Interesting history of London (and world) epidemics in the 1800s. From the detail, it left me with the impression this was a pivotal time in western history where science and mythology truly began to diverge, at least with respect to public health.

Then came the epilogue. The author’s pro-city/anti-rural bias exploded into full flame. I stopped listening to his silliness shortly after he suggested it would be better to cram all the humans into densely populated cities - think Mumbai, Tokyo, or Hong Kong dense. Somehow, this is supposed to save the earth from devastating (and nonexistent) global climate change.

His specific example is waste-handling systems in cities vs rural areas. Yes, rural systems serve fewer people, per capita. The one thing conveniently ignored is: When rural waste systems need repair/maintenance/replacing, the cost and timing is borne by the owner. In cities, residents are at the mercy of bureaucrats who decide when to do that work and how much to spend on it. Neither system is perfect and both require trade-offs. I prefer my freedom, so I will stay in my rural community, thank you very much. ( )

Feb Book club.

To say the least, it was an interesting read. I did walk away knowing a lot more about the epidemic than I ever thought I would.

But

At the same time, I've NEVER seen so many different terms and "artistic" ways of talking about....well.... human waste. It's discussed so much in the book that the author appears to have really gotten creative with trying to use new descriptive words all they could. Some times, the terms were so outrageous I had to laugh!

I'm glad I read it. It was not a book I normally would have read (if it weren't for the book group I'm in) But, I'm glad I did read it. ( )

Quite an interesting book on the cholera epidemics in London. Made me quite thankful God put me in the age in which I live. ( )

A fascinating look at 19th century cholera epidemics on a micro and macro level. Although I respect the author's ideas about large cities at the end, I don't share his rapturous love of them, so that part was a little annoying. Also, Victorian London was gross. Really gross. And there was no anesthetic. ( )

A very informative account of the London 1850s cholera outbreak. The author presents the facts well and rounds them of with well-placed literary examples from Dickens. There are good comparatives with evolutionary biology on how a society functions.
All in all a very important book and definitely commendable. ( )

I have mixed feelings about this one. I enjoyed the first part of the book, for the most part, when he was just talking history. Toward the end, and after the original source of the disease was revealed, it took an eye-rolling turn. I wish I would have just stopped after the history and skipped the global warming, fear mongering, and treatise on cities = good; country = ignorant people who can't stop having kids. (Dear author, I live in Arkansas by choice and am from Oregon by birth. I have 9 children. I'm also really smart. Sorry I don't fit your narrative.)

The author is a preachy humanist/environmentalist/atheist annoying pain in the &%#%@# so it's hard to take some of his future solution ideas very seriously. Just give me the facts...let me figure out my own response to them.

Hillbilly Me did manage to math enough to figure out that this epidemic was far, far worse than the one we're supposedly currently experiencing. The COVID death rate for England and Wales at the time of my figurin' was .00002%, while the rate for cholera was .0003%. Both are pretty miniscule, but one death is enough to investigate the cause and make reasonable and intelligent changes.

Regardless of my over the top, too personal feelings of dislike for the author, I love books like this that are chockfull of history. While I don't believe in macro-evolution, micro-evolution has always fascinated me. I found his ideas about inconsistencies among various cultures regarding alcohol adaptation/resistance especially interesting. I also had to chuckle at so much of the ignorant thinking in those days and wondered if the board of health was so worried about the air, why were they sending people in to so intimately investigate? When I read about the ignorance of past science, it makes me wonder how many of our fantastic and innovative ideas will one day be viewed as ignorant? Ha! ( )

I like Johnson’s style. You get the whole story, but he’s got an underlying theme to give the whole thing form and meaning. An enjoyable read and you know a whole bunch about this interesting turning point in history by the end. ( )

This book was absolutely MADE of context, in a way that I found incredibly satisfying. At its most basic level, this is the story of cholera epidemic in London that led to the discovery (finally) of how cholera is transmitted.

But it is the how, yes? How this happened that is fascinating, and Johnson is all about placing this moment in its proper contexts -- from economics, sanitation, city planning, dominant scientific paradigms, communication, the medical profession...

Sometimes all these layers of context can cause some circling back that may cause impatience if you're just trying to get to the payoff, but for the most part, I was delighted. ( )

One of the finest books I've read ( )

I love micro-histories like this. The close up look at something specific, like a disease, is always interesting. I got a little hazy on the connections he was trying to make at the end regarding nuclear disaster, but overall this was a really informative book. ( )

Cholera: not just something you perished from while playing Oregon Trail! Once thought to be caused by miasma/foul air, the 1854 cholera outbreak in London was a turning point in humanity's understanding of the disease and its spread. Intrepid physician John Snow fought an uphill battle against local authorities who were convinced cholera was spread by noxious sewer gases and could not be persuaded otherwise...until Snow drew up a map of victims' homes and their relationship with the Broad Street water pump.

I was surprised to find this book about a devastating, feared and deadly disease to be so enjoyable. I learned a great deal about not only cholera, but also 19th-century urban sanitation, medicine and municipal infrastructure. The final chapters revealed some fascinating things with respect to urban vs. city dwelling and, having now come through the other side of the global COVID-19 epidemic, were freakily prescient regarding potential future viruses. I love that there is now a pub named "John Snow" right next to location of Broad Street pump. Highly recommended for fans of narrative nonfiction. ( )

When I lived in London, we had an assessment to do any leisure activity that you would not have otherwise done. My class partner and I decided to go through her oddities of London book, which landed us in the Jon Snow pub. Ever since, I've been enamored by Jon Snow. His story is not just one of life-saving epidemiology, but also the triumph of good science (germ theory!) over bad (miasmists) and real science (...still germ theory) over social prejudice. Steven Johnson would also have you believe that this story is about urbanism and the way that population density results in vulnerability (I think. More on that later.) So, pretty much no matter what you're into, this is one of the coolest stories in Western history.

And Johnson just destroys it. I spent a lot of time thinking about how this went wrong. I read a lot of popular science, and there's some classical ways to mess it up: oversimplifying to the point of boredom, getting too bogged down in the details, getting attached to a pet theme, etc. Johnson does none of those. In fact, if I were to describe the content of the book, it would seem perfect. In addition to the science, Johnson explores how contemporary science and the politics therein reacted to this discovery and opposed it, how the friendship developed between the disparate Snow and Whitehead and how Whitehead's better social skills improved his ability to really test the hypothesis well. Those sorts of themes were key to my enjoyment of Johnson's the Invention of Air, which is one of the best history of science books I've ever read.

First, I thought there was something innately boring about the discussion of Victorian sewage*. But I'm the sort of person who loves pedantic details and I have enough medical training that I am unimpressed by extensive discussion of unmentionable topics. I think there was just no organization to what was happening. And as a result, every 25 pages or so, for no clear reason, Johnson would start repeating one of his key themes, not really apropos of anything but because it had been a long enough time since a central thesis that I think he forgot what he'd already said.

The other problem was that the backend of the book was a mess. After an extremely in-depth exploration of very specifically the broad street pump outbreak of cholera, Johnson tries to expand to discussing urbanism in general and his thoughts are completely discombobulated. Included within this chapter are: But urbanism is good for the environment even though no one used to believe that, and Johnson and his family certainly will live in a city and he loves cities and this is the global city, but urbanism is bad if there is terrorism and terrorism is relevant because it could be bioterrorism, but vaccines will work against bioterrorism and they won't work against conventional terrorism, so it'll probably be a bomb and also, there's this idea of mutually assured destruction but what if a lone actor gets their hands on a nuclear bomb? With about that degree of organization between thoughts.

All of this disorganization happening at the end of a reasonable chapter about how Jon Snow made a physical map to prove his point, which Johnson used as an opening to discuss how critical graphics are in science and then *did not include* said map. And yes, it's 2017 and I had a smart phone handy to google it, but come on.

*(This book is shockingly dry, given that its about a water pump.) ( )

Enjoyable and interesting read about the cholera outbreak in London and the men who helped trace back to the source in the early days of understanding microbiology . I ( )

An interesting read about the investigation of the cause of the cholera outbreak in London in 1854. Very engaging. ( )

Recommended by Jen - great example of narrative nonfiction, fascinating story, and a great new perspectives on what it means to be urban. ( )

A somewhat gross dive into mid-19th century London's SOHO district where Cholera spread rapidly around the Broad Street pump. One researcher, the self-made but eminent pioneering anesthesiologist, Dr. Snow, was already following water as the vector for the disease, while an Anglican neighborhood priest was collecting information for his own report. The narrative takes a while to get to how these two came to work together and how while the findings that the water from the pump was the vector was not widely accepted or lauded at the time it was the first real step away from the intuitive miasma theory and came into its own well before the end of the century. ( )

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 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.

( )

This book was going to be a 4-star book until the second half of the last chapter when the author veered from the premise of the book and started philosophizing about terrorists and population density. I thoroughly enjoyed the book until that point. ( )

Too many rambling detours on the way to the subject of the title. Abandoned halfway through, before mention of any maps. Once I found that I was only skimming through filler for relevant content, instead of reading for enjoyment, I set the book down for good. ( )

This book tells the true story of the London cholera epidemic in the 1850s and how Dr. John Snow and Reverend Henry Whitehead eventually teamed up to solve the mystery of how the disease is transmitted. At the time, it was believed to be spread via “miasma” (bad air) and putrid smells. Snow believed in the water-born theory where vibrio cholerae bacteria is transmitted by drinking contaminated water.

Dr. Snow mapped the progress of the disease, tracing cases and deaths, to find the source of the outbreak. His methods were scientific, but at the time, superstitions and prevailing theories were ingrained, and it was difficult to overcome the rigid thinking. In fact, one of the most enlightening aspects is observing how unproven speculations garner so much traction that evidence to the contrary is dismissed.

I particularly liked Steven Johnson’s vivid portrayal of London. The smell of cesspools and overflows of human waste into cellars must have been atrocious, and it is easy to see how the miasma theory originated. The scavenging hierarchy is fascinating.

A lengthy epilogue covers the future of urbanization and threats to it. The author advocates bringing advancements in infrastructure to developing countries to improve sanitation and provide clean drinking water. He also covers global pandemics (a particularly relevant topic, obviously), genomic advancements as applied to microbiology, and bioterrorism.

This audio book sounds like a documentary and will appeal to people that want a deep dive into a single science-related topic. It is read by Alan Sklar. He narrates smoothly and his voice has a deep timbre, which works well for this subject matter. ( )

This is an eye-opening report on the worst epidemic of cholera in London, which took place in the summer of 1854. At that time, London had a population of over 2 million, and the city had no infrastructure to take care of the tons of shit that this massive amount of humans produced. People would actually throw their caca into the gutter, or into a cistern, or into the cellars, or into their shared back courts. In the poorest parts of the city, dung hills would reach as high as a house. Moreover, as there was no running water in the houses, the poorest people would actually drink water that Rose to the surface of shit ponds! Feces from Leaking cisterns found its way into the water pipes that led to the public water pumps, and the index case of this outbreak occurred on August 28th, 1854. Popular opinion blamed disease on miasmas--bad smells-- and thus authorities blamed the poor themselves for the outbreak of disease, blaming their cramped, filthy living conditions and "bad constitutions." Read the book to find out the struggles needed and suffered before it was finally accepted that disease did not come from"bad smells." ( )

An interesting read, although it was a little pedantic and a little pedestrian. One thing it gets across quite clearly, especially in the first half of the book, is just how filthy London (and pretty much all cities) are in that time period. It's amazing that outbreaks didn't just kill everyone. The listing of the different jobs built around cleaning up filth is at once fascinating and disgusting. The people that empty shit out of the city are among the best paid of their class. The descriptions are horrific. Once we get to the 'science' part of the book, however, it loses steam and becomes kind of 'meh'--maybe because I already know the story, but also I think because of writing style. ( )

medical-history, nonfiction, public-health, sewers, British-history, cholera, epidemiology, microbiology*****

Cholera has been around for centuries, but more became known about it in 1854 when a man ahead of his time studied the pattern of dissemination in a time when all water was grossly contaminated with feces. By his studies the knowledge that this highly contagious and devastating killer was spread by contaminated water and very slowly changes were made. Cholera is not dead. It hides in poorly treated water worldwide.
Very detailed and written in a way that is clear to all. Well worth the time and money. ( )

I may be biased, because I read this right after realizing that I'm going to be an epidemiologist, but I'm sure this is a good book regardless.

It's like a murder mystery, but you already know the culprit. It's history, but it's entertaining. It's informative. Exciting. Emotional(?). This is definitely my book. For the layperson.

You'll be there with Dr. John Snow (no relation to the Westerosi) as he tries to convince the public health board of his theory, presumably rooting for him to win against the commonly held beliefs that all disease is caused by smell and that commoners get sick because ew, they're lower class. Or you may side with that.

It's like watching Monk or House, but... this shit is real. (And really shitty.)

And then he starts talking about nuclear bombs. wtf? ( )

This is the story of Victorian London and the cholera outbreak that occurred there in the summer of 1854. It began in the neighborhood of Soho, centered on Broad Street. Over 120 people died in a three day period in Soho, and a local doctor named John Snow, along with young clergyman Henry Whitehead both set out to investigate, trying to understand how the outbreak had happened.

Author Steven Johnson works to provide a comprehensive view of the city, the times, the events of the outbreak, and the confluences and synchronicities that led to the breakthrough in understanding of the spread of cholera.

He starts with a description of the London underclass. These were the bone-pickers, the mud-larks and the “night soil” men, among others, whose scavenging jobs helped to provide the basic sanitary services that were not yet a centrally delivered feature of city living. Victorian London was the first city whose population reached 2 million souls, and without those central services it was a smelly, filthy place. As the city had not yet figured out how to successfully deal with its human waste needs in particular, outbreaks of diseases like cholera were the result.

But at the time no one understood what caused cholera. In smelly London, the prevailing wisdom was that all communicable diseases, cholera included, came from bad smells - known as miasmas. It wasn’t until the work by Snow and Whitehead that it began to be realized that cholera in fact is waterborne, resulting from infected human waste contaminating drinking supplies.

Snow and Whitehead independently visited the homes of the sick, trying to understand the course of the disease even as it was happening. Snow, one of the first anesthesiologists in England, already had spent time researching cholera and had come to believe that it was spread via water and not through the air. In his investigations in Soho, Snow was able to determine that a single water pump on Broad Street seemed to be the source of the infection. He convinced the local authorities to remove the pump handle, after which the number of cases fell.

Whitehead did not believe Snow’s analysis. It was only after seeing Snow’s mapping of the deaths in the neighborhood - his “ghost map” - that he became convinced. Together they were then able to unravel the sequence of events and locate the outbreak’s index case - it’s patient zero. Their groundbreaking work set the bar for all future epidemiological studies, and did so well before the germ theory of disease was even established. The map that Snow drew has been reproduced in “countless textbooks on cartography, information design, and public health.”

The book is a well done combination of a lovingly evoked word painting of Victorian London, and a medical thriller. There are a couple of miscues however. For one thing, even though the book is named after Snow’s famous map, the map itself does not appear anywhere in it (though a portion of the map is used as a faded set piece before each chapter). The other miscue is the epilogue, in which Johnson tries to use Snow’s map work as an entry point to discussing several modern problems, and which rambles on for twenty four pages without clearly hitting its mark. Skip the epilogue - you won’t be missing much. ( )