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This is a legendary story about human courage and rationality, and the stories of heroes are always so similar.
Jon snow (Jon Snow) is a soldier who leads the night watchman against the ghost army in the popular American TV series Game of Thrones.
/kloc-In London in the 0/9th century, there was also a john snow (usually translated as john snow) who guarded the safety of Londoners like a night watchman.
That's right, the name is only one letter short.
Jon snow in Game of Thrones
Martin, the author of All, has never publicly revealed that jon snow's prototype is the real John Snow, but his story is no less wonderful than Snow's struggle with ghosts in the Great Wall in the north.
In the19th century, he fought against cholera, an infectious disease at that time, alone in London. He didn't use the sword made in valyrian steel or the magic dragon crystal, but investigated and followed strict logic.
He created a unique "epidemiology" discipline in medical history and wrote a hymn of human courage to fight infectious diseases.
Dr john snow.
0 1
Cholera-the King of Infectious Diseases in that era
Cholera was an acute infectious disease that frightened people at that time. It ranks alongside smallpox and plague as one of the three deadly infectious diseases of human beings, and is called "the world disease of19th century".
Bacteria in the human body will double every 12 minutes. Cholera patients will have diarrhea for a short time. How long will diarrhea last? Until the number of people quickly dehydrated and died within a few hours!
The suffering of cholera patients
Cholera first originated in Ganges valley in India, and after the great voyage, frequent trade brought it to Europe.
In Europe, the mortality rate of cholera is higher. The first large-scale outbreak in Britain occurred in 183 1 year, causing thousands of deaths. 1849 broke out again, and the two outbreaks killed more than 14000 people.
However, when cholera broke out for the third time in Europe, Britain controlled it well.
You know, this epidemic has caused more than 6,543.8+million deaths in Russia alone, while less than 6,543.8+million deaths in Britain. So how did the British defeat the king of infectious diseases?
Today we will begin to tell the story of our hero john snow-
02
John snow-a man of humble origin.
John snow was born on 18 13 in York, an important town in the British industrial age. His father is a coal miner. Usually, coming from such a family seems destined for an ordinary life in Si Nuo.
But his father refused to accept his fate and was determined to change the fate of his children. He scrimped and saved, and insisted on sending Si Nuo to a private religious school.
/kloc-York city in the 0 th and 9 th centuries
1827, 14-year-old Si Nuo was sent to Longbottom as an apprentice to surgeon Hardcastle.
18 years old, the young Snow White witnessed the terrible cholera for the first time. As a medical apprentice, he provided medical help to local coal miners suffering from cholera. After all, his father is also a coal miner, and his sympathy inspired Snow White's sense of mission.
At the age of 23, Si Nuo, an ambitious young intern from a small place, decided to go to London, the largest city in Europe at that time. He didn't ride a horse or take a bus, but walked 200 miles alone to London at that time.
In London, Si Nuo began his formal medical education at Hunter Medical College, University of London. 1837, Si Nuo began to work in Westminster hospital.
Long-term practical experience and good medical literacy make young Bai Xue outstanding in the field of anesthesia. Si Nuo was admitted as a member of the Royal College of Surgeons in 1838, and even gave anesthesia for the delivery of Queen Victoria's third child.
From the son of a coal miner to a well-known doctor who delivered the queen's baby, Si Nuo completed a difficult upward mobility with his diligence and professionalism. However, Si Nuo has no interest in the lure of London's upper class; What he is really interested in is the unsolved problem.
03
People at that time knew nothing about cholera.
The development of human science and technology is always advancing by leaps and bounds. Just over 200 years ago, human understanding of all infectious diseases actually made little progress-no progress-compared with that before 2000.
At that time, the mainstream view of British society was that cholera was spread through polluted air.
Why is this view deeply rooted in the hearts of the people? Before answering this question, let's briefly understand the City of London at that time-
London is the center of Britain, and the Victorian era is the peak of the infinite glory of the empire that never sets. The industrial revolution is rapidly changing this expanding empire with the roar of various steam factories.
People began to gather in cities, and materials became more and more abundant. Legendary wealth stories spread among the expanding crowd.
/kloc-London in the 0/9th century
London, with a population of 2.4 million at that time, was the largest industrial city in Europe and the most densely populated city in the world. Its population density is three times that of Mumbai today. At that time, London was not as elegant, quiet and rich as people imagined, and the sanitary condition of the city was extremely worrying.
Carriages galloped in the dirty streets, and horse manure was splashed everywhere. People who used toilets discharged it into the Thames through simple sewers in the open air.
The whole city stinks, mosquitoes are flying all over the sky ... cowsheds, animal droppings, slaughterhouses and rotten smells fill the foggy capital of the British Empire.
Dung digger in London
"It was a hopeful spring and a desperate winter." Dickens' novels described the contradictory times. ......
Cholera does usually occur in areas with poor sanitation. These places really stink. At that time, the medical community always believed that cholera was spread through "miasma" in the air.
In addition to the mainstream medical field at that time, people who supported this view included the editor-in-chief of The Lancet, Nightingale, the founder of modern nursing, and Queen Victoria.
Although Newton's mechanical theory had inspired scientific enlightenment among the public at that time, the middle of19th century was still an ignorant time for medicine and physiology.
Ignorance is as terrible as cholera.
04
The query of young doctor Si Nuo.
Si Nuo, a young doctor, has different views on the theory that cholera spreads through the air. He thinks cholera should be spread through polluted water. His idea originated from a simple judgment-
If cholera is transmitted by air, it should be the lungs, not the intestines. His experience can prove his judgment-/kloc-at the age of 0/8, he stayed in a stinking mine for a long time, treating cholera of coal miners, but he didn't get sick himself.
Of course, it is obviously not feasible for Si Nuo to convince people only for this reason; Why? Because the smell is an intuitive feeling, it is hard for people who have smelled the stench of London to believe that there is nothing wrong with these pungent smells.
Bacteria in water are invisible (bacteriology was not put forward at that time, although the microscope has been invented, it is still very rough and it is impossible to identify bacteria in water); At the molecular level, the nose is much more sensitive than the eyes. Rotting objects give off two substances-corpse ammonia and rancid ammonia. As long as a few molecules enter the nasal cavity, people will feel a strong stench.
Without direct perception, people believe that one thing is difficult. For example, it is easy for people to wear masks nowadays, but many people don't pay attention to hand washing which is equally important but can't be directly perceived, while the elderly don't wear masks or wash their hands.
A rigorous scientist will not easily draw a conclusion with simple judgment. Si Nuo, who received strict medical training, made a very detailed investigation. He first conducted a large-scale investigation in London and found a very convincing evidence-
Tap water in London is supplied by two companies, one named Lamberthz and the other named Nanhuake. 1During the cholera epidemic in August, 849, according to the statistics of Si Nuo, the mortality rate of residents in the two water supply companies was quite different.
The mortality rate of residents covered by Nanhuac Company is 3. 15%, and that of Lamberthz Company is 0.38%, which is almost 10 times worse. But Southwark, which has a high mortality rate, is in the lower reaches of the Thames, and the possibility of water pollution is indeed greater.
Si Nuo has accumulated a lot of similar evidence, and combined with his own analysis, he wrote a paper on the mode of cholera transmission, aiming to prove to people that cholera is transmitted through water pollution rather than air pollution, and at the same time, he suggested that the authorities strengthen public health management. In this sense, Si Nuo can also be regarded as the exposer of cholera in London.
However, because the theory of "miasma" of air pollution was too deeply rooted at that time, and Si Nuo did not find more direct evidence, his theory still did not attract enough attention at that time and was not accepted by the mainstream medical profession and the public at that time.
05
The devil is dancing:
Cholera broke out in kuanjie
Snow is not discouraged. He is an anesthesiologist himself. Studying cholera is not his main business, but he always has a fatal connection with this ghost hovering over Britain. He is waiting for an opportunity to prove his theory.
August 3 1, 65438, 854, the devil came again-cholera broke out near wide street in Soho district of London. Fifty-six people died on the first day, and the death toll soared to 143 on the second day and 178 on the third day. ......
People in this block, rich or poor, almost lost a member, and some families were killed by cholera.
In just a few days, most residents fled their familiar homes, and the originally lively Kuanjie became a large-scale death scene. Only those who couldn't leave stayed there, and terror spread and despair enveloped the whole block.
In just five days, more than 500 people died of dehydration caused by cholera, and the devil was dancing. .....
Si Nuo opened a clinic in Soho. He didn't run away from his home where he lived day and night like other rich people, although he could easily do so. But choose to be a retrograde person of that era. He is the night watchman in London, and he decided to face the devil.
Si Nuo began to take great risks to investigate the death cases in every block. We can imagine the scene at that time-
In the abandoned London neighborhood where the plague raged, a young doctor knocked on the door that might be full of corpses and asked them in detail about their illness and daily activities. Every time I knock on the door, I pass by death, which is thrilling.
06
Death Map: Facing Infectious Diseases
In that horrible September, Si Nuo made a detailed investigation regardless of life and death during the day. In the evening, he began to paint under the oil lamp. He wants to explain his theory to people in a more intuitive way.
He found a map of London and marked all the deaths in detail on it. He used a short black horizontal line to represent the death toll.
John snow drew a map of death at that time.
This map, which was painstakingly made, recorded the location and number of death cases in the street in detail, and was later called the famous "death map".
When all the statistics were completed, Si Nuo made a detailed analysis. He found that most of the deaths were concentrated near London's Wide Street, where there happened to be a free public water pump, and residents of many nearby streets took water there.
The total death toll in the block within 230m of the water pump is as high as 700, and Si Nuo suspects that the water pump is polluted.
Because the obvious fact is that there are the most deaths around the pump, and the farther away from the pump, the fewer deaths.
In the center of the death map, the red box shows the location of the water pump.
Si Nuo needs to continue to test his theory. His first thought was to sample and observe water with a microscope, but the result was not satisfactory. At that time, the microscope technology was still immature. He found nothing in the sample water except some white flocs.
Although he suspected that there was something wrong with these white flocs, he did not observe the real pathogenic bacteria, which was not enough to convince people at that time.
Although Si Nuo's death map can explain some problems, some people question that the spread of miasma can also explain this picture-there are more deaths in the central area of miasma, and the farther away from the center of miasma, the fewer deaths.
Others say that the water source of the wide street pump is much cleaner than that of the "Xiaobao Street" pump not far from here. If the "water source theory" is correct, the water in Xiaobao Street should be more deadly.
Si Nuo continued to investigate the condition of nearby residents like a detective.
This time, in addition to investigating the characteristics of those who died, he also began to analyze the characteristics of nearby residents who were not sick. He found the following facts:
1. Workers in a brewery brewing malt beer, which is only 180 meters away from Kuanjie, were not sick in this cholera. Huggins, the owner of the brewery, told Si Nuo that these workers usually drink beer instead of water because beer in the brewery is free.
2. There are 535 prisoners in a prison not far from Kuanjie in Suhao District, and there are almost no cholera cases. Si Nuo found that the prison had its own well, and at the same time bought a lot of water from Dazhangkeshen Water Plant, and did not drink the water from Kuanjie Water Pump.
3. Si Nuo found two cholera deaths in hampstead, which is very far from Kuanjie. They are an old widow and her niece. Si Nuo found the widow's son by bike. After asking, Si Nuo discovered an amazing fact-
It turns out that this widow once lived in Broad Street. She misses the smell of well water, so much so that she will ask her servant to bring her a big bottle of water from the wide street with a trolley every day. The last bottle of water for her and her niece was bottled from a wide street well when the epidemic began on August 3 1.
At this point, the truth is finally clear in Si Nuo's investigation-the problem lies in the water pump, and Si Nuo found the dragon crystal beaten by the alien ghost. The whole process is like a mystery novel.
On September 7th, 1854, Si Nuo reported his research to the authorities in Suhao District, and the authorities adopted his suggestions. The next day, he took off the handle of the pump and turned it off.
Miracle happened-the cholera epidemic in London quickly disappeared after that.
It took only eight days from the first cholera outbreak on August 3rd1to the submission of detailed investigation report on September 7th.
07
History always has regrets and twists and turns.
Of course, the actual plot is always tortuous and complicated. Although the epidemic has been eliminated, the scene of people cheering for the snow like heroes has not appeared.
The sanitary situation in London has not improved, and even Si Nuo's theory of water transmission is still in doubt. In the struggle between science and ignorance, reason does not always prevail easily.
At this time, the pastor of St. Luke's Church Henry whitehead became a loyal supporter of Si Nuo, which is very rare in the miasma-ridden church.
He also lives in Soho. Although he didn't believe Si Nuo's theory at first, he was full of respect for Si Nuo's work. He used his influence in the community to continue to validate Si Nuo's research.
Finally, after several months of investigation, Whitehead interviewed a woman named Louise at 40 Kuanjie, Suhao District.
A five-month-old baby girl of this woman died of diarrhea at the beginning of the outbreak, and the time of death showed that she was the first case of cholera in London.
Henry whitehead
The women poured the water for washing baby diapers into a sewage pool in Wide Street, which was only three feet away from the well corresponding to the pump in Wide Street. After excavation, it was found that the wall of the sewage pond had been damaged, and it was this sewage pond that polluted the well.
Whitehead wrote a detailed article about his findings and the investigation of sanitation in Soho, which was published in the influential magazine "Builder" at that time.
At this time, people really believed Si Nuo's theory of cholera water transmission; Comics about the source of cholera began to appear in popular books.
1856, when a new cholera broke out in bromley, people quickly controlled it with Snow White's theory, effectively preventing the large-scale outbreak of the epidemic. At this point, Snow White's theory began to take root in people's hearts.
The London government also started to take action-1859. Five years after the cholera in Broad Street was investigated in Si Nuo, London carried out the next large-scale sewer reconstruction project.
This project was designed by barzel Jie, an outstanding engineer, and took six years to complete. This is the first modern urban sewage system in the world. London's sewage is completely cut off from drinking water sources, discharged to the mouth of the Thames and finally flowed into the Atlantic Ocean.
1865, louis pasteur, a French microbiologist, confirmed the existence of bacteria with the famous goose neck bottle experiment, and formed the first set of bacterial disease theories.
For the first time, people know the kinds of bacteria.
After 18 and 1883, German microbiologist robert koch successfully found and isolated Vibrio cholerae, which proved that Vibrio cholerae in water was the real culprit of cholera. 1905 won the nobel prize in medicine.
Robert Koch
At this point, Si Nuo's theory finally won a great victory.
However, history is always full of regrets-1858, 10 In June, Si Nuo suffered a stroke while exercising and died six days later, at the age of 45, just four years after he drew a famous map of death.
He didn't live to the day when Koch discovered Vibrio cholerae in the water, nor did he wait for the day when the London sewer project started.
0 1
John snow's Legacy
Snow is undoubtedly great.
The wide street cholera survey initiated by him in 1854 opened a large-scale investigation of modern epidemics, which was a pioneering and landmark work in this field and was recognized as the "father of epidemiology" in the medical field.
His "map of death" was also regarded by later generations as the beginning of "data visualization", which opened up the wisdom of people of that era in a concise and intuitive way.
Visualization map of novel coronavirus epidemic made by Peking University Visualization Team.
Today, at the American Centers for Disease Control in Atlanta, when scientists are looking for simple answers about epidemics, they sometimes ask each other, "Where is the pump of this epidemic?"
In a broader sense, Si Nuo's research on cholera in Kuanjie is also an important watershed in the history of human urban development.
Since then, human beings have fully realized the importance of public health for urban infrastructure construction. Clean water source and sewage classification system have been included in the urban planning agenda, and sewers have become the "conscience of the city".
The sewer system in modern London
Today, many years later, when we are enjoying the clean water source and mature sewage treatment system in metropolis, we still want to thank 100 years ago a doctor named Si Nuo for his fearless investigation. .....
Before serious infectious diseases were effectively controlled, thousands of years of human history experienced a fatalistic pattern-"population growth-outbreak of infectious diseases-population growth-outbreak of infectious diseases".
Before the19th century, the population of a single human city never exceeded 3 million. Today, Tokyo, Japan and Mumbai, India have reached the scale of 30 million people.
Tokyo, a super metropolis with a population close to 30 million.
Si Nuo's spirit also inspired future generations. 20 10, 10 In June, cholera broke out after the earthquake in Haiti, and Piarroux, a French epidemiologist, entered Haiti as a humanitarian.
French epidemiologist-Piaru
The book "Deadly River: Cholera and Cover-up after Haiti Earthquake" published on 20 16 describes in detail his investigation and contribution to the prevention and treatment of cholera in Haiti.
2065438+In April 2007, Piarrooux was awarded the "French Knight Order". In a sense, Piaru is john snow today.
Cholera has not disappeared on the earth, and mankind continues to face the threat of more new infectious diseases.
09
The City of London will not forget, nor will mankind forget.
Today, if you travel to Soho, London, you can still find a bar called "john snow" at the corner of Broad Street and Cambridge Street.
On the other side of the bar, a lonely pump model stands quietly, which is a monument for Londoners to commemorate the "London Night Watch".
This black water pump sculpture seems to remind people in the future all the time-don't forget your courage and rationality.
John Snow Bar and Water Pump Sculpture in Soho, London
Si Nuo has never been married and has no children. He is a strict vegetarian. He doesn't even drink, but only boiled distilled water.
Whenever disasters are raging, people will always think of the courage and wisdom given to us by those who have struggled for human life.
John snow's tombstone