If you take a stroll along North Street, following the south bank of the river between Lendal and Ouse Bridges, you’ll be passing through a quiet, curiously mixed neighbourhood that manages to combine both the best and worst aspects of York. It’s here you’ll find the exquisite 13th century church of All Saints North Street, home to the most spectacular stained glass outside the Minster; but also the almost comically unsympathetic attempt at early 1970s opulence that was the Viking (now Radisson) hotel.
But despite the rather graceless municipal landscaping - and the likely attention of some of the city’s most territorial geese - the tree-lined esplanade alongside the river is worth a visit, not least for the views of the medieval guildhall and Victorian gothic council chamber on the opposite bank. What you may not immediately notice is that this shady spot, frequently deserted apart from lunchtime office workers, is also home to one of York’s most enigmatic and overlooked public monuments.
It’s a Victorian water pump (or, rather, a sculptural representation of one) sited here by York Civic Trust in 2017. The blue plaque alongside announces that it commemorates John Snow (1813-58) who was born and lived in this area up to the age of 14. But there is something noticeably amiss about the monument: the pump handle has been broken off and is lying on the plinth alongside. Fortunately this is not the work of vandals. The detached handle is a reference to a man whose pioneering work in tracing the spread of pandemics still influences the means by which we attempt to recover from Covid-19.
So who was Dr John Snow, and why is he so significant? The short answer is that he was the son of a labourer, born in 1813 to a family of nine children. According to a poll conducted in 2003 by Hospital Doctor magazine, Snow was ranked as the most significant medic of all time (pushing Hippocrates into second place). And yet outside the medical community most people would still only recognise John Snow as a character from Game of Thrones.
Dr John Snow is principally known for his work developing safe anaesthetics. Though he wasn’t the first to use ether to knock people out, he developed a mechanism for delivering a safe, regulated dose of the vapour. As the most in-demand anaesthetist in Britain, he dosed Queen Victoria with chloroform at the births of her last two children, Prince Leopold and Princess Beatrice.
Yet in the post-Covid world, Snow is arguably even more important for applying a statistical approach to the spread of disease.
At the time of Snow’s baptism in the church of All Saints, North Street was a lowly parish regularly flooded by foetid river water. Yet no-one at the time made the connection between a river full of sewage and the devastating outbreak of cholera that occurred in 1832. Referred to as ‘the Pestilence of India’, it was believed that cholera was transmitted as a ‘miasma’ present in the air. With York’s graveyards full to overflowing, two mass burial pits were dug outside the boundary of the city walls - one of these can be seen as the green patch shaded by cypress tress opposite the railway station. The other is now under the hardly-less-pleasant coach park at Union Terrace.
Snow left York at the age of 14 to become apprenticed to a surgeon in Newcastle, before completing his medical training at the Great Windmill Street School of Medicine in London. He established a practise at Frith Street, Soho, where his patients were among some of the poorest in the capital. Cholera outbreaks were common, but Snow had a significant hunch. If the ‘miasma’ theory of transmission were correct, surely the disease would present first in the lungs, rather than attacking the bowel and stomach. Snow’s conviction that the problem began with contaminated water was outlined in a landmark study On The Mode of Communication of Cholera; which he published at his own expense in 1849. Making his theories available cost Snow £200 at a time when his annual income was £3/12 shillings. And yet the medical establishment dismissed it out of hand. A reviewer in a contemporary journal wrote: "There is, in our view, an entire failure of proof that the occurrence of any one case could be clearly and unambiguously assigned to water”.
Yet worse was still to come. The most severe pandemic yet to afflict Britain broke out in Soho at the end of August 1854. Snow recorded it as ‘the most terrible outbreak of cholera that ever occurred in the kingdom’. Yellow flags were hung as a warning to avoid the area. 127 people died during the first three days; many of the victims were taken to the Middlesex Hospital where they were treated by Florence Nightingale, who joined the hospital in September to help deal with the pandemic.
Snow’s systematic response to the outbreak was unprecedented for the time. Working with a colleague he identified the addresses of the sick and charted a map highlighting instances of infection - perhaps the first ever example of contact tracing. By far the highest concentration of cases were found to have occurred within the vicinity of a public water pump at the junction of Broad Street and Cambridge Street (present-day Broadwick Street and Lexington Street). Despite local opposition, Snow successfully lobbied for the parish authorities to disable the pump by removing the handle. Once the pump had been decommissioned, infection rates within the area rapidly began to fall.
Snow died of a stroke in 1858 at the pitifully early age of 45. It would be a further 10 years before Louis Pasteur’s work brought greater acceptance to the bacterial theory of disease; and the specific cholera bacillus would only finally be identified by the German microbiologist Robert Koch in 1884. Though Snow’s career had taken him from a lowly York parish to anaesthetising the Queen, at the time of his death Snow’s epidemiological theories still marked him out as something of a crank. Yet his intimate understanding of deprived neighbourhoods such as North Street in York and Broad Street in London inspired an early commitment to improving public health and sanitation that can hardly be overstated. And if establishing the principles for contact tracing were not enough, as early as 1841 Snow devised a pump for the purposes of artificial respiration - the forerunner of the ventilator. As a committed vegetarian, he was even among the first to advocate the careful washing of hands before handling food.
Today we are grappling with the worldwide spread of a disease whose transmission and cure are as little understood as the outbreaks of cholera which plagued the 19th century. It’s worth pausing for a moment by the broken pump on North Street, to reflect that the heroes we need in these times of crisis can be born anywhere.