After John Snow explained his connection between the pump on Broad St and the cholera deaths in the surrounding area, and sufficiently convinced city planners that something dangerous was lurking in the waters, the pump was closed. After closing the well, and thereby removing a serious point of contamination, the epidemic began to slow down in the area affected by the well. Johnson notes the reaction by the Globe.

The Globe published an upbeat—and typically miasmatic—account of the present state of the neighborhood: “Owing to the favorable change in weather, the pestilence which has raged with such frightful severity in this district has abated…(131).”

Reading this made me think of the vaccine scare, and the way news media hyped reports from angry parents who wanted to connect their children’s autism to some palpable causative factor, even though none of the evidence was there. In the case of the Globe’s story, they were likely well aware that a significant change in the neighborhood was the closing of pump. The pump was an important landmark and known for its quality water, and closing it inconvenienced a fair number of people. However the Globe chose to write a story appealing to what people already think, that is, that weather patterns, smells, and air born “humors” somehow cause diseases. This made me think of the vaccine issue, because despite the fact that there has been as far as I know zero proof that vaccines cause autism—and it has been established by researchers that a connecting factor among those babies who have autism and were vaccinated is that they were formula fed, which is much more likely to be related—the concept of autism from vaccines is still in the vernacular. And some publications reported on the issue despite the entire lack of evidence, and only further perpetrated the concept, as with the Globe and the miasma theory.

-Jesse Geisler

“62 percent of all recorded deaths were of children under five. And yet despite this alarming mortality rate, the population was expanding at an extraordinary clip (74).”

I sampled this quote, because it is indicative of an interesting mistake I think people make in talking about lifespan in pre-antibiotic times.  People often state that the average lifespan during medieval into industrial revolution times was around 30 years, or something like that. However as we can see from Johnson’s quote, the majority of deaths from this disease, and in general mortalities altogether, afflict those under the age of five. This means that because there were so many infant deaths at that time, when you calculate the average lifespan the age is vastly reduced because the young deaths of babies offset the statistic. In actuality, if you survived past five, many people enjoyed healthy lives into their 50s and 60s.

The observations regarding beer—that those who avoided water and stuck to fermented beverages seemed to dodge the affliction—was also interesting. This research, while I am sure is accurate, contradicts to an extent findings that other researchers into cholera in London—such as Friederich Engels—found. He found a higher correlation between alcoholics and deaths from cholera. Researchers today have since connected the correlation between alcoholics and susceptibility to certain infections of the gut to the fact that regular excessive consumption of alcohol significantly changes the PH values of your stomach, making conditions of life more favorable for some bacteria. I guess the conclusion I would draw from Snow’s observation that some beer drinkers seemed protected from the disease is that they likely were protected if they stuck strictly to beer and beer only. Because if they had any exposure to the bacteria, even a dispersed and non concentrated sample, the PH conditions in their stomach likely would lead to rapid bacterial growth and their progression of symptoms from cholera would occur at perhaps a higher rate then other individuals.

-Jesse Geisler

I appreciated Johnson’s opening to the chapter, with his focus on recycling. London at that time, a city of two million people, had none of the public infrastructure, services, or works we today take for granted. Instead there arose a whole class of different gatherers, scavengers, and waste collectors, operating out of necessity, who scooped up items that alone represented little value but when collected and sold by the pound could return enough for someone to live on. The entrepreneurial spirit (or spirit of desperation) of these unemployed and desperately poor Londoners kept the city cleaner and more efficient then had economic conditions not forced people to eek out a dirty, grueling, dangerous existence collecting and retailing society’s garbage. I though Johnson’s segway from waste recycling at a societal level to recycling at a biological or chemical level a fairly clever way of highlighting the importance of utilizing waste: to do so is a basic function of most successful organisms.

“All nucleated organisms generate calcium as an excess waste product. Since at least the Cambrian times, organisms have accumulated these calcium reserves, and put them to good use: building shells, teeth, skeletons. Your ability to walk upright is due to evolution’s knack for recycling its toxic waste (16).”

Johnson then goes on to note that regardless of the reasons for a population’s density, (London’s population explosion can be attributed to the industrial revolution, whereas humanity’s first confrontation with population explosion, waste management, and disease came during transitions from hunter gatherer to agricultural based societies) without efficient forms of recycling, these forms of life cannot survive long (18).

Johnson also provided an example of how economic realities affected disease control and general cleanliness in the city. Despite the actions of the various waste collectors in London, the city was still filthy. However cesspools and latrines, those cleaned by “night soilers” were somewhat maintained given that the pay was high enough (night soilers would sell the human excrement to farmers outside the city) for many people to engage in the profession. However Johnson notes that as the city expanded, it became increasingly expensive to transport the waste outside the city walls to farms, meaning that the cost for cleaning each cesspit became unaffordable for many families. This is an economic reality, given that the factors of production (transport) had become more expensive, however it had the disastrous effect of allowing disgusting amounts of waste to accumulate, and disease causing bacterial populations to flourish.

The discussion of cholera, and the terror and devastation it caused, is relevant because despite the fact that today with have a significant amount of knowledge about the mechanics and operations of pathogens in our environment, there are massive frontiers of knowledge we have yet to discover. Reading about the dangerous beliefs in London at that time, such as that if water looked clean to the eye it had to be pure, or that disease is the result of moral failings, it prompts one to question how much of our knowledge is truly as factual as we would like it to be.

One thing that bothered me in the reading however, was this little gem of a quote, “to this day, the Netherlands has the highest population density of any country in the world” (16). I immediately questioned the validity of this assertion. How could a country like the Netherlands, a wealthy, highly stable, European country, with an aging population and declining birth rate, rival the population density of say, Bangladesh? When I looked up population density by country, not a single website had Netherlands in even the top ten. Although this doesn’t discredit Steven Johnson’s work, it does to an extent draw doubt to the validity of some of the data he raises, and leads one to believe that he may embellish generously so as to prove a point.

-Jesse Geisler

After reading the ending of the Ghost Map, I was able to acquire a better understanding of the role Whitehead had in the cholera epidemic in London. A seemingly small person in society had an outstanding impact on the future of an enormous city. Henry Whitehead had sought out an investigation of Snow’s waterborne theory in an attempt to disprove it. Whitehead had a clear edge over Snow in his investigation because Whitehead had a comprehensive background of the neighborhood as a whole. He was able to gather information on citizens who used to live in Soho and moved out as a result of the epidemic. Whitehead was able to conclusively determine that the Lewis baby was the first case of the cholera outbreak.

When reflecting upon this, I realized the importance of knowing your patients and surroundings well. One can even argue that Whitehead’s role in containing the cholera outbreak was just as important as Snow’s role. Without Whitehead, the true source of the cholera outbreak would have possibly never been determined. This eventually led to the construction of a proper sewage system and prevented another outbreak of cholera. The ending of the novel was very chilling in that the author made a reference to another possibility of a cholera outbreak emanating from the Lewis household; a kind of cyclic ending, I would suppose.

So my question is how would London react to the Cholera outbreak if indeed it were to occur like the author foreshadowed in the last few lines of the novel?

In our age, tea and beer are considered by some to be staple, ordinary beverages and the remarkable impact of these beverages on early civilization is often overlooked. Brewed tea supposedly contributed to London’s population growth by providing a source of sterile water that helped to ward off waterborne disease. The popularity of tea in the general population helped to prevent dysentery and child mortality. Beer served a similar role in an earlier period by providing a liquid which was free from pathogens. The author states that “it is a great testimony to the connectedness of life on earth that the fates of the largest and the tiniest life should be so closely dependent on each other.” These two beverages alone have forever altered the civilization genetically and socially. One can only wonder what other foods and beverages that we consider to be ordinary staples today, have had huge impacts on the development of modern society.

I found it interesting how Snow seemed to be the only one in London at that time who was able to think out of the box and see that the miasma theory wasn’t correct. It wasn’t even like all this happened over a couple of days. Snow had already been trying to figure out what the problem was for more then a year yet people were still stuck on the miasma theory after all that time. It obviously wasn’t the problem if more people were dying even with their attempts to clear the air. I would think people would realize their water system was contaminated even if it wasn’t visible to the human eye since their city was practically filled with waste. You would think scientists would try a new theory once they realized nothing was changing.

As we read about Snow, I find his dilligence commendable. He found something he thought was wrong and went through with it even though the whole city didn’t believe him at that time. It’s also interesting to see how a city goes through changes during times like these. With the outbreak, they finally realized they needed a better sewage system instead of keeping all their waste. Because I live in such a modern time now, it’s hard for me to imagine for people to be okay with there being waste everywhere. Now people complain if they see a couple piece on the sidewalk let alone fecal matter everywhere. I wouldn’t want to leave my house if that’s what my streets looked like.

“The sewers were killing people because of what they did to the water, not the air” (Ghost Map 82).

I keep thinking about how people did not realize that the disease was not air born. The miasma theory was held to such a high regard that the top physicians and nurses stood stubbornly by it. Timing was important at this time period and even though there was a great deal of evidence against the miasma theory, many people still did not believe. An Italian scientist in the University of Florence even identified the cholera species; Snow realized that the Lambeth inhabitants were not dying,

Yet, the streets were still coated with chloride of lime and bleach to get rid of bad stench, Chadwick made many decisions that brought death to thousands of people,  Nightingale promoted fresh clean air, and the rich were considered to be in better “health standings” than the poor.

It’s interesting to see how officials did not believe Snow’s theory that there was something wrong with the water. This is probably because it was much easier to believe in an old theory than to deal with a new one. The miasma theory was simple and it was easier to believe because it was more “tangible” at the time. You can smell bad air but you cannot taste anything wrong in the water. If for example, the water smelled, looked, or even tasted different, then people may have had an easier time believing in cholera. Finally, Ghost Map talks about how the miasma theory was an ancient theory, which dated back to Hippocrates and the Greeks, and so well embedded in the minds of Londoners in the 1800s.