The father of epidemiology? A man that helped stop cholera in its tracks? Nope, not this Jo(h)n Snow….
This one! A somewhat more dashing but less follicle-d (Dr) John Snow.
For me, cholera was always most comfortably viewed at a distance as a disease entrenched in the past, keeping company with the likes of typhoid, dysentery and typhus. A disease, that while sometimes fatal, could almost be glamours (owing perhaps to deceptive fiction titles such as Love in the Time of Cholera. ) Oh, how wrong I was! Sandra Hempel’s non-fiction history book, The Medical Detective: John Snow and the Mystery of Cholera is a fascinating account of the spread of cholera to Europe in the 19th century, its impact on the human body, and the fact that, despite the amazing work of Dr John Snow, it still persists today.
Summary and Analysis
The Medical Detective is a richly detailed read that chronicles the spread, treatment and eventual prevention of this deadly virus. Central to the story is the ground-breaking work of the now famous Dr John Snow, who fought to prove that cholera was a water-borne disease, despite conventional wisdom suggesting its source came primary from ‘bad air’ or miasma.
Despite the slow start, Hempel’s account of the rise of cholera in Europe, and the investigative work of Dr Snow, is gripping. She tells, in just enough detail, the frightening pace in which cholera spread from India across to Europe, and the toll it exacted on the populations of major 19th century cities, including St Petersburg, Hamburg, and finally, London. By using extracts of letters, personal accounts, speeches and various images, Hempel is able to give her reader a rare insight into the real ‘time’ of cholera.
Hempe’s tell-all style also draws out the shocking impact that cholera (or the Blue Death) had on the human body, including discoloration of the skin, vomiting, low blood pressure and diarrhea. She also details the frightening ‘treatments’ ministered by the medics of the day: hot mustard “poultices applied to the abdomen and boiling water to the feet; enemas of every description…and draughts of medicine containing ammonia, oil, pepper, spices and sulfuric acid” (p42). It is here, in the first stages of the book, where Hempel’s experience as a health and social issues journalist really shines.
The Work of Dr Snow
As cholera swept to the UK from Continental Europe, the quest to discover how the disease spread became even more urgent. The dominant theory of disease spread in the 19th century was based on the idea that a disease was caught via ‘bad air’ or miasma, a theory that had its roots in medieval times. While the efforts of leading miasmatists, including Sir Edwin Chadwick, did lead inadvertently to some reduction in disease via promoting better hygiene, cholera outbreaks were still occurring into the mid- late 1800s.
It was the ground breaking work of anesthetist, Dr John Snow, that identified that cholera was spread through water, thus leading the way to the rise of modern sanitation in London. The turning point for Snow was when, during the 1854 cholera epidemic that swept Soho, he was able to map the presentation of the disease across the local areas, linking water from the Broad Street pump as the source of the cholera outbreak. This water was supplied by a private company who used dubious sanitation and filtration measures .
Sadly, Dr Snow’s work was only acknowledged in the years after his premature death at 45. In fact, during his lifetime, not only was his work not considered serious, he had to face ridicule and skepticism from the medical establishment in London. As Hempel tells it, Snow’s ground-breaking work in disease theory and epidemiology eventually prompted William Farr, a statistician, to conduct further work into the spread of cholera in 1866, resulting in further, concrete, evidence to support Snow’s hypothesis. This led to vindication for Snow and the demise of miasma disease theory.
Not only is Hempel’s book a celebration of Snow’s work, but it is a lesson that sometimes being right is one thing, but being heard is absolutely another…
I recommend The Medical Detective to readers with an interest in medical history, Victorian literature (Dickens gets a mention) and public health.
On a sadder note, I did some further reading about cholera and discovered it caused the death of 7000+ people worldwide in 2011, primarily due to poor sanitation and limited access clean drinking water (Source: WHO). A dire situation indeed, when, due to the diligence and hard work of Dr Snow, we do know how to prevent this disease. However, the lack of resources limits what can be done. It’s a strange world.
First published in Great Britain by Granata Books in 2006. ISBN-13: 978-1-86207-842-0
What do you know, a vampire/cholera article!….