There were 21 medical schools in London offering training for dual qualification. This meant that they fulfilled the requirements of both the ‘college’ and ‘hall’ as they were known, or Royal College of Surgeons and Apothecaries’ Hall. Both exams qualified the holder to practice as a general practitioner. The hall specified the lectures they expected their students to take in each term as well as the beginning and end of medical practice. On the other hand, the college listed merely the required courses and the length of surgical practice to be undertaken by their students.
Lists and descriptions of courses were published in the Lancet at the beginning of the autumn term. Some establishments offered a full course of lectures and anatomy, but practice had to be gained at external hospitals. Other private schools offered only a selection of courses with no links to a specific hospital either, and then there were of course the hospital-based medical schools offering the full programme.
With prices ranging from £34 for the Hunterian School of Medicine, which offered a full lecture and an anatomy course, to £69 6s for the all-inclusive Guy’s Hospital programme, it is likely that John Snow chose the first due to financial reasons. Next he found lodgings nearby in 11 Bateman’s Buildings, a row of houses of Soho Square. His room was so small that it was of not more use than for sleeping in it, but with the long hours he tended to keep at medical school, this would not have been too much of an inconvenience.
He attended the school from 1836-38 and repeated a good number of courses, which he had already taken in Newcastle. It is thought that he probably did so because he wanted to get to know his teachers in London better. He especially involved himself with anatomy and midwifery. The first brought him into contact with Joshua Parsons, a fellow student who, like Snow, stayed long after the course had finished. The two built a friendship and helped each other cramming for the first year exams.
Parsons had already attended courses at the North London Hospital School, which he had failed. This hospital had been renamed in the meantime into University College Hospital, and although this hospital was nearest to Snow’s school and lodgings, he chose Westminster Hospital to walk the wards. This decision might have been influenced by Parsons’ previous experiences.
After Parsons had graduated, he returned to his native Somerset to set up as a General Practitioner. Snow on the other hand increased his efforts in anatomy and became assistant to his professor, helping to prepare the bodies and specimens for the other students. He was made aware by his professor of a foreign article that suggested to inject a solution of arsenic of potash into blood vessels to highlight them. A technique he adopted and developed straight away with much success.
During these sessions, some of his attending class mates started to fall ill with cramps or vomiting and he began to investigate the cause. As the reason of this poisoning, a reaction product of the injected substance came to light: it was pure arsenic. This provided an ideal subject for his first publication for the Westminster Medical Society. This society had been originally set up in connection with the Hunterian school in 1809 and its main investigation at the time was on the poisoning use of white arsenic in candles. White arsenic made candles burn brighter and was a popular substance at the time.
Snow had found his group of like-minded medical men in London, who were questioning and debating all aspects of public health and he continued to stay connected with this group all through his lifetime. He attended the weekly meetings from April 1837 and was elected a full member to the group in October of that same year. He was later to become a member of different advisory committees and Vice President of the Westminster Medical Society from 1848-49.
John Snow, after completing all necessary courses, passed the college’s oral examination in May 1838 as the 7th out of 240 successful candidates. His knowledge and deep interest of anatomy must have impressed the examiners. He then qualified as an Apothecary in October 1838 and his medical training was over.
Contrary to the usual choice of location, he decided not to return north to set up private practice near his home town, but stayed in London. His interest in new hospital medicine and research must certainly have been a factor.
Of great importance was also, of course, his links to the other medical researchers that he had met since joining the Westminster Medical Society and the fact that he was starting to publish his own research.
His first attempt to gain employment was an application to Westminster Hospital, when the position of Apothecary became vacant. It looked like his appointment was almost certain, until at the last minute his application was rejected. This would have been an ideal starting point for his career in London. Instead, Snow now decided to stay on and join the large number of general practitioners trying to make a living in the city.
He set up in 54 Frith Street, just around the corner form his old lodgings. The street housed about 540 people living on a street 600 ft long, which was served according to the 1841 census by at least 4 general practitioners. He chose to focus on midwifery again as well as signing up to a number of friendly societies, whose working class members would pay a penny a week towards treatment, which was paid to the practitioner in a lump sum, independent of the quantity of treatments required.
His fortune only began to change with the advent of ether 8 years later.
Snow, S. J. 2008. “John Snow: the making of a hero?” The Lancet 372, n. 9632: 22-23.
Vinten-Johansen, Peter, et al. 2003. Cholera, Chloroform, and the Science of Medicine: A Life of John Snow. Oxford: Oxford University Press.
Zuck, D. 2008. “John Snow’s London.” Proceedings of the History of Anaesthesia Society 39: 109-127.
The Lancet 1 (1836-37): 7-15.
To cite this post : Iris Millis, “John Snow, the first English anaesthetist. Part 2 –Medical School Days”, Museum Highlights (blog on oldoperatingtheatre.com), December 11th, 2016.
Iris Millis is currently a museum officer at the Old Operating Theatre Museum and Herb Garret. She has previously worked for the Anaesthesia Museum and Bodyworlds. She is member of the History of Anaesthesia Society and the John Snow Society. Follow her on Twitter, @historical_iris.