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

by Steven Johnson

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1,596 ratings, 3.80 average rating, 474 reviews (more data...)

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published

October 19th 2006 by Riverhead Hardcover

binding

Hardcover, 299 pages

isbn

1594489254 (isbn13: 9781594489259)

description

A thrilling historical account of the worst cholera outbreak in Victorian London-and a brilliant exploration of how Dr. John Snow's solution revolutio...more

[close] A thrilling historical account of the worst cholera outbreak in Victorian London-and a brilliant exploration of how Dr. John Snow's solution revolutionized the way we think about disease, cities, science, and the modern world.

From the dynamic thinker routinely compared to Malcolm Gladwell, E. O. Wilson, and James Gleick, The Ghost Map is a riveting page-turner with a real-life historical hero that brilliantly illuminates the intertwined histories of the spread of viruses, rise of cities, and the nature of scientific inquiry. These are topics that have long obsessed Steven Johnson, and The Ghost Map is a true triumph of the kind of multidisciplinary thinking for which he's become famous-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.

The Ghost Map takes place in the summer of 1854. A devastating cholera outbreak seizes London just as it is emerging as a modern city: more than 2 million people packed into a ten-mile circumference, a hub of travel and commerce, teeming with people from all over the world, continually pushing the limits of infrastructure that's outdated as soon as it's updated. Dr. John Snow-whose ideas about contagion had been dismissed by the scientific community-is spurred to intense action when the people in his neighborhood begin dying. With enthralling suspense, Johnson chronicles Snow's day-by-day efforts, as he risks his own life to prove how the epidemic is being spread.

When he creates the map that traces the pattern of outbreak back to its source, Dr. Snow didn't just solve the most pressing medical riddle of his time. He ultimately established a precedent for the way modern city-dwellers, city planners, physicians, and public officials think about the spread of disease and the development of the modern urban environment.

The Ghost Map is an endlessly compelling and utterly gripping account of that London summer of 1854, from the microbial level to the macrourban-theory level-including, most important, the human level. [close]

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12/14/07

Kay rated it:

(review of isbn 0713999748)

bookshelves: london, medical, social-issues

Read in January, 2008

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"...more 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" 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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09/07/08

Kirsti rated it:

(review of isbn 1400102987)

bookshelves: history, nonfiction

Read in September, 2008

recommends it for: history/psychology buffs

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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2 comments

03/07/08

Croaker rated it:

Read in April, 2008

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;...more 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; 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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08/07/07

David rated it:

(review of isbn 1594482691)

bookshelves: read-in-2007

Read in November, 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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08/01/08

Jamie rated it:

Read in March, 2008

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...more 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 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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01/23/09

Brack rated it:

Read in April, 2008

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....more

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11/15/08

Sandi rated it:

(review of isbn 1594482691)

bookshelves: 2009, non-fiction

Read in February, 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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09/04/08

Sara* rated it:

bookshelves: true

Read in September, 2008

recommended to Sara* by: hunter college
recommends it for: history buffs, map lovers

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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08/05/08

Bettie (Goodreads Reader!) rated it:

bookshelves: history, plague-disease, sciences

Read in August, 2008

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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07/26/07

Max rated it:

bookshelves: science-maps-mathematics, to-read

Read in August, 2007

recommends it for: information theory buffs

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 ...more 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 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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11/25/08

Sarah rated it:

bookshelves: 2008, historical-non-fiction, medical

Read in November, 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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11/05/08

Svitlana rated it:

(review of isbn 1594482691)

Read in January, 2009

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 mo...more

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02/04/09

TJ rated it:

bookshelves: history, own

Read in February, 2009

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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03/04/09

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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12/29/07

Lynne rated it:

(review of isbn 0713999748)

bookshelves: audiobooks, history

Read in July, 2008

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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02/01/09

Daniel 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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12/10/08

Donna Holzbaur 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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12/10/08

Perryvillereference added it

bookshelves: angela, nonfiction

Read in January, 2008

“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 ...more

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06/25/09

Tassava rated it:

Read in June, 2009

This book is hard to review in that it's exactly what the jacket copy and other online reviews suggest: a cogent, informative, well-written narrative about London's 1854 cholera epidemic, which was caused by the giant city's pathetic sanitation system and ended when a brilliant scientist, John Snow, figured out that the disease was being transmitted through the (foul) water being consumed in one impoverished neighborhood. Along the way, Johnson describes the recycling economy of mid-nineteenth c...more

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06/09/09

Bruce rated it:

Read in June, 2009

In the 1850s London was a "Victorian metropolis with an Elizabethan public infrastructure." It was a monster with a life of its own. The large growth of population in the city of London was a result of natural growth, the enclosure movement, and the drinking of tea. The later because it actually cut down on disease due to the need for boiling water and the natural antiseptic qualities, including tannic acid, that it contained. At the time of the outbreak of cholera in 1853 the lear...more

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