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W. F. Bynum reassesses the work of John Snow, the Victorian 'cholera cartographer'.
Tomorrow is the bicentenary of the birth of John Snow, one of the founding fathers of epidemiology and anaesthesiology. His posthumous reputation is much greater than any he enjoyed during life.
Snow's epidemiological fame rests primarily on the second edition of his On the Mode of Communication of Cholera (1855), which rests, in turn, on his meticulous mapping of the disease in London and creative use of figures to show how cholera is transmitted. An ascetic man who never married, he died young; but his life was one of discipline, ambition and honest toil.
Born into a working-class family in York, UK, Snow was trained by apprenticeship to general practitioners and some courses in medical schools in north-east England, with little financial backing. He nevertheless based his career in London. He set up a general practice, worked in the outpatient's department at Charing Cross Hospital and became medical officer to several convalescent homes set up by working men's clubs.
London suffered three severe cholera epidemics during Snow's lifetime, in 1832, 1848-49 and 1853-54. In the first edition of On the Mode of Communication of Cholera, published in 1849, Snow extended arguments he had long held: that cholera is a specific disease spread by water contaminated by faeces. At the time it was generally thought to be a nonspecific fever transmitted through 'miasma' in the air. Far from claiming that his ideas were original, Snow scoured the literature and badgered acquaintances such as the epidemiologist William Farr for corroboration. He found some, but in many instances offered his own interpretations of the facts that they presented to him.
That foul...