Cholera, Chloroform and the Science of Medicine - A Life of John Snow

The absence of a comprehensive history of epidemiology must in part reflect epidemiology’s initial appearance as a public health problem-solving tool that was seemingly (as Thomas Huxley once said of science in general) “nothing but trained and organized common sense” (Huxley’s emphasis (1)). Thus, in searching for missing forefathers, modern epidemiologists keep looking for historical heroes who once did what we would like to think we would do now. John Snow (1813–1858) is a worthy forefather, not just because he (mostly) got it right about cholera but also because his two 1854 investigations (of Thames River water and the “Broad Street pump” (2)) seem to have been ahead of their time. How did he do it? Missing from the hundreds of works on Snow—including an often-republished 1858 remembrance of Sir Benjamin Ward Richardson (3), David Shephard’s 1995 biography (4), and a 1995 doctoral dissertation by Stephanie Snow (5)—is any comprehensive examination of the bases, evolution, and context of Snow’s thinking. This new biography (6) by Peter Vinten-Johansen and his Michigan State University colleagues (the self-described “Snowflakes”) seeks to repair this deficiency.

Although there is little new here for historians, much of this material will probably be new to epidemiologists, especially the information on Snow’s early years and his remarkably self-disciplined upward mobility. The authors also examine links between Snow’s epidemiologic approaches and his work in respiratory physiology, pathology, and experimental science—a laudable attempt to understand his thinking processes. Still, there are disappointments, such as the distancing of Snow as a person and a “Snow-centric” emphasis on what he alone thought and did, omitting much of the context within which his ideas evolved.