The Ghost Map: The Story of London's Most Terrifying Epidemic--and How It Changed Science, Cities, and the Modern World

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The Ghost Map: The Story of London's Most Terrifying Epidemic--and How It Changed Science, Cities, and the Modern World

by Steven Johnson

3.86 · rating details · 5,369 ratings · 1,140 reviews

Trust Steven Johnson to put an intriguing and unconventional spin on a well-known story! The nimble-minded nonfiction writer who dazzled us in Emergence, Mind Wide Open, and Everything Bad Is Good for You now parses a storied incident from the annals of public health-- the Broad Street cholera epidemic of 1854, a deadly outbreak that literally decimated London's population...more

Hardcover, 299 pages

Published October 19th 2006 by Riverhead Hardcover (first published 2006)

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Mar 27, 2010

Eric_W rated it

Shelves: history-historiography

Cholera is a nasty little bug. Once ingested, it forms colonies on the intestinal wall, begins to reproduce with ferocious speed, and proceeds to trick the cells into excreting water rather than absorb it. It doesn't really matter of the host dies soon, because millions of new little cholera bacteria rush out of the host with the excreta waiting for the next person to ingest some excrement. That is the key. The only was to get cholera is by ingesting the excrement of another person so infected....moreCholera is a nasty little bug. Once ingested, it forms colonies on the intestinal wall, begins to reproduce with ferocious speed, and proceeds to trick the cells into excreting water rather than absorb it. It doesn't really matter of the host dies soon, because millions of new little cholera bacteria rush out of the host with the excreta waiting for the next person to ingest some excrement. That is the key. The only was to get cholera is by ingesting the excrement of another person so infected. Now you might say, whoa, that's more than I really wanted to know and I have no intention of so doing anyway. Well, you're right, all homo sapiens have a predisposition NOT to do just that, but given the rise of cities, the closeness with which we live, the relative ease of transportation, and the total misunderstanding of basic sanitation that existed until the 20th century, it was inevitable that the little buggers would escape their original habitat along the Ganges River.

Johnson discusses the interrelationship of the rise of cities, alcohol tolerance as a genetic adaptation to increased agriculturalization. Drinking water could be quite hazardous, but drinking beer and other alcoholic drinks had survival value from a natural selection standpoint because the fermentation process and alcohol killed off many harmful bacteria. Since alcohol is a poison and ill-tolerated by many, the speculation is that as agriculture and cities began to predominate, those who could tolerate alcohol better than others survived to reproduction age.

In another of those little actions that are intended to benefit, but which have unintended consequences, the change in use of sewers in London, inadvertently laid the groundwork (pun intended) for the cholera epidemic. Sewers had been designed to channel away rain water to and help prevent flooding in the city. In fact, it was prohibited to dump anything in the sewers and the Thames had been teeming with fish and quite clean. As the population increased, waste accumulated, and the aroma of piles of excrement in basements and elsewhere gave the miasmatists (those who believed disease was transmitted in the air) food for thought (the puns just keep rolling along.) So they had the brilliant idea of using the sewer system to wash the excrement out of the city and into the river which soon became foul. As it had also been the source of drinking water, the transmission of the cholera bacteria was efficient and inevitable.

Snow's rational approach to discovering the cause of the disease is remarkable in other ways. It had been common (a mythos that still is often heard today) to blame disease on lack of moral fiber. Since most of the victims were poor, and we all know that the poor are morally unfit, the victims themselves were somehow responsible for the illness. Snow rejected that possibility, rationally looking at evidence and building his case for the water-bourne nature of the disease. Johnson turns a nice metaphor in describing Snow's discovery: "...how great breakthroughs usually happen in practice. It is rarely the isolated genius having a eureka moment alone in the lab. Nor is it merely a question of building on precedent, of standing on the shoulders of giants, in Newton's famous phrase.Great breakthroughs are closer to what happens in a flood plain, a dozen separate tributaries converge and the rising waters lift the genius high enough that he or she can see around the conceptual constructions of the age."

How the source of cholera epidemics in London in 1854 was identified and explained is the subject of this engrossing work. A very good companion book to read with this one is Yellow Fever, Black Goddess: The Coevolution of People and Plagues which has an excellent section on modern cholera treatments.(less)

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Jan 28, 2008

Kay rated it

· review of another edition

Shelves: medical, london, social-issues

By turns thought-provoking and irritating, The Ghost Map meanders from its central story -- how an unorthodox physician found the source of a cholera epidemic that swept through London in 1854 -- into a host of other issues. Expecting a more straightforward account of the unraveling of this medical mystery, I set this book aside twice in frustration, bored with the author's tendency to stretch out the narrative, and particularly his repeated examination of the hold the "miasma paradigm"...moreBy turns thought-provoking and irritating, The Ghost Map meanders from its central story -- how an unorthodox physician found the source of a cholera epidemic that swept through London in 1854 -- into a host of other issues. Expecting a more straightforward account of the unraveling of this medical mystery, I set this book aside twice in frustration, bored with the author's tendency to stretch out the narrative, and particularly his repeated examination of the hold the "miasma paradigm" had upon medical minds in the mid nineteenth century. He can't seem to get over the fact that all manner of educated and otherwise reasonable people believed that disease was caused by noxious smells. His lengthy discussion of the bureaucratic obstacles faced by John Snow, the physician who linked cholera with contamination of drinking water with sewage, begins to wear thin about half-way through the book.

The Ghost Map certainly starts promisingly enough, with a description of Victorian London's hitherto unheralded "recyclers" - the "night-soil men," "mudlarks," rag-gatherers, bone-pickers and others who made a living scavenging in London's streets, rivers, and sewers. This is fascinating stuff -- who knew, for example, that such a person as a "pure finder" (dealer in dog shit, or "pure, which was used by tanners) existed? In this Dickensian world, an astonishing diverse array of second- (or third-) class citizens eked out a living on the margins.

From an examination of this nether world, Johnson then moves on to the slums of London, doing a crack-up job describing the cramped, horrid living conditions. He zeros in on one street and one family; a harried mother is caring for a sick infant, who eventually dies. The child suffers from virulent diarrhea and is wasting away. The mother washes the soiled diapers and tosses the dirty water in the cesspool just outside her door. The cesspool, in turn, oozes into a local well. The stage is set for the beginning of an epidemic.

Johnson is best when he describes this world, with its reeking slums. But he is inclined, frequently, to hare after philosophical questions, not the least of which is mankind's inability to see beyond the dominant scientific paradigms of the time. This bogs the narrative down. While Johnson has many interesting ideas and speculations, it's tiring to be taken on so many unresolved side journeys. It's not quite so interesting, for example, to read (at length) of John Snow's battles with pig-headed authorities, who are blind to the obvious link that Snow establishes between one particular source of contaminated water and the cholera epidemic. Nor was I particularly enthralled to read the minutia of Snow's statistical analysis he built for his case. Johnson also seems inordinately fond of the idea of a "map" as a grand organizing theme, one which he stretches out well past the 19th century in the final chapter.

Actually, the final chapter leaves Snow's London altogether and is something of an eye opener. Johnson discusses the role of cities in the modern world, as well as the gravest threats that mankind faces today. This chapter could well be a stand-alone essay. It made me think, ultimately, that this book would have made two excellent books -- one the tale of the cholera epidemic and the other of the social consequences of the rise of cities. As it is, putting them into one book, weaving between factual account and philosophical premise, was over-reaching a bit.
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Sep 07, 2008

Kirsti rated it

· review of another edition

Recommends it for: history/psychology buffs

Shelves: history, nonfiction

WARNING: Do not read this review if you are squeamish. Or eating.

This book is about cholera, and as a result, the author uses an impressive number of words for shit--including excrement, ordure, human waste, and the Victorian euphemism night soil. And shit, of course.

Johnson explains that a key question in the development of civilization has always been "What are we going to do with all this shit?" This book dramatically improved my vocabulary regarding topics ...more

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Dec 15, 2011

Kerrie rated it

· review of another edition

Shelves: from-library, non-fiction, audiobook

This started out as an engrossing account of the filth and unhygienic conditions of Victorian London, where people literally piled shit in their basements, later to be removed by "nightsoil men" and a cemetery meant for 3000 bodies ended up containing 80,000 and gravediggers would jump up and down on the bodies in order to make room for more. It sounds insane today that anyone could live in those conditions and what's more...WTF did Victorian London SMELL like?

However, afte...more

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Apr 17, 2008

Croaker rated it

On August 28, 1854, working-class Londoner Sarah Lewis emptied a bucket of waste water into the cesspool of her squalid apartment building and triggered the deadliest outbreak of cholera in the city's history. A Victorian city with more than 2 million people packed into a ten-mile circumference. This is the story of two men: Dr. John Snow who pioneered the use of ether as an anesthetic in the United Kingdom, and on a personal note, mentions the first medical use of ether by Dr. William Morton;...moreOn August 28, 1854, working-class Londoner Sarah Lewis emptied a bucket of waste water into the cesspool of her squalid apartment building and triggered the deadliest outbreak of cholera in the city's history. A Victorian city with more than 2 million people packed into a ten-mile circumference. This is the story of two men: Dr. John Snow who pioneered the use of ether as an anesthetic in the United Kingdom, and on a personal note, mentions the first medical use of ether by Dr. William Morton; and the Reverend Henry Whitehead, an Oxford-educated young man whose Anglican calling did nothing to abate his fondness for London taverns.

The book begins with a description of London as a city of scavengers: bone-pickers, rag-gatherers, pure-finders, dredgermen, mud-larks, sewer-hunters, dustmen, night-soil men, bunters, toshers and shoremen. Against this backdrop of vile and ghastly smells, and in the face of a horrifying epidemic, Snow posited the then radical theory that cholera was spread through contaminated water rather than through miasma, or smells in the air. Against considerable resistance from the medical and bureaucratic establishment, Snow persisted and, with hard work and groundbreaking research, helped to bring about a fundamental change in our understanding of disease and its spread. Johnson weaves in overlapping ideas about the growth of civilization, the organization of cities, and evolution to thrilling effect.
This is a multifaceted book incorporating a detective story, an introduction to statistics (math), and a personal history. The Ghost Map is a book that, like the work of Jared Diamond, presents both vivid history and a powerful and provocative explanation of what it means for the world we live in. Unlike Jared Diamond however, Steve Johnson does not load the facts to reach the objective that Diamond would have us believe. From Snow's discovery of patient zero to Johnson's compelling argument for and celebration of cities, this makes for an illuminating and satisfying read. It is not a book for the squeamish however; a vivid description of death from cholera is graphically and terrifyingly detailed.
As interesting as the main body of the book is, Johnson ends with an Epilogue, which I believe was probably written well after he finished the telling of Dr. Snow’s story. If, for no other reason, read that chapter, but don’t expect to sleep well again. And when you read a newspaper article about a poultry worker dying in Thailand, think about what would happen if H5N1 were to undergo a single transgenic shift. Now, try to go back to sleep.
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Nov 11, 2007

David rated it

· review of another edition

Shelves: read-in-2007

This was an excellent account of the (successful) efforts of two men, John Snow and Henry Whitehead, to understand the means by which cholera is transmitted, following an 1854 outbreak in London's Soho district. The "ghost map" constructed by Snow, and the identification of the index case by Whitehead, were eventually successful in displacing the prevailing "miasma theory" by establishing linkage beyond reasonable doubt to contamination at a single water pump (the Broad Stree...more

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Aug 01, 2008

Jamie rated it

I think I can pretty say that this book by Steven Johnson isn't going to be for everybody. It tells the story of how several men tried to cope with and understand a massive outbreak of cholera in London during 1854. Yeah, riveting, right?

Actually, it was. In addition to talking about the disease itself (which basically causes death by diarrhea), the book follows the quest of a London doctor named John Snow as he propels the nascent science of epidemiology into its own. Snow went door...moreI think I can pretty say that this book by Steven Johnson isn't going to be for everybody. It tells the story of how several men tried to cope with and understand a massive outbreak of cholera in London during 1854. Yeah, riveting, right?

Actually, it was. In addition to talking about the disease itself (which basically causes death by diarrhea), the book follows the quest of a London doctor named John Snow as he propels the nascent science of epidemiology into its own. Snow went door to door in what was largely considered a doomed neighborhood, gathering information about who died, what their habits were, and most importantly how they got their water. He was working on a theory (one that turned out to be quite solidly supported) that cholera was transmitted via drinking water, and one public water pump in particular: the now infamous Broad Street pump that was befouled because a cholera victim's septic tank was leaking into its water supply.

This was a time before the germ theory of disease was widely known or accepted, so Snow was more of an underdog and outsider than you might think. The prevailing wisdom of the time was the "miasma theory," which held that "all smell is disease," and that cholera and other maladies were literally carried on the wind in the form of smells and bad air. It was amazing how hard Snow and the other main protagonist of the tale, Reverend Henry Whitehead, had to fight against this theory, which was largely taken as fact despite its frequent lack of evidence. But the team's tenacity and creativity won the day, resulting in the closure of the Broad Street pump, the avoidance of another cholera outbreak, and the iconic map of cholera deaths from which the book takes its name.

In addition to this central story, Johnson talks about related subjects, such as the London underclasses, the sociology and civic engineering of large cities, and the new London sewer systems. (The latter were particularly interesting, since they were built as a means of cleaning up the filth of the city, but they basically just ended up flushing it all into the Thames river and making waterborne diseases like cholera worse.) About the only complaint I have about the book is that it goes off the edge towards the end in what is basically a thinly veiled plug for Johnson's Outside In project. But in general, the whole narrative proved to be both fascinating and educational. Plus I guess I just love this history of science when it's presented in a context and with interesting characters.(less)

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Jan 23, 2009

Brack rated it

A map of the carnage. A layout of the bodies, defining the organism via the footprints. Tracking a microscopic bacteria with only the tool of the mind. No bigfoot in this region, but ignorance, rumor, inuendo and prejudice abound. That is the surge you are up against. It is all speculation with the support of keen and disciplined observation. Take that Mr Bell and your theorum. Who can tell you that your observations are not subtly leading you by the nose. Truth has it’s own particular agenda. I...more

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Feb 27, 2009

Sandi rated it

· review of another edition

Shelves: non-fiction, 2009

This book starts out as a fascinating exploration of poop disposal, or the lack thereof, in mid-19th century London. Forget any romanticism you may have about the Victorian London. It was absolutely disgusting as Steven Johnson makes horrifyingly clear in "Ghost Map". People dumped poop out their windows, stored it in their cellars, flushed it into sewers that ran straight to the Thames. London was a stinky, poopy place.

The total free-for-all of sewage disposal led to s...more

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Apr 19, 2010

Bethanne rated it

Shelves: book-club

I finally got through a book! All it took was my honeymoon and a beach! Considering I was becoming borderline illiterate, I read this book quite fast. The story of the cholera epidemic in London was a page-turner, and I was disappointed that more of the book didn't focus on that alone. While the chapters on the rise of epidemiology and the idea of mega-cities were interesting, the cholera story alone kept me coming back to this book. Very good!

Addendum: I recommended this to my...more

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Sep 26, 2008

Sara* rated it

Recommends it for: history buffs, map lovers

Recommended to Sara* by: hunter college

Shelves: true

I really lucked out this semester in my Cities & Health course by getting a chance to read The Ghost Map by Steven Johnson. The book, both a thrilling jaunt into the past and a terrifying look at the possibilities of the future, centers on 1854 London during the city's worst Cholera outbreak. The book follows a unorthodox Doctor, Dr. John Snow, and a man with his ear to the streets, Reverend Henry Whitehead, in the Golden Square neighborhood in Central London. The book chronicles the doctor's ch...more

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Jan 16, 2009

Bettie rated it

Shelves: history, sciences, plague-disease, nonfiction

Broadwick Street showing the John Snow memorial and pub

Snow was a skeptic of the then-dominant miasma theory that stated held that diseases such as cholera or the Black Death were caused by pollution or a noxious form of "bad air". The germ theory was not widely accepted at this time, so he was unaware of the mechanism by which the disease was transmitted, but evidence led him to believe that it was not due to breathing foul air. He first publicized his theory in an essay On the Mode of Communication of Cholera in 1849. In 1855 a second edition was published, with a much more elaborate investigation of the effect of the water-supply in the Soho, London epidemic of 1854.

By talking to local residents (with the help of Reverend Henry Whitehead), he identified the source of the outbreak as the public water pump on Broad Street (now Broadwick Street). Although Snow's chemical and microscope examination of a sample of the Broad Street pump water was not able to conclusively prove its danger, his studies of the pattern of the disease were convincing enough to persuade the local council to disable the well pump by removing its handle. Although this action has been popularly reported as ending the outbreak, the epidemic may have already been in rapid decline, as explained by Snow himself:

There is no doubt that the mortality was much diminished, as I said before, by the flight of the population, which commenced soon after the outbreak; but the attacks had so far diminished before the use of the water was stopped, that it is impossible to decide whether the well still contained the cholera poison in an active state, or whether, from some cause, the water had become free from it.

Snow later used a spot map to illustrate how cases of cholera were centred around the pump. He also made a solid use of statistics to illustrate the connection between the quality of the source of water and cholera cases. He showed that companies taking water from sewage-polluted sections of the Thames delivered water to homes with an increased incidence of cholera. Snow's study was a major event in the history of public health, and can be regarded as the founding event of the science of epidemiology.(less)

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Jul 26, 2007

Max rated it

Recommends it for: information theory buffs

Shelves: science-maps-mathematics

If you can get past Johnson's rather nauseatingly detailed descriptions of choleric outbreak and his many accounts of the smells and cesspits of nineteenth century london, The Ghost Map ends up being a very interesting look at how local information and the painstaking research of a few visionaries changed dominant theories about disease and contagation.

Johnson's main focus is the shift in the mid to late nineteenth century from the prejudicial understanding of disease spread through ...moreIf you can get past Johnson's rather nauseatingly detailed descriptions of choleric outbreak and his many accounts of the smells and cesspits of nineteenth century london, The Ghost Map ends up being a very interesting look at how local information and the painstaking research of a few visionaries changed dominant theories about disease and contagation.

Johnson's main focus is the shift in the mid to late nineteenth century from the prejudicial understanding of disease spread through filth and miasma to a research oriented and scientifically grounded understanding of disease transmission. His main subject is the work of John Snow in the middle of the nineteenth century. Snow was a physician and a pioneering anethesiologist working in London during Cholera outbreaks that proved more devastating than the plague. Unsatisfied with the prevailing view that Cholera was transmitted through "miasma" (literally a cloud of filth) and was mainly a disease of the poor and the dregs of society, Snow used statistical research and local accounts to map the source of the disease to a contaminated water pump on London's Broad street. His findings, in spite of being well documented and soundly researched, went ignored for decades as outbreaks continued through the century. This was a period of time before v. Cholerae would have been readily visible with the available technologies. Snow relied on his understanding of the way Cholera attacked the body and his own on-the-ground research, tracing the footpaths of Cholera's victims to the broad street pump, to create a map of Cholera's spread, eventually convincing hard won authorities to close the pump down and take a look at the way Londonders handled their sewage and drinking water.

Johnson's book is an account about how the use and transmission of information - from the lives of Cholera's victims to the creation of Snow's map - can change deep set and prevailing understandings. It's also an account of incredible shortsightedness and prejudice on the part of many otherwise highly intelligent men.

Not exactly for the weak-stomached, but definitely enlightening.(less)

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Apr 14, 2009

Dan Schiff rated it

This starts out so well, with descriptions of the guys who used to scavenge in the sewers of London. It then goes into the nitty gritty of where all those Londoners used to put their shit (basically a lot of them just piled it up in their cellars). I love this kind of thing -- looking at the forgotten underside of a period or place in history.

Unfortunately, Johnson runs out of steam pretty fast. He repeats the same points over and over again about how crazy people were for believing ...more

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Dec 01, 2008

Sarah rated it

Shelves: historical-non-fiction, medical, 2008

eh, this was okay as far as medical infectious disease books go. it got a little dry and repetitive towards the end, but it was interesting and informative for nearly the entire book.

i liked the way the author interspersed quotations from dickens and other authors of the time in addition to quotations from medical books/newspapers/other informational literature of the time.

cholera seems like a pretty nasty disease that i would never want to get, but it's such a simple o...more

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Jan 14, 2009

Svitlana rated it

· review of another edition

Recommends it for: Everyone

This was an AMAZING novel!!!!! If you like science, this book is just right for you! It all started with one microorganism...It was capable to kill thousands of people. Learn about London’s most dreadful epidemic. It made me feel so nervous and suspicious, because of that mysterious origin of the bacteria… This novel truly uncovered for me the importance of interdependece and the life order the earth depends on. This novel uncovered for me that competition in scientific world can help and motiva...more

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Jun 02, 2010

Sharon rated it

Difficult subject made easy for the layman to understand. I never realized what a disgusting pit London was during the 19th century. Filth and disease everywhere! But how we humans adapt; creating many jobs that filled the need to rid the city of its wastes. Just amazing. Equally amazing is how the two protagonists set out to understand and stop the spread of cholera that frequently decimated the city.

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Feb 05, 2009

TJ rated it

Shelves: history, own

another good book that tells the story of epidemics and how they affect us and are figured out. Strong book, though the ending and the author's thoughts on current politics and the possiblities of terrorism and bioterrism left a little to be desired.
But overall a good read. And informative as well

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Apr 16, 2009

Miranda rated it

Can't put this one down. Nothing like a little bit of plague and pestilence to make one's day.

A very nicely written, thought-provoking book. Got me thinking as much about the manner in which we do science as about what the science tells us, or can tell us. A lot of thinking rolled into a tidy package, wrapped up in a rollicking good tale of a cholera epidemic. Satisfying as a read, on so many levels. I find myself revisiting often the thoughts I had while going through this love...more

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Jul 24, 2008

Lynne rated it

· review of another edition

Shelves: audiobooks, history

I enjoyed most of the book, but I hated the concluding chapter. I would have preferred it if he had stuck to his subject rather than stringing together a series of personal opinions. The discussion of the relative risks of a nuclear holocaust versus bio-terrorism via a genetically engineered virus seemed forced. Does it really matter? The author somehow managed to work in references to both the Iranian nuclear policy and intelligent design in a book about cholera in the nineteenth century. Wa...more

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Feb 01, 2009

Daniel Hadley rated it

Johnson describes how cities (in this case, Victorian London) both create situations where diseases (in this case, cholera) can spread rapidly, and contain the solutions to our modern problems (in this case, by providing the density and creative energy necessary to produce John Snow's map, which paved the way for modern epidemiology). Contrary to the then-popular miasmatic theory of disease, cholera was spreading rapidly in London's contaminated water. When Snow teamed with another Soho resid...more

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Dec 10, 2008

Donna rated it

A 'thrilling review' doesn't quite capture it - I thought it was a little dull sometimes. The story is fascinating - providing more detail to the story of how Dr John Snow (a man from humble origins who rose to become not a surgeon but a physician. He even studied and perfected anesthesia and gave it to the queen during childbirth)along with a local pastor named Whitehead set about proving the way that cholera is spread. During the Victorian era most people were miasmaists. (Miasma is conside...more

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Dec 10, 2008

Perryville Library added it

Shelves: angela, nonfiction

“This is a story with four protagonists: a deadly bacterium, a vast city, and two gifted but very different men. One dark week a hundred fifty years ago, in the midst of great terror and human suffering, their lives collided on London’s Broad Street, on the western edge of Soho.”

The cholera bacterium had claimed many victims prior to 1854, but that year there was a particularly deadly outbreak in September. Contaminated air, “miasma”, was the well-established theory about the cause ...more

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Jan 07, 2012

Sue rated it

Shelves: history, medicine

Good writing, careful research, and an interweaving of the microcosmic (literally) and the macrocosmic make this a very good history of an event most of us know little about -- the London cholera epidemic of 1854, an event that was pivotal in modern medicine's understanding of the transmission of disease. The author does a really fine job of teaching the reader (even the grossly uninformed reader, namely me) about a) Victorian London and the sorry state of its sanitation systems, b) cholera and...more

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Jul 24, 2011

John E. Branch Jr. rated it

Shelves: nonfiction

In late August 1854, cholera broke out in an area of London's Soho called Golden Square. Neither the first nor the last outbreak in a large city, this one was different for marking a turning point in mankind's efforts to combat the disease. Employing a subtle scheme of dual organization (which one of his blog posts alerted me to), Steven Johnson divides his account into chapters reporting the day-by-day situation on the scene while also stepping back to illuminate a particular theme or player in...more

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Jul 20, 2011

Lisa rated it

Shelves: not-owned

Cholera periodically swept through London, and other major cities, into the middle of the 19th century, killing thousands. People blamed it on things like the weather, digging near graveyards, or poor ventilation, and felt that personal fortitude and moral integrity, based on class, would determine whether you lived or died. Actually, cholera is spread when drinking water is contaminated with sewage. Because the poorer parts of London had the worst sanitation, the disease tended to strike hardes...moreCholera periodically swept through London, and other major cities, into the middle of the 19th century, killing thousands. People blamed it on things like the weather, digging near graveyards, or poor ventilation, and felt that personal fortitude and moral integrity, based on class, would determine whether you lived or died. Actually, cholera is spread when drinking water is contaminated with sewage. Because the poorer parts of London had the worst sanitation, the disease tended to strike hardest in these areas. The public’s conclusion, however, was that the poor brought it upon themselves. As to how the disease was spread, even public health officials agreed that it spread through the air or miasma, and especially through noxious smells.

All smell is, if it be intense, immediate acute disease; and eventually we may say that, by depressing the system and rendering it susceptible to the action of other causes, all smell is disease. –A statement by Edwin Chadwick, head of the General Board of Health, to a parliamentary committee in 1846.

Therefore, they felt that the solution was to get rid of the smell by routing all the sewage into the Thames and letting the river carry it away. Unfortunately, the Thames supplied drinking water to the majority of the city (unless you could afford your own well or got your water from a tributary).

When the 1854 epidemic broke out in their neighborhood, two men stepped up to try and find the cause. The first was Dr. John Snow, a preeminent anesthesiologist and scientifically-minded loner. The other was a gregarious and well-known clergyman in the neighborhood, Henry Whitehead. Snow focused on proving that the cholera was coming from the water supply, and Whitehead, at first opposed to the waterborne theory, eventually came to support it and even to find the index case for the epidemic. As a result of their work, sanitation and public works became a priority, not just in London, but other large cities as well.

Although the book is quite repetitive, if it had ended here, I would have been a satisfied reader. Unfortunately, once the author moved beyond the historical, the book became a monologue on the author’s personal theories. These theories cover a wide range of topics, including the ecological and social networking advantages to living in cities; the possible threats to urban areas, such as terrorism and global warming; and why we will come to happily reside on a “planet of cities” despite these threats. My recommendation would be to skip the last two chapters of the book and stick with the 1854 epidemic.(less)

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Jul 08, 2011

Elle rated it

Highly recommend this book, very interesting (although a little bit long). Fascinating account of how the first public health interventions unwittingly caused the largest outbreak of cholera at that time, of the enduring physician that employed empiricism to identify the cause, of the resistance the encounters, and the eventual acceptance of his ideas (which was too late to be of any use to London as it had already undertaken construction of sewers, but has enabled other cities to take preventat...more

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Jun 21, 2011

Marilyn rated it

· review of another edition

Not for those with a queasy stomach. You are warned. Cholera is a bacterial infection that causes profuse vomiting and watery diarrhea. It won't necessarily kill you as long as you can keep from getting too dehydrated. A person with cholera can produce four or five gallons, yes, gallons of diarrhea a day, and that doesn't factor in the volume of vomitus. You can die within hours because of dehydration-related electrolyte disturbances causing the heart to fail.

This book takes us back t...more

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Mar 25, 2011

Eddie rated it

· review of another edition

Shelves: favorites

I've had this book for a couple years, just collecting dust on my bookshelf, staring at me the whole time and begging me to read it every time I caught eye-contact with it. Fortunately, when I made eye-contact with it earlier this week, I finally caved in and took it off the bookshelf and gave it its much needed attention and read it. But when I initially took it off the bookshelf I read the front and back cover over and noticed something that almost made me say: F.U. I am not spending a minute ...moreI've had this book for a couple years, just collecting dust on my bookshelf, staring at me the whole time and begging me to read it every time I caught eye-contact with it. Fortunately, when I made eye-contact with it earlier this week, I finally caved in and took it off the bookshelf and gave it its much needed attention and read it. But when I initially took it off the bookshelf I read the front and back cover over and noticed something that almost made me say: F.U. I am not spending a minute with you and that was the little fact that Steven Johnson also wrote a book, that I haven't read nor will I read, called Everything Bad is Good For You. Here is the synopsis of the book that I've taken from goodreads: Americans of every political stripe agree on at least one thing: Video games are awful. The $10 billion-a-year video gaming industry has come under attack from critics ranging from right-wing televangelists to Upper West Side literati. But Mind Wide Open author Steven Johnson argues that these fast-clicking junk culture machines aren't mind-numbing; they're brain-enhancing. Drawing from fields as diverse as neuroscience, economics, and literary theory, he shows that technologies that we are so eager to dismiss are actually making us more intelligent. In fact, he says, our pop culture has never been smarter.

Yes, I'm sure there are many good arguments that holds some thread of truth in regards to that that synopsis, but really, Jersey Shore and American Idol and every other idiotic "reality-TV" show are pop culture and I'm sorry, are not signs that it's smarter now than it ever has been.

Anyhow, back to this book...

This book was a fantastic, nimble book that almost makes me want to change my mind and actually read Everything Bad is Good For You because I thoroughly enjoyed this one so much. This nonfiction, fine piece of literature took me into a world where times were so different and literally, full of shit. It took me to 1854 Victorian England that experienced the worst cholera outbreak the country ever encountered. This book and others such as The Emperor of All Maladies furthers my realization and my "duh" moments that if it wasn't for rogue(fuck you, Sarah Palin, you do not count!), tenacious individuals or collective groups of people to stare the ugly monsters of our history, or even our current beast of today down, we'd be shit out of luck. Books like this make me also realize, not ALL of us are just average, self=centered, I won't contribute a goddamn thing to humanity that is worthwhile and meaningful. No, winning an Oscar or some Grammy doesn't mean you're on top of the world in my eyes. I'm talking about changing the course of humanity and the direction it takes to ensure our lives our better lived. This book takes you through Dr. John Snow's John Whiteheads unrelenting, yet different approach and final solution that finally met in the middle, attack on the beast that killed so many, cholera. Their approach, one scientific and the other being curious and more fearless, changed the way cities were built, the way maps were drawn and the way our collective shit was dealt with.

This book may not be for everybody, but for me, I couldn't put it down and I repeat: I liked it so much, I may just give his Everything Bad is Good For You. Happy Reading. (less)

· see review

Mar 13, 2011

Sarah rated it

I give this book 5 stars for the first 190 pages, and 3 stars for the author's conclusion and epilogue.

Johnson's account of the events surrounding London's 1854 cholera outbreak were concise, enlightening, and generally awe-inspiring. It was history at its best and most fascinating.

For some reason, as concise as he was during the story-telling portion of the book, he was extremely generic and rambling during the last 70 pages. I understood what he was getting at with 31...more

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About Steven Johnson

Steven Johnson is the author of the bestsellers Where Good Ideas Come From, The Invention of Air, The Ghost Map, Everything Bad Is Good For You, and Mind Wide Open, as well as Emergence and Interface Culture. He is the founder of a variety of influential websites—most recently, outside.in—and writes for Time, Wired, The New York Times, and The Wall Street Journal. He lives in Marin County, Califor...more

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Where Good Ideas Come From: The Natural History of Innovation

Emergence: The Connected Lives of Ants, Brains, Cities, and Software

Mind Wide Open: Your Brain and the Neuroscience of Everyday Life

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“This is how great intellectual breakthroughs usually happen in practice. It is rarely the isolated genius having a eureka moment alone in the lab. Nor is it merely a question of building on precedent, of standing on the shoulders of giants, in Newton's famous phrase. Great breakthroughs are closer to what happens in a flood plain: a dozen separate tributaries converge, and the rising waters lift the genius high enough that he or she can see around the conceptual obstructions of the age.” — 6 people liked it

“How could so many intelligent people be so grievously wrong for such an extended period of time? How could they ignore so much overwhelming evidence that contradicted their most basic theories? These questions, too, deserve their own discipline: the sociology of error.” — 2 people liked it

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title link	preview: The Ghost Map: The Story of London's Most Terrifying Epidemic--and How It Changed Science, Cities, and the Modern World
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