John Snow (medic)

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John Snow 1856 (published 1887 in Asclepiad. Volume 4)

John Snow (born March 15, 1813 in York , † June 16, 1858 in London ) was a British surgeon, pioneer in the epidemiological research of cholera and the introduction of anesthesia with ether and chloroform . John Snow is considered to be the first medical specialist in anesthesia .

Youth and education

John Snow came from a humble background and was born in a modest house on North Street in York, England . He was born in 1813 as the oldest of nine children. His father William Snow (1783-1846) was originally a miner , but was able to improve his social position by acquiring land. His mother's maiden name was Frances Askham (1789-1860). John Snow was baptized in the All Saints Church on North Street in York.

All Saints Church on North Street, York: This is where John Snow was baptized

After attending a private school in York, John Snow began a five-year training course at the age of fourteen in 1827 with the pharmacist and doctor William Hardcastle (1794–1860) in Newcastle upon Tyne , who also worked as a surgeon and obstetrician at the local hospital, Newcastle Infirmary at Forth Banks , worked. When the region was ravaged by cholera in 1831/32, Snow von Hardcastle was employed in the care of the sick in Killingworth , where he first experienced the disease. In 1833 he left Newcastle and assisted the doctor John Watson in Burnop Field near Newcastle for a year. In 1834, after a brief stay in York, he moved to the small village of Pateley Bridge in Yorkshire and worked as an assistant to the pharmacist Joseph Warburton. During his apprenticeship Snow became a vegetarian , in 1836 he joined the abstinence movement, in which Warburton was also involved. After eighteen months in Pateley Bridge, he returned to York for a few months and then went on a hike via Liverpool , Wales and Bath in October 1836 to study medicine in London .

Years of study in London

In London he first studied anatomy at the Hunterian School of Medicine and did a hospital internship at Westminster Hospital from October 1837 . In May 1838 he passed his medical exams and became a member of the Royal College of Surgeons of England , in October 1838 he also passed the pharmacist examination. He joined the Westminster Medical Society, whose lectures he attended since April 1837, and initially practiced without his own practice at Charing Cross Hospital. After he had already published several articles in the Lancet and the London Medical Gazette in 1838/39 , he began in 1841 to present his research findings and inventions in lectures before the Medical Westminster Society. In 1841 he gave three such lectures, which were then printed in the London Medical Gazette : on deformations of the chest and spine in newborns (March 13th), on the causal relationships in suffocation and a ventilator he invented for newborns (October 16) whose innovation consisted in the fact that not only was fresh air supplied through the nose, but at the same time stale air was sucked out through the mouth; and a device for puncturing the chest cavity, in which a valve mechanism should prevent air from entering the thorax. This was followed in the following years by further lectures on the importance of the pulmonary capillaries for the exchange of oxygen between breathing air and the bloodstream (January 21 and February 4, 1843) and on a case of lead carbonate poisoning (November 19, 1844).

After Snow had set up a general medical practice in London, he received a bachelor's degree in medicine (BM) from the University of London on November 23, 1843 and became a member of the Royal Medical and Surgical Society , which he passed on December 20, 1844 Examination as Doctor of Medicine (DM). After he had cured a kidney disease in the summer of 1845 and made a trip to Beckington and the Isle of Wight in the fall, he returned to London and in April 1846 received a position as lecturer ( lecturer ) in forensic medicine at the Aldersgate School of Medicine , where he taught for the next three years until the school was closed.

anesthesia

In October 1846, William Thomas Green Morton carried out the first successful public anesthesia with diethyl ether in the USA (then called sulfuric ether ). The news was quickly spread through the press. On December 28, 1846, such a demonstration took place in London in the house of the dentist James Robinson, which John Snow attended. Well prepared through his investigations into asphyxia and its causes in the bloodstream, he immediately set out to investigate the new procedure and within just three weeks developed an improved apparatus for vaporizing and inhaling the ether. With the help of animal experiments and self-experiments, he developed a fundamental understanding of the relationships between the dosage of the anesthetic, the concentration of the active ingredients in the blood and the symptoms of the effect, which enabled him to successfully use the procedure in operations at St. George's Hospital and University College to apply and to convince the initially skeptical colleagues of the practicability of the method. Since January 1847, he has presented his findings on ether anesthesia to the public through lectures and a series of publications (three articles and a monograph in 1847), which are now considered the founding documents of anesthesiology . Most London surgeons now have their patients anesthetized by Snow. When James Young Simpson also made the anesthetic effects of chloroform known in Edinburgh in the same year , Snow soon turned to this new agent, published it since 1848 and switched its practical applications to it.

Thanks to his success in introducing the new anesthetic method, Snow soon gained a prominent role in the London medical community. In 1850 he became a member of the Pathological Society of London , in 1856 President of the Westminster Medical Society and in 1857 a member of the Advisory Board of the Royal Medical and Surgical Society of London . His successes also convinced the court: in 1853 he performed anesthesia with chloroform on Queen Victoria when she was delivered by Prince Leopold , and also in 1857 when Princess Beatrice was born .

cholera

Card from Dr. John Snow with the accumulation of deaths in the 1854 cholera epidemic

Joseph Griffiths Swayne , Frederick Brittan and William Budd (1811–1880) examined wastewater and found comma-shaped microorganisms. In 1849 John Snow and William Budd presented the treatise The Mode of Communication of Cholera , in which they (35 years before Robert Koch's discovery of " Vibrio comma " ) took the view that cholera was caused by specific living microorganisms in drinking water .

In a further investigation in 1854, John Snow discovered that the prevailing cholera in London was not spread by vapors ( miasms ), as was generally assumed at the time: When trying to flush the open, foul-smelling sewers into the Thames , Soho was closed drinking water poisoning and a cholera epidemic with 14,000 dead. John Snow was able to prove that the deaths were concentrated in the area of ​​a water pump on Broad Street (see map). After he put the pump out of operation by removing its handle , the epidemic came to a standstill. He worked closely with the doctor and microbiologist Arthur Hill Hassall , who carried out the microbiological tests on water from pump systems and from the Thames as well as on stool samples from patients and was able to detect the pathogen causing cholera, Vibrio cholerae .

However, his theory was not recognized by the scientists and doctors of the time during his lifetime and was only confirmed a few years after his death.

His map drawing with the epidemic cases is considered to be one of the first proven spatial analyzes beyond epidemiology.

See also: London Sewer System

death

After suffering a minor stroke, John Snow died of another stroke the following day.

Fonts (selection)

  • Arsenic as a preservative of dead bodies. 1838, The Lancet 1 (November 10, 1838): 264.
  • Action of recti muscles. London Medical Gazette , LMG 23 (December 29, 1838): 559-60.
  • Mechanism of respiration. Lancet 1 (5 January 1839): 653-55.
  • On the bands in the recti muscles. LMG 23 (January 28, 1839): 719-20.
  • On distortions of the chest and spine in children, from enlargement of the abdomen. LMG 28 (1841): 112-16
  • On Asphyxia and on the Resuscitation of Still-Born Children. LMG 29 (1841-1842): 222-27.
  • On paracentesis of the thorax. LMG 29 (1841-1842): 705-07.
  • Uterine hemorrhage, with retention of the placenta. LMG 31 (November 3, 1842): 224-25.
  • On the circulation in the capillary blood vessels, and on some of its connections with pathology & therapeutics. LMG 31 (1842-1843): 810-16.
  • A new kind of pessary. LMG 32 (April 7, 1843): 100
  • Case of acute poisoning by carbonate of lead. LMG 35 (November 22, 1844): 248-50.
  • Case of malignant hemorrhagic small-pox. LMG 35 (January 31, 1845): 585-86.
  • Pericarditis after scarlet fever. LMG 35 (March 7, 1845): 728-29.
  • On the pathological effects of atmospheres vitiated by carbonic acid gas, and by a diminution of the due proportion of oxygen. Edinburgh Medical and Surgical Journal 65 (1846): 49-56.
  • On the use of the term 'Allopathy. Lancet 1 (21 February1846): 229.
  • Some remarks on alkalescent urine and phosphatic calculi. LMG 38 (November 20, 1846): 877-81.
  • Case of strangulation of the ileum in an aperture of the mesentery. In: LMG. Volume 38, (December 18) 1846, pp. 1049-1052.
  • Table of the quantity of the vapor of ether in one hundred cubic inches of air. In: MT. Volume 15, (January 23) 1847, p. 325.
  • Table for calculating the strength of ether vapor. In: LMG. Volume 39, (January 29) 1847, pp. 219 f.
  • Table of the quantity of the vapor of ether in one hundred cubic inches of air. In: PharJ. Volume 6, (February 1) 1847, p. 361.
  • On the inhalation of the vapor of ether. In: LMG. Volume 39, March 19, 1847, pp. 498-502, and March 26, 1847, pp. 539-542.
  • On the Inhalation of the Vapor of Ether in Surgical Operations. 1847
  • On the fatal cases of inhalation of chloroform. In: Edinburgh Medical Journal. Volume 72, (July 1) 1849, pp. 75-87; also reprinted in: Faulconer, Keys (1965), pp. 469–481.

expenditure

Only posthumous issues are included. The John Snow Archive and Research Companion of Michigan State University offers an online directory of publications during the author's lifetime, with online versions of numerous texts.

  • Benjamin Ward Richardson (Ed.): On chloroform and other anaesthetics: their action and administration, by John Snow. Edited, with a memoir of the author, by Benjamin W. Richardson . John Churchill, London 1858.
  • Benjamin Ward Richardson, Wade Hampton Frost (Ed.): Snow on cholera: being a reprint of two papers by John Snow, together with a biographical memoir by BW Richardson and an introduction by Wade Hampton Frost. Commonwealth, no local name, 1936. (Reprint: Hafner, New York 1965)
  • Richard H. Ellis: The case books of Dr. John Snow. Wellcome Institute for the History of Medicine, London 1994, ISBN 0-85484-061-3 . (= Medical History, Supplement 14)

literature

  • Albert Faulconer, Thomas Edward Keys: John Snow. In: Foundations of Anesthesiology. 2 volumes, Charles C Thomas, Springfield (Illinois) 1965, Volume 1, pp. 469 (-481).
  • Spence Galbraith: Dr John Snow (1813-1858): his early years. An account of the family of Dr John Snow and his early life . Royal Institute of Public Health, London 2002, ISBN 1-901660-10-9 .
  • Sandra Hempel: The strange case of the Broad Street pump: John Snow and the mystery of cholera . University of California Press, Berkeley 2003, ISBN 0-520-25049-4 .
  • Sandra Hempel: The medical detective: John Snow and the mystery of cholera . Granta, London 2006, ISBN 1-86207-842-4 .
  • David E. Lilienfield: John Snow: The First Hired Gun? In: American Journal of Epidemiology. 152,1 (2000), pp. 4–9 (on Snow's appearance in 1855 as an expert before the parliamentary committee on the draft law on the elimination of unhealthy industrial facilities)
  • David AE Shepard: John Snow: anesthetist to a queen and epidemiologist to a nation: a biography. York Point Publishing, Cornwall (Canada) 1995, ISBN 1-57087-103-5 .
  • Stephanie J. Snow: John Snow MD (1813-1858). Part I: a Yorkshire childhood and family life. In: Journal of medical biography. 8 (2000), pp. 27-31; John Snow MD (1813-1858). Part II: becoming a doctor - his medical training and early years of practice. In: Journal of medical biography. 8 (2000), pp. 71-77.
  • Stephanie J. Snow: John Snow 1813-1858: The emergence of the medical profession. Diss. Keele University (UK), 1995.
  • JP Vandenbroucke, HM Eelkman Rooda, H. Beukers: Who Made John Snow a Hero? . In: American Journal of Epidemiology. 133, 10 (1991), pp. 967-973 (on the rediscovery of Snow in the epidemiology of the 20th century)
  • Peter Vinten-Johansen u. a .: Cholera, chloroform, and the science of medicine: a life of John Snow . Oxford University Press, Oxford 2003, ISBN 0-19-513544-X .
  • Ronald D. Barley : The Dark Secret of the Pump on Broad Street. For the 200th birthday of John Snow . Chirurgische Allgemeine , Volume 15, Issue 2 (2014), pp. 123–126.
  • Christoph Weißer: Snow, John. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1341.

Web links

Commons : John Snow  - collection of pictures, videos and audio files

Individual evidence

  1. ↑ UCLA. Department of epidemiology. John Snow by Ralph R. Frerichs, online
  2. ^ Spence Galbraith: William Hardcastle (1794-1860) of Newcastle upon Tyne, and his pupil John Snow. Archaelogia Aeliana 5 XXVII, pp. 155-170
  3. ↑ www.chroniclelive.co.uk: The story of Newcastle's hospitals from Forth Banks to Keelman's .
  4. ↑ Faulconer, Keys (1965), p. 469 (“general practice”).
  5. ^ Snow Inhaler, Mark II. Illustration from the Wood Library Museum
  6. ↑ Another model of an ether inhaler by John Snow
  7. ↑ Christoph Weißer: Snow, John. 2005, p. 1341.
  8. ^ Wikisource Joseph Griffiths Swayne
  9. ^ Michael Whitfield: The Bristol Microscopists and the Cholera Epidemic of 1849. Avon Local History and Archeology 2011, ALHA Books, Bristol 2011
  10. ^ Wikisource William Budd
  11. ↑ JG Swayne; W. Budd: An account of certain organic cells in the peculiar evacuations of cholera. Lancet, 1849, 54: 398-399.
  12. ^ PE Brown: John Snow - the autumn loiterer. Pp. 519-528, online
  13. ↑ Milton Wainwright: Microbiology before Pasteur. Microbiology Today, Vol. 28 / Feb. 01, p. 20
  14. ^ Anaesthesia, Cholera and the Medical Reading Society of Bristol, online
  15. ^ Stephanie J. Snow: Death by Water. John Snow and the cholera in the 19th century. Liverpool Medical History Society. 4 March 1999 ( Memento from April 4, 2015 in the Internet Archive )
  16. ^ AH Hassall, In: Great Britain, General Board of Health, Report of the Committee for Scientific Inquiries in relation to the Cholera Epidemic of 1854. London 1855
  17. ↑ Amanda J. Thomas: The Lambeth Cholera Outbreak of 1848–1849: The Setting, Causes, Course and Aftermath of an Epidemic in London. McFarland, 2009, ISBN 978-0-7864-5714-4 , p. 37 f.
  18. ^ F Fowke: On the First Discovery of the Comma-Bacillus of Cholera. British medical journal 03/1885; 1 (1264): 589-92.
  19. ^ Fortin, Dale: Spatial Analysis. 2005, p. 7.
  20. ↑ was a weekly medical journal; founded in 1827 and published until 1852
  21. ↑ John Snow's Published Works ( English ) Michigan State University. Retrieved May 23, 2019.
personal data
SURNAME Snow, John
BRIEF DESCRIPTION English doctor
DATE OF BIRTH March 15, 1813
PLACE OF BIRTH York
DATE OF DEATH June 16, 1858
Place of death London