UCLA Epidemiologist Creates a Web Site About a Pioneer in the Field

By Jessica Ludwig

Everyone has heard of cholera, but few people know anything about John Snow, the man who determined how the disease is transmitted. A Web site dedicated to Snow's life and the era in which he lived is a continuing project of Ralph R. Frerichs, a professor who is chairman of the department of epidemiology at the University of California at Los Angeles School of Public Health.

"In public health, we don't have many heroes," admits Dr. Frerichs. "Over the course of time, John Snow has been reduced into a 15-minute caricature."

In addition to a brief biography of Snow, the site describes Snow's early life, medical education, and death. Users will find three portraits of the doctor, maps and pictures of the houses he occupied in London, a friend's remembrances of Snow after his death, and even information on the London pub that bears his name.

The site includes the full 139-page text of Snow's "On the Mode of Communication of Cholera," the 1855 treatise in which he set forth his observations and recommendations on instances of cholera in London. Snow is most famous for his conclusion that water from a public pump was the cause of an epidemic in the Broad Street area. After the local government removed the pump handle at Snow's request, the number of cholera cases decreased and then stopped.

Snow was also an anesthesiologist, and users can read the notes he made after administering chloroform to Queen Victoria during the birth of two of her children. The site's index of people and places in 19th-century London has proved a resource to scholars of Victorian England, Dr. Frerichs says.

While the main page provides what seems like a straightforward index to the site, Dr. Frerichs warns that the information "doesn't unfold in a linear fashion" but rather "reflects the scientific process, especially in epidemiology." For example, the multiple maps on the site encourage users to "wander and move back and forth," and Dr. Frerichs says "what emerges is a totality." A high-resolution map of London in 1859 can be used in conjunction with a map locating deaths during the Broad Street cholera outbreak.

Dr. Frerichs says he chose to present the material in this contemporary and nonlinear format to inspire students to visit parts of the site they might not initially take the time to read, such as Snow's extensive medical treatise.

While partial to Snow's contributions to public health, the site offers various views, historical and contemporary, of the importance of Snow's removing the Broad Street pump handle. Dr. Frerichs's slide presentation, "A Sight and Sound Voyage Into the History of Epidemiology," asks if Snow was "riding to glory on the downhill slope of an epidemic curve," and whether Snow's observations were more timely than pertinent.

Since he created the site, Dr. Frerichs says, he has noticed increasing worldwide interest in John Snow, and he plans to continue updating the site and adding additional audio and video to it.