Synopsis: During London 1854, in an era predating common knowledge of microbes and germs, a cholera outbreak ravaged the city and left hundreds dead within a matter of days. Amidst the competing quack theories and medieval treatment methods that arose, an anesthesiologist by the name of John Snow sets out to prove the causal connection between the contaminated water source and the spread disease.
Review: Initially drawn to the book in part due to my penchant for the morbid, I had expected the book to be laden with gruesome descriptions. I will borrow word to which the author used to describe John Snow–consiliency. A major point of emphasis to solving the outbreak was Snow’s multitude of talents and his interdisciplinary approach of science and statistics, along with a local curate named Henry Whitehead who knew the city and its people intimately. Similarly, as if to echo Snow’s approach, the author documents the case from several perspectives: setting up the squalid living conditions and infrastructure, painting the portrait of the everyday average denizen from the night-soilers to the local tailor, describing the systematic process of how vibrio cholerae invades and depletes the human body, to the competing scientific paradigms as ideologies and classes pitting against each other, and construction of the eponymous “Ghost Map” which drew corollaries between the location of deaths and water pumps with a Voroni Diagram.
The parts which I found particularly fascinating was the scientific approach and thought process one ought to undertake the solve the issue: how does one connect observations with the conclusion/result? It is often easy (and convenient) to erroneously attribute cause and the result, for scientists in who subscribe to different paradigms tend to look for what their paradigm instructs. For example, the miasma theory — the idea that it was the noxious effluvia causing the ailment — an examiner who had been sent to investigate the Soho District only had looked at air conditions like temperature, pressure, etc. without insomuch as regarding examining the water quality. Consequently, since the report only contained evidence deemed relevant by the examiner, it concluded the miasma-causing disease assertions were correct. Could this thought process be applied to Snow as well, who believed in the waterborne theory? For when he interviewed residents, he inquired the source of water they consumed? Perhaps what made the discting stood out was the discussion of how Snow investigated outliers to determine why there were outliers.
If there’s one thing I admired, it was Snow’s diligent and meticulous tenacity to persevere to continue investigating and traveling to the centre of the outbreak itself in full peak in person to interview people, even if he was ridiculed for going against the common belief of the time. Another reviewer which he aptly put, “Snow was a badass.” Yes, yes he was. He developed usage of applying ether and choloroform as an anaethesia ground-up when surgeons where still hacking away limbs with only using opium/brandy as sedatives. Because he worked with gases, he knew basically the “bad air” theory was bullcrap and had observed something was going on in the small intestine, which he then conjectured that it was probably due to something people ingested, not inhaled.
ALSO I TOTALLY SHIP WHITEHEAD AND SNOW BC THEIR UNLIKELY FRIENDSHIP LIKE THE UNEXPECTED PLOT TWIST WAS MY FAV PART OF HOW THEY BONDED DESPITE WHITEHEAD NOT BELIEVING HIM INITIALLY BUT EVENTUALLY THEY COMPARED NOTES AND SOLVED IT TOGETHER DUDE LIKE WHITEHEAD KEPT A PORTRAIT OF SNOW SEVERAL DECADES AFTER HIS DEATH TO REMIND HIM OF HIS QUIET DEMEANOUR SERIOUSLY THOUGH HOW ADORABLE IS THAT
One major drawback of the book was the lack of diagrams illustrating the flow of water routes, streets, and overall infrastructure of the city. Considering how crucial understanding the inner working to the issue, the passages describing these complex networks and routes gets hard to follow. The conclusion of the book is mostly spent on describing recent phenomena of urban development, and improvements since then, which wasn’t nearly as interesting. I liked how the point was made that the cholera outbreak was the culmination of the decrepit living conditions that had allowed to fester, as it was a symptom of a the greater need to reform the entire sewage/water system, thus forcing city governments to play a more active/direct involvement in urban development.
Despite the author’s attempts to touch on many topics, I would recommend this book primarily for readers who are interested in urban geography and development, and for those who are interested in a landmark case study in statistical applications, and epidemology.