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Epi Wit & Wisdom Articles
John Snow and the Future of
Epidemiology
Whatever the merits of the
debate on risk factor epidemiology, “black boxes” and the New Public
Health, some historical facts should be set straight. There is a myth
in epidemiology that John Snow sneaked out of his bed at night to
remove the handle of the Broad Street pump, thereby stopping the
cholera epidemic.
The real course of events can be
read in the work of John Snow himself, on page 40 of the 1936 reprint
of his book. On the evening of September 7th, Snow told the Board of
Guardians of St. James’ parish about his findings. As a consequence,
they decided to remove the handle the next day. Snow informed
non-medical public dignitaries, and they took action. Further on, Snow
writes that the epidemic was already declining before people stopped
using the water.
Moreover, it has been repeatedly
demonstrated that the work of John Snow is a very good example of the
influence of strong biologic reasoning (a very firm belief in the germ
theory of disease) that preceded his observations and colored them (AJE
1997; 146: 363-4).
Jan. P. Vandenbroucke
Published November 1997 v
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