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Description
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and commerce, teeming with people from all over the world, continually pushing the limits of infrastructure that's outdated as soon as it's updated.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.… (more)
User reviews
LibraryThing member fundevogel
"It's true enough that the Victorians were grappling with heady issues like utilitarianism and class conciousness. But the finest minds of the era were also devoted to an equally pressing question: What are we going to do with all this shit?"
Somewhere around chapter two I realized this is a book
Victorian London saw an insane population explosion (brought on by industrialization I believe) for which it had neither the square footage nor the infrastructure to support. With gross class disparity this meant millions of poor were packed into squalid neighborhoods basically living on top of each other. Technology had come far enough to make water closets a thing, but even if you had one they just drained to your cesspool or your basement, yard or whatever public space it encroached on if you were too cheap to have the nightsoil-men empty said cesspool. A lot of people were too cheap, or just couldn't afford it. Hell, plenty of people just emptied their filth out the window.
As you might expect this created an enviroment less romantic than you probably imagined the last time you saw or read a story placed in Victorian London. It was just really shitty. Really Shitty. And then they started dumping the waste in the Thames to try and get rid of the fetid stink...you see where this is going?
Cholera is normally a little bacterium that knocks out a humdrum existence living on plankton or something. But you introduce it to the human digestive system and it loses its mind (so to speak). Once it hits your small intestine it produces a chemical that tricks the human body into endlessly dispelling its water into the intestines while the bacterium replicates itself in the trillions. People can lose as much as 30% of their body's water in a single day. A person can go from perfectly healthy to cadverous in a day. Or dead. I'm not sure I ever heard of a disease that can tear down a human body as quickly as cholera. Thankfully because cholera has to be introduced to the digestive track one infection is unlikely to result in transmission...unless the cholera bacterium's wildest dreams comes true and it stumbles into a communtiy of humans that regularly ingest each other's fecal matter.
So non existent waste disposal + ground water = ground water you don't want to ingest
This seems obvious today, but Victorian Londoners didn't have a lot of options at their disposal and no one had a goddamn idea what caused disease anyway. Ok, they had ideas...but they were wrong. In fact the primary theory of the time, that they were caused by miasma (bad smells/air), was actually the basis for the decision to turn the Thames into a sewer (they thought it would help the smell).
So this was the situation that paved the way for London's brutal cholera epidemic. Johnson's book primarily follows two men, a scientist and a clergy man, who, initially on the ground independently with dispart theories regarding the epidemic eventually came together to uncover the source of the disease and it's means of transmision. Honestly it reads like a mystery. Without any knowedge of the existence bacteria or means of actually seeing it the two were none the less able to track it and deduct it's means if transmission with their exhaustive boot leather investigation of the neighborhood, it's inhabitants and their habits.
I've never appreciated sewers so much.
Somewhere around chapter two I realized this is a book
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about shit. And that's ok. It turns out it's something that needs addressing once you start packing enormous qualtities of people (who are very good at making shit) into a comparatively small area (like Victorian London). Victorian London saw an insane population explosion (brought on by industrialization I believe) for which it had neither the square footage nor the infrastructure to support. With gross class disparity this meant millions of poor were packed into squalid neighborhoods basically living on top of each other. Technology had come far enough to make water closets a thing, but even if you had one they just drained to your cesspool or your basement, yard or whatever public space it encroached on if you were too cheap to have the nightsoil-men empty said cesspool. A lot of people were too cheap, or just couldn't afford it. Hell, plenty of people just emptied their filth out the window.
As you might expect this created an enviroment less romantic than you probably imagined the last time you saw or read a story placed in Victorian London. It was just really shitty. Really Shitty. And then they started dumping the waste in the Thames to try and get rid of the fetid stink...you see where this is going?
Cholera is normally a little bacterium that knocks out a humdrum existence living on plankton or something. But you introduce it to the human digestive system and it loses its mind (so to speak). Once it hits your small intestine it produces a chemical that tricks the human body into endlessly dispelling its water into the intestines while the bacterium replicates itself in the trillions. People can lose as much as 30% of their body's water in a single day. A person can go from perfectly healthy to cadverous in a day. Or dead. I'm not sure I ever heard of a disease that can tear down a human body as quickly as cholera. Thankfully because cholera has to be introduced to the digestive track one infection is unlikely to result in transmission...unless the cholera bacterium's wildest dreams comes true and it stumbles into a communtiy of humans that regularly ingest each other's fecal matter.
So non existent waste disposal + ground water = ground water you don't want to ingest
This seems obvious today, but Victorian Londoners didn't have a lot of options at their disposal and no one had a goddamn idea what caused disease anyway. Ok, they had ideas...but they were wrong. In fact the primary theory of the time, that they were caused by miasma (bad smells/air), was actually the basis for the decision to turn the Thames into a sewer (they thought it would help the smell).
So this was the situation that paved the way for London's brutal cholera epidemic. Johnson's book primarily follows two men, a scientist and a clergy man, who, initially on the ground independently with dispart theories regarding the epidemic eventually came together to uncover the source of the disease and it's means of transmision. Honestly it reads like a mystery. Without any knowedge of the existence bacteria or means of actually seeing it the two were none the less able to track it and deduct it's means if transmission with their exhaustive boot leather investigation of the neighborhood, it's inhabitants and their habits.
I've never appreciated sewers so much.
Show Less
LibraryThing member GeekGoddess
“The probability of an outburst or increase during [calm, mild] weather, I believed to be heightened on holidays, Saturdays, Sundays, and any other occasions where opportunities were afforded the lower classes for dissipation and debauchery” – unattributed quote by ‘expert’ regarding how
As strange as this seems to modern eyes, this statement was backed up by scientific evidence, or at least what passed for such in England of the mid-19th century. During this time, the predominant theory for the spread of contagion and sickness was miasma (Greek for “pollution”), that is bad smells and foul air were the causes of disease.
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) is the story of Dr. John Snow and Rev. Henry Whitehead’s discovery of the water-born transmission of cholera, a disease which struck with terrifying regularity in London and other large cities. The popular folklore is that Dr. Snow plotted cases of cholera deaths on a map, and deduced that the outbreak’s source was a particular well in a poor section of London, and removed the handle to the pump, thereby halting the epidemic, and was hailed as a hero.
The true story is not nearly so neatly packaged. Dr. Snow noticed, in earlier epidemics, a pattern of isolated groups either contracting cholera in isolation, or seeing groups that were spared contagion in the middle of a raging epidemic. Using his skills and experience, he correctly deduced that water somehow carried the source of the disease (although he had no idea about germ theory), and managed to track the common source to the water well located on Broad Street, in the area now known as Soho. Although he was unable to find anything in the water that could be the source of the disease (in fact, other wells had cloudy or smelly water, but no pattern of contagion). Over a period of months, however, he was unable to convince the health boards and community groups of his findings, because it was commonly known that bad smells were the source of disease, and indeed this had been known for centuries. This belief was continually reinforced because the most stricken areas, such as Broad Street, also happened to be the dirtiest and most fetid location in London. The scientists of the day could confirm their views by taking an (admittedly short) stroll through the impacted areas.
London grew from a city of a few hundred thousand to over 2 million in a matter of decades. Before the growth, most human waste was collected and carried to the surrounding farmland for fertilizer. However, with the rapid grow and expansion of the city limits, the feasibility and cost to remove ‘night soil’ became too expensive for the poor, and so the waste collected in the cesspools under the houses and in open pits in the alleys and yards. What few sewage systems existed dumped the untreated water directly into the Thames. The invention of the water closet increased the problem, since the additional water used for flushing ended up in the same overflowing pits. London was drowning in human waste, and it was commonly believed that the city would eventually perish under its mountain of refuse. And, common ‘scientific’ belief was that since the worst situation, and the worst smells, existed in the poorest neighborhoods, as did the greatest incidences of disease, crime, and death, the poor somehow brought it upon themselves, hence the quotation at the beginning of this article.
Dr. Snow eventually persuaded the local council to remove the pump handle, but by this time, new cases of cholera (and the original index source of the outbreak) had moved on. The councils were not, however, persuaded of the validity of their belief in miasma. In fact, Dr. Snow’s views were openly mocked on the pages of The Lancet and the newspapers of the day. How did they explain that in some cases, some members of a family died while other survived, while supposedly breathing the same foul air? Or that one household might entirely succumb while their immediate neighbors, who shared a yard, might all survive? The Victorians concluded, based on their understanding of the evidence, was that a person’s inherent constitution and moral character could be protective. Reverend Whitehead, who served as the local vicar and knew nearly all of the people of the Broad Street area on a first-name basis, initially scoffed at Dr. Snow’s hypothesis, as well, but became intrigued and finally assisted Dr. Snow’s data collection efforts when he realized that the ‘constitution and moral character’ of the individuals succumbing to cholera did not necessarily jive with the mortality cases. He also helped Dr. Snow track down and tabulated cases of cholera among ‘the better sort’ of people who no longer lived in the Broad Street area but may have partaken of the well’s water during a visit. He was also impressed that the entire population of a workhouse (the Victorians’ favorite scapegoat) survived the outbreak, as did all of the workers at a particular brewery, who were paid in product and never drank water.
In the end, it was not an epiphany that led Dr. Snow to his breakthrough, but years of plodding, shoe leather, tedious tabulation of victims, and his now-famous map, that convinced the skeptics of his claim. It was nearly 10 years after the outbreak before Dr. Snow’s discovery was finally accepted by mainstream scientists and politicians, and it was shortly after that that London finally embarked on the ambitious plan to install both sewer collection systems and to supply filtered water to the population of London. The last cholera outbreak was in 1866, shortly before the completion of the system. London’s example served as a model for the other great cities of the world.
Dr. Snow and Rev. Whitehead’s true legacies are not that they stopped cholera epidemics, but that they introduced a multidisciplinary approach in thinking about medical and scientific problems, and moderized the methods of scientific inquiry.
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cholera disproportionally attacks the poor and other social underclasses, in Victorian London. As strange as this seems to modern eyes, this statement was backed up by scientific evidence, or at least what passed for such in England of the mid-19th century. During this time, the predominant theory for the spread of contagion and sickness was miasma (Greek for “pollution”), that is bad smells and foul air were the causes of disease.
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) is the story of Dr. John Snow and Rev. Henry Whitehead’s discovery of the water-born transmission of cholera, a disease which struck with terrifying regularity in London and other large cities. The popular folklore is that Dr. Snow plotted cases of cholera deaths on a map, and deduced that the outbreak’s source was a particular well in a poor section of London, and removed the handle to the pump, thereby halting the epidemic, and was hailed as a hero.
The true story is not nearly so neatly packaged. Dr. Snow noticed, in earlier epidemics, a pattern of isolated groups either contracting cholera in isolation, or seeing groups that were spared contagion in the middle of a raging epidemic. Using his skills and experience, he correctly deduced that water somehow carried the source of the disease (although he had no idea about germ theory), and managed to track the common source to the water well located on Broad Street, in the area now known as Soho. Although he was unable to find anything in the water that could be the source of the disease (in fact, other wells had cloudy or smelly water, but no pattern of contagion). Over a period of months, however, he was unable to convince the health boards and community groups of his findings, because it was commonly known that bad smells were the source of disease, and indeed this had been known for centuries. This belief was continually reinforced because the most stricken areas, such as Broad Street, also happened to be the dirtiest and most fetid location in London. The scientists of the day could confirm their views by taking an (admittedly short) stroll through the impacted areas.
London grew from a city of a few hundred thousand to over 2 million in a matter of decades. Before the growth, most human waste was collected and carried to the surrounding farmland for fertilizer. However, with the rapid grow and expansion of the city limits, the feasibility and cost to remove ‘night soil’ became too expensive for the poor, and so the waste collected in the cesspools under the houses and in open pits in the alleys and yards. What few sewage systems existed dumped the untreated water directly into the Thames. The invention of the water closet increased the problem, since the additional water used for flushing ended up in the same overflowing pits. London was drowning in human waste, and it was commonly believed that the city would eventually perish under its mountain of refuse. And, common ‘scientific’ belief was that since the worst situation, and the worst smells, existed in the poorest neighborhoods, as did the greatest incidences of disease, crime, and death, the poor somehow brought it upon themselves, hence the quotation at the beginning of this article.
Dr. Snow eventually persuaded the local council to remove the pump handle, but by this time, new cases of cholera (and the original index source of the outbreak) had moved on. The councils were not, however, persuaded of the validity of their belief in miasma. In fact, Dr. Snow’s views were openly mocked on the pages of The Lancet and the newspapers of the day. How did they explain that in some cases, some members of a family died while other survived, while supposedly breathing the same foul air? Or that one household might entirely succumb while their immediate neighbors, who shared a yard, might all survive? The Victorians concluded, based on their understanding of the evidence, was that a person’s inherent constitution and moral character could be protective. Reverend Whitehead, who served as the local vicar and knew nearly all of the people of the Broad Street area on a first-name basis, initially scoffed at Dr. Snow’s hypothesis, as well, but became intrigued and finally assisted Dr. Snow’s data collection efforts when he realized that the ‘constitution and moral character’ of the individuals succumbing to cholera did not necessarily jive with the mortality cases. He also helped Dr. Snow track down and tabulated cases of cholera among ‘the better sort’ of people who no longer lived in the Broad Street area but may have partaken of the well’s water during a visit. He was also impressed that the entire population of a workhouse (the Victorians’ favorite scapegoat) survived the outbreak, as did all of the workers at a particular brewery, who were paid in product and never drank water.
In the end, it was not an epiphany that led Dr. Snow to his breakthrough, but years of plodding, shoe leather, tedious tabulation of victims, and his now-famous map, that convinced the skeptics of his claim. It was nearly 10 years after the outbreak before Dr. Snow’s discovery was finally accepted by mainstream scientists and politicians, and it was shortly after that that London finally embarked on the ambitious plan to install both sewer collection systems and to supply filtered water to the population of London. The last cholera outbreak was in 1866, shortly before the completion of the system. London’s example served as a model for the other great cities of the world.
Dr. Snow and Rev. Whitehead’s true legacies are not that they stopped cholera epidemics, but that they introduced a multidisciplinary approach in thinking about medical and scientific problems, and moderized the methods of scientific inquiry.
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LibraryThing member lyzadanger
Taut and engrossing, Steven Johnson's 'The Ghost Map' is a rollicking multidisciplinary romp through Victorian London's scientific, cultural and medical evolution. Johnson's focal point is a devastating--indeed, decimating--1854 cholera outbreak in Soho, which becomes a crucible of the nascent
Johnson paints a picture of early Victorian London as a place of quack doctors, scientific misunderstanding and cultural prejudice. Indeed, outbreaks of cholera and other infectious diseases were seen as wafting in on waves of the city's stench--miasmas--and affecting mostly those of 'lesser quality', the vast masses of urban poor living in crowded squalor cheek-by-jowl with open sewers.
By contrast, our hero, sleuth-doctor-researcher John Snow, is turning the medical community on its ear by suggesting that cholera might be, somehow, 'in the water.' His detective work is aided by a surprising sidekick, local clergyman Henry Whitehead. It is, as you might imagine, an uphill battle to topple what is presumed as medical fact: things that smell bad make you sick.
Johnson's attention rarely seems to wander, and the momentum of the story is nearly unrelenting. He takes crisp, intriguing side trips into related subjects, but consistently keeps his eye on the ball. As a result, the book is an absolute page-turner. He even manages to describe the deplorable sanitary conditions of 19th century London without sounding like he's trying for shock value--a real skill.
Highly recommended.
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field of epidemiology and highlights the stark changes in science throughout the mid-19th century. Johnson paints a picture of early Victorian London as a place of quack doctors, scientific misunderstanding and cultural prejudice. Indeed, outbreaks of cholera and other infectious diseases were seen as wafting in on waves of the city's stench--miasmas--and affecting mostly those of 'lesser quality', the vast masses of urban poor living in crowded squalor cheek-by-jowl with open sewers.
By contrast, our hero, sleuth-doctor-researcher John Snow, is turning the medical community on its ear by suggesting that cholera might be, somehow, 'in the water.' His detective work is aided by a surprising sidekick, local clergyman Henry Whitehead. It is, as you might imagine, an uphill battle to topple what is presumed as medical fact: things that smell bad make you sick.
Johnson's attention rarely seems to wander, and the momentum of the story is nearly unrelenting. He takes crisp, intriguing side trips into related subjects, but consistently keeps his eye on the ball. As a result, the book is an absolute page-turner. He even manages to describe the deplorable sanitary conditions of 19th century London without sounding like he's trying for shock value--a real skill.
Highly recommended.
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LibraryThing member lizaboo
Oddly, I felt it needed more maps.
LibraryThing member atheist_goat
The first half, with its history and science, is extremely interesting. The second half devolves into a fawning and self-congratulatory tribute to city life and New York City in particular. I wanted to read about cholera in London in the nineteenth century, Steve, not how smug you are about not
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needing a car. Show Less
LibraryThing member sjmccreary
This is mostly a fascinating look at the London cholera outbreak of 1854 and the efforts of 2 men to discover the true cause of the epidemic. At that time, and for many years afterwards, most people believed that disease was caused by miasma - bad smells. Years before any knowledge of germs, there
Near the end of the book, however, he veers off onto a tangent about the development of urban communities in current times and the ways that "mapping" is being developed and used in unconventional ways. If this is interesting to you, then keep reading by all means. If you are waiting for him to come back around to 19th century London and wrap everything up, then feel free to stop reading at any time. He never does. These last two chapters (labelled as "conclusion" and "epilogue") very nearly spoiled the entire book for me. I had to think about it for a day, but I realized that I still enjoyed the first 7 chapters more than I hated the last 2.
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were still a few who questioned the miasma theory. Nor did they believe that susceptibility to disease was a result of social or economic class or fortitude, as were also common. Johnson walks us through the steps taken to identify and prove that cholera was caused by contaminated water. And follows that up with the progress taken by London, and other cities, to improve sanitation in the last half of the 19th century to the point where cholera is virtually unheard of in modern urban areas. Near the end of the book, however, he veers off onto a tangent about the development of urban communities in current times and the ways that "mapping" is being developed and used in unconventional ways. If this is interesting to you, then keep reading by all means. If you are waiting for him to come back around to 19th century London and wrap everything up, then feel free to stop reading at any time. He never does. These last two chapters (labelled as "conclusion" and "epilogue") very nearly spoiled the entire book for me. I had to think about it for a day, but I realized that I still enjoyed the first 7 chapters more than I hated the last 2.
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LibraryThing member magicians_nephew
[The Ghost Map] is so many of my favorite kinds of books rolled up into one.
It’s a history book – a mystery story – and a fascinating character study – in one book. How can you miss?
We are introduced to one Dr. John Snow a man who made his reputation on the correct medical use of
His descriptions of his early research are charming. He would set up a clock, dose himself with ten drops of the chloroform, and thump! his head would hit the table. Then he would wake up, note the time, and try twenty drops and resume.
But he really came into his own when the cholera hit London. This was in the 1840’s and nobody even knew what caused cholera – except that you got massive uncontrollable diarrhea and died usually by dehydration within 48 hours.
Dr. Snow’s methodology was unique – he created a map of the deaths in London a “Ghost Map” and then looked at the map to see why some people died and some people didn’t.
And in the end (spoiler alert) he determined the disease vector and solved the case.
The author Stephen Johnson is a good writer and he makes the story live. (He did a nice little tome about Priestly and the discover of oxygen too)
Well done.
It’s a history book – a mystery story – and a fascinating character study – in one book. How can you miss?
We are introduced to one Dr. John Snow a man who made his reputation on the correct medical use of
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chloroform as an anesthetic during surgery. His descriptions of his early research are charming. He would set up a clock, dose himself with ten drops of the chloroform, and thump! his head would hit the table. Then he would wake up, note the time, and try twenty drops and resume.
But he really came into his own when the cholera hit London. This was in the 1840’s and nobody even knew what caused cholera – except that you got massive uncontrollable diarrhea and died usually by dehydration within 48 hours.
Dr. Snow’s methodology was unique – he created a map of the deaths in London a “Ghost Map” and then looked at the map to see why some people died and some people didn’t.
And in the end (spoiler alert) he determined the disease vector and solved the case.
The author Stephen Johnson is a good writer and he makes the story live. (He did a nice little tome about Priestly and the discover of oxygen too)
Well done.
Show Less
LibraryThing member argyriou
Interesting piece of the history of science. The author depicts life in Victorian London terrifyingly well, and sketches his portraits of the important characters quite well. However,the epilogue was not worth reading - it meanders and speculates in a way which weakens the book overall.
LibraryThing member Othemts
This book explores the ideas of urbanism, epidemiology, and social networks through the lens of the 1854 Broad Street cholera outbreak in the Soho district of London. Dr. John Snow, with the help of Reverend Henry Whitehead, created a map of where people infected with cholera lived and drew their
Johnson details how the evolutionary response to putrefaction and vile odors made such beliefs plausible, but practices such as "cleaning up" the city by deliberately washing waste into the water inadvertently caused infections to increase. Johnson also depicts the urban environment as a unique battleground for humans and microorganisms. All in all this is a fascinating account of an historic account, with broader implications for how we live today and into the future.
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water to trace the infection to a water pump on Broad Street. That Snow and Whitehead knew the neighborhood and its people well proved advantageous in creating the connections needed to document the spread of disease. Snow also had to fight an uphill battle against the prevailing scientific belief that diseases like cholera were spread through the air, known as the miasma theory. Johnson details how the evolutionary response to putrefaction and vile odors made such beliefs plausible, but practices such as "cleaning up" the city by deliberately washing waste into the water inadvertently caused infections to increase. Johnson also depicts the urban environment as a unique battleground for humans and microorganisms. All in all this is a fascinating account of an historic account, with broader implications for how we live today and into the future.
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LibraryThing member lauralkeet
In 1854, cholera tore through a London Soho neighborhood with speed and impact far greater than previous outbreaks. Prevailing views on disease attributed the transmission of cholera to “miasma,” meaning there was something in the air, and that certain individuals would be more or less
The Ghost Map was a fascinating account of a public health situation, the state of London’s infrastructure during that era, and the ways in which even the most knowledgeable people can fail to see their limits or accept new data points. I would have preferred the book had ended with its concluding chapter focused on Victorian London, and not the epilogue. This final section leaps forward to the 21st century and discusses the rise of urban living, the internet, and public health concerns at the time of publication (2006): annual flu vaccines and the H5N1 avian flu virus. This was doomed to obsolescence from the start, and I found myself wishing the author had stuck with the history. But his final sentences are spot on:
However profound the threats are that confront us today, they are solvable, if we acknowledge the underlying problem, if we listen to science and not superstition, if we keep a channel open for dissenting voices that might actually have real answers. The global challenges that we face are not necessarily an apocalyptic crisis of capitalism or mankind’s hubris finally clashing with the balanced spirit of Gaia. We have confronted equally appalling crises before. The only question is whether we can steer around these crises without killing ten million people, or more. So let’s get on with it.
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susceptible depending on their socioeconomic class and living arrangements. These beliefs, firmly entrenched in the medical establishment, hindered the authorities’ response to the outbreak. Enter John Snow, a neighborhood physician who had been studying cholera for years. Through door-to-door canvassing and painstaking documentation, Snow developed a new theory of water-borne bacteria, and then faced the daunting task of convincing the authorities to respond accordingly. His unlikely partnership with local curate Henry Whitehead was instrumental in making the case. The Ghost Map was a fascinating account of a public health situation, the state of London’s infrastructure during that era, and the ways in which even the most knowledgeable people can fail to see their limits or accept new data points. I would have preferred the book had ended with its concluding chapter focused on Victorian London, and not the epilogue. This final section leaps forward to the 21st century and discusses the rise of urban living, the internet, and public health concerns at the time of publication (2006): annual flu vaccines and the H5N1 avian flu virus. This was doomed to obsolescence from the start, and I found myself wishing the author had stuck with the history. But his final sentences are spot on:
However profound the threats are that confront us today, they are solvable, if we acknowledge the underlying problem, if we listen to science and not superstition, if we keep a channel open for dissenting voices that might actually have real answers. The global challenges that we face are not necessarily an apocalyptic crisis of capitalism or mankind’s hubris finally clashing with the balanced spirit of Gaia. We have confronted equally appalling crises before. The only question is whether we can steer around these crises without killing ten million people, or more. So let’s get on with it.
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LibraryThing member jugglebird
While decent enough, I was generally disappointed in The Ghost Map. The story is certainly compelling and Dr. John Snow's pursuit of the early science of geoinformatics in pursuit of defeating cholera is a great story. But Johnson fails to wrap up the tale in a satisfying way, letting the final
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third of the book drag on indefinitely. Show Less
LibraryThing member sylliu
A gripping medical mystery set in Victorian London - in a city with open cesspools and dung heaps, an extremely virulent epidemic of cholera is sweeping a neighborhood near Broad Street in 1854. The prevailing scientific consensus is that cholera and sickness is spread through "miasma" or bad air
This book documents one of the first instances where modern scientific inquiry (making decisions based on empirical observations and deductions instead of superstition) resulted in a public health response. London eventually developed its underground sewer system once people realized the connection between drinking water and sewage.
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and that lower classes suffer disproportionately from contagion due to their lesser constitutions. Only John Snow, a doctor from a poor background known for his pioneering research in anesthesiology (ether & chloroform), had the insight to consider water wells as a potential source of the disease. His relentless detective work soon uncovers one well pump as the culprit. Though the authorities disbelieve him, they shut down the well. A local priest, Henry Whitehead sets out to disprove Snow's theory but is soon convinced when his extensive detective work uncovers the source of the outbreak, a baby girl whose mother tossed her dirty diaper water feet from the well. John Snow's "ghost map" which documented the deaths of each household around the well based on the time it took to walk to the well was a key piece of evidence that ultimately convinced the public.This book documents one of the first instances where modern scientific inquiry (making decisions based on empirical observations and deductions instead of superstition) resulted in a public health response. London eventually developed its underground sewer system once people realized the connection between drinking water and sewage.
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LibraryThing member mfedore
The Ghost Map tells the story of London's worst cholera epidemic and the men who worked to identify the true cause of that disease's contraction and spread. Steven Johnson described the fear and dread widespread in London as this disease devastated families in the Soho section of the city. However,
I got the sense this book could almost have been the product of a dissertation as the final chapter explored the 21st century implications and connections to the Ghost Map. Johnson made a lot of interesting points, but I didn't really feel like his conclusion connected to the historical story as well as I would have liked. It's a good book, but probably not one that I'd pick up and read again.
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I felt like the book never really established that feeling as strongly as it could have. The story of how John Snow and Henry Whitehead collaborated to use maps, anecdotal evidence, and scientific research to demonstrate that cholera was water-based and not the result of miasma was very interesting, particularly as they challenged the medical establishment of the mid-19th century.I got the sense this book could almost have been the product of a dissertation as the final chapter explored the 21st century implications and connections to the Ghost Map. Johnson made a lot of interesting points, but I didn't really feel like his conclusion connected to the historical story as well as I would have liked. It's a good book, but probably not one that I'd pick up and read again.
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LibraryThing member DevonShea5
I really enjoyed this book. Mr. Johnson seems to have a gift in making the people behind the history of the cholera epidemic actually real to the modern person. So many history books are dry and boring and just leave you thinking you just walked out of class with Ben Stein: lots of facts but
My only problem with this book was the epilogue. It was a tad bit preachy and definitely could have been left out. Other than that, the book was a great insight into the beginnings of epidemiology and modern sewer and water delivery.
Without the epilogue the book rates five stars. Skip it and be happy.
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nothing interesting. My only problem with this book was the epilogue. It was a tad bit preachy and definitely could have been left out. Other than that, the book was a great insight into the beginnings of epidemiology and modern sewer and water delivery.
Without the epilogue the book rates five stars. Skip it and be happy.
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LibraryThing member Dorritt
A well-researched exploration of how two men - one, a "gentleman scientist," the other, an observant and curious prelate - applied scientific method (a rare and misunderstood thing back in those days!) to pinpoint the source of a deadly cholera outbreak in London during the 1850s. What I liked
* A fascinating snapshot into the state of medical knowledge in the 1850s. The amount of ignorance that still remained in the field is staggering! Definitely makes you appreciate how far we've come in a relatively short time.
* Interesting discussion of how human psychology impacts (significantly) the willingness of folks to accept new scientific explanations that don't necessarily jibe with their own qualitative observations. Eerily pertinent to what's going on with climate change right now.
* An accessible account of the specific physiological impacts of cholera on the infected host; also, the precise circumstances under which the contagion is able to spread. Also very pertinent, given current ongoing outbreaks of cholera in Africa and in countries that have recently experienced mass infrastructure devastation due to natural events (tsunamis, hurricanes).
* Interesting insights into how parasites and hosts have been shaping the evolution of one another through time - including a rather fascinating argument that Europeans evolved the ability to consume quantities of alcohol - a toxic substance - because drinking alcohol afforded us the evolutionary advantage of resistance against disease-causing bacteria. Again pertinent, given growing alarm over antibiotic-resistant bacteria ... proof, if proof was needed, that bacteria and other living organisms are just as driven to survive as we are.
* A cool reflection on how visual imaging can shape and communicate data in powerful, sometimes transformative ways. We learn that our two ersatz scientists admonished local health boards in vain to make the necessary infrastructure improvements ... until one of them thought to overlay the data they had collected on a map of London, creating the "ghost map" of the title that was ultimately successful in "selling" their message. An insight we take almost for granted here in the 21st century, the era of infographics, but which was still an emerging idea back in the 1900s
What I didn't like about the book:
* The text felt "stretched" - in the words of Bilbo Baggins, "like butter scraped over too much bread." Obvious inferences were explained ad nauseum, and specific anecdotes/details were often repeated multiple times. Feel like the story could have been told just as effectively over 200 pages vs. the current 300.
* The loooong discussion of London's ecosystem, which - while moderately relevant - seems way too specific and prolonged for Johnson's avowed purpose. I got the feeling Johnson couldn't decide if he was writing a science text or a socio-economic history.
All-in-all, though, a worthy, engaging, and informative read, both as a history and as a source of insights relevant to world issues today. If we gave students this information in school, I bet no sewer infrastructure improvement ballot initiative would ever go unfunded again!
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about the book:* A fascinating snapshot into the state of medical knowledge in the 1850s. The amount of ignorance that still remained in the field is staggering! Definitely makes you appreciate how far we've come in a relatively short time.
* Interesting discussion of how human psychology impacts (significantly) the willingness of folks to accept new scientific explanations that don't necessarily jibe with their own qualitative observations. Eerily pertinent to what's going on with climate change right now.
* An accessible account of the specific physiological impacts of cholera on the infected host; also, the precise circumstances under which the contagion is able to spread. Also very pertinent, given current ongoing outbreaks of cholera in Africa and in countries that have recently experienced mass infrastructure devastation due to natural events (tsunamis, hurricanes).
* Interesting insights into how parasites and hosts have been shaping the evolution of one another through time - including a rather fascinating argument that Europeans evolved the ability to consume quantities of alcohol - a toxic substance - because drinking alcohol afforded us the evolutionary advantage of resistance against disease-causing bacteria. Again pertinent, given growing alarm over antibiotic-resistant bacteria ... proof, if proof was needed, that bacteria and other living organisms are just as driven to survive as we are.
* A cool reflection on how visual imaging can shape and communicate data in powerful, sometimes transformative ways. We learn that our two ersatz scientists admonished local health boards in vain to make the necessary infrastructure improvements ... until one of them thought to overlay the data they had collected on a map of London, creating the "ghost map" of the title that was ultimately successful in "selling" their message. An insight we take almost for granted here in the 21st century, the era of infographics, but which was still an emerging idea back in the 1900s
What I didn't like about the book:
* The text felt "stretched" - in the words of Bilbo Baggins, "like butter scraped over too much bread." Obvious inferences were explained ad nauseum, and specific anecdotes/details were often repeated multiple times. Feel like the story could have been told just as effectively over 200 pages vs. the current 300.
* The loooong discussion of London's ecosystem, which - while moderately relevant - seems way too specific and prolonged for Johnson's avowed purpose. I got the feeling Johnson couldn't decide if he was writing a science text or a socio-economic history.
All-in-all, though, a worthy, engaging, and informative read, both as a history and as a source of insights relevant to world issues today. If we gave students this information in school, I bet no sewer infrastructure improvement ballot initiative would ever go unfunded again!
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LibraryThing member labfs39
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
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 1946.
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.
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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 1946.
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.
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LibraryThing member noirem
It's the history of London in the summer of 1854, specifically the people living around the Broad Street pump in Soho, and one of the worst Cholera outbreaks in English history.
It was interesting on several levels, not the least of which being that it was well written. I hadn't known much, if
The last third of the book is an assessment of the threats that still face our society, including nuclear suit-case bombs and why we're afraid of Avian Flu. That part was interesting but incomplete. Anytime you say, "I could explain more but I recently published an article about it for Wired magazine that you can read if you're interested" you've dropped the ball. Either get permission to reproduce it in part or in whole or use your notes to write it differently for the new publication.
All in all, it's worth reading, especially if you have an interest in Victorian London, epidemiology, or the terrors or modern life.
It was interesting on several levels, not the least of which being that it was well written. I hadn't known much, if
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anything, about Cholera so I got to learn about an unfamiliar disease (it's a particularly bad case of diarrhea (as in you can lose 30% of your weight in water in less than 24 hours which basically causes massive organ failure), still being passed around slums in developing cities, which is particularly sad given that it's really easy to cure - just get lots (and lots and lots and lots) of fluids). It's also a great period piece, capturing a London neighborhood at a particular point in time and really delving into what it would have been like to live there (more people per square mile than NY today with all of it's sky-rises, your neighbors dropping dead, human excrement over-flowing everywhere). We present the Dickens Christmas Fair as an idyllic Christmas postcard, but that wasn't Dickens' world nor was it the world he was portraying in his novels: read Bleak House if you don't believe me.The last third of the book is an assessment of the threats that still face our society, including nuclear suit-case bombs and why we're afraid of Avian Flu. That part was interesting but incomplete. Anytime you say, "I could explain more but I recently published an article about it for Wired magazine that you can read if you're interested" you've dropped the ball. Either get permission to reproduce it in part or in whole or use your notes to write it differently for the new publication.
All in all, it's worth reading, especially if you have an interest in Victorian London, epidemiology, or the terrors or modern life.
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LibraryThing member et.carole
The Ghost Map was extremely interesting, for the first two thirds. The last third was rehashing some of the same points over, and over, and over again—I kept paging to the end, thinking, “this has got to be the ending, yet I have fifty pages left…” As long as he was writing about cholera,
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he was fascinating, and even the background provided in the meat of the book, thought it went far afield, was fascinating. But when Johnson went theorizing willy nilly about the challenges of the future, he has been proven vastly wrong. His urban superiority complex shows, and he misses all the connections that might be made between the virus and larger geographic and social networks. Show Less
LibraryThing member rivkat
The story of the cholera outbreak in London that, in memory, began the science of epidemiology and dealt a death blow to the theory of disease-causing “miasma.” Johnson suggests it was much more complicated than that, with “experts” and laypeople fighting and door-to-door data collection
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carried on in significant part by one amateur vital to the conclusion that cholera was spread by infection-carrying water. This was necessary because figuring out where people got their water in pre-city planning London was quite complicated. Show Less
LibraryThing member Lostshadows
I really liked most of it. The end, where the author starts talking about modern urbanization, I found a bit repetitive at times and not anywhere near as interesting.
LibraryThing member MellowOwl
An extremely well written, accessible account of the birth of the domain of public health. Johnson looks at every level of the cholera epidemic, from the microbial level to the politics of miasma theory. This depth makes in much easier to understand the importance of the containment of the Broad
The one major strike against "Ghost Map" is that its conclusion and especially its epilogue lacks the focus that makes the body of the book so successful. Johnson strays into the growth of super-cities and the impact of terrorism as a limiting factor of urban development, neither of which has anything to do with cholera or public health (except for a few words on bio-terrorism). Discussions of urban development are crucial when discussing public health, but Johnson fails to make this connection explicit. Clearly, Johnson was moved by the fear that gripped New York City after September 11th and felt a connection with the fear that gripped London during the Broad St. cholera outbreak. Regardless, this is still an excellent book whose ending begins to drift away from its thesis. Well worth reading.
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St. outbreak from a history of public health standpoint than if the book was presented without the microbial or political motivators behind the containment. Finally, "Ghost Map" is a concise read that avoids getting caught up in the minutiae of the epidemic which also adds to its accessibility.The one major strike against "Ghost Map" is that its conclusion and especially its epilogue lacks the focus that makes the body of the book so successful. Johnson strays into the growth of super-cities and the impact of terrorism as a limiting factor of urban development, neither of which has anything to do with cholera or public health (except for a few words on bio-terrorism). Discussions of urban development are crucial when discussing public health, but Johnson fails to make this connection explicit. Clearly, Johnson was moved by the fear that gripped New York City after September 11th and felt a connection with the fear that gripped London during the Broad St. cholera outbreak. Regardless, this is still an excellent book whose ending begins to drift away from its thesis. Well worth reading.
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LibraryThing member Stbalbach
I enjoyed Steven Johnson's treatment of a famous cholera epidemic in Victorian London. I was skeptical at first a book-long treatment would hold my interest, like so many non-fiction books these days which are bloated with encyclopedia tangents and hung along a thin cord of a story. But Johnson's
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narrative skills are top notch and the book works well on a number of levels. On the surface it's a Sherlockian detective story, the mystery of what is causing the cholera and how its discovered. There were times I could hear the horse hoves on cobblestone, smell rank sewers and see black pools of sewage. Johnson sets the stage throughout and is a master at providing context in an atmospheric way that turns a seemingly dry topic into a lively trip back in time. It's also literary with many references to Dickens and other period excerpts. I also liked how Johnson looked at so many aspects from the biological to the sociological to the political - he can zoom out from the very small to the very large, from the specific "micro history" to the grand "big history" and bring it all together. Overall a well crafted story that is educational and entertaining popular history. Show Less
LibraryThing member Eliz12
At times brilliant, at times tedious.
I love Johnson's writing and his account of a horrific cholera epidemic, how it was uncovered and the ramifications of that - along with all the characters involved.
The last chapter, though, one of those "and here's what it means to us today," kind of things,
When he sticks to the story, though, Johnson is one of the best writers I've ever read.
I love Johnson's writing and his account of a horrific cholera epidemic, how it was uncovered and the ramifications of that - along with all the characters involved.
The last chapter, though, one of those "and here's what it means to us today," kind of things,
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was pretty dreary. I also have no patience for the author's lectures about how some communities today still endure epidemics and how we should all be ashamed that this is true. (I don't need the author to be my teacher/parent/religious leader.)When he sticks to the story, though, Johnson is one of the best writers I've ever read.
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LibraryThing member Katya0133
I'd heard this book widely praised from a number of quarters and it deserves its reputation. My one complaint is that its conclusion and epilogue seemed to be trying to hard to reach some sort of global conclusion about city life and epidemiology, which detracted from the overall strength of the
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book as a solid case study. Show Less
LibraryThing member TerriBooks
This is a fascinating exploration of a specific outbreak of cholera in 19th century London, that the author uses as a jumping-off to all sorts of more general topics related to it. Middle of the 19th century, and the germ theory of disease had yet to appear... so why do pockets of this awful
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disease appear? I was intrigued by the idea that the real culprit -- it was spread through the drinking water -- was rejected by most, even in the face of what seems obvious evidence, because the scientists of the time "knew" that disease was spread through miasma (bad air). (How often are we blinded by what we already know?) The chain of cause and effect, the history of urban living and water supplies, and the development of a specific theory for this specific disease are told in a way that grabs attention and makes you want to keep reading. Show Less
Awards
The New York Times Notable Books of the Year (Nonfiction — 2006)