Tag Archives: John L. Leal

June 16, 1858: Death of Dr. John Snow

Dr. John Snow

Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

June 8, 1909: Leal and Fuller Papers Presented at AWWA Conference

Chloride of lime feed system used at Boonton Reservoir

June 8, 1909: John L. Leal, George W. Fuller and George A. Johnson present papers at the AWWA annual conference on this day in Milwaukee, Wisconsin, on the chloride of lime treatment system at Boonton Reservoir, New Jersey. Unlike previous presentations on the addition of disinfection chemicals to water, the three papers were received enthusiastically by the audience. The then President of AWWA, William P. Mason, stated in the discussion section of the papers, “…when I first came in contact with this process I was a very strong disbeliever; in fact, I am on record in print as not approving of the process. I have been converted, however…because of the results of many experiments. I found, very greatly to my surprise, that the dose was exceedingly small that was required to produce satisfactory treatment.” The full story of the chlorination of the Jersey City water supply can be found in The Chlorine Revolution which was published in April 2013.

“Testimony at the second Jersey City trial described the plant facilities in some detail, and later publications gave an overview of the facilities along with selected design details.

Figure 10-1 is a schematic of the chloride of lime feed facility at Boonton. According to Fuller’s testimony, he made only nine engineering design drawings to guide the contractor during construction of the plant. For an equivalent facility today, dozens of drawings would be required.

The chloride of lime facility was housed in a one-story wooden building that was constructed adjacent to the gate house located at the foot of Boonton Dam. In addition to all of the mechanical equipment required to feed chloride of lime, the building housed a small laboratory used to perform simple chemical tests and to conduct bacteriological examinations.

The concentrated chloride of lime powder was put into dissolving tanks along with dilution water from the reservoir (Figure 10-1). Typically, the bleaching powder contained 35 percent available chlorine. A highly concentrated solution of chloride of lime was made in the dissolving tanks and then fed by gravity into the solution tanks. More dilution water was added to the solution tanks to create the desired strength for the chloride of lime mixture. Triplicate pairs of dissolving and solution tanks allowed the operator to produce large batches (about 10,000 gallons each) of 0.5–1 percent dilute solutions.

A belt-driven turbine pump4 (in duplicate) moved the dilute solution up to one of the two orifice tanks. The orifice tanks were positioned at a relatively high elevation, enabling them to feed chlorine solution by gravity into the chamber below. The chamber was downstream of the 48-inch pipelines connecting the outlet tower of the dam to the pipeline delivering water to Jersey City. Duplicate orifice tanks were a critical design factor because chloride of lime in 0.5–1 percent solutions tended to build up solid deposits on the sides of the orifice plate and obstruct the opening.”

Reference: McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Jersey City Chlorination Facility at Boonton Reservoir

June 3, 1844: Birth of Garret A. Hobart

June 3, 1844: Birth of Garret A. Hobart. “Garret Augustus Hobart (June 3, 1844 – November 21, 1899) was the 24th Vice President of the United States (1897–1899), serving under President William McKinley…. As vice president, Hobart proved a popular figure in Washington and was a close adviser to McKinley.”

While much is known about Hobart’s role as vice president, his role in the formation of private water companies and his support of these companies through legislation is less well known. Hobart was elected to the New Jersey Assembly and Senate during the early part of his career. During the 1870s and 1880s there was a lot of legislative activity that appeared to be for the benefit of private water companies.

In 1881, one bill that was introduced by Garret A. Hobart, then a state senator, was designed to give private water companies the power to acquire and distribute water resources independent of municipal or state control. While not explicitly stated, the bill purportedly had a single intention of giving one company, the Passaic Water Company, more power to access water supplies to prevent water shortages at the factories of Paterson which were forced to idle production in the summer season.

The bill was not successful, (New York Times, March 22, 1881) which was undoubtedly due in part to the widespread suspicion that the bill would grant powers to companies to export New Jersey water supplies to New York. “[New York speculators] have been attracted by the magnificence and extent of New Jersey’s water-shed, and by the sweetness and purity of its waters. Last year’s scheme was said to be intended to enable the tapping of New Jersey’s hills for the New York supply.”(New York Times, March 7, 1881)

Hobart was a resident of Paterson, New Jersey for most of his life. In 1885, Garret A. Hobart joined the Board of the Passaic Water Company and two years later was elected President of the Company. Hobart was described in one source as representing a syndicate of New York capitalists. (Nelson and Shriner 1920) The company had been supplying Paterson and the surrounding area since 1857.

The East Jersey Water Company was formed on August 1, 1889 for the stated purpose of supplying Newark, New Jersey with a safe water supply. All of the men who were shareholders of the new company (including Hobart) were identified with the Lehigh Valley Railroad Company. (New York Times, August 2, 1889) However, the company’s vision extended far beyond a water supply for Newark. The company began as a confidential syndicate composed of businessmen who were interested in executing grand plans for water supply in northern New Jersey and New York City. (Colby and Peck 1900) Nothing came of these grand plans.

Hobart was also a mentor to Dr. John L. Leal of Paterson and encouraged Leal to leave city employment and work full time as the sanitary advisor to several private water companies.(McGuire 2013)

“Hobart died on November 21, 1899 of heart disease at age 55; his place on the Republican ticket in 1900 was taken by New York Governor Theodore Roosevelt.”

References:

Colby, Frank M. and Harry T. Peck eds. The International Year Book—A Compendium of the World’s Progress During the Year 1899. n.p.:Dodd, Mead and Co., 1900.

McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Nelson, William and Charles A. Shriner. History of Paterson and Its Environs. Vol. 2, New York:Lewis Historical Publishing Company, 1920.

New York Times. “Jersey’s Water Supplies—Senator Hobart’s Bill and Its Effect.” March 7, 1881.

New York Times. “New Jersey’s Law Makers—Mr. Hobart’s Water Bill Killed.” March 22, 1881.

New York Times. “To Give Newark Water.” August 2, 1889.

May 23, 1904: Boonton Water Supply Delivered to Jersey City

Boonton Dam on the Rockaway River

May 23, 1904: First delivery of water from the Boonton supply to Jersey City, New Jersey. At the end of the 19th century, the water supply for Jersey City, New Jersey was contaminated with sewage and the death toll from typhoid fever was high. In 1899, the city contracted with a private company for the construction of a new water supply on the Rockaway River, which included a dam, reservoir and 23-mile pipeline. The project was completed on May 23, 1904; however, no treatment was provided to the water supply, because the contract did not require it. The city, claiming that the contract provisions were not fulfilled, filed a lawsuit in the Chancery Court of New Jersey. Jersey City officials complained that the water served to the city was not “pure and wholesome.”

Two trials resulted from the lawsuit. In the second trial, Dr. John L. Leal and several other defendant expert witnesses were able to convince the Special Master, William J. Magie, that the use of chlorine to disinfect the water supply was safe, effective and reliable. After the favorable verdict, the use of chlorine for drinking water disinfection exploded across the U.S. and typhoid fever was eradicated.

Reference: McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Boonton Reservoir, water supply for Jersey City on the Rockaway River

May 5, 1858: Birth of John L. Leal

May 5, 1858: 159th anniversary of the birth of John L. Leal, physician and water treatment expert who pioneered chlorine disinfection in the U.S. There are many unsung heroes who contributed significantly to public health at the turn of the 20th century. John L. Leal is one of them and after reading this, I think you will agree that he did more than most to save people’s lives.

John L. Leal was born in the small town of Andes, New York on May 5, 1858. His father, John Rose Leal was a physician who joined the 144th Regiment, New York Volunteers and fought in the Civil War. During the siege of Charleston, South Carolina, John Rose Leal contracted what was most likely a case of amoebic dysentery from contaminated drinking water. He suffered from the disease for more than 17 years before he finally died of it in 1882.

John L. Leal attended Princeton College and graduated in 1880. He went on to Columbia College of Physicians and Surgeons finishing his medical education in 1883. He opened a medical practice in Paterson, New Jersey and went to work for the Paterson Board of Health where he remained until 1899. He left City employment and became the sanitary adviser to private water companies including the East Jersey Water Company and the Jersey City Water Supply Company. In 1888, he married Amy L. Arrowsmith and they had one son, Graham, later that year. So far, his life was well spent but not exemplary.

In the field of water supply, there were big moves afoot in the state of New Jersey at the turn of the 20th century. Jersey City had suffered with a contaminated water supply for decades causing tens of thousands of deaths from typhoid fever and diarrheal diseases. In 1899, the City contracted with Jersey City Water Supply Company to build a dam on the Rockaway River and provide a new water supply. The dam created Boonton Reservoir, which had a storage capacity of over seven billion gallons. Leal’s job with the company was to remove sources of contamination in the Rockaway River watershed above the reservoir. Water from the project was served to the City beginning on May 23, 1904.

When it came time for Jersey City to pay the company for the new water supply, they balked. The price tag was steep—over $175 million in current dollars. Using newly developed bacteriological methods, consultants for the City claimed that the water was not “pure and wholesome,” and they filed suit against the company to get a reduced purchase price. The trial that resulted pitted the water quality experts of the day against one another in a battle of expert witnesses. The opinion of the judge was published on May 1, 1909. In that opinion, Vice Chancellor Frederic W. Stevens said that Boonton Reservoir did a good job on average of reducing the bacteria concentrations in the water provided. However, he noted that two to three times per year, especially after intense rainstorms, the reservoir short-circuited and relatively high bacteria levels resulted.

Rather than build expensive sewers that would deal with only part of the bacteria contamination problem (an early recognition of non-point source pollution) Leal and the company attorney argued to install “other plans or devices” that would do a better job. The judge agreed and gave them a little over three months to prove their idea. Leal had decided in May 1909 that it was time to add a chemical disinfectant to drinking water. He was all too familiar with the suffering and death caused by typhoid fever and diarrheal diseases. He knew of some successful instances of using forms of chlorine in Europe, but nothing had been attempted in the U.S. on a large-scale basis or over any continuous time period.

But, there was a problem. The public feared chemicals in their food, medicines and water. Adulteration of food and medicines was rampant during this period, which was faithfully catalogued in Upton Sinclair’s The Jungle.

“How could they know that the pale-blue milk that they bought around the corner was watered, and doctored with formaldehyde besides?. . .How could they find out that their tea and coffee, their sugar and flour, had been doctored; that their canned peas had been colored with copper salts, and their fruit jams with aniline dyes?”(1)

At any conference of water professionals in the late 19th and early 20th centuries, strong language was used to oppose chemical disinfection. Even George W. Fuller early in his career was not supportive of chemical disinfectants.

1893, George Warren Fuller: “While chemicals have been of much aid in surgery by bringing about antisepsis and asepsis, it is very improbable that people would allow their drinking water to be drugged with chemicals, even with the view of removing dangerous bacteria–indeed, such a method might prove very dangerous in many cases.”(2)

1894, Thomas M. Drown: “…the idea itself of chemical disinfection is repellent.”(3)

1904, George C. Whipple: “Thus in St. Louis the popular prejudice against the use of alum in clarifying the water is said to be so intense that a local engineer has said ‘it is very doubtful if alum could be used, no matter how excellent the results which might be obtained.’. . .‘We don’t want to drink puckered water.’”(4)

1906, George C. Whipple: “The idea of adding poisonous chemicals [like chlorine] to water for the purpose of improving its quality for drinking purposes has generally been considered as illogical and unsafe. . .”(5)

1906, William P. Mason: “I very much question if the public at large would be willing to disinfect water to-day. We are scarcely driven that far yet.”(6)

1906, P.A. Maignen: “Among the so-called ‘disinfectants’ tried may be cited copper, chlorine and oxalic acid. . .Such poisonous materials should not be permitted to be used on water intended for public supplies.”(7)

Nonetheless, Leal was convinced that adding a disinfectant to the Jersey City water supply was the best course. He had done laboratory studies that convinced him that a fraction of a ppm of chlorine would kill disease-causing bacteria. In the face of the certain disapproval of his peers and possible condemnation by the public, he moved forward. Where he found the courage to follow the path of chemical disinfection when all of the experts railed against it is not known for certain. His father’s gruesome illness and death and the unnecessary deaths he personally observed as Health Officer for Paterson must have contributed to his decision.

However, no chlorine feed system treating 40 million gallons per day had ever been designed or built and if the feed system failed to operate reliably, all of the courage of his convictions would not have amounted to much. He needed the best engineer in the country to do the work. He needed George Warren Fuller. In 1908, Fuller was famous for his work in filtration. He had designed an aluminum sulfate feed system treating 30 million gallons per day for the Little Falls treatment plant. On July 19, 1908, Leal left his attorney’s office in Jersey City and took the ferry to Manhattan. In Fuller’s office at 170 Broadway, he hired the famous engineer (undoubtedly on the basis of a handshake) and told him that the bad news was that he needed the work done in a little over three months.

Ninety-nine days later, the chlorine feed system was built and operational. Calcium hypochlorite (known then as chloride of lime or bleaching powder) was made into a concentrated solution, diluted with water and fed through a calibrated orifice to the water before it traveled by gravity to Jersey City. The feed system worked flawlessly from day one and continued to operate successfully for all of the following days. Liquid chlorine eventually replaced chloride of lime, but September 26, 2012, marks the 104th anniversary of the first continuous use of chlorine on a water supply—the longest period of water disinfection anywhere in the world.

In a second trial, the court vindicated Leal’s decision. Afterwards, the use of chlorine spread like wildfire throughout the U.S. Typhoid fever death rates plummeted and children under one year of age stopped dying by the hundreds of thousands.

John L. Leal was not a physically imposing figure. Photographs of him show a man of average height and build with a kind face. Nothing in his appearance hinted at the steel spine and dogged courage that he possessed. One definition of the word hero reads: “a man of distinguished courage or ability, admired for his brave deeds and noble qualities.” These days, many people feel that the word hero has been overused in this country. I think that promoting a water treatment process that saves millions of lives qualifies Leal to be known as a Hero of Public Health.

Why doesn’t everyone know about Leal? Another man, George A. Johnson was wrongly given the credit for the idea of chlorinating the water supply for Jersey City. Johnson was able to get away with his charade, in part, because John L. Leal died on March 13, 1914, and Johnson lived for another 20 years.

Still not convinced? Well, you will have to wait for the full story that has been published in my book, The Chlorine Revolution: Water Disinfection and the Fight to Save Lives which will be available for shipment on March 20, 2013.(8)

References

(1) Sinclair, Upton. The Jungle: With an Afterword by Emory Elliott. New York:Signet Classic, 1990, original copyright 1905, originally published in 1904.

(2) Fuller, George W. “Sand Filtration of Water, with Special Reference to Results Obtained, at Lawrence, Massachusetts.” In American Public Health Association, Public Health Papers and Reports. Vol. 20, Columbus, OH:APHA, 64-71. 1895.

(3) Drown, Thomas M. “The Electrical Purification of Water.” Journal NEWWA. 8 (1894): 183-7.

(4) Whipple, George C. Discussion of “Purification of Water for Domestic Use.” Transactions ASCE. 54:Part D (1905): 192-206.

(5) Whipple, George C. “Disinfection as a Means of Water Purification.” Proceedings AWWA. (1906): 266-80.

(6) Mason, William P. “Discussion.” Proceedings AWWA. (1906): 282-3.

(7) Maignen, P.A. “Discussion.” Proceedings AWWA. (1906): 285-6.

(8) McGuire, Michael J. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, Colorado:American Water Works Association. 2013.

Commentary: On May 5, 2013, at Cedar Lawn Cemetery in Paterson, New Jersey, a grave monument was dedicated to Dr. Leal. For 98 years, his grave was unmarked. The granite obelisk has the names of John L. Leal and five members of his immediate family carved on the sides. Under John L. Leal’s name is the descriptor: Hero of Public Health.

Grave Monument for Dr. Leal

March 31, 1934: Death of George A. Johnson

March 31, 1934: Death of George A. Johnson. George A. Johnson was born in Auburn, Maine on May 26, 1874. From his involvement in the Louisville study with Fuller to his death in 1934, Johnson’s career was boosted by his association with George W. Fuller.

Johnson never attended college and had no formal training as an engineer, chemist or bacteriologist. Johnson identified himself during his testimony in the second Jersey City trial as a “sanitary engineer,” which was clearly an overstatement of his accomplishments up to that point. By the time he became involved in the Boonton chloride of lime plant, he said that he had 14 years of experience as a sanitary engineer—since September 1895. The first three years of this period were devoted to working with George W. Fuller on the filtration studies in Louisville and Cincinnati. From reports of those studies, it was clear that Johnson was a laboratory technician and had no responsibilities or duties as a sanitary engineer.

From 1899 on, Johnson became involved in some of the most interesting studies and implementation projects for filtration and sewage treatment in the U.S. under the guidance and supervision of George W. Fuller and Rudolph Hering. Project locations included York, PA, Norfolk, VA, Washington, DC, Philadelphia, PA, and St. Louis MO. “At many of the places mentioned my work embodied not only straight laboratory work of a bacterial and chemical nature, but also the practical operation of filtration works.” Clearly, from his own words, Johnson was a plant operator and lab technician who aspired to become a sanitary engineer someday through experience alone.

Johnson had a supporting role in the great Chicago Drainage Canal case when he made investigations of the purported contamination caused by the discharge of Chicago’s rerouted sewage into the Mississippi 43 miles above the St. Louis water intake. He worked at the Little Falls treatment plant, helped conduct a sanitary survey of the Hudson River for New York City (with George C. Whipple) and investigated sewage treatment methods in Cleveland, OH in addition to water treatment methods for their water supply.

Johnson took some time off in 1905-6 and traveled around the world. He visited water works in many countries and published a paper on his adventures when he returned. The paper is a curious recitation of unremarkable water works. It is hard to understand what a U.S. reader might learn from his description of the Calcutta waterworks. Calcutta is in the Ganges Valley which was the source for all of the horrifying cholera epidemics in the 19th century which killed millions of people around the world.

When he returned to the U.S., he rejoined Hering and Fuller as Principal Assistant Engineer and he continued his work on water treatment and sewage disposal plants. During this period he operated the Boonton chloride of lime plant for three months in late 1908.

He left the firm of Hering and Fuller in 1910 and formed the consulting firm Johnson and Fuller with William Barnard Fuller. He continued as a consultant for the rest of his career except for two years (1918-20) when he joined the U.S. Army where he managed fixed properties and utilities in the U.S. for the War Department.

He was a member of a number of professional societies including the APHA and the AWWA. He received the Dexter Brackett Medal from the New England Water Works Association. He published many articles in professional journals during his career.

In the obituary written by his mentor, George W. Fuller, his qualities were generously described: “Colonel Johnson was a devoted son and husband, generous to a fault. He was a man of marked and likeable personality, keen in his appreciation of human relations, and aggressive in advancing his views both on technical and non-technical subjects.” (emphasis added)

He was a member of the Explorers Club and the Circumnavigators Club, where he edited its monthly publication, The Log, for many years. He died of a heart attack while working at his desk on March 31, 1934. George W. Fuller would die just two and one-half months later.

References:

Between the Mayor and Aldermen of Jersey City, Complainant, and Patrick H. Flynn and Jersey City Water Supply Company, Defendants: On Bill, etc. (In Chancery of New Jersey) 12 vols. n.p.:privately printed. 1908-10, (February 8, 1909, p. 5126).

McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Commentary: Johnson took inappropriate credit for the first use of chlorine in a drinking water supply. He claimed to first use chlorine in the Bubbly Creek treatment plant which was used to treat water for cows and pigs. He then wrote about the chlorination of the water supply for Jersey City and either omitted the leadership of Dr. John L. Leal from his writings or emphasized improperly his own contributions. Dozens of secondary and tertiary sources have perpetuated the myth that Johnson started. Chapter 13 of The Chlorine Revolution examines this issue in full detail.

March 15, 1813: Birth of Dr. John Snow

Dr. John Snow

March 15, 1813: Birth of John Snow. Dr. John Snow (March 15, 1813–June 16, 1858) is famous for the Broad Street Pump episode but he accomplished so much more than that. He was first and foremost a physician who trained in England in the early part of the 19th century. He made significant contributions to the development of anesthesia and he is considered by many to be the Father of Modern Epidemiology.

The story of Dr. John Snow and how he discovered the cause of a cholera epidemic in the Golden Square neighborhood of London in 1854 has reached almost mythical proportions in public health literature.  Three excellent books describe Snow’s life and the details of the Broad Street Pump incident. (Hempel 2007; Johnson 2006; Vinten-Johansen et al. 2003)

Snow was born on March 15, 1813 in the City of York.  He served his medical-apothecary apprenticeship in Newcastle-on-Tyne with later assistantships in the villages of Burnop Field and Pateley Bridge.  In 1836 at the age of 23, Snow moved to London to complete his medical education.  He qualified as a licensed apothecary in 1838 and a surgeon with a London practice in October 1838.  With an office in the parish of Saint Anne-Soho, Snow would have a medical career of only two-dozen years before he was struck down at the age of 45.

At the age of 17, Snow became a vegetarian and soon thereafter committed to only drinking boiled water or, preferably, distilled water as a result of the writings of John Frank Newton.  He embraced abstinence from alcohol around 1836.  Snow was known to be quiet, frugal and energetic, a man of integrity and a surgeon with an indifferent bedside manner.  He refused to dispense pills and other medicines just because his patients wanted them.  He was able to make a living and acquire some success as a physician when he perfected the administration of chloroform as an anesthetic used during surgeries and infant deliveries.  He even delivered two babies while attending Queen Victoria.

He never married.  His solitary existence and his abstinent personal habits allowed him more time than his colleagues to develop his medical practice and enabled him to pursue his intense interest in determining the cause of cholera epidemics.

Snow gave away all of the knowledge he developed.  He made it available for free to any doctor who wanted it.  No attempt was made by him to patent his many devices for dispensing chloroform and ether. As a result, physicians hired him to use his skill with their patients and he became famous for this.

One overriding personal characteristic of this ascetic doctor of the Victorian era was courage.  He worked hard to develop his ideas and used the scientific method and laboratory investigations to establish his case in whatever area he was working.  Once he became convinced of the rightness of his position, nothing could dislodge him.  It was only his tremendous courage that made it possible for him to go up against the establishment and argue that something other than foul air was causing the deadly cholera. (McGuire 2013)

Snow’s determination of the cause of the cholera epidemic near the Broad Street pump and his ability, albeit temporary, to have the pump handle removed is worthy of recounting here.  The 1854 cholera epidemic struck the Golden Square neighborhood of London with particular viciousness. It began on August 31 and started to wind down about September 7, however, many died over the next few days. Well over 500 people died during this epidemic in a small neighborhood. Snow tracked the numbers of deaths in the neighborhood, and it was clear to him from the pattern of death that the Broad Street pump was the center of the affliction and most likely the source of infection. On September 7, Snow convinced the Board of Governors and Directors of the Poor of St. James Parish that the epidemic was being caused by water from the pump. The next day the commissioners ordered that the pump handle be removed. Structural defects in the Broad Street well sump and the cross-connection to the nearby house sewer were not corrected until 1855.

Incredibly, the residents of Broad Street petitioned the Commissioners to reopen the well that had caused hundreds of deaths in their neighborhood.  This was partly due to the official linkage of the severe, isolated epidemic in the Broad Street area to miasma (foul air). In an amazing footnote to history, the commissioners voted 10 to 2 to reopen the well on September 26, 1855, one year and one week after the last deaths during the epidemic.  According to contemporary reports, there was much rejoicing in the street that the Broad Street well was reopened.  The polluted well was not permanently closed until the cholera epidemic of 1866.

With the emphasis on the Broad Street pump episode in most historical accounts, his pioneering work in epidemiology based on cholera occurrence in a district of London served by two water supplies usually gets lost.  Snow was able to demonstrate that homes in areas of London that were being served contaminated water from the tidal portion of the Thames Estuary were far more likely to have cholera deaths than the homes served water from an unpolluted upland source. He believed that dumping sewage into a water supply perpetuated the death spiral caused by cholera and other waterborne diseases. Snow had strong opinions on sewers and drinking water systems.

“Snow who distilled his own drinking water, agreed that London water should be improved, but he considered the abolition of cesspools and the increasing preference for water closets a sanitary disaster…water closets connected to sewer lines that emptied into rivers also used for metropolitan drinking water were, in his mind, primarily an efficient means of recycling the cholera agent through the intestines of victims as rapidly as possible.  Sanitary reforms were needed, but flushing the waste of a town into the same river by which one quenched ones’ thirst seemed sheer stupidity.” (Vinten-Johansen et al 2003)

Dr. John Snow died of a stroke on June 16, 1858, 42 days after the birth of John L. Leal who grew to be a physician who carried on Snow’s concern about the ability of contaminated water to spread disease.  If the discoveries of Dr. John Snow had been accepted and followed by engineers, sewer planners and drinking water providers beginning in 1854, millions of deaths would have been avoided.  Snow was only one person trying to overcome the juggernaut of the miasma theory.  He was far ahead of his time.

References:

Hempel, Sandra. 2007. The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera. Los Angeles, Ca.: University of California.

Johnson, Steven. 2006. The Ghost Map: The Story of London’s Most Terrifying Epidemic and How It Changed Science, Cities and the Modern World, New York City, N.Y.: Riverhead Books.

McGuire, Michael J. (2013). The Chlorine Revolution:  Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.

Vinten-Johansen, Peter, Howard Brody, Nigel Paneth, Stephen Rachman and Michael Rip. 2003. Cholera, Chloroform, and the Science of Medicine. New York City, N.Y.: Oxford University Press.

Commentary: In 2013, we had a great time celebrating the 200th anniversary of his birth.