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