In his 1855 book, John Snow attempted to identify how cholera was spread from one person to another.  He first wrote of  case-studies that had come to his attention.  One such study  was of John Barnes and his ill-fated family.  The material came from a report, Observations on Asiatic Cholera, written by Dr. Simpson of York. The story involved five communities in the central region of  England: York where author Simpson lived,  Leeds and Redhouse, Moor Monkton  and Tockwith. 

JOHN BARNES

John Barnes lived in Moor Monkton, an agricultural village north-west of York where cholera had not previously appeared. Here is what John Snow wrote of John Barnes in his 1855 book. 

"John Barnes, aged 39, an agricultural laborer, became severely indisposed on the 28th of December 1832; he had been suffering from diarrhea and cramps for two days previously. He was visited by Mr. George Hopps, a respectable surgeon at Redhouse, who, finding him sinking into collapse, requested an interview with his brother, Mr. J. Hopps, of York. This experienced practitioner at once recognized the case as one of Asiatic cholera; and, having bestowed considerable attention on the investigation of that disease, immediately enquired for some probable source of contagion, but in vain: no such source could be discovered. When he repeated his visit on the day following, the patient was dead; but Mrs. Barnes (the wife), Matthew Metcalfe, and Benjamin Muscroft, two persons who had visited Barnes on the preceding day, were all laboring under the disease, but recovered. John Foster, Ann Dunn, and widow Creyke, all of whom had communicated with the patients above named, were attacked by premonitory indisposition, which was however arrested." 

The facts were at hand. John Barnes was dead.  His wife and two friends who had contacted Barnes shortly before he died developed cholera but recovered.  Finally three persons who had contact with the two friends but not Barnes, became sick and recovered.  While John Barnes seemed to have transmitted the disease to others who then passed it on to more people, how did Barnes become sick in the first place?

THE MYSTERY IS SOLVED  

"Whilst the surgeons were vainly endeavoring to discover whence the disease could possibly have arisen, the mystery was all at once, and most unexpectedly, unraveled by the arrival in the village of the son of the deceased John Barnes. This young man was apprentice to his uncle, a shoemaker, living at Leeds. He informed the surgeons that his uncle's wife (his father's sister) had died of cholera a fortnight before that time, and that, as she had no children, her wearing apparel had been sent to Monkton by a common carrier. The clothes had not been washed; Barnes had opened the box in the evening; on the next day he had fallen sick of the disease."

To John Snow, this story suggested that cholera was spread both directly from person to person and indirectly by contact with contaminated objects.  While Snow in his text did not mention an incubation period, for John Barnes it was likely the time between contact with the unwashed clothes and the first signs and symptoms of his infection, or one day. 

The problems of John Barnes' family continue, due to the spirit of the human heart.  When his wife, Mrs. Barnes, became sick sometime between December 26 and 29 and remained ill for days thereafter, her mother rushed to help.     

"During the illness of Mrs. Barnes, her mother, who was living at Tockwith, a healthy village five miles distant from Moor Monkton, was requested to attend her. She went to Monkton accordingly, remained with her daughter for two days, washed her daughter's linen, and set out on her return home, apparently in good health. Whilst in the act of walking home she was seized with the malady, and fell down in collapse on the road. She was conveyed home to her cottage, and placed by the side of her bedridden husband. He, and also the daughter who resided with them, took the malady. All the three died within two days. Only one other case occurred in the village of Tockwith, and it was not a fatal case." 

The mother appears to have been infected by Mrs. Barnes while she was taking care of her.  She brought the disease back to her home village where the disease was rare, and infected her husband and daughter (the sister of Mrs. Barnes).  So the story ends.  In the course of few days, cholera robbed Mrs. Barnes of her husband, caring mother, father and sister, all brought on by a package that arrived on Christmas day. 

Source: Snow J. On the Mode of Communication of Cholera, 1855.

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