DIET  

The link between John Snow's diet and his state of health has been the subject of much speculation. At the age of seventeen, John Snow became a vegetarian and continued to abstain from meat for eight years.  He had, however, supplemented his vegetarian diet with butter and milk.  When others pointed out that he was not adhering to the regime of an absolute vegetarian, he proceeded to eliminate all animal products from his diet. He also had been a strong advocate of temperance, and was a total abstainer from alcohol.  In 1836 he had joined the York Temperance Society, and remained a member of this organization until his death.  He also in 1845 became the Honorary Secretary of the Medical Temperance Society of London, reflecting the strength and persistence of his views. 

ILL-HEALTH

The health of John Snow had never been the best.   After receiving in 1844 his MD from the University of London, Snow had suffered from tuberculosis of the lungs.  He recovered by spending a good deal of time in the fresh air.  In 1845 he had an acute attack of renal disease.  His physician told him to abandon his strict vegetarian diet and to take wine in small quantities. He complied and thereafter his health was reported to have improved.  

Likely of greater significance regarding his premature  death at age 45 was his inappropriate use of anesthesia.  Snow did frequent experiments with anesthetic agents upon himself.  He was the first to carry out experiments on the physiology of anesthesia, and did not spare himself in investigating every possible substance that might be employed as an anesthetic.  The pathologic effect of most of these agents was not known in Snow's time. 

Adding another clue to the cause of his early death is Snow's index finger on his right hand (shown at left), which appeared in his 1857 photograph. Such swelling of the fingers has been associated with chronic renal failure. Exposure to anesthetic gases is now know to have numerous adverse health effects, including severe damage to the kidney. In John Snow's case, his swollen fingers were likely due to extensive self-experimentation over nearly a decade with a variety of anesthetic agents (e.g., ether, chloroform, ethyl nitrate, carbon disulfide, benzene, bromoform, ethyl bromide and dichloroethane). For additional details on Snow's tell-tale hands, click below.

 Mawson, A.R. The hands of John Snow: clue to his untimely death? Journal of Epidemiology and Community Health 63(6), 497-499, 2009.

For more on addiction to chloroform in a contemporary of Dr. Snow and fellow pioneer in chloroform research, click below. 

Defalgue RJ and Wright AJ. The short, tragic life of Robert M. Glover. Anaesthesia 59, 394-400, 2004.

 

 

 

DEATH

On the evening of June 9, 1858, John Snow joined a small group of medical colleagues to discuss a new bi-aural (i.e., two ear pieces) stethoscope, and joined a  committee to investigate the cause of the first heart sound (i.e., measure of systolic blood pressure).  The next morning, he suffered a slight stroke while working on his monograph, On Chloroform and other Anesthetics.  He recovered sufficiently to pen a portion of his book, and had written almost to the end when he suffered another cerebral accident a few days later.  His housekeeper found him on the floor, having lost all power over his left arm and leg, and his mouth appeared drawn to the right side.  Fortunately, memory and consciousness were unimpaired until almost the end, which occurred at 3 pm on June 16, 1858.  His brother Thomas was with him when he died of stroke (i.e., "apoplexy") and renal failure, and registered his death.

At autopsy, Snow's kidneys were found to be "shrunken, granular and encysted." While there was also scar tissue in the kidney from old boughts of turberculosis, it is likely that his kidney problems arose from anesthetic experimentation, which subsequently caused his premature stroke.

On June 26, 1858, the following short notice of death appeared in The Lancet:

In the ensuing weeks, two letters appeared in The Lancet, offering further testimonial to the life of Dr. John Snow.  To read the letters, click here

After Snow's death, a friend of long standing, Dr. Benjamin Richardson, edited and prepared his manuscript for the press. On Chloroform and other Anesthetics, published in 1858, is now regarded as one of the first textbooks in the field of anesthesiology. 

Snow was buried in London at the Brompton Cemetery, located a short  distance from the site where the Southwark and Vauxhall Company (the object of his famous epidemiological investigation) drew cholera-contaminated water from the Thames River.  While founded in 1837 as a private company, Brompton Cemetery had many financial problems and was not successful as a business venture.  In 1852, six years before the death of John Snow, the shareholders sold the cemetery to the British  government.  

MONUMENT

Soon after his death, his friends erected a suitable monument in Brompton Cemetery, which itself has a unique history.

 

The inscription started poorly with an error in his date of birth, listed as March 15, 1818 rather than March 15, 1813. The full text on the upper section of the monument reads:

TO

JOHN SNOW, M.D.

BORN AT YORK

MARCH 15, 1818

DIED IN LONDON

JUNE 16TH, 1858.

IN REMEMBRANCE OF

HIS GREAT LABOURS IN SCIENCE

AND OF THE EXCELLENCE

OF HIS PRIVATE LIFE

AND CHARACTER

THIS MONUMENT

(WITH THE ASSENT OF

MR. WILLIAM SNOW)

HAS BEEN ERECTED OVER

HIS GRAVE

BY HIS PROFESSIONAL BRETHREN

AND FRIENDS.

The monument was restored in 1895 and then again in 1938, as described in the lower section:

RESTORED IN 1895

BY SIR BENJAMIN W. RICHARDSON, F.R.S.

AND A FEW SURVIVING FRIENDS.

INSCRIPTION RESTORED IN 1938 BY MEMBERS

OF THE SECTION OF ANAESTHETICS OF THE

ROYAL SOCIETY OF MEDICINE AND ANAESTHETISTS IN

 THE UNITED STATES OF AMERICA.

 

 

 

 

In World War II, the monument was destroyed by a bomb during a 1941 air raid.  In later years it was restored a third time, with the date of birth now correctly shown as March 15th, 1813.

 

 

 

 

 

 

 

His grave, located near the Brompton Road entrance, is well-known to the gate-keepers of London's Brompton Cemetery. 

The Record Room of the Brompton Cemetery contains the Burial Registry for most persons buried in the cemetery. John Snow is listed as entry 18588, with date of death and other related information, including his last address at 18 Sackville Street (see below, the other names have been blurred to respect their privacy). 

Sources:  

Anaesthesia 5(1): 48, 1950.

J of History of Medicine 1(4), 551-66, 1946.

The Lancet 1, 635, 1858.

Froggatt P. Anaesthesia 57 (7), 667-675, 2002.

Galbraith, S. Dr. John Snow (1813-1858) -- His Early Years, 2002.

Mackintosh RR. Anaesthesia 24(2): 269-70, 1969.

Mawson AR. J Epidemiol Community Health 63(6), 497-9, 2009.

Snow SJ. J Medical Biography 8(2), 71-77, 2000.

Thornton, JL. Anaesthesia 5(3): 129-34, 1950.

Vinten-Johansen, P et al. Cholera, Chloroform, and the Science of Medicine. A life of John Snow, 2003.

 

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