Top life changing books
22 March 2025
Top Books That Changed My Life If there is anything we know for sure at AQUILA HQ, it’s that books
Right from the start of his medical career, John Snow showed he had an analytical mind, filling notebooks with data and adding his own thoughts and observations.
He was born in 1813 in York and attended a private school as a boy. He was a medical apprentice in Newcastle, and worked in Killingworth – a mining village – during a cholera outbreak in 1832.
By 1844 he was based in Frith Street, London, as a surgeon and general practitioner (GP). At first his main field of research was in the use of ether and chloroform as an anaesthetic during surgical operations. He would later put this to good use when he attended the birth of two of Queen Victoria’s children, Leopold (1853), and Beatrice (1857).
A vegetarian and teetotaller, who only ever drank boiled water (not a surprise – ed) for most of his life, Snow never married. He died following a stroke at the age of just 45. He is buried in Brompton Cemetery, in London.
In the middle of the 19th century, conditions were very poor in many parts of London. Houses did not have their own supply of water. Instead of a kitchen tap, residents had to collect water from a series of local street pumps. Towards the end of 1853, a bad outbreak of cholera hit the Soho area of London.
The view then was that diseases like the plague and cholera were spread through bad air (miasma), when gases escaped from sewers, swamps, rubbish heaps and graves. (Nice! Ed)
Snow was not convinced by the miasma theory. Most victims complained of symptoms that involved their stomachs and intestines, and not their mouths, noses or lungs. It seemed more likely that the cause of the outbreak was something that had been consumed, rather than inhaled.
Snow used a detailed street map of the area to mark the locations of houses where cholera had occurred. He also marked the sources of water residents were using in these areas. This is called a dot distribution, or dot density map.
Symbols show the presence of a feature or phenomenon. By studying the results of the dot density map, Snow could see that the number of cholera cases was clustered around use of a water pump at Broad Street. Snow did not have access to the right equipment to test a water sample from this pump, so the tests he did perform were inconclusive (unclear). There was supporting evidence, however. Inhabitants at the local workhouse were not dying from cholera. They had their own well. Some cases of the disease had occurred far away from the main cluster. It turned out that the residents at these houses travelled the distance to the accused pump because they preferred the taste of the water there. Other cholera cases that occurred outside of Soho turned out to be people who drank from the tainted pump on their way to and from work, or school.
A bacterial disease, cholera begins with stomach pain, which develops into severe vomiting and diarrhoea. This causes dehydration, which – if it goes untreated – can often prove fatal within a couple of days. Cholera is no longer found in the UK, but it is found elsewhere in the world, wherever there is no clean water supply, or modern sewage system.
Based on the evidence he had assembled, Snow persuaded the local authority, the Board of Guardians of St. James’ Parish, to remove the handle from the Broad Street pump, so that it could no longer be used. Immediately the number of cases began to decline, although this may have been partly due to the fact that some people fled the area when the epidemic took hold.
For Snow, the detective work needed to continue. If this was indeed the guilty pump, how had the water from it become contaminated in the first place? With the help of other doctors and the local assistant curate, the Rev Henry Whitehead, Snow continued to investigate the cause of the epidemic for months afterwards. By talking to victims’ families, Whitehead eventually found what he believed to be the index case (first recorded case) at 40 Broad Street, where the mother of a young child, suffering from cholera, caught elsewhere, had emptied water from a washed soiled nappy into the nearby cesspool. This cesspool was only one metre from the well feeding the pump in question. Examination found the cesspool was leaking through its stone walls into the well. This is what had contaminated the water supply.
Opposition to Snow’s views continued for some time in medical journals and newspapers, even after the Soho outbreak was over. Indeed, Snow died without ever knowing that, in 1854, an Italian scientist Filippo Pacini had discovered that bacteria causes cholera by examining the walls of the intestines of victims under a microscope. Later work by other scientists like Louis Pasteur did much to establish what is now known as the germ theory of disease.
Then in 1884, Robert Koch, a German microbiologist, was able to isolate the particular cholera bacterium. He also did similar work with anthrax and tuberculosis.
For his detective work in the Soho epidemic, Snow has been called the father of epidemiology – the branch of medicine that is concerned with the incidence and distribution of diseases and other factors related to health. Snow is also attributed with the important discovery that a number of serious diseases (like cholera) are waterborne (spread by dirty water). His work inspired fundamental changes to the water supply and waste disposal systems of London, and this brought about improvements to public health in other cities in Britain and worldwide.
Over 600 people died in the cholera epidemic that hit Soho in London in 1854.
Dr John Snow published the first edition of his best-known book On the Mode of Communication of Cholera in 1849. A further edition was published after the outbreak in Soho.
There is a memorial stone pump near the site of the original one in what is now called Broadwick Street in London. The handle has been removed. Nearby there is a public house named after Dr John Snow.
Every year at the Pumphandle Lecture in London, given by a leading authority in public health, members of the John Snow Society remove and then replace a pump handle to symbolise the continuing challenge for advances in public health.
The John Snow Award is made annually. It is a bursary to pay for an undergraduate medical student to carry out research in the field of anaesthetics.
The World Health Organisation believes there are still 47 countries in the world affected by cholera today. Organisations like WaterAid (www.wateraid.org/uk) work tirelessly to make sure this situation improves. A global task force on cholera control is supporting countries to reduce cholera deaths by 90 per cent by 2030.
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Written by John Davis. Illustration by Nick Taylor
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