Why? The itch and the scratch. Most people know Dr. John Snow was a physician. Even more people know he was the father of Epidemiology. Many are aware of the linkages to Cholera and Victorian England, sewerage, sanitation and lest we forget the good Chadwick and Prince Albert.
Here’s what less readers induct and take it from my hard earned understanding. Dr. Snow also died pitifully young for a man of his convictions. The reason for all of it was the itch and the scratch.
If Dr. Snow was still alive today here’s the testimony I imagine I he would give. Epidemiology is an itch and scratch business. Heed my words good people. If you surf diseases you will suffer for every arrow you steal from the quiver of authoritarianism.
Consider the curious case of Mr. Snow. In 1853, his first 15 minutes of fame came from the seasoned veteran of childbirth pain, Queen Victoria and her open minded husband Prince Albert, via the invitation of their trusted Physician Sir James Clark. Note the Sir, our current monarch fat Joffrey wants a Nobel Prize—my dream is to be knighted by Queen Victoria. We all must embrace reality.
We know from Dr. Snow’s first folio, his journals, that he arrived at the Palace around midnight and administered a titration of 0.9 ml of chloroform by handkerchief every 15 mins. That was anesthesia in the Victorian era, and Dr. Snow was reportedly at the peak of his discipline.
Now hearing about Dr. Snow’s first act will no doubt leave the hungry Epidemiologist wondering. What does this event have to do with an itch or scratching? Well let’s clear that up. The itch to young Dr. Snow was the dosage of a novel medication that was just as easily lethal as palliative. Ironically enough this also explains the scratch, for a Victorian doctor that administers a medication that can just as easily kill his queen as deliver her, would not report for duty without a scientists certainty and a bravery of the highest order. In lesser words, Dr. snow was a curious scientist with the bravery to look at health seriously and with enough personal accountability to solve the problems before him.
Understand folks this is why I have always sympathized with Dr. Snow’s first act as well as his second. Indeed the second is why we are here. The reason is to be another tribute to the great man and template for the solutions we are losing.
In many ways Dr. Snow was a poor choice for a figurehead. Like we mentioned before he only lived half a lifespan. Darwin and Farr made it past 70 years, Dr. Snow failed to see 50. In addition he was never married, essentially an orphan with one loving uncle, and he had no children. Yet so many children have survived because of Dr. Snow’s itch and scratch.
There are other ways to understand the concept of the itch. Many people, all in fact I dare say, can recognize at least one itch in their life history. Maybe it was just a twitch on their head along the evolutionary hair line where they scratch and ponder why I am covered in hair like an animal? I mention evolution here because that’s the answer to the simplest example. Humans have hair because like rodents and primates and so many other phyla we share genes and molecular structures that make up other Metazoans. We are all the beneficiaries of Natural Selection.
Dr. Snow’s itch was different though. His scratch was different too. What this mean? Well okay let’s say he walked through his neighborhood and smelled miasma, bad air, the smells of the bad air is a sensation that can easily become an itch, and a lot of people in Dr. Snow’s time smelled the same air, and they had different strategies to scratch their miasma itch. We can investigate their findings. Ultimately there were a few camps.
First though it’s important to know that the only reason Dr. Snow was able to scratch his itch was because London had a General Board of Health in the 1850’s when Cholera epidemics first began to terrorize England’s industrial coast lines. Let’s look back to 1854. Aside from Palaces and Cathedrals the largest buildings in London were prisons. One especially infamous example was Millbank Prison on the north bank of the Thames.
In the decades to follow the Albert, Victoria, and Chelsea embankment projects would transform these low tidal marshlands befouled with sewer effluent, salt water, and industrial waste into a narrow tidal canal with high solid walls and deep water channel.
Nested within this dynamic transforming landscape a threshold of human progress and civil works would develop and lead to a revolution in sanitation that would change the world. What was Dr. Snow’s role in all of it though. To be considered.