When I picked up Johnson’s book, I knew nothing about Cholera. Sure I’d heard the name, but I didn’t know what a plague it was, during the 19th century.
Johnson’s book is at once a thriller, of the deadly progress of the disease. But in that story, we learn of the squalor inhabitants of victorian england endured, before public works & sanitation. We learn of architecture & city planning, statistics & how epidemiology was born. The evidence is weaved together with map making, the study of pandemics, information design, environmentalism & modern crisis management.
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“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. In a city like Victorian London, unchallenged by military threats and bursting with new forms of capital and energy, microbes were the primary force reigning in the city’s otherwise runaway growth, precisely because London had offered Vibrio cholerae (not to mention countless other species of bacterium) precisely what it had offered stock-brokers and coffee-house proprietors and sewer-hunters: a whole new way of making a living.”
1. Scientific pollination
John Snow was the investigator who solved the riddle. He didn’t believe that putrid smells carried disease, the miasma theory prevailing of the day.
“Part of what made Snow’s map groundbreaking was the fact that it wedded state-of-the-art information design to a scientifically valid theory of cholera’s transmission. “
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2. Public health by another name
“The first defining act of a modern, centralized public health authority was to poison an entire urban population”
Although they didn’t know it at the time, the dumping of waste water directly into the Thames river was in fact poisoning people & wildlife in the surrounding areas.
In large part the establishment was blinded by it’s belief in miasma, the theory that disease was originated from bad smells & thus traveled through the air.
3. A Generalist saves the day
The interesting thing about John Snow was how much of a generalist he really was. Because of this he was able to see thing across disciplines that others of the time were not able to see.
“Snow himself was a kind of one-man coffeehouse: one of the primary reasons he was able to cut through the fog of miasma was his multi-disciplinary approach, as a practicing physician, mapmaker, inventor, chemist, demographer & medical detective”
4. Enabling the growth of modern cities
The discovery of the cause of Cholera prompted the city of London to a huge public works project, to build sewers that would flush waste water out to sea. Truly, it was this discovery and it’s solution that has enabled much of the population densities we see in the 21st century. Without modern sanitation, 20 million plus cities would certainly not be possible.
5. Bird Flu & modern crisis management
In recent years we have seen public health officials around the world push for Thai poultry workers to get their flu shots. Why? Because although avian flu only spreads from animal to humans now, were it to encounter a person who had our run-of-the-mill flu, it could quickly learn to move human to human.
All these disciplines of science, epidemiology and so forth direct decisions we make today. And much of that is informed by what Snow pioneered with the study of cholera.