Frith-street, Soho-square, No. 54, was the house at which Mr. Snow, to use his own words, first “nailed up his colours”. He removed from Bateman’s Buildings in the beginning of September 1838, and became, in Frith-street, the tenant of Mrs. Williamson, widow of Captain Williamson, known as the author of several works on India. He bought no practice, nor exhibited any pretence. Like mighty Columbus, his caravel was very insignificant when compared with the voyage on which he embarked, and through which he sailed so successfully. He did not find the voyage very smooth either at first. How could he? A man cast at large in the modern Babylon, with few introductions, no plethora of purse, and great purposes in hand, need never ignore the necessities from the idea of rising to the crest of the wave by three cheers and a long pull. Snow was too foreseeing to be ignorant of this, and he prepared accordingly. A more thoroughly girded man for the world’s encounter could hardly be conceived than he at this time. He took no wine nor strong drink; he lived simply of the simple, on anchorite’s fare, with more than anchorite resolution, with the temptations of the world always before him; he clothed plainly, and made the best of everything; he kept no company, and found every amusement in his science books, his experiments, in his business, and in simple exercise.
To fill up time till the money patients should come, he became one of the visitors of the out-patients of Charing Cross Hospital; and to many a poor representative of the great half-starved, extended a skill which would have been a blessing to a duke. The Librarian of the College of Surgeons’ Library knew him as a quiet man, who read closely, and was not too proud to ask for a translation when an original bothered him. All who knew him said he was a quiet man, very reserved and peculiar—a clever man at bottom perchance, but not easy to be understood and very peculiar.
The connection with the “Westminster Medical” led to Mr. Snow’s first attempts at authorship. On October the 16th, 1841, he read at the Society a paper on “Asphyxia and on the Resuscitation of new-born Children.” The paper in full will be found in the London Medical Gazette for November the 5th of the same year. The paper is remarkable for the soundness of its reasonings, and the advanced knowledge which it displays. The object of the paper was to introduce to the Society a double air-pump, for supporting artificial respiration, invented by a Mr. Read, of Regent Circus. The instrument was so devised that by one action of the piston, the air in the lungs could be drawn into one of the cylinders, and by the reverse action, the said air could be driven away, and the lungs supplied with a stream of pure air from the second cylinder. There was also advanced, in the concluding part of the communication, a sentence or two on the cause of the first inspiration, which is well worthy of note. The cause of the first inspiration, he explained, is probably the same as the second or the last, viz., a sensation or impression arising from a want of oxygen in the system. So long as the placenta performs its functions, the fœtus is perfectly at ease, and feels no need of respiration; but whenever this communication between the child and its mother is interrupted, at least in the later months of pregnancy, the child makes convulsive efforts at respiration similar to those made by a drowning animal.
On December the 18th, 1841, Mr. Snow was again before the “Westminster Medical” with a very ingenious instrument which he had invented for performing the operation of paracentesis of the thorax. The description of the instrument will be found in the Medical Gazette of January 28th, 1842.
In the Medical Gazette for November 11th, 1842, Mr. Snow published a note on a new mode for securing the removal of the placenta in cases of retention with hæmorrhage; and in the same journal for March 3rd, 1843, he communicated an essay on the circulation in the capillary vessels. The essay was selected and rearranged from papers read before the “Westminster Medical” on January 21 and February the 4th. We have in this essay an admirable sketch of the capillary circulation. He advanced, on this occasion, the idea that the force of the heart is not alone sufficient to carry on the circulation, but that there is a force generated in the capillary system which assists the motion. He explained also the great importance of the cutaneous exhalation, and reasoned that in febrile states, accompanied with hot skin, the transpiration from the skin is in reality greater than is normal, and that the good effect of poultices and similar applications to inflamed skin is due to their influence in checking the transpiration from the affected part.
But what of practice during all this work at the purer science of medicine? The story to be told is an old one. Practice did not come, at least not from the wealthy. He had plenty of practice in so far as seeing patients was concerned certainly, for he was encumbered with four sick clubs; and his club practice, together with the out-patient work at the Charing Cross Hospital, kept the bell ringing all day, and not unfrequently enlivened the night with the clamorous music. But the patients with the fees in their hands kept at a respectful distance. Why? The answer gives another old story—because the practitioner at 54, Frith Street, Soho, was an earnest man, with not the least element of quackery in all his composition, with a retiring manner and a solid scepticism in relation to that routine malpractice which the people love. I have heard many reasons alleged for the want of success which attended Mr. Snow’s first labours as a claimant on the public confidence. These reasons have all had one reading, in that they refer to every cause but the true one. The true cause was, that a young man having no personal introduction to the bedsides of dowagers of the pillmania dynasty, sought to establish his fame on the basis of a sound and rational medicine—because impressed with the knowledge of the external origin of disease, he went in for the removal of external causes, and studied nature in preference to the Pharmacopœia.
Pushing on in the higher branches of his profession, and aiming always at the best, the degree of the University of London became a temptation, and Mr. became Dr. Snow on the 23rd of November, 1843, by passing the M.B. examination. He was enrolled in the second division on this occasion. On the 20th of December in the following year, he passed the M.D. examination, and came out in the first division of candidates.
The harass of London life by this time commenced to tell on Dr. Snow. He had suffered a few years previously from threatened symptoms of phthisis pulmonalis, but took plenty of fresh air, and recovered. He again became slowly unhinged for work, and in the summer of 1845, was attacked with acute and alarming symptoms of renal disorder. His friend and neighbour, Mr. Peter Marshall, then of Greek Street, now of Bedford Square, gave him his able assistance, and the advice of Dr. Prout, and, I believe, of Dr. Bright, was obtained. He was induced by their general opinion to change his mode of living, and even to take wine in small quantities. In the autumn of 1845, he paid a visit to his friend and old colleague, Mr. Joshua Parsons, at Beckington, with whom he stayed a fortnight, enjoying himself very much. The friends resumed their old controversies, and the Doctor admitted that he had been obliged to relinquish his vegetable diet in favour of a mixed regimen. He improved greatly, says Mr. Parsons, during his stay; but it was obvious that London life and hard study had hold of him. From Beckington he went to the Isle of Wight, but soon returned to London and to his work. A little after this, he was elected Lecturer on Forensic Medicine at the Aldersgate School of Medicine, and held the appointment till the establishment dissolved in 1849. I have often heard from him, in his quiet droll way, many laughable stories in relation to his duties in the forensic chair. When he left off teaching, he found that, in addition to the labour implied and the cost of experiments, he had to pay, with the rest of his colleagues, a ransom for his release.
There is no night without its morning. The eventful medical year of 1846 proved the turn of tide season with our struggling Esculapian. In this year, the news came over from America that operations could be performed without pain under the influence of sulphuric ether.
The fact was just such an one as would at once attract the earnest attention of Dr. Snow. It was a physiological, as well as a practical fact. It was rational in its meaning, and marvellously humane in its application. The question once before him, was in a scientific sense his own. His previous experimental studies on respiration and asphyxia had prepared him for this new inquiry. He lost no time, therefore, in investigating the new fact; he took it up for its own sake, however, not from any thought, at the time, of a harvest of gold.