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  • [ intro ]

  • These days, most people are like me,

  • they hear the nameJon Snowand think Game of Thrones.

  • Or they think of that British news anchor.

  • But before there was Jon Snow, the fan-beloved Brother of the Night's Watch,

  • there was John Snow with an “H”

  • a 19th-century medical doctor from England.

  • But Dr. Snow has a few claims to fame,

  • including developing early anesthetics and administering anesthesia for the Queen while

  • she delivered two of her kids.

  • But mostly, he's remembered for the way he fought cholera.

  • In the 1850s, his timely action and clever thinking stopped an outbreak,

  • and even though he was never recognized during his lifetime,

  • he's now considered one of the founders of epidemiology.

  • Our story starts in mid-19th-century London,

  • which was, in a word, gross.

  • In two words, super gross!

  • Like many cities in the 1800s, London saw a huge increase in population,

  • and with that came a huge increase in poop

  • which nobody quite knew how to deal with.

  • Sewer systems hadn't quite spread to the entire city, so in places like the SoHo district,

  • people sloshed their waste into the streets, dumped into overflowing cesspools,

  • or trucked it over to the Thames River.

  • The river that, notably, also served as the city's primary water supply.

  • During this period, London and the rest of Europe were also being plagued

  • with persistent outbreaks of cholera:

  • a highly infectious, sometimes deadly diarrheal illness.

  • And there was considerable disagreement over why.

  • We didn't know that bacteria and viruses were at the root of most infectious diseases,

  • so the prevailing idea was miasma theory,

  • which said they were passed around by bad air.

  • This is where John Snow came in.

  • He had encountered cholera before in mining populations,

  • and had come to believe the disease was spread not by air,

  • but by ingesting stuff contaminated with human waste.

  • After all, the miners brought their meals to work,

  • didn't have a bathroom down there, and probably didn't wash their hands before eating.

  • gross.

  • When Snow observed the situation in London,

  • he therefore concluded that cholera was spread by tiny fecal particles in the water.

  • And in 1854, he got a chance to prove it.

  • The year before, a new cholera outbreak reached a London borough near Snow's home,

  • and it killed more than five hundred people in a matter of weeks.

  • Based on the area, Snow was suspicious of one water pump on Broad Street,

  • especially after his sample of the water

  • turned up visible white flecks of organic material.

  • So he obtained a list of some people who'd been killed by the outbreak and began talking

  • to their families.

  • And ultimately, he found the common factor was where those victims had gotten their water:

  • that pump on Broad Street.

  • Snow then took his evidence to the local officials,

  • who agreed to take the handle off the pump to prevent people from using it.

  • And behold:

  • The outbreak quickly subsided!

  • But even then, nobody really believed Snow about why

  • including Britain's General Board of Health.

  • It's possible that his sample size wasn't enough to convince them,

  • or maybe it was the fact that he couldn't prove what in the water was causing the disease.

  • In any case, Snow was confident enough in his findings

  • that when other cholera outbreaks appeared,

  • he continued trying to find the contaminated water behind them.

  • And ultimately, that led him to a more city-wide discovery.

  • At some point, Snow realized all the districts in London affected by the outbreaks

  • had their water piped in from one of two suppliers

  • one that got their water from upstream of London, and one that got it from downstream.

  • He suspected the downstream water as you might also suspect had a bunch of sewage in it,

  • so cholera should have been more common in neighborhoods that drank it.

  • To prove this, he began rifling through hundreds of parliamentary death records.

  • And he found that areas with downstream water had fourteen times more deaths from cholera

  • during the outbreak.

  • Now to you and to me,

  • that might seem like pretty conclusive evidence thatsewage equals cholera,”

  • but for various reasons, the idea didn't still catch on.

  • And thatwas the end of that.

  • Or at least, it was Snow's last published attempt

  • at convincing the medical community what caused cholera.

  • He /did/ continue to investigate it privately and do other kinds of research,

  • but unfortunately, he died prematurely only a few years later after these events.

  • The thing is, thoughSnow was right.

  • Cholera is typically a waterborne disease spread by sewage-contaminated water.

  • It just took a few more decades of work

  • and proof that microbes can cause diseases

  • for scientists to finally prove and accept that.

  • Thankfully for all of us, though,

  • Snow's methods didn't fade into obscurity:

  • Even if his work was rejected in the 1850s,

  • his outbreak management strategies are still in use today.

  • His idea to map the origin of cases is a technique that's saving lives,

  • and it was so unique that it was a foundation of modern epidemiology.

  • Looking back, Dr. John Snow may have not had a sword,

  • he may not have had an army at his command,

  • but he did wield mass health information and help shape a major field of science.

  • So even though Snow wasn't celebrated during his lifetime,

  • there's a lot to celebrate about him today.

  • Because in the end, there's no doubting that his contributions have helped save millions.

  • [ outro ]

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ジョン・スノーの実話 (The Real Story of John Snow)

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    林宜悉 に公開 2021 年 01 月 14 日
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