Cholera, Chloroform, and the Science of Medicine: Peter Vinten-Johansen, Howard Brody, Nigel Paneth,...

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Social Science & Medicine 60 (2005) 1163 Book review Cholera, Chloroform, and the Science of Medicine Peter Vinten-Johansen, Howard Brody, Nigel Paneth, Stephen Rachman, Michael Rip, Oxford University Press, New York, 2003, 437pp., ISBN. 0-19-513544x Price $59.95 US This book is not a simple history. While its subject is the work of 19th century medical researcher John Snow, its focus is the relation between idea and execution in research in health, the ‘‘science of medicine.’’ As the authors note, Snow’s work remains the critical and sometimes paradigmatic case in epidemiology, public health, and medical cartography. Understanding Snow adds insights into a range of contemporary health sciences, especially medical cartography. Cholera, Chloroform, and the Science of Medicine is the best study available on both John Snow and his epical studies of the incidence of cholera in 19th century London, the most complete and the most thoughtful. The authors recreate, day by day, the Broad St. epidemic—providing enormous detail—and recreate, too, Snow step-by-step research, both his visits to the homes of patients and his growing understanding of the outbreak’s source. As detailed, and as impressive, is their review of Snow’s lesser known but more ambitious South London study. Both studies are placed in an historical and social context that adds greatly to our modern understanding of these cases and by inference, the relation between social and intellectual contexts and their effect on health-related research. Importantly, the authors represent an interdisciplin- ary team of researchers who pool their respective discipline’s perspective in an attempt to understand Snow’s approach to medical science. They include an anesthesiologist, a professor of English, two epidemiol- ogists and a professor in the Centre for Ethics and Humanities at Michigan State University. Three of the five are medical doctors and two of the authors have non-medical doctorates. It is this interesting mix of specialties that permits the study to delve simultaneously into Snow’s work and its historical context. Here, for the first time, the importance of Snow’s as an anesthesiol- ogist is shown to have been central to his thinking about the nature of cholera, then widely believed to be air- borne. A strength of this book then is the multi- disciplinary focus its authors bring, and thus to the more general problem of understanding the relation between states of disease and health. Interestingly, for a book about the iconic figure in medical cartography, and in a book that uses maps expertly, the authors downplay the importance of Snow’s maps in his research and as a legacy. Indeed, they make it clear that they have little patience with modern mapping, dismissing GIS-based mapping as generally insufficient and limited. Many involved in medical cartography would disagree. For them, how- ever, the book will stand as a challenge to prove the relevance of computerized mapping as something critical to not only historical but also contemporary health studies as well. Tom Koch Department of Geography (Medical), University of British Columbia, Vancouver, BC, Canada V5T 1Z2 ARTICLE IN PRESS doi:10.1016/j.socscimed.2004.02.005

Transcript of Cholera, Chloroform, and the Science of Medicine: Peter Vinten-Johansen, Howard Brody, Nigel Paneth,...

Social Science & Medicine 60 (2005) 1163

ARTICLE IN PRESS

doi:10.1016/j.so

Book review

Cholera, Chloroform, and the Science of Medicine

Peter Vinten-Johansen, Howard Brody, Nigel Paneth,

Stephen Rachman, Michael Rip, Oxford University

Press, New York, 2003, 437pp., ISBN. 0-19-513544x

Price $59.95 US

This book is not a simple history. While its subject is

the work of 19th century medical researcher John Snow,

its focus is the relation between idea and execution in

research in health, the ‘‘science of medicine.’’ As the

authors note, Snow’s work remains the critical and

sometimes paradigmatic case in epidemiology, public

health, and medical cartography. Understanding Snow

adds insights into a range of contemporary health

sciences, especially medical cartography.

Cholera, Chloroform, and the Science of Medicine is

the best study available on both John Snow and his

epical studies of the incidence of cholera in 19th century

London, the most complete and the most thoughtful.

The authors recreate, day by day, the Broad St.

epidemic—providing enormous detail—and recreate,

too, Snow step-by-step research, both his visits to the

homes of patients and his growing understanding of the

outbreak’s source. As detailed, and as impressive, is

their review of Snow’s lesser known but more ambitious

South London study. Both studies are placed in an

historical and social context that adds greatly to our

modern understanding of these cases and by inference,

the relation between social and intellectual contexts and

their effect on health-related research.

Importantly, the authors represent an interdisciplin-

ary team of researchers who pool their respective

discipline’s perspective in an attempt to understand

cscimed.2004.02.005

Snow’s approach to medical science. They include an

anesthesiologist, a professor of English, two epidemiol-

ogists and a professor in the Centre for Ethics and

Humanities at Michigan State University. Three of the

five are medical doctors and two of the authors have

non-medical doctorates. It is this interesting mix of

specialties that permits the study to delve simultaneously

into Snow’s work and its historical context. Here, for the

first time, the importance of Snow’s as an anesthesiol-

ogist is shown to have been central to his thinking about

the nature of cholera, then widely believed to be air-

borne. A strength of this book then is the multi-

disciplinary focus its authors bring, and thus to the more

general problem of understanding the relation between

states of disease and health.

Interestingly, for a book about the iconic figure in

medical cartography, and in a book that uses maps

expertly, the authors downplay the importance of

Snow’s maps in his research and as a legacy. Indeed,

they make it clear that they have little patience with

modern mapping, dismissing GIS-based mapping as

generally insufficient and limited. Many involved in

medical cartography would disagree. For them, how-

ever, the book will stand as a challenge to prove the

relevance of computerized mapping as something critical

to not only historical but also contemporary health

studies as well.

Tom Koch

Department of Geography (Medical), University of

British Columbia, Vancouver, BC, Canada V5T 1Z2