John Snow and the Medical Reading Society of Bristol

Introduction

The Medical Reading Society of Bristol (MRS) was founded by 11 Bristol doctors in March 1807 “for the purpose of promoting medical knowledge and a friendly intercourse among its members, and for purchasing medical books” 1 . It soon elected a 12th member and has never had more than 12 members at any one time. With few exceptions it has met monthly since its foundation. John Snow interacted with members of the Society in both the fields of cholera and of anaesthesia.

John Snow and the Medical Reading Society
of Bristol

Cholera

In August 1849 Snow published his pamphlet On the Mode of Communication of Cholera 2 . In September William Budd, “Bristol’s most famous physician” 3 , published Malignant cholera, its mode of propagation and its prevention 4 . Both men agreed that cholera was a waterborne disease, but Budd thought it could also be transmitted by inhalation and that a fungus was the causative organism. Publication of Budd’s work had been timed to coincide with a report of microscopical studies by his colleague Joseph Swayne 5 . Budd was not a member of the MRS at this time (member 1855 – 1869), but Swayne was (member 1845 – 1858). In October Swayne was present at a lecture on cholera by Snow at the Westminster Medical Society 6 . In discussion afterwards Swayne again put forward the Bristol view that a fungus was the causative organism.

Between 1832 and 1856 the MRS bought 13 pamphlets/books on cholera 7 , the last of which, proposed by Budd, was John Simon’s Report on the Last Two Cholera Epidemics in London, as Affected by the Consumption of Impure Water 8 . However Simon did not acknowledge Snow's painstaking studies during the 1854/5 epidemic, of which his own work was corroboration and an extension. At a meeting of the British Medical Association in Birmingham later in the year Budd strongly supported a motion of regret at this omission, once again giving Snow due recognition for his "admirable, long prior, and entirely original researches" 9 .

William Budd 1811 - 1876

The society bought two pamphlets on anaesthesia by Snow . However in November 1855 Snow on the inhalation of Chloroform in Disease, etc was proposed but was not purchased. Presumably this referred to the second collection, parts 8 -16, of On Narcotism by the inhalation of Vapours that had been published previously in the London Medical Gazette.

The monthly meeting was held at Dr Swayne's November 7, 1855. .
Absent at 8 o'clock. Mr Morgan, Mr Coe, Mr Smerdon and Mr Cross. Absent at 81/2 o ’ clock ditto. Mr Hore proposed Snow on the inhalation of Chloroform in Disease, etc .
Mr Sawer and Dr Budd being proposed as new members to supply the vacancy occasioned by Mr Waldo's resignation, it was decided by the votes of the Society that Dr Budd should be balloted for. He was accordingly balloted for and elected.

Anaesthesia


Purchased	Title	Proposer
1847 Oct	Snow J . On the Inhalation of the Vapour of Ether in Surgical Operations. London: Churchill, 1847	Mr Morgan
1848 Mar	Curling TB The Advantages of Ether and Chloroform in Operative Surgery, London: Highley, 1848.	Mr Morgan
Oct	Simpson JY. Answer to religious objections to the use of chloroform in midwifery. Edinburgh: Sutherland & Knox, 1847.	Dr Swayne
Oct	Protheroe Smith Scriptural authority for the mitigation of the pains of labour, by chloroform and other anaesthetic agents. London: Highley, 1848.	Dr Swayne
Oct	Merriman S. Arguments against the indiscriminate use of Chloroform in Midwifery. London: Churchill, 1848.	Dr Swayne
1855	Murphy EW. Chloroform: its properties and safety in childbirth. London: Wilson and Maberley, 1855.	Dr Swayne
1858	Snow J . On Chloroform and other Anaesthetics, ed. Richardson BW. London: Churchill, 1858.	Dr Budd

Pamphlets on anaesthesia purchased by the Medical Reading Society 1847 - 1858

So by March 1848 William Morgan, surgeon to the Bristol Royal Infirmary (member of MRS 1825 - 1878) had access to two very positive papers about anaesthesia, including one by Snow, that he himself had proposed . Yet the first anaesthetic at the Infirmary was not given until August 1850, in contrast to the Bristol General Hospital where anaesthesia was enthusiastically received 10-12 . .

In April 1857 Snow reported a death under amylene * anaesthesia 13 . Augustin Prichard (member of MRS 1844 - 1885) in a presidential address to the Bristol and Bath branch of the British Medical Association 14 was scathing in his criticism of amylene and, by implication at least, of Snow. Snow defended both himself and amylene strongly at this time 15 though he did abandon amylene later that year. He finished his riposte with this sentence: :

I doubt whether the style of sarcastic reprimand, if not exultation, which he has employed, would be calculated to encourage other laborious attempts to advance the science and practice of medicine.

I venture to prophesy that anaesthetics will more and more fall into disuse and will ultimately be had recourse to only for the most severe or protracted operations.

William Morgan 1809 - ?

Augustin Prichard
1819 - 1898

During his final illness Snow was attended by William Budd ' s brother, George .

John Snow

1813 - 1858

References

1. Griffiths LG. The Medical Reading Society. Brist Med-Chi J. 1907,XXV.97:222-23. Written to mark the hundredth anniversary of the society. Go there
2. Snow J. On the Mode of Communication of Cholera. London: Churchill, 1849. Go there
3. Michael Dunnill. Dr William Budd, Bristol's most famous physician ,. Bristol: Redcliffe Press, 2006. An excellent biography.
4. Budd W. Malignant Cholera: Its Mode of Propagation and Its Prevention. London: John Churchill, 1849
5. Swayne JG. An account of certain organic cells peculiar to the evacuation of cholera. Lancet 2 (1849): 368 -71, 398 -99
6. Vinten-Johnansen P., Brody H., Paneth N., Rachman S., Rip M. Et al. Chloroform, Cholera, and the Science of Medicine, a Life of John Snow. Oxford: University Press, 2003. An outstanding biography.
7. Powell J. Anaesthesia, Cholera and the Medical Reading Society of Bristol 2007. www.johnpowell.net/anchol333.htm. Lecture given to the Bristol Medico-Historical Society in March 2007 to celebrate the 200th anniversary of the society. This deals more with fully with the topics touched upon in this poster.
8. Simon J. Report of the last two cholera epidemics of London, has affected by the consumption of the impure water. London: HMSO, 1856
9. Association Medical Journal August 9th: 683, and 25th: 780, 1856. The second is a follow-up letter from Budd who felt there were inaccuracies in the original report. Go there.
10. Weller R. The first general anaesthetic in Bristol. The History of the Anaesthesia Society Proceedings, 1999; 25: 80-84. Go there
11. Bennet JA. The eclipsed dawn of anaesthesia in Bristol. The History of the Anaesthesia Society Proceedings, 1999; 25: 85-89. However Ref. 12 clearly demonstrates that anaesthesia was not actually eclipsed in Bristol, but only at the Infirmary.
12. Landsdown JG. On the use of ether and chloroform in surgery and midwifery. Lancet 1 (1847): 10-11. This is discussed in reference 7.
13. Snow J. Case of death from amylene. Medical Times Gazette 15 (1857): 133-34 Go there
14. Presidential address by Augustin Prichard to the Bath and Bristol branch annual meeting 1857. Brit.Med.J. 2 (1857): 631-2. Go to text of relevant section , but note that the full presidential address is available online in BMJ archives.
15. Snow J. Mr A. Prichard on the amylene. Brit.Med.J. 2 (1857): 654. Go there
16. Weller R. Death in Bristol -an exchange of views between Augustin Prichard and John Snow.Anaesthesia 31, 90-96, 1976. Go there , but also note that the original report on and subsequent letters are available online at the BMJ website .
17. Snow J. On the Vapour of Amylene. MTG 14 (1857): 60-62, 82-84 . Go there

Joseph Swayne 1816 - 1895

their "fungus" (soon refuted)

* C₅ H _10 , not C₁₀ H₁₀
as Snow stated ¹⁷

In February 1858 a death under chloroform anaesthesia occurred at the Bristol Royal Infirmary 16 . Prichard reported this in the British Medical Journal (BMJ). Snow commented the following week, and a series of letters took place in the pages of the BMJ between Prichard and Snow. Snow reminded Prichard that a death had also occurred in Bristol in 1854, and said that if chloroform was a problem why not go back to using ether? Prichard reminded Snow that he too had had a death with chloroform. In his final acrimonious letter Prichard wrote: :

Medical Reading Society home page click here
LG Griffiths's paper on the first 100 years of the Society click here

Members of the Medical Reading Society 1807 - 2009 click here

John Powell's homepage click here