE MODERN "JOHN SNOW"

While there can be only one John Snow, another epidemiologist has appeared on the scene who shares many characteristics of John Snow - French epidemiologist Renaud Piarroux, MD, PhD. The true story of his investigation of cholera in Haiti was told in Deadly River - Cholera and Cover-up in Post-Earthquake Haiti, 2016, by Ralph R. Frerichs. 
  Deadly River book website
On June 3, 2017 Renaud Piarroux was officially inducted as chevalier or �knight� in the French la L�gion d�honneur or �Legion of Honor.� Given the choice of location, Piarroux requested the ceremony be held in Saint-�tienne-d'Albagnan, a picturesque village in southern France, the site of his marriage years earlier. Presiding over the ceremony was Bernard Meunier, President of the French Academy of Sciences (at left). Also participating were Ralph R. Frerichs, author of Deadly River (at center-right) and Philip G. Alston, the United Nations Special Rapporteur for Extreme Poverty and Human Rights (at right).
  Epidemiologist knighted in the French Legion of Honor for his work on cholera in Haiti. Epidemiology Monitor 38(4), April, 2017.

 THE LAMBETH CHOLERA EPIDEMIC PLAQUE

In 2010 a plaque was erected in the Lambeth region of London to remember the cholera epidemic of 1848-49 and the impact it had on the local populace. The plaque provides a gripping tale of what occured in this London neighborhood more than 160 years ago, and mentions the important contributions of Dr. John Snow to addressing the cholera epidemic.

IMPORTANCE OF SNOW

Comments about Dr. John Snow from two of the world's most prominent medical officials.

JOHN SNOW AS "GREATEST DOCTOR"

In a March 2003 survey by Hospital Doctor magazine, John Snow was voted the "greatest doctor" of all time, with Hippocrates (460-370 BC) coming in second.  While the poll was likely biased with over-representation of John Snow supporters, the findings do point to the increased prominence of Dr. Snow among contemporary physicians.

IMAGES OF SNOW

Two pictures at 34 and 44 years of age, respectively. 

Thomas Jones Barker

BIOGRAPHY OF SNOW

Written in 1898, 40 years after Snow's death.

MEMORIES OF A FRIEND 

Fond remembrances in 1887 by Sir Benjamin W. Richardson, 29 years after Snow's death.

ARTICLES ON JOHN SNOW SINCE 1950 (new addition)

Many journal articles have been written about John Snow in the past half century.  They appear here for distribution as PDF files to historians, teachers, students or other interested persons.

BOOKS ON JOHN SNOW

Several books on John Snow have either been written during the past few years or are in process.  They range from fiction to non-fiction, children to adult, but all attempt to bring insight to the contributions of Snow to the fields of epidemiology and anesthesiology.

YOUTH ARTICLE ON JOHN SNOW

The Broad Street pump story is featured in Cricket, a magazine for young people, aged 9 and up.  Stories such as this on the accomplishments of John Snow help bring the excitement of epidemiology to a younger audience.

YOUTH GOLD MEDAL PAPER ON JOHN SNOW

The 2009 National History Day gold medal senior paper on John Snow was won by Laura Ball from Wauwatosa, Wisconsin. Laura has just completed tenth grade at University School of Milwaukee. The 2009 theme of the USA-wide competition was "The Individual in History: Actions and Legacies." Laura's gold medal paper represents the highest honor possible through National History Day in the United States. 

ON THE MODE OF COMMUNICATION OF CHOLERA

The historical treatise by John Snow (2nd Ed., London, 1855) for which he is most famous in epidemiology (click above to view his 139 page book)

Map 1 (Broad Street Pump Outbreak)

 

1843

Earlier version (-11 years) of Snow's map

 

1846

Earlier version (-8 years) of Snow's map

 

1854

Map in Snow's book of 1855

 

 

 

High resolution pdf file for printing

 

1862

Later version (+8 years) of Snow's map

 

1870

Later version (+16 years) of Snow's map

 

1998

Current version (+144 years) of Snow's map

Map 2 (The Grand Experiment)

 

1854

Map in Snow's book of 1855

 

 

High resolution pdf file for printing

ON CONTINUOUS MOLECULAR CHANGES

Snow's views in an 1853 oration of cholera and epidemic diseases in general, showing early understanding of infectious disease epidemiology

Current knowledge of cholera in 2004 (The Lancet)

ON THE INHALATION OF ETHER

John Snow in 1847 published a book on the use of ether as an anesthetic agent in surgical operations.  While his fame in anesthesiology derived from his extensive work with chloroform, he also was a pioneer in the use of ether. 

 

 

BROAD STREET PUMP OUTBREAK

A well-written summary of the 1854 cholera outbreak in the Soho neighborhood of London.

VIDEO OF BROAD STREET PUMP OUTBREAK

A You-Tube video by Mike Jay of Medical London on Dr. John Snow and the cholera outbreak of 1854. The video includes the handle-less Broad Street pump in Soho and tours the nearby John Snow pub.

MAPPING THE 1854 BROAD STREET OUTBREAK

John Snow presented two maps of the Broad Street pump outbreak, the first being the most famous and the second offering minor corrections.  Other map makers have tried to improve on his originals, using dots rather than bars, but with less success.

REMOVAL OF THE PUMP HANDLE

Following the outbreak of cholera in the Broad Street area in 1854, did removing the handle from the Broad Street pump stop the local epidemic?

Index Case at 40 Broad Street

Birth and Death certificates of Index Case

Reverend Henry Whitehead

ABBEY-ROW PUMP WELL OUTBREAK

John Snow wrote of a small outbreak in 1857 in eastern London, just outside the area covered by the 1859 map of John Snow's London.

JOHN SNOW'S EARLY YEARS

His life and family from birth to age 23 years, when he started his formal medical education (click first).

Early Medical Education

Teetotal address (age 23)

The Mysterious Uncle

JOHN SNOW'S MEDICAL EDUCATION

Describes his formal education, experience in a hospital, and medical certification (click first).

Hunterian School of Medicine

Westminster Hospital

University of London 

JOHN SNOW'S FINAL REST

His death, including likely cause, and the monument erected to commemorate his life.

Letters of Remembrance  

PRINCIPAL WRITINGS OF JOHN SNOW 

During his short but active life, Snow contributed 107 publications (including many letters to the editors) to the scientific literature.

The following maps, linked with names and dates in the text, are used to view John Snow's history and narrations in place and time.

1818 MAP OF LONDON PRE-JOHN SNOW

Cary's map of London in 1818 shows the city prior to the arrival of John Snow, still living in York (center left) with his parents at aged 5 years.  This large historical map with 27 panels was published by John Cary in early 1818.

1846 MAP OF LONDON DURING JOHN SNOW  

Cruchley's map of London in 1846 shows the city a decade after John Snow's arrival in 1836.  This delicate paper map, purchased by people for every-day-use, provides details of the City in 25 panels.  The map was first published in 1827 and updated every few years thereafter.

1856 MAP OF LONDON WATER WORKS  

All the water companies mentioned by John Snow in his book are presented for the mid-1850s in a contour map of London and its environs. The 1856 map is similar but more detailed than John Snow's Map 2 of 1854. 

1856 MAP OF ENGLAND & WALES DURING JOHN SNOW  

John Snow's life outside of London can be view in a map of England and Wales that comes from a rare edition of Colton's Atlas of the World, published for a short while in 1856.

1859 MAP OF JOHN SNOW'S LONDON  (slowly evolving)

Sites of John Snow's life and investigations in a historical map published by James Reynolds in 1859.

London Historical References and Sites

John Snow's References and Sites

1872 MAP OF LONDON REGION POST-JOHN SNOW

Wyld's map of the the country 25 miles round London shows the region during John Snow's adult life and following his death in 1858.  The map was acquired by cartographer James Wyld from William Faden in 1823, and then periodically updated until 1880.  The presented map is the penultimate 1872 edition, nearly identical to the 1865 edition and very similar to the 1850 edition.

WOODCUT OF LONDON IN 1844  

Panorama view of London along the River Thames from Vauxhall Bridge (to the west) to the Isle of Dogs (to the east) derived from a wood engraving by Smyth in 1845.

PHOTO TOUR OF JOHN SNOW'S LONDON 

Photos of current sites in the Soho Region of London that were meaningful to John Snow one and a half centuries earlier. 

HISTORY OF LONDON'S WATER

Water played a central role in John Snow's legacy, as he explained the spread of deadly cholera. Adrian Prockter presents the history of water acquisition in London, and sets the stage for the dramatic events of the mid-1800s that terrified this great city.

PHOTO TOUR OF HISTORY OF S&V WATER COMPANY

The Southwark and Vauxhall (S&V) Water Company was created in 1845 by merger of existing waterworks.  The water intake from the River Thames of the merged company remained in the heart of London, supplying contaminated water which eventually included waste of cholera patients, as investigated by John Snow in his "grand experiment." Water contamination remained, until S&V moved its intake upriver in 1855 to Hampton.  Adrian Prockter presents images of the formation of S&V, bringing visual life to an important event in the history of London.

PHOTO TOUR OF LAMBETH WATER WORKS UNTIL 1852

In his "grand experiment," John Snow demonstrated that persons drinking contaminated Thames River water were more likely to experience cholera then those drinking clean water.  After 1852, the Lambeth Waterworks became the source of clean water, leaving the Southwark and Vauxhall Water Company to provide contaminated water. Adrian Prockter presents text and images of the area by the Lambeth Waterworks prior to the company moving upstream.

PHOTO TOUR OF LAMBETH WATERWORKS AFTER 1852

Seeking cleaner water to supply London, the Lambeth Waterworks in 1852 relocated well-upstream to Thames Ditton along the River Thames.  Adrian Prockter, in images and text, provides a current view of the historical move, which enabled Snow's "grand experiment" of 1854.  This classic epidemiologic investigation offered compelling evidence that cholera was waterborne.

PHOTO TOUR OF TIDAL RIVER THAMES

The River Thames had much to do with the epidemic spread of cholera in nineteenth century London.  When the water companies were told by Parliament in 1852 to move their intakes up river to above Teddington Lock, it served as a major step in improving the drinking water.  One company (Lambeth) complied quickly, and the other (Southwark and Vauxhall) waited until the last minute, right before the August, 1855 deadline.  When cholera reappeared in London during the mid-1800s, the delayed move of the Southwark and Vauxall company provided the basis for Snow's "grand experiment." Adrian Proctor offers a photo tour of these historical times.

COMPETING THEORIES OF CHOLERA

Some like William Farr believed that cholera was caused by bad air or miasmata while others favored John Snow's  germ theory.  Snow, perhaps, favored too strongly his theory which proved true for cholera but not for all diseases, especially those caused by environmental pollutants.

Snow's Testimony

Reaction and Committee Action 

WHO FIRST DISCOVERED VIBRIO CHOLERA

While Robert Koch is often identified as the first person to identify Vibrio cholerae as the causative agent of cholera (1884), the honor rightfully goes to Filippo Pacini who first identified the organism in 1854. 

Life and major scientific achievements of Filippo Pacini

CURRENT DESCRIPTION OF CHOLERA AND NEWS OF CHOLERA

Biological, medical and epidemiological description by the World Health Organization (WHO) of Vibrio cholerae the agent causing Cholera. WHO also reports cholera outbreaks making news in various regions of the world, and often includes a map of the outbreak site.

PANDEMICS OF ASIATIC CHOLERA 

During John Snow's life time there were three pandemics of Asiatic cholera (1817-23, 1826-37 and 1846-63), two of which reached the British isles. 

CHOLERA: TRACKING THE FIRST TRULY GLOBAL DISEASE

In a National Geographic presentation, Sharon Guynup captures the feelings of the times, as historical London contends with disease, stench and filth.  

LECTURE ON HISTORY OF CHOLERA 

Dr. Andrew Hayward presents the history of cholera, including John Snow's contributions, in a Supercourse lecture.

CHOLERA AND HIV EPIDEMICS 

Cholera in the nineteenth century has much in common with current HIV/AIDS, both in fear and confusion over solutions.

HIV Controversies

Personal screening for HIV

Winners and losers

VICTORY IN SIGHT

A sense of both John Snow and the significance of his work comes forth in this well-crafted chapter from King Cholera (1966) by Norman Longmate.

PAST LESSONS OF THE PAST 

Reflections by R.J. Morris on what was learned in England following the first cholera epidemic of 1831-32, to help prepare for London's epidemics of 1848-49 and 1853-54.

ANESTHESIA AND QUEEN VICTORIA 

Dr. Snow was also prominent as an anesthesiologist.  He administered chloroform to the Queen on two occasions. 

Birth of Prince Leopold

Critical reaction of The Lancet

Birth of Princess Beatrice

AN ANESTHETIC CONTROVERSY 

When he thought he was right, John Snow was not adverse to controversy.  The story, Death in Bristol, started in February 1858, four months before Snow's  death.  It was his last published exchange, but involving anesthesiology rather than epidemiology.

 

THE ILL-FATED BARNES FAMILY

An innocent looking package that arrived during the holidays brought devastation to a family in central England.

LOCATION OF WATER COMPANIES

In 1854, John Snow analyzed the grand experiment, a natural study of the association between water exposure and  cholera.  This section tells what happened and the location of the water companies that provided the exposure.

Grand Experiment of 1854

VISUAL DISPLAY OF JOHN SNOW

The famed Edward R. Tufte has thoughts on John Snow and his visual display of Broad Street cholera cases.

MAP-MAKING AND MYTH-MAKING 

Did John Snow use a map of cholera deaths near Broad Street in 1854 to identify a contaminated pump?  The authors of a July 1, 2000 article in The Lancet believe the story is more involved, and certainly more fascinating.

Cartographer Tom Koch adds fuel to the myth-making fire by showing how depictions of Snow's 1854 map of the Broad Street pump outbreak have been altered over time. (PDF)

WILLIAM FARR: CAMPAIGNING STATISTICIAN  

While William Farr supplied John Snow with epidemiologic data, he differed with Snow for many years on the interpretation of the findings.  The author of this 2000 article in the Journal of Medical Biography presents an interesting account of Farr, often viewed as the "father" of modern vital and health statistics. 

THEORIES OF JOHN SNOW VS. WILLIAM FARR

John Snow and William Farr had different theories on the cause of cholera. Farr during his lifetime had more scientific supporters but Snow eventually reached greater fame, arising from being right.  Historian John Eyler authors a thoughtful article on the changing assessment of these two scientists, then versus now.  

LONDON EPIDEMIOLOGICAL SOCIETY

John Snow was a founding member of one of the first professional societies devoted to epidemiology.

JOHN SNOW PUB

A London pub honoring the life and legend of John Snow.

JOHN SNOW SOCIETY

Founded in 1993, the John Snow Society aims to promote the life and works of Dr John Snow as anesthetist and pioneer of epidemiological methods. In 2001, the Society became part of the Royal Institute of Public Health, London.

JOHN SNOW COLLEGE

John Snow lives on at the University of Durham, Stockton-on-Tees, England where a college bears his name. 

BUILDING NAMED AFTER JOHN SNOW

The National Health Service building in Durham, England was named the John Snow House, in honor of Dr. Snow.  A plaque describes his link to the region and the reasons for his fame.

LECTURE THEATER NAMED AFTER JOHN SNOW

The London School of Hygiene and Tropical Medical has named a state-of-the art lecture theater after Dr. John Snow. Doing so continues the memory among future public health leaders of Snow's thoughts and accomplishments

SNOW AS YORK'S UNSUNG HERO

According to a writer in the Yorkshire Post, fans in his home town of York want his contribution to medicine and to vast improvements in public health to be more widely known and celebrated.

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