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Cholera, Chloroform and the Science of Medicine: A Life of John Snow. Howard Brody, Michael Russell Rip, Nigel Paneth, Peter Vinten-Johansen, Stephen Rachman

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Cholera, Chloroform and the Science of Medicine: A Life of John Snow Howard Brody, Michael Russell Rip, Nigel Paneth, Peter Vinten-Johansen, Stephen Rachman ebook pdf
Publisher: Oxford University Press, USA
Language: English
Page: 454
ISBN: 019513544X, 9780195135442

From The New England Journal of Medicine

John Snow has long been revered, most notably by anesthetists and public health workers, for the pioneering medical work he did in the 19th century. But the majority of writings about Snow (who was my husband's great great uncle) have focused on either anesthesia or public health. As a result, he has been regarded perhaps as a somewhat quixotic figure, well known in parallel but unconnected fields. This book, however, provides a synthesis of Snow, a holistic account of a mid-19th-century medical doctor whose primary aim was to use the science of his day to improve the medical understanding of disease and the clinical treatment of ill health. The team from Michigan State University that researched the book made the sensible decision to have one writer at the helm. The narrative is consistent and flowing, much of it told through Snow's own words. It follows Snow's life chronologically, from his early years as the eldest son of a working-class family in York, England, to a medical apprenticeship in Newcastle upon Tyne to student days in London. While he was a student at the Hunterian School of Medicine on Great Windmill Street, in the Soho area of London, Snow was taught the very latest techniques of the new "hospital" medicine. At the core of this approach was the integration of the outward lesions of the body and inward pathology; students were trained to examine patients with Laennec's innovative new instrument, the stethoscope. Experimental research making use of chemistry, physiology, and vivisection was encouraged. The authors rightly draw attention to the importance of this period in equipping Snow with both the vision and the skills that were at the core of his future work. Once he was qualified, Snow set up in general practice in Soho, bucking the usual trend for young doctors to return to their hometowns, where it was easier to make a living. Snow's practice was slow to build, but he used the years fruitfully, becoming an active member of the Westminster Medical Society, which later became the Medical Society of London, and the Royal Medical and Chirurgical Society. It was also during this period that he researched the physiology of respiration, investigating such subjects as asphyxia and carbon monoxide poisoning. The book traces well the trajectory of his intellectual development in these areas. So it was that when news of the discovery of the powers of ether to induce unconsciousness, and thus insensibility to the pain of surgery, reached London in December 1846, Snow was immediately receptive to the potential of this new technique. He became respected and valued within the London medical community, and his contribution to the establishment of the specialty of anesthesia was so great that it is still marked in the 21st century. (Figure) In 1848, though, while he was building up his anesthesia practice, cholera returned to London, and by 1849, about 53,000 deaths were registered for England and Wales. Snow put his mind to work on the key questions of the day: What was the cause of cholera, and how was the disease transmitted? His radical theory that water was an important means of transmission won him few followers. When the next cholera epidemic struck London, in 1854, Snow saw it as an opportunity to collect proof and validate his hypothesis. The story of his involvement with the Broad Street pump has become legendary within the history of public health and has frequently been mistold and misrepresented. The real importance of that event was the way that Snow used his medical authority to persuade local officials to take action. His complementary investigation into the supply of water to districts in South London was a visionary experiment. This book's reworking of both these epidemiologic studies is particularly good, dispelling the myths and reconstructing Snow's focused and singular approach to the problem. Snow's ambition and desire to make a difference in humane terms gave him the courage to take hold of science and use it to the full in his medical practice. This book confirms just how significant his achievement was, and it will be enjoyed by doctors and historians alike. Stephanie J. Snow, Ph.D.Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Review

"...a welcome addition in historical literature. It offers the most thorough, detailed, and careful account of Snow's multifaceted career. The narrative is highly informative, and the text contains numerous illustrations and labels intended to amplify the authors' arguments. ...this is an important work. Members of the health professions and historians will certainly benefit by reading this book." --International Epdemiological Association

"One of the many strength of this book is its careful chronological construction that illuminates the logical progression of Snow's work. This book provides a beautifully graphic analysis of how Snow substantiated his theory through the shoe-leather inquiries he personally made into the water supply of 658 of 860 cholera victims in the 1854 outbreak. This exemplary interdisciplinary biography of one of the greatest doctors is long overdue, but well worth the wait. It replaces the caricature of the socially inept loner with an authoritative portrayal of Snow as a consciencious and confident medical scientist and practitioner." --The Lancet, Vol. 362, September 6, 2003

"A fascinating look at an iconic figure in the history of two very different fields, epidemiology and anaesthesiology. This ingeniously argued and carefully researched study makes a powerful case for Snow as an original thinker committed not only to medicine as an enterprise linking the clinic and the laboratory, but to the idea that it was necessarily integrative and multidisciplinary -- from the molecular to the societal. It is a vision that remains illuminating-- cutting edge--a century and a half after Snow's influential work. The authors have made an important contribution not only to the history of biomedicine but to English societal history as well."--Charles E. Rosenberg, Ernst Monrad Professor of the Social Sciences, Department of the History of Science, Harvard University

"The tale of how John Snow removed the handle from the Broad Street pump has made him the central iconic figure for the history of public health. In this meticulously documented collaborative book, the authors use extensive archival research to revise the previous mythology surrounding Snow's life and work to reveal a far more complex and nuanced historical figure than has previously been recognized."--Joel D. Howell, MD, PhD, Victory Vaughn Professor of the History of Medicine, Professor of Internal Medicine, History, and Health Management and Policy, University of Michigan

"This is an outstanding biography. The authors have demonstrated how it is possible to reconstruct a nuanced account of someone who left few private papers behind. They also triumphantly show that John Snow was one of the most creative individuals within Victorian medicine. Snow is no longer a prophet without honour."--W.F. Bynum, Wellcome Trust Centre for the History of Medicine, University College London

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