Good health, Dr John Snow

Only 5 minutes walk from busy Oxford Circus in London there’s a small pub on the corner of Lexington and Broadwick Streets in Soho called the John Snow pub. Right outside at the edge of the grey footpath there is a single rectangular red granite kerbstone that marks a very significant spot in medical history: the site of the Broad Street Pump. I almost had trouble identifying the spot because the red granite was in fact a dirty shade of pink, and smeared with something grubby.

Why the pilgrimage? This is the location of a captivating story of medical history about the terrible cholera epidemic that killed hundreds of people here in 1854. Dr John Snow is the central medical figure in the story and his work in identifying the source of the illness is hailed as the founding event of the science of Epidemiology. I had read on the Wellcome Trust blog that March 15th was the 200th anniversary of Dr John Snow’s birth and since I was in London for the day last week a visit to the pub seemed appropriate.

Back in 1854 at the time the cholera epidemic took hold in London the pump on Broad Street (as Broadwick Street was called then) was the source of water for the people who lived in the surrounding area. At that time it wasn’t known that cholera bacteria were the cause of the illness, bacteria had not even been discovered then. The general belief was that this deadly illness was caused by bad air – “miasma.”

Dr Snow noticed the concentration of illness and deaths around the Broad Street area and set about gathering and analysing data on who had, and had not, become sick, when, where they lived and where they obtained their water. He uncovered the circumstances of those afflicted with the deadly illness and traced back that they had drunk water sourced from the Broad Street pump and those that were not sick had not – like the nearby brewery workers who a) drank beer and b) had a separate water well in the brewery from which they obtained their water. He drew out maps of the cases and correctly concluded that the source of the “contagion” was the water from the Broad Street pump.
Eventually he convinced the local authorities to remove the pump handle to prevent further water being drawn from this source. That he did this work without whizz bang computer modelling and against the weight of the deeply held views of the time was remarkable.

As a result he is described as the father of modern epidemiology; and now this pub is named after him – which is actually a slightly ill-fitting honour since he was a teetotaller. I’ve been a fan since I visited the Wellcome Gallery a couple of years ago when the “Dirt” exhibition was on and then read a fascinating book on this story – The Ghost Map by Steven Johnson. I marked my visit to the pub by having a shandy and signing the visitors’ book. Cheers.

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