The product of six years of collaborative research, this fine biography offers new interpretations of a pioneering figure in anesthesiology, epidemiology, medical cartography, and public health. It modifies the conventional rags to riches portrait of John Snow by synthesizing fresh information about his early life from archival research and recent studies. It explores the intellectual roots of his commitments to vegetarianism, temperance, and pure drinking water, first developed when he was a medical apprentice and assistant in the north of England. The authors argue that all of Snow's later contributions are traceable to the medical paradigm he imbibed as a medical student in London and put into practice early in his career as a clinician: that medicine as a science required the incorporation of recent developments in its collateral sciences--chiefly anatomy, chemistry, and physiology--in order to understand the causes of disease. Snow's theoretical breakthroughs in anesthesia were extensions of his experimental research in respiratory physiology and the properties of inhaled gases. Shortly thereafter, his understanding of gas laws led him to reject miasmatic explanations for the spread of cholera, and to develop an alternative theory in consonance with what was then known about chemistry and the physiology of digestion. Using all of Snow's writings, the authors follow him when working in his home laboratory, visiting patients throughout London, attending medical society meetings, and conducting studies during the cholera epidemics of 1849 and 1854. The result is a book that demythologizes some overly heroic views of Snow by providing a fairer measure of his actual contributions. It will have an impact not only on the understanding of the man but also on the history of epidemiology and medical science.

Introduction 1. York and Newcastle, 1813-33 2. Senior Apprentice and Assistant, 1830-1836 3. London Medical and Surgical Training, 1836-38 4. Forging a London Career, 1838-1846 5. Ether 6. Chloroform 7. Cholera Theories: Controversy and Confusion 8. Snow's Cholera Theory 9. Professional Success 10. Cholera and Metropolitan Water Supply 11. Broad Street 12. Snow and the Mapping of Cholera Epidemies 13. Snow and the Sanitarians 14. Further Developments in Anesthesia 15. Common Ground: Continuous Molecular Changes 16. Snow's Multiple Legacies

Peter Vinten-JohansenAssociate Professor of History, Howard BrodyProfessor in the Departments of Family Practice and Philosophy, and in the Center for Ethics and Humanities in the Life Sciences, Nigel PanethProfessor of Epidemiology and Pediatrics and Human Development, and Associate Dean for Research, Stephen RachmanAssociate Professor of English and Director of the American Studies Program, Michael RipAssistant Professor of Epidemiology at the Department of Epidemiology, Assistant Professor of Security Studies, and Director of Graduate Studies in the Department of Epidemiology, all at Michigan State University

"A fascinating new look at an iconic figure in the history of two very different fields, epidemiology and anaesthsiology. 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 social history as well."--Charles E. Rosenberg, Ernst Monrad Professor of the Social Sciences, Department of the History of Science, Harvard University |k No