It’s common knowledge today that you can’t get cholera by breathing foul air, but in 19th-century England it was a subject of much debate. Today we understand the way cholera spreads—through contaminated drinking water—thanks to the foundational work of one man, a British physician named John Snow. He believed (correctly) that cholera came from the water supply, going against the popular notion that the disease stemmed from breathing air polluted by the smell of industries like tanneries. This was cause for a clash with the editor of the prestigious medical journal The Lancet, Thomas Wakley, who held Snow’s theories in such low esteem that when Snow died in 1858, he was given an insultingly short obituary. At just under 40 words long, the brief blurb mentioned nothing of Snow’s work on cholera, simply calling him a “well-known physician” and mentioning his contributions to the field of anesthesia.
“It’s analogous to a literary magazine who, at the time of Shakespeare’s death, gave him a one-sentence obituary saying ‘the guy had a few good lines,’” says Dr. Jeffrey Koplan, an epidemiologist who directed the Centers for Disease Control and Prevention from 1998 to 2002, and is currently the vice president for global health at Emory University.
Now, more than 150 years later, and 200 years after Snow’s birth, The Lancet has finally decided to set the record straight. In a recent article, “after an unduly prolonged period of reflection,” the journal finally comes clean, lightheartedly admitting that “some readers may wrongly have inferred that The Lancet failed to recognise Dr Snow’s remarkable achievements in the field of epidemiology,” as well as “his visionary work” in discovering how cholera is spread.
Snow may be best remembered for tracing a 1854 cholera outbreak to a well on Broad St. in London—and then having the pump handle removed, so the locals couldn’t draw water there anymore; even today a pump handle is a symbol associated with epidemiology. It was a study he undertook around the same time, however, that was more telling: he compared the cholera rates among populations receiving water from two different water companies. While one company, called Southwark and Vauxhall, was taking water from the Thames at a place contaminated by sewage, another had moved upstream, thus providing cleaner water, and, as Snow discovered, causing far fewer cases of cholera. As Koplan notes, Snow’s analytical methods have provided a model for the way outbreaks are investigated and solved today.
Why did The Lancet’s old editor, Thomas Wakley, dislike Snow so much? Wakley wanted the foul-smelling tanning and soap industries out of London, arguing that it was the bad air, or miasmas, that caused cholera. Snow disagreed and told Parliament as much, thus hurting the argument that the industries should leave town.
He also made pioneering contributions to anesthesiology, and even anesthetized Queen Victoria with chloroform while she gave birth. The man is honored today with a pub in London called the John Snow Tavern, as Dr. Michael Ramsay, the chairman of the anesthesiology department at Baylor University Medical Center, points out. “Right outside is a pump with a pump handle off,” Ramsay says. “And the irony of all that was that poor old John Snow was a teetotaler—he never drank.”