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  • John Snow, Anaesthetist to a Queen and Epidemiologist to a Nation: A Biography
  • John M. Eyler
David A. E. Shephard. John Snow, Anaesthetist to a Queen and Epidemiologist to a Nation: A Biography. Cornwall, Prince Edward Island, Canada: York Point Publishing, 1995. 373 pp. Ill. $24.00 (paperbound).

Although this biography was not written to demonstrate how men without fortune or connection could rise to prominence in the Victorian medical profession, the career of its subject illustrates the channels for social and professional mobility that British historians such as Jeanne Peterson have described. John Snow, one of eight children of a Yorkshire carter turned farmer, exploited the multiple paths to medical training available in his age, first in the provinces and then in London—obtaining his M.R.C.S. and L.S.A. in 1837, his M.B. and B.S. in 1843, his M.D. in 1844, and at the age of thirty-seven becoming L.R.C.P. in 1850. Snow established his reputation within the profession by active participation in local medical societies and by frequent contributions to the medical press. Finally, while he maintained a general practice until his death, his professional success depended on his early adoption of and leadership in a new form of practice, the administration of anesthetics. When he died at the age of forty-five, he was a leader of his profession with a thriving specialty practice that included [End Page 716] attendance on the Queen, and past offices in some of London’s most important medical societies.

But it is Snow’s contributions to anesthesiology and epidemiology that are remembered today, and it is those that this biography emphasizes. The first three chapters describe his early life, education, and general practice. There follow two chapters on his work with ether and chloroform and two more on his investigations of the transmission of cholera. Relying on Snow’s three surviving casebooks and on his clinical papers, the author provides an informative discussion of Snow’s general practice. An anesthesiologist himself, David Shephard is at his best describing Snow’s investigations and use of ether and chloroform. Snow was among the first British practitioners to adopt these two agents, but what set him apart were the careful experiments (using both animals and himself as subjects) that he undertook in order to determine their effects and mode of action, to relate the depth of anesthesia to the physical signs observable in patients, and to design inhalers that would permit him to administer these agents predictably and safely. Shephard explains the problems Snow faced, the research he undertook, and the clinical significance of that research. I know of no better discussion of this topic.

There has been much historical analysis of the cholera debates, and Shepard’s handling of this aspect of Snow’s career is less distinguished. He does offer a fair and quite complete reading of Snow’s publications on cholera, but his discussion of their significance suffers in comparison to that of others such as Margaret Pelling. Shephard tries to draw too sharp a dichotomy between the strict contagionists like Snow and the rest of the medical profession. He also is preoccupied by the problem of trying to explain why it was Snow and not someone else who got the right answer.

A second disappointment with this book is its final two chapters, one dealing with Snow’s publications and the second with Snow as “the compleat physician.” These are highly repetitive, both of themselves and of earlier chapters. What new insights they offer could easily have been incorporated into the earlier chapters; the result would have been a shorter and more focused account. These two reservations aside, this book has a good deal to offer. The picture it provides of general practice in Victorian London and its discussion of Snow and anesthesia are especially recommended.

John M. Eyler
University of Minnesota, Minneapolis
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