E Ray Lankester and the making of modern British biology

wrote a lot, using a simple and effective style. He died suddenly, in his prime, but not before producing work of lasting importance in two separate fields, anaesthesiology and epidemiology. He has a blue plaque in London and a society commemorating his name. Nevertheless, David Shephard's is the first fulllength biography of this remarkable Victorian general practitioner. Part of the reason for this undoubtedly is the absence of any collection of his correspondence and other private papers. Even the archives of people with whom he might be expected to have corresponded, such as Edwin Chadwick, are silent. The one exception are the three volumes of Snow's Case Books, held in the Library of the Royal College of Physicians of London, and recently transcribed and magnificently edited by the late Richard Ellis (Medical History, Supplement No. 14, 1994). The poignant dedication of Shephard's biography is a paste-over In Memoriam to Ellis and Roderick Calverley, two anaesthetists cut off in 1995, also in their primes. Shephard has made good use of the Case Books, although Ellis's editorial apparatus and greater familiarity with Snow's handwriting were not available to him. The Case Books allow Shephard to comment on Snow's anaesthetic and general practice. For the most part, however, Shephard confines himself to Snow's published writings and what they say about his evolving ideas on the nature and mode of spread of cholera, and on the science and art of anaesthesia. His bibliography of Snow's writings is a full one, and every publication gets at least a mention. The discussion of Snow's epidemiological investigations during the 1854 cholera outbreak in London is especially cogent, for it goes beyond Snow's classic work around Broad Street, Soho, and his comparison of the cholera incidence in houses supplied by two different water companies, to scrutinize the immediate reception of Snow's findings. Shephard emphasizes that Snow never believed that contaminated water was the sole mode whereby cholera is spread (soiled bedding could be equally as effective), and provides a sound analysis of the evidence Snow gathered in arguing that cholera is essentially a disease of the bowels, rather than of the blood. Not surprisingly, Shephard (himself an anaesthetist) has plenty to say about the other string to Snow's bow. Occasionally, the lack of direct evidence leads Shephard to unnecessary poetic licence, and some of Snow's contemporaries are not treated as seriously or as fully as they deserve. Around the fringes, there are a few lapses: William Wilberforce was not MP for York when Snow was born, and nonconformists did not have a monopoly on evangelicalism. Erwin Ackerknecht's name is consistently misspelt. Nevertheless, we now have a full-length biography of Snow, and a good one. And if the book, as an object, is a rather poor thing, at least the price is right.