On the Mode of Communication of Cholera

Book excerpt: John Snow (1813-1858) first became interested in cholera at Newcastle-on-Tyne during the epidemic of 1831-1832. Recurrent outbreaks of the disease gave him the opportunity to investigate it in detail. Snow's first paper on cholera, published in the London Medical Gazette in 1849, contained his demonstration of the nature of the disease, which he defined correctly as an infection of the alimentary canal transmitted by ingesting fecal matter from cholera patients, in most cases via contaminated water. Snow proved his theory of cholera transmission by collecting data on a large number of outbreaks and correlating them to local water supplies. His information aroused much controversy among physicians, many of whom still held the ancient belief that cholera, along with all other infectious diseases, was carried by atmospheric "miasmas" emanating from noxious sources.