Mythological Endings: John Snow (1813–1858) and the History of American Epidemiology

Abstract

During the COVID-19 epidemic, the name of the 19th-century English physician John Snow (1813-1858) has cropped up to a surprising extent, notably in connection with the severe cholera epidemic of 1854 in the district of Golden Square, London. It is repeatedly stated that Snow brought this epidemic of waterborne disease to an end by removing the handle of the Broad Street pump. It is also widely known that this story is a myth. Nonetheless, the Broad Street pump story as told by Snow's close friend Benjamin Ward Richardson remains embedded, partly, it is argued, because of its appeal to areas of the cultural consciousness. In America, Snow and his work on the epidemiology of cholera, including the Broad Street pump story, achieved a serious status which has endured, in one form or another, to the present day. In contrast to Britain, the heroic age of public health in America coincided with the optimism of the bacteriological revolution and higher hopes for medical science. However, this rapidly changing environment exacerbated differences of opinion as to what the small and emergent specialty of epidemiology should look like, what its project was, and where it should be based. Different versions of Snow's persona came to represent basic and often conflicting conceptions of epidemiology and the status (or lack of it) of its practitioners. For many, consciously or otherwise, the removal of the Broad Street pump handle remained an individualistic triumph, a single human intervention which resembled modern medicine in providing a "cure."