Richardson on Snow’s cholera investigations
(South London and Broad Street, Golden Square)
Transcription of xix-xxii from Benjamin Ward Richardson’s biographical memoir, which precedes John Snow, On Chloroform (1858).
[xix] In the year 1848, Dr. Snow, in the midst of his other occupations, turned his thoughts to the questions of the causes and propagation of cholera. He argued in his own mind that the poison of cholera must be a poison acting on the alimentary canal by being brought into direct contact with the alimentary mucous surface, and not by the inhalation of any effluvium. In all known diseases, so he reasoned, in which the blood is poisoned in the first instance, there are developed certain general symptoms, such as rigors, headache, and quickened pulse; and these symptoms all precede any local demonstration of disease. But in cholera this rule is broke; the symptoms are primarily seated in the alimentary canal, and all the after symptoms of a general kind are the results of the flux from the canal. His inference from this was, that the poison of cholera is taken direct into the canal by the mouth. This view led him to consider the mediums through which the poison is conveyed, and the nature of the poison itself. Several circumstances lent their aid in referring him to water as the chief, though not the only, medium, and to the excreted matters from the patient already stricken with cholera, as the poison. He first broached these ideas to Drs. Garrod and Parkes, early in 1848; but feeling that his data were not sufficiently clear, he waited for several months, and having in 1849 obtained more reliable data, he published his views in extenso in a pamphlet entitled “The Mode of Communication of Cholera”. During subsequent years, but specially during the great epidemic outbreak of the disease in London in 1854, intent to follow out his grand idea, he went systematically to his work. He laboured [xix/xx] personally with untiring zeal. No one but those who knew him intimately can conceive how he laboured, at what cost, and at what risk. Wherever cholera was visitant, there was he in the midst. For the time, he laid aside as much as possible the emoluments of practice; and when even, by early rising and late taking rest, he found that all that might be learned was not, from the physical labour implied, within the grasp of one man, he paid for qualified labour. The result of his endeavours, in so far as scientific satisfaction is a realization, was truly realized, in the discovery of the statistical fact, that of 286 fatal attacks of cholera, in 1854, occurring in the south districts of the metropolis, where one water company, the Southwark and Vauxhall, supplied water charged with the London fæcal impurities, and another company, the Lambeth, supplied a pure water, the proportion of fatal cases to each 10,000 houses supplied by these waters, was to the Southwark and Vauxhall Company’s water 71, to the Lambeth 5.
There was, however, another fact during this epidemic, which more than the rest drew attention to Dr. Snow’s labours and deductions. In the latter part of August 1854, a terrific outbreak of cholera commenced in and about the neighbourhood of Broad-street, Golden-square. Within two hundred and fifty yards of the spot where Cambridge-street joins Broad-street, there were upwards of five hundred fatal attacks of cholera in ten days. To investigate this fearful epidemic was at once the self-imposed task of Dr. Snow. On the evening of Thursday, the 7th of September, the vestrymen of St. James’s were sitting in solemn consultation on the causes of the visitation. They might well be solemn, for such a panic possibly never existed in London since the days of the great plague. People fled from their homes as from instant death, leaving behind [xx/xxi] them, in their haste, all the mere matter which before they valued most. While, then, the vestrymen were in solemn deliberation, they were called to consider a new suggestion. A stranger had asked, in modest speech, for a brief hearing. Dr. Snow, the stranger in question, was admitted, and in few words explained his view of the “head and front of the offending”. He had fixed his attention on the Broad-street pump as the source and centre of the calamity. He advised the removal of the pump-handle as the grand prescription. The vestry was incredulous, but had the good sense to carry out the advice. The pump-handle was removed, and the plaque was stayed. There arose hereupon much discussion amongst the learned, much sneering and jeering even; for the pump-handle removal was a fact too great for the abstruse science men who wanted to discover the cause of a great natural phenomenon in some overwhelming scientific problem. But it matters little. Men with great thoughts in their heads, think of little things which little men cover with their wide-spread feet. It matters little, for the plague was stayed; and whoever will now read dispassionately the report of a committee, afterwards published by the vestry, and the demonstrative evidence of the Rev. Mr. Whitehead, will find that the labours and suggestion of Dr. Snow, in reference to the Broad-street epidemic of cholera, must become each day better and better appreciated, as time, which never yet told a lie, tells the tale and points the moral of the event which is here so imperfectly described. Some who, at first, were amongst those who held up the labours of our friend to ridicule, or passed them over in contemptuous silence, have, indeed, since modified their opinions, and have either tacitly accepted his facts, or have done far worse by attempting to put them forward as though they were the work of no single man, or of some one unknown, or as though their connection [xxi/xxii] with a theory destroyed the originality of the facts themselves. It was my privilege, during the life of Dr. Snow, to stand on his side. It is now my duty, in his death, as a biographer who feels that his work will not be lost, to claim for him not only the entire originality of the theory of the communication of cholera by the direct introduction of the excreted cholera poison into the alimentary system; but, independently of that theory, the entire originality of the discovery of a connection between impure water supply and choleraic disease. The whole of his inquiries in regard to cholera were published in 1855, in the second edition of his work on the “Mode of Communication of Cholera”–a work in the preparation and publication of which he spent more than £200 in hard cash, and realized in return scarcely so many shillings.