Source: Wall Street Journal, October
The Ghost Map The Story
of London's Most Terrifying Epidemic — and How It Changed Science, Cities, and
the Modern World
by Steven Johnson
Riverhead Books, New York, 2006. ISBN: 1594489254.
Lost in a Time of Cholera
How a doctor's search solved the mystery of an
epidemic in Victorian London
By Ferdinand Mount
Mr. Mount is the author of "Jem (and Sam)" and
"Fairness." He was editor of the Times Literary Supplement 1991-2002.
The sociology of error is a wonderful subject. Some
university ought to endow a chair in it -- and then make Steven Johnson the
first professor. Mr. Johnson last provoked the public with his counterintuitive
polemic "Everything Bad Is Good For You," in which he argued that TV and
videogames actually improve our cognitive skills. In "The Ghost Map" he tells
the story of how for 30 years and more the medical establishment in Victorian
London refused to accept what was staring them in the face, namely that cholera
was a waterborne disease.
Thousands of Londoners died while doctors and
public-health officials stubbornly clung to the view that the plague was an
airborne miasma that hung in the foul atmosphere of the slums and was inhaled by
the wretched creatures who lived there. Every kind of cure was proposed: opium,
linseed oil and hot compresses, smoke, castor oil, brandy -- everything but the
simple, obvious remedy of rehydration, which reduces the otherwise fatal disease
to a bad case of diarrhea.
The fact that the cholera toxin tricks the cells in
the lining of the colon into expelling water at a terrifying rate (victims have
been known to lose 30% of their body weight in a matter of hours) should surely
have alerted someone to the possibility that putting this Niagara back into the
body might be worth trying. Only one doctor, Thomas Latta, hit upon the answer,
in 1832, just a few months after the first outbreak ever in Britain. His mistake
was not to inject enough salty water, and his lone initiative was soon
overwhelmed by the brainless babble of the quacks.
Chief among the villains of Mr. Johnson's
unputdownable tale was the man whom we were brought up to revere as the father
of public sanitation, Edwin Chadwick (see
dour, tactless, unpopular reformer laid the foundations for all the government
interventions in public health that we now take for granted. Yet in this story
he labored under not one but two illusions that proved catastrophic.
The first was his belief that, since the mephitic
odors of private cesspools posed such a clear and present danger to health,
sewage ought instead to be discharged down public drains into the Thames, from
which most Londoners took their drinking water. As the great builder Thomas
Cubitt remarked: "The Thames is now made a great cesspool instead of each person
having one of his own."
The consequences of this well-intentioned blunder
were worse even than those of the decision of the Lord Mayor during the Great
Plague of 1665-66 to exterminate all the city's dogs and cats because of the
false rumor that they were spreading the plague, thus allowing an exponential
increase in the population of the rats who were the real transmitters.
Having contaminated a large part of the population
he was trying to protect, Chadwick committed his second mistake, sternly setting
his face against the simple explanation that would bring about a cure. To his
dying day -- which did not come until 1890 -- Chadwick remained an unrepentant
miasmatist, as proponents of the airborne explanation for cholera were known. So
was Florence Nightingale. The Lancet, the leading medical journal,
venomously denounced the waterborne theory and its dogged proponent, John Snow (see
With the austere teetotaller and vegetarian Dr. Snow
and his devoted helper in the Soho slums, the Rev. Henry Whitehead, "The Ghost
Map" gains not one but two heroes. Patiently they mapped the patterns of victims
and survivors and narrowed down the most likely source of the cholera plague to
the Broad Street pump. But even after the pump handle was removed so that
Londoners could no longer fill their buckets there and the illness subsided, the
miasmatists were not convinced. Snow then tramped the streets of Battersea and
Vauxhall to demonstrate that those who had their water from higher up the
Thames, above the reach of the tide, remained unharmed, while those who took it
from the foul tidewater perished in the hundreds. This was no easy task, since
the pattern of water pipes under London's houses was as tangled as the pattern
of Internet service providers are today.
Why did it take so long? Because mapping epidemics
was only in its infancy, though Snow's famous map was not quite the first.
Because the questions that Chadwick's public-health board researched were
self-fulfilling, all having to do with the smells and personal habits of the
poor and not with the water they drank. The researchers mistook correlation for
causation: Nobody died on the high ground of Hampstead, where the air was purer,
therefore higher was safer -- or so it seemed until a Mrs. Eley, who had retired
thither, arranged to receive a jugful of water from her beloved Broad Street
pump and got cholera.
But above all Chadwick and his crew were certain of
themselves because the stench of the slums was so utterly disgusting and because
smell acts so powerfully on our imaginations. Only the most careful and
dispassionate investigators were free of the obsession with stench. Henry
Mayhew, for example, noted in his "London Labour and the London Poor" (1851)
that sewer-hunters, who scavenged deep underground knee-deep in muck, lived to a
ripe old age. The Great Stink of 1858, which finally persuaded the government to
commission Sir Joseph Bazalgette to lay down the magnificent network of sewers
that have lasted to this day, did not kill a single Londoner -- yet still
Chadwick did not believe.
This is a marvelous little book, based to a large
extent on the essays delivered to an academic colloquium, just as was Dava
Sobel's "Longitude" (1996). Yet "The Ghost Map" is a far more ambitious and
compelling work. What Mr. Johnson shows us is that the crucial test of a
mega-city is whether it can digest its own waste. That whole vagabond London
crew of scavengers, bone-pickers and rag-gatherers were not just pitiable
victims of the System. In providing their unofficial janitorial services, as
Mayhew perceived so well, they were "engaged on one of the most important of
social operations" and deserved respect as well as sympathy. Victorian Londoners
depended on them as utterly as they (and we) depend on the incessant operation
of zillions of microbes.
Mayhew -- the third hero of this book -- saw clearly
how our cities, like our bodies, are constantly decomposing and recomposing. The
mega-city is in fact something like a natural organism, which begins to fail
when one link in the chain breaks. In the case of London's cholera epidemic, the
breakdown occurred when a certain class of cleaners, the sewage removers known
as night-soil men, found that they could charge as much as one shilling for
emptying each cesspit. The poor and their more unscrupulous landlords left the
sewage to overflow into the cellars -- and ultimately to leak into the Broad
Snow had the precious gift of consilience --
"jumping together" (the term was invented by the Victorian historian of science
William Whewell and revived by the biologist E.O. Wilson). That is, he could
bring side by side techniques or theories from two different disciplines to make
a further leap forward. His microscope was not powerful enough to see the
comma-shaped cholera bacillus; his only instrument was statistical -- the
analysis of the weekly bills of mortality. But his greatest asset of all was a
clear head unclouded by preconceptions about the moral and physical squalor of
Steven Johnson ends by branching out into wider
speculations. The density of cities is, he argues, a virtue rather than a
defect, except when it comes to suicide bombers. New York is the greenest city
on earth, because its jam-packed citizens consume so little energy per head. Mr.
Johnson is never less than lively and beguiling in these closing chapters, but
for me the image that lingers is that of the tireless Dr. Snow and the Rev.
Whitehead padding round the streets of Soho night after night, asking every
householder and passer-by the innocent but fateful question: "Where do you get
your water from?"
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