Abstract
A new book plunges the reader into a Victorian urban nightmare, charting in novelistic fashion the 1854 cholera epidemic, finds Wendy Moore
The story of cholera is as much the story of human waste and its disposal as the discovery and defeat of a disease. It is fitting, therefore, that Steven Johnson's book The Ghost Map opens with a gripping description of the army of scavengers that once roamed London to rummage through the rubbish and detritus the city's dwellers left behind.
Recreating this Dickensian world of “excrement and death,” Johnson describes the toshers who scoured the river for saleable metal, the mudlarks who salvaged the rubbish even the toshers discarded, the night soil men who emptied household cesspits in the hours of darkness, and the “pure finders” who possessed perhaps the least enviable job of all—collecting dog excrement for use in the leather tanning industry.
From this headlong plunge into the Victorian urban nightmare, where dirt and disease worked a profitable partnership, Johnson unrolls the story of the 1854 cholera epidemic, which led the physician and anaesthetist John Snow to solve the mystery of how cholera was spread.
The story of Snow's dogged determination to link the cholera outbreak centred on Golden Square with the water from the Broad Street pump is a classic narrative in the history of medicine and will be familiar to every self respecting doctor or student. Johnson retells it vividly with a day by day—almost breath by breath—account of the disease's ferocious progress through the wretched slums around Broad Street while Snow quietly and methodically worked to pin down the epidemic's cause.
Snow's calm collection of data to show that the vast majority of cholera victims had drunk from the Broad Street pump provides a brilliant and timeless example of scientific method combined with sheer hard graft. It is well known that the cholera epidemic had already peaked before Snow persuaded the parish authorities to remove the handle of the offending pump, but Johnson rightly points out that this action may well have prevented a second outbreak. The original source of the cholera Vibrio had disappeared with the death of the first victim, the Lewis baby, but when the baby's father later succumbed to the disease this could easily have unleashed a fresh epidemic.
It was not Snow but his friend and fellow campaigner the Reverend Henry Whitehead who identified Baby Lewis as the index case and pinpointed how the family's cesspool had leaked into the Broad Street well, and this fact is rightfully given prominence—though not, as Johnson says, for the first time.
Recreating the stench and oppressive heat of the vile Victorian summer of 1854 in novelistic style, Johnson's tale generally makes compelling reading, although his diversions into the development of cities, fear of terrorism, and significance of the internet occasionally detract. Like the noxious River Thames of Snow's era, the story is mostly fast moving, occasionally meandering, and sometimes finds itself lost up a creek.
Some of these off-course wanderings provide thought provoking insights. The fact that part of Victorian Soho was more densely populated than modern Manhattan, for all its skyscrapers, gives a poignant perspective to the reality of 19th century overcrowding, for example.
However, Johnson can be fanciful and self indulgent. His rallying call to trust in science and invest in public health infrastructure as our best bet for human survival is well argued and welcome—but do we need to know that “My wife and I are passionately committed to the idea of raising our kids in an urban environment”?
More seriously, Johnson, whose last book was the bestselling Everything Bad is Good for You, overplays the Broad Street story to the extent that it becomes almost meaningless. The partnership of Snow and Whitehead in applying cold hard logic to solve a public health disaster of appalling scale—while working sensitively with their local community—stands for all time as a powerful example of scientific triumph. To overegg that by arguing that the pair “helped make possible” a planet of cities, or that Broad Street marked “the emergence of a metropolitan culture,” is unnecessary and unhelpful. After all it was Edwin Chadwick, civil servant and relentless miasmatist, believing disease emanated from smells, who championed the building of sewers; and it was the “Great Stink” of 1858 that pushed parliament into ensuring sewage did not enter the Thames above tidal reaches, before Snow's evidence of waterborne transmission had been fully accepted.
Investing John Snow's accomplishment with false importance serves only to undermine its genuine significance. By the end of the book it seems that Johnson has so thoroughly mined the Broad Street story that the ground beneath it is barren—or the well has run dry.
Ultimately it is unclear what The Ghost Map adds to the body of literature on John Snow. Better researched popular narratives have already been published—all the “primary” sources Johnson cites on Snow's life are actually secondary sources. Vast amounts of academic commentary and theory already exist. Attempting to combine the two seems to satisfy the interests of neither.
Johnson retells the story vividly with a day by day—almost breath by breath—account of the disease's ferocious progress through the wretched slums around Broad Street