Crediting his critics' concerns: Remaking John Snow's map of Broad Street cholera, 1854

• Published in: Social science & medicine (1982) Vol. 69; no. 8; pp. 1246 - 1251
• Main Authors: Koch, Tom, Denike, Kenneth
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2009; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Bacterial diseases; Biological and medical sciences; Cholera; Cholera - epidemiology; Cholera - history; Cholera Medical cartography Medical history Methodology John snow; Disease Outbreaks - history; Disease Outbreaks - statistics & numerical data; Diseases; Epidemics; Epidemiology; General aspects; Geography; History of medicine; History, 19th Century; Human bacterial diseases; Human geography; Humans; Infectious diseases; John; John snow; London - epidemiology; Mapping; Maps as Topic; Medical cartography; Medical history; Medical sciences; Methodology; Miscellaneous; Public Health; Public Health - history; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk; Snow, John; Social research; Topography, Medical - history; Topography, Medical - methods; Tropical bacterial diseases; Water Microbiology; Water Supply - history; London; United Kingdom > UK; England; Westminster Borough-London England; British Isles, England, Greater London, London; John snow; Medical history; Cholera; Methodology; Medical cartography; Human; Cartography; Century 19th; History; Epidemiology; Infection; Maps; Bacteriosis; Street; Social medicine; Public health
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2009.07.046

Few cases in the history of epidemiology and public health are more famous than John Snow's investigation of a neighborhood cholera outbreak in the St. James, Westminster, area of London in 1854. In this study Snow is assumed to have proven that cholera was water rather than airborne through a methodology that became, and to a great extent remains, central to the science and social science of disease studies. And yet, Snow's work did not satisfy most of his contemporaries who considered his proof of a solely waterborne cholera interesting but unconvincing. Uniquely, this paper asks whether the caution of Snow's contemporaries was reasonable, and secondly, whether Snow might have been more convincing within the science of the day. The answers significantly alter our understanding of this paradigmatic case. It does so in a manner offering insights both into the origins of nineteenth century disease analysis and more generally, the relation of mapping in the investigation of an outbreak of uncertain origin. The result has general relevance—pedagogically and practically—in epidemiology, medical geography, and public health.