The Song of the Cell: An Exploration of Medicine and the New Human

by Siddhartha Mukherjee

Early health reformers thus concentrated on sanitary reform and public hygiene to prevent and cure illness. They dug sewage systems to dispense waste, or opened ventilation ducts in homes and factories to prevent the contagious fog of miasmata from accumulating indoors. The theory seemed to be fogged by an indisputable logic. Many cities, undergoing rapid industrialization and unable to deal with the influx of wageworkers and their families, were malodorous arenas of smog and sewage—and disease seemed to track the worst-smelling, most populated areas. Resurgent waves of cholera and typhus stalked the poorer parts of London and its vicinities, such as the East End (now glistening with shops and restaurants selling high-end linen aprons and expensive bottles of single-distillery gin). Syphilis and tuberculosis were rampant. Childbirth was a terrifying event, with a distinct likelihood of ending not in birth but in death—of the infant, the mother, or both. In the wealthier parts of town, where the air was clean, and sewage adequately discarded, health prevailed, while the poor, who lived in miasma-filled areas, inevitably succumbed to illness. If cleanliness was the secret to health, then disease must be a condition of uncleanliness or contamination.