Who was John Snow?
John Snow was a physician and surgeon from England who was one of the prolific advocates of using ether and chloroform as surgical anaesthetics. He was also a leading figure in the development of medical hygiene. A native of York, Snow grew up in an impoverished household. Since he was a child, he displayed an aptitude for mathematics. At the age of 14, he began a medical apprenticeship with William Hardcastle. He was later educated at the Hunterian school of medicine in Great Windmill Street, London, and the University of London. In 1850, he joined the Royal College of Physicians. Widely regarded as one of the founders of modern epidemiology, he did pioneering work in finding the source of a cholera outbreak in Soho, London, in 1854. According to researchers at Oxford University, Snow’s work paved the way for the adoption of anaesthesia as well as radical modifications in the water and waste systems of London. This inspired similar modifications in other cities, which, in turn, led to the betterment in general public health around the world.
Childhood & Early Life
Born on March 15, 1813, in York, United Kingdom, John Snow was the son of William and Frances Snow. His father worked as a labourer at a local coal yard before becoming a farmer in a small village to the north of York.
Growing up in one of the most impoverished neighbourhoods of the city, he witnessed unsanitary conditions and contamination in his hometown. Most of the streets were unclean, and the rivers had become polluted by runoff water from market squares, cemeteries and sewage.
As a child, he demonstrated a prodigious talent for mathematics. At the age of 14, he started a medical apprenticeship with William Hardcastle in the area of Newcastle-upon-Tyne.
In 1832, while he was serving as a surgeon-apothecary apprentice, he had his first encounter with a cholera outbreak in the coal-mining village of Killingworth. He garnered valuable experience by providing treatment to multiple patients.
He served as an assistant to a colliery surgeon in Burnopfield, County Durham, and later in Pateley Bridge, West Riding of Yorkshire. In October 1836, he began attending the Hunterian school of medicine in Great Windmill Street, London.
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In the 1830s, John Snow was employed at the Newcastle Infirmary, where he closely worked with surgeon Thomas Michael Greenhow on cholera epidemics. In 1837, he was hired by Westminster Hospital.
On 2 May 1838, he joined the Royal College of Surgeons of England. He obtained his MD from the University of London in December 1844. In 1850, he joined the Royal College of Physicians. He co-founded the Epidemiological Society of London in May 1850.
In 1857, he wrote the pamphlet, ‘On the adulteration of bread as a cause of rickets’. One of his earliest works, his study on rickets is often overlooked in favour of his more popular contributions to the world of medicine.
Development of Anaesthesia
After graduating from the University of London, John Snow established his surgical and general practice at 54 Frith Street in Soho. He was part of the Westminster Medical Society, a London-based medical discussion group that focused on clinical and scientific demonstrations.
In 1841, he published the article ‘On Asphyxiation, and on the Resuscitation of Still-Born Children’, in which he wrote about his findings on the physiology of neonatal respiration, oxygen consumption, and the effects of body temperature change.
In 1843, he started working with ether. He was especially interested in its effects on respiration.
In 1847, he authored ‘On the Inhalation of the Vapor of Ether’, an article in which he provided the guidelines on how to use it. In 1858, after his death, a more elaborate version of the article was published, titled ‘On Chloroform and Other Anaesthetics and Their Action and Administration’.
Although he did extensive work on ether as an anaesthetic, he never had any intention of patenting it. He simply continued to work with the substance and publish his discoveries. In time, he became the country’s most prolific anaesthetist.
He was one of the early physicians to analyse and figure out the correct dosage of ether and chloroform as surgical anaesthetics, so they could be safely administered on patients before surgical and obstetric procedures. He developed instruments that would serve the purpose and created a mask for administering chloroform.
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Snow’s understanding of chloroform was as extensive as his understanding of ether. He realized that chloroform was more potent between the two substances, and a doctor needed to be more attentive and precise while using it on patients.
Snow used chloroform on Queen Victoria during the births of her last two children, Leopold (born 1853) and Beatrice (1857). Chloroform’s use during childbirth was regarded as unethical by the Church of England and even numerous physicians. After the queen allowed it to be administered on herself, its use eventually became more common.
Fight Against Cholera
Throughout his career, Snow remained a critic of the miasma theory, which proposed that the cause of diseases like cholera and the bubonic plague was pollution or a noxious form of "bad air".
At the time, the germ theory of disease had not been established, so Snow had no idea about how these diseases spread. In his 1849 essay ‘On the Mode of Communication of Cholera,’ he dismissed the theory of foul air.
In 1855, he put out a more comprehensive treatise, in which he discussed his findings on how contaminated water supply was responsible for the Soho epidemic of 1854.
Aided by Reverend Henry Whitehead, he spoke to various local residents and realised that the outbreak originated from a public water pump on Broad Street (now Broadwick Street).
While the chemical and microscope tests he conducted on a water sample from the pump did not provide a conclusive answer, his research on the pattern of the disease prompted the local council to disable the pump by taking out its handle or force rod.
Utilizing a dot map, he demonstrated the agglomeration of cholera cases around the pump. He made use of statistics to showcase the link between the quality of the water source and cholera cases.
He proved that the Southwark and Vauxhall Waterworks Company sent water from sewage-polluted sections of the Thames to people’s homes. His study is considered the founding event of the science of epidemiology.
Family & Personal Life
Since John Snow was 17 years old, he had been a vegetarian. He was also a teetotaller. He maintained an ovo-lacto vegetarian diet, in which vegetables and grains are supplemented with eggs and dairy products. Following this lifestyle, he became an excellent swimmer.
At some point, he embraced veganism. In the mid-1840s, his health started to decline, and he developed a renal disorder which, according to him, was the result of the vegan diet.
He subsequently started consuming meat and wine. He also purified (by boiling) water before drinking.
In 1830, he joined the temperance movement. He was accepted into the York Temperance Society in 1845.
Snow was a lifelong bachelor. He resided at 18 Sackville Street, London, from 1852 to his death in 1858. On June 10, 1858, while he was in his office in London, he had a stroke. He passed away six days later, on June 16, 1858, at the age of 45. He is interred in Brompton Cemetery.