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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.
story of a map that lies at the intersection of all those different vectors, a map created to help make sense of an experience that defied human understanding. It is also a case study in how change happens in human society,
it is an argument for seeing that terrible week as one of the defining moments in the invention of modern life.
toshers wading through the muck of low tide, dressed almost comically in flowing velveteen coats, their oversized pockets filled with stray bits of copper recovered from the water’s edge.
pure-finders eked out a living by collecting dog shit
pickers foraged for carcasses of any stripe. Below ground, in the cramped but growing network of tunnels beneath London’s streets, the sewer-hunters slogged through the flowing waste of the metropolis.
The scavengers, in other words, lived in a world of excrement and death. Dickens began his last great novel, Our Mutual Friend, with a father-daughter team of toshers stumbling across a corpse floating in the Thames, whose coins they solemnly pocket.
bone-picker from seven to nine hours to go over his rounds, during which time he travels from 20 to 30 miles with a quarter to a half hundredweight on his back.
without any central planner coordinating their actions, without any education at all, this itinerant underclass managed to conjure up an entire system for processing and sorting the waste generated by two million people.
Mayhew discovered, these people were actually performing an essential function for their community. “The removal of the refuse of a large town,” he wrote, “is, perhaps, one of the most important of social operations.” And the scavengers of Victorian London weren’t just getting rid of that refuse—they were recycling it.
We value tropical rain forests because they squander so little of the
energy supplied by the sun, thanks to their vast, interlocked system of organisms exploiting every tiny niche of the nutrient cycle. The cherished diversity of the rain-forest ecosystem is not just a quaint case of biological multiculturalism. The diversity of the system is precisely why rain forests do such a brilliant job of capturing the energy that flows through them:
If some rogue virus wiped out every single mammal on the planet, life on earth would proceed, largely unaffected by the loss. But if the bacteria disappeared overnight, all life on the planet would be extinguished within a matter of years.
late summer of 1854, as the toshers and the mud-larks and the bone collectors made their rounds, London was headed toward another, even more terrifying, battle between microbe and man. By the time it was over, it would prove as deadly as any in the city’s history.
The contents are allowed to desiccate in the open air, and they are frequently stirred for that purpose.” Mayhew described this grotesque scene in an article published in the London Morning Chronicle in 1849 that surveyed the ground zero of that year’s cholera outbreak:
London was slowly re-creating the horrific demise of Richard the Raker: it was drowning in its own filth.
shameful testimony to future ages, how civilization and barbarism walked this boastful island together.
parish was a place for those who “care more for the approval than the applause of men.” At St. Luke’s he worked as a kind of missionary to the slum dwellers of Berwick Street, and was a well-regarded and familiar figure in the tumultuous neighborhood.
A modern-day visitor time-traveling back to Victorian London wouldn’t be surprised to see horses (and, consequently, their manure) in great numbers in the city streets, but he would probably be startled to discover how many farm animals lived in densely packed neighborhoods like Golden Square. Veritable herds would stream through the city; the main livestock market at Smithfield would regularly sell 30,000 sheep
as Dickens put it at the end of Little Dorrit. But in all that turbulence, certain patterns appear, like eddies in an otherwise chaotic flow. The streets flex with the Victorian equivalent of rush hour, rising at daybreak and then subsiding with nightfall; streams of people pour into each daily service at St. Luke’s; small queues form around the busiest street vendors.
They are there for the water. — The Broad Street pump had long enjoyed a reputation as a reliable source of clean well water. It extended twenty-five feet below the surface
There is something remarkable about the minutiae of all these ordinary lives in a seemingly ordinary week persisting in the human record for almost two centuries.
Most world-historic events—great military battles, political revolutions—are self-consciously historic to the participants living through them. They act knowing that their decisions will be chronicled and dissected for decades or centuries to come. But epidemics create a kind of history from below: they can be world-changing, but the participants are almost inevitably ordinary folk, following their established routines, not thinking for a second about how their actions will be recorded for posterity.
Imagine living with that sword of Damocles hovering above your head—every stomach pain or watery stool a potential harbinger of imminent doom.
One of cholera’s distinctive curses is that its sufferers remain mentally alert until the very last stages of the disease, fully conscious both of the pain that the disease has brought them and the sudden, shocking contraction of their life expectancy. The Times had described this horrifying condition several years before in a long feature on the disease: “While the mechanism of life is suddenly arrested, the body emptied by a few rapid gushes of its serum, and reduced to a damp, dead…mass, the mind within remains untouched and clear,—shining strangely through the glazed eyes, with light
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rough mask of blue, leathery skin would have covered his face. His condition would have matched this description of William Sproat from 1831: “countenance quite shrunk, eyes sunk,
lips dark blue, as well as the skin of the lower extremities...
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days. Cholera is a species of bacterium, a microscopic organism that consists of a single cell harboring strands of DNA. Lacking the organelles and cell nuclei of the eukaryotic cells of plants and animals, bacteria are, nevertheless, more complex than viruses,
which are essentially naked strands of genetic code, incapable of surviving and replicating without having host organisms to infect. In terms of sheer numbers, bacteria are by far the most successful organisms on the planet.
two basic metabolic strategies: photosynthesis and aerobic respiration. There may be astonishing diversity in the world of multicellular life—whales and black widows and giant redwoods—but beneath all that diversity lie two fundamental options for staying alive: breathing air and capturing sunlight.
Without the metabolic innovations pioneered by bacteria, we would literally have no air to breathe.
it’s been one long Age of Bacteria on this
planet since the days of the primordial soup. The rest of us are mere afterthoughts.
in extreme cases people have been known to lose up to thirty percent of body weight in a matter of hours. (Some say that the name cholera itself derives from the Greek word for “roof gutter,” invoking the torrents of water that flow out after a rainstorm.) The expelled fluids contain flakes from the epithelial cells of the small intestine (the white particles that inspired the “rice water” description).
an accidental ingestion of a million Vibrio cholerae can produce a trillion new bacteria over the course of three or four days. The organism effectively converts the human body into a factory for multiplying itself a millionfold.
our bodies retain a genetic memory of their watery origin. Fertilization for all animals takes place in some form of water; embryos float in the womb; human blood has almost the same concentration of salts as seawater.
an infected person emits the bacteria during one of the violent bouts of diarrhea that are the disease’s trademark, and another person somehow ingests some of the bacteria, usually through drinking contaminated water. Drop it into a setting where excrement eating is a common practice, and cholera will thrive—hijacking intestine after intestine to manufacture more bacteria.
“All the world’s bacteria essentially have access to a single gene pool and hence to the adaptive mechanisms of the entire bacterial kingdom. The speed of recombination over that of mutation is superior: it could take eukaryotic organisms a million years to adjust to a change on a worldwide scale that bacteria can accommodate in a few years.”
better strategy is to pursue a low-intensity attack on the human host: reproduce in smaller numbers, and keep the human alive longer, in hopes that over time some bacterial cells will find their way to another intestine, where the process can start all over again.
The Londoner enjoying his new water closet or his expensive private water supply from the Southwark Water Company was not just engineering his private life to make it more convenient and luxurious. He was also, unwittingly, reengineering the DNA of V. cholerae with his actions. He was making it into a more efficient killer.
The tragic irony of cholera is that the disease has a shockingly sensible and low-tech cure: water. Cholera victims who are given water and electrolytes via intravenous and oral therapies reliably survive the illness,
It occurred to Whitehead that, contrary to the prevailing wisdom, the sanitary conditions of the homes seemed to have no predictive power where the disease was concerned.
That scrutiny itself relied on his firsthand knowledge of the neighborhood and its residents. He detected these early patterns
Snow’s mastery of ether and chloroform raised him to a new echelon in the London medical world. He became the most sought-after anesthesiologist in the city, assisting with hundreds of operations a year. By the 1850s, a growing number of doctors were recommending chloroform as a palliative for the discomfort of childbirth. As the birth of her eighth child approached in the spring of 1853, Queen Victoria decided to give chloroform a try,
Snow’s research into anesthesia had elevated him from a surgeon of humble origins to the very apogee of Victorian London. But, in a way, the most impressive thing about his research was not the levels of social class that he traversed but rather the intellectual strata, the different scales of experience that his mind crossed so effortlessly.
You could be in the same room with a patient near death and emerge unscathed. But, somehow, you could avoid direct contact altogether with the infected person and yet still be seized with the cholera, simply because you lived in the same neighborhood. Snow grasped that solving the mystery of cholera would lie in reconciling these two seemingly contradictory facts.
caused by some as-yet-unidentified agent that victims ingested, either through direct contact with the waste matter of other sufferers or, more likely, through drinking water that had been contaminated with that waste matter. Cholera was contagious, yes, but not in the way smallpox was contagious. Sanitary conditions were crucial to fighting the disease,
The Thomas Street outbreak showcased Snow’s on-the-ground investigative skills, his eye for the details of transmission patterns, sanitary habits, even architecture. But Snow also surveyed the outbreak from the bird’s-eye view of citywide statistics. During his research, Snow had amassed an archive of information about the various companies that supplied water to the city, and that study had revealed a striking fact: that Londoners living south of the Thames were far more likely to drink water that had originated in the river as it passed through Central London.
the cholera seemed to segment itself around shared water supplies.
“Dr. Snow deserves the thanks of the profession for endeavouring to solve the mystery of the communication of cholera,” a reviewer wrote in the London Medical Gazette.
