The Lancet has published four separate papers offering perspectives and commentary about the work of John Snow, his legacy, and the impact on epidemiology today. One of these is a review paper based on the abstracts of the celebration of Snow’s life held at the London School of Hygiene and Tropical Medicine in mid April (see related article this issue). What follows is a recap of the other papers, including a new obituary for Snow written for The Lancet by Snow author Sandra Hempel.

New Obituary for Snow

The new obituary for John Snow is in effect an apology for the way The Lancet handled his original brief obituary in 1858 with no mention of epidemiology and cholera, and for the erroneous editorial criticisms of Snow which the journal made on more than one occasion. The new editorial also recounts the major elements of Snow’s contributions to epidemiology and adds many interesting details about his personal life (he had a talent for telling funny anecdotes).

The assessment of Snow’s work which proved to be the most incisive was not that of The Lancet and its editor but that of a medical officer who said in a letter, “although ephemeral criticism has been uniformly against him, yet I venture confidently to predict, that the facts which have been brought to light by his indefatiguable industry will prove to posterity that he was by far the most important investigator of the subject of cholera who has yet appeared.”

Singular Man

In a perspectives paper entitled “The Singular Science of John Snow”, Nigel Paneth from Michigan State Univesity and Paul Fine from the London School trace Snow’s thinking and contributions on anesthesia as well as cholera. The authors characterize Snow’s science work as “creative and productive” and reflecting a “singular, unified scientific approach”. What comes through in the paper is that Snow was truly “one of a kind”, and this uniqueness in multiple domains helped him to make the contributions he is known for.

Epidemiology for the People

In a third commentary by Paul Fine and colleagues at the London School, entitled “Epidemiology---A Science For The People”, the authors comment on the evolution, influence, and expanding scope of epidemiology as a discipline. They trace the evolution of epidemiology from its focus on infectious diseases to what today is a much wider set of applications. The authors attribute this wider use to what they describe as a shift in thinking and emphasis in epidemiology towards the logic of problem solving.

This shift is perhaps not surprising to those who have always considered the problem-solving mindset as the key ingredient of the epidemiologist, and Snow the scientist was considered a practical problem solver by Paneth and Fine in their description of his “singular” nature.

The authors conclude that it is to society’s advantage that the methods of epidemiology be applied as broadly as possible to a wide range of societal as well as individual human ills. Epidemiology is considered so relevant and useful in fact that the authors propose it should be incorporated as part of the science course requirements for all high school students. Viewed in this way, epidemiology literacy should be a key component of population-wide science literacy, and explains the title of this commentary which presents epidemiology as a science for the people.
 

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