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Review: The Ghost Map PDF Print E-mail
Swift
Written by Naomi Baker   

"The probability of an outburst or increase during [calm, mild] weather, I believed to be heightened on holidays, Saturdays, Sundays, and any other occasions where opportunities were afforded the lower classes for dissipation and debauchery"  - unattributed quote by ‘expert' regarding how cholera disproportionally attacks the poor and other social underclasses, in Victorian London.

As strange as this seems to modern eyes, this statement was backed up by scientific evidence, or at least what passed for such in England of the mid-19th century.  During this time, the predominant theory for the spread of contagion and sickness was miasma (Greek for "pollution"), that is bad smells and foul air were the causes of disease.

The Ghost Map: the Story of London's Most Terrifying Epidemic - and How it Changed Science, Cities, and the Modern World, by Steven Johnson (Riverhead Books) is the story of Dr. John Snow and Rev. Henry Whitehead's discovery of the water-born transmission of cholera, a disease which struck with terrifying regularity in London and other large cities.  The popular folklore is that Dr. Snow plotted cases of cholera deaths on a map, and deduced that the outbreak's source was a particular well in a poor section of London, and removed the handle to the pump, thereby halting the epidemic, and was hailed as a hero.

The true story is not nearly so neatly packaged.   Dr. Snow noticed, in earlier epidemics, a pattern of isolated groups either contracting cholera in isolation, or seeing groups that were spared contagion in the middle of a raging epidemic.  Using his skills and experience, he correctly deduced that water somehow carried the source of the disease (although he had no idea about germ theory), and managed to track the common source to the water well located on Broad Street, in the area now known as Soho.  Although he was unable to find anything in the water that could be the source of the disease (in fact, other wells had cloudy or smelly water, but no pattern of contagion).  Over a period of months, however, he was unable to convince the health boards and community groups of his findings, because it was commonly known that bad smells were the source of disease, and indeed this had been known for centuries.  This belief was continually reinforced because the most stricken areas, such as Broad Street, also happened to be the dirtiest and most fetid location in London. The scientists of the day could confirm their views by taking an (admittedly short) stroll through the impacted areas.

London grew from a city of a few hundred thousand to over 2 million in a matter of decades.  Before the growth, most human waste was collected and carried to the surrounding farmland for fertilizer.  However, with the rapid grow and expansion of the city limits, the feasibility and cost to remove ‘night soil'  became too expensive for the poor, and so the waste collected in the cesspools under the houses and in open pits in the alleys and yards.  What few sewage systems existed dumped the untreated water directly into the Thames. The invention of the water closet increased the problem, since the additional water used for flushing ended up in the same overflowing pits. London was drowning in human waste, and it was commonly believed that the city would eventually perish under its mountain of refuse.  And, common ‘scientific' belief was that since the worst situation, and the worst smells, existed in the poorest neighborhoods, as did the greatest incidences of disease, crime, and death, the poor somehow brought it upon themselves, hence the quotation at the beginning of this article.

Dr. Snow eventually persuaded the local council to remove the pump handle, but by this time, new cases of cholera (and the original index source of the outbreak) had moved on.  The councils were not, however, persuaded of the invalidity of their belief in miasma. In fact, Dr. Snow's views were openly mocked on the pages of The Lancet and the newspapers of the day. How did they explain that in some cases, some members of a family died while other survived, while supposedly breathing the same foul air?  Or that one household might entirely succumb while their immediate neighbors, who shared a yard, might all survive?  The Victorians concluded, based on their understanding of the evidence, was that a person's inherent constitution and moral character could be protective.  Reverend Whitehead, who served as the local vicar and knew nearly all of the people of the Broad Street area on a first-name basis, initially scoffed at Dr. Snow's hypothesis, as well, but became intrigued and finally assisted Dr. Snow's data collection efforts when he realized that the ‘constitution and moral character' of the individuals succumbing to cholera did not necessarily jive with the mortality cases.  He also helped Dr. Snow track down and tabulated cases of cholera among ‘the better sort' of people who no longer lived in the Broad Street area but may have partaken of the well's water during a visit.  He was also impressed that the entire population of a workhouse (the Victorians' favorite scapegoat) survived the outbreak, as did all of the workers at a particular brewery, who were paid in product and never drank water.

In the end, it was not an epiphany that led Dr. Snow to his breakthrough, but years of plodding, shoe leather, tedious tabulation of victims, and his now-famous map, that convinced the skeptics of his claim.  It was nearly 10 years after the outbreak before Dr. Snow's discovery was finally accepted by mainstream scientists and politicians, and it was shortly after that that London finally embarked on the ambitious plan to install both sewer collection systems and to supply filtered water to the population of London.  The last cholera outbreak was in 1866, shortly before the completion of the system.   London's example served as a model for the other great cities of the world.

Dr. Snow and Rev. Whitehead's true legacies are not that they stopped cholera epidemics, but that they introduced a multidisciplinary approach in thinking about medical and scientific problems, and moderized the methods of scientific inquiry.

The Ghost Map can be ordered through the JREF Amazon link on the lower lefthand side at www.randi.org.

 


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written by Rogue Medic, July 02, 2009
At the end of the book, he points out that our best defense against biological terrorism will come from improving our knowledge of science. Rejecting the anti-science that is rampant in so many places.

Will unicorn medicine protect us from a Ted Kaczynski with a biological weapon? No. Only improvements in science will do that.

Will unicorn medicine protect us from a Timothy McVeigh with a biological weapon? No. Only improvements in science will do that.

Will unicorn medicine protect us from a bin Laden acolyte with a biological weapon? No. Only improvements in science will do that.

This is a book about both history and the future. We can repeat the mistakes of the miasmists and help future terrorists to kill millions. Or we can improve our focus on the science that will protect us. Early identification of diseases. Vaccination. Improved research. Improved communication. Improved coordination.
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Or on DVD...
written by BillyJoe, July 02, 2009
"The Sewer King" an episode of the BBC's series "Seven Wonders of the Industrial World" gives an account fo the John Snow incident as well as the building of the sewer.

BJ
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written by sibtrag, July 02, 2009
I haven't read the book, but from Naomi Baker's retelling, I see a few interesting patterns.

The first is an idea that is openly scoffed at by scientists eventually becoming accepted as truth. Not everything scoffed at by scientists is untrue. This applies to today's issues as well. But, of course, the scoffing of scientists does not necessarily indicate truth.

We also see "alternative medicine" becoming "mainstream medicine" once it is taken seriously by scientists & studied. A significant number of today's mainstream medicine techniques and substances were originally folk remedies. (Even vaccination has roots in folk wisdom that those who got cow pox would not get small pox.) However, this process leaves "alternative medicine" mostly a mix of studied and rejected ideas. Which is why some scientists are scrambling to learn folk medicine in remote areas in hopes of finding some untested idea that turns out true.

And, finally, we see a religious character having a positive impact on science. In part because of how well he knows his parishioners' character and constitution well enough to see there is no correlation.
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written by pxatkins, July 02, 2009
To be fair, miasmists too were a link in the long chain of science: 'if it stinks it's probably bad' was (and remains) pretty good advice. The error was believing the corollary 'if it don't stink it's probably OK' which holds good only some of the time.
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sibtrag
written by Sadhatter, July 02, 2009
Could you provide what you mean by

"However, this process leaves "alternative medicine" mostly a mix of studied and rejected ideas."

It kind of sounds like you could be saying good ideas and known bad ideas in a grab bag. Or you could be saying that it is made up of ideas that have already been studied and rejected.

Probably just the fact that i just got up and i don't understand, and no offense intended by this post, i just didn't want to get the wrong impression from your statement.
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written by sibtrag, July 02, 2009
@Sadhatter:

I was intending the latter...that what is now called "alternative medicine" is mostly what is left after the scientists have stolen all the good stuff to be part of "mainstream medicine".
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written by Griz, July 02, 2009
I was going to observe that the "unicorn" medicine folks (I love that epithet, Rogue Medic) would take this to demonstrate that some valid scientific ideas are derided when they first come to light and therefore all ideas, no matter how crackpot are worth investigation, but Sibtrag has beaten me to the punch.

What the unicorns never want to do, though, that Dr. Snow did, is do the work to prove their concept. In fact, it's not in their best interests to do so because their ideas can only be proven wrong, so they don't fight, they just flit from scam to scam when the heat of scientific light gets too much for them. That's why there will never be a John Snow for "alternative" medicine, and that's why what John Snow proposed was NOT alternative medicine. It was medicine, pure and simple, provable by scientific method and upheld by later research.

It also exemplifies another thing we don't seem to see much any more: religion working with science to benefit people. Rev. Whitehead was clearly a progressive thinker and not hung up on sticking with the church sanctioned idea of the cause of the disease or the even handier refuge of simply chalking the deaths up to god's judgement.
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written by Rogue Medic, July 02, 2009
@sibtrag,

I was intending the latter...that what is now called "alternative medicine" is mostly what is left after the scientists have stolen all the good stuff to be part of "mainstream medicine".



the scientists have stolen all the good stuff?

That would suggest that there is no good stuff left that is available to people. That would suggest that scientists have taken the good stuff away from the people. This is nonsense. What scientists have done is confirmed that some treatments do work. Those treatments are now accepted by science and conventional medicine, because they have been shown to work.

This is not stealing. This is one of the problems of unicorn medicine, there is no objectivity. Things are attacked, or stolen, or described in some other emotional way. Science is about finding out the truth. Unicorn medicine is about ignoring the truth.

There may be alternative medicine treatments that actually work, but they are not the stuff that has been well studied. Look at the results of NCCAM. Dr. Sen. Tom Harkin is criticizing the center for not doing as it was told - for not validating unicorn medicine. He does not see scientific validation of a treatment as stealing.

http://roguemedic.blogspot.com...force.html


The only treatments likely to be validated by science, or shown to be effective, are the ones not yet studied. These are most likely the ones practiced by small numbers of people, who do not have much contact with the rest of the world. In other words:

Not reiki,

Not acupuncture,

Not naturopathy,

Not homeopathy,

Not anything you will find in your local community.

Richard Dawkins describes alternative medicine as a set of practices which cannot be tested, refuse to be tested, or consistently fail tests.

Alternative medicine is fraudulent medicine. It is medicine as practiced by quacks.

http://en.wikipedia.org/wiki/Quackwatch
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written by BillyJoe, July 02, 2009
Rogue Medic,

I think sibtrag agrees with you.
He just chose different words to describe the same thing.

BTW, you left Chiropactic out of your list smilies/wink.gif

BJ
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written by Rogue Medic, July 02, 2009
BillyJoe,

I think sibtrag agrees with you.
He just chose different words to describe the same thing.

BTW, you left Chiropactic out of your list smilies/wink.gif


It could be that we agree. The term stolen suggests the appeal to emotion that is so common among the unicorn medicine mob.

I apologize for omitting chiropractic. I have been reading so much about them and their bogus criticism of Simon Singh, that I overlooked it just from being too familiar. I am sure I missed a lot of unmedicine. For example, the magical mystery herbs that Daniel Hauser prefers to chemotherapy. The chemotherapy is keeping him alive with a good prognosis for healthy survival, but why let facts get in the way of a good emotional appeal, some smoke, mirrors, and media whores. smilies/sad.gif
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written by Machpoint005, July 03, 2009
Always interests me that Dr Snow gets most, if not all, of the credit, but Joseph Bazagette was the one who saved countless lives by engineering an effective sewerage system for London. It was so effective it is still in use today.
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written by Willy K, July 03, 2009
One factor about these kind of discoveries that seems to be under reported is what do the vocal disbelievers (disbelievers in science that is) have to say after something is proven scientifically.

Where are the mea culpas???

Will Jenny McCarthy ever admit she is totally wrong? I doubt she would have the courage to say so. smilies/cry.gif
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written by Willy K, July 03, 2009
Griz said... religion working with science to benefit people. Rev. Whitehead was clearly a progressive thinker...


I hate to split hairs with you ole Grizzie, but religion never "works" to benefit anyone. Your observation about Rev. Whitehead is the correct part of that statement. A persons character is basic, any "religion" they have is just a bit of social covering that can be dispensed with at will. How many "believers" in the Abrahamic Bible ignore that commandment "thou shalt not kill" whenever they deem it necessary? smilies/cry.gif
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written by tctheunbeliever, July 03, 2009
And who is it that corrects scientists when they are wrong?
That's right, other scientists! (as in people who follow the evidence)
There's another inconvenient truth for homeopaths.
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written by BillyJoe, July 03, 2009
I hate to split hairs with you ole Grizzie, but religion never "works" to benefit anyone.
Not sure what you mean by "works", but religion certainly does benefit certain people. My father for example. He was a good man whom everyone liked without exception. He was a war survivor, though, and it was clear his religion was a great solace for him. I never bothered him about irrationality of his religion because of that.

A persons character is basic, any "religion" they have is just a bit of social covering that can be dispensed with at will.
Again, I think you overstate your case. Many religious people cannot shed their religion. It is, in fact, an integral part of who they are. In some cases, it is even true to say that their religion made them who they are.

BillyJoe
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written by GeekGoddess, July 03, 2009
@Machpoint005: The book does cover the decision and the efforts involved in building the sewage system as well as a city-wide clean water distribution system, albeit in brief. Additionally, contributions of other individuals is covered.

Rev. Whitehead's interest in helping solve the problems of the cholera epidemic within his vicarage came from his intimate knowledge and his concern for the people of the Golden Square and area surrounding Broad Street. Religion is not always a 'social covering' but for some people informs their actions. What they feel about their religion may guide specific actions to, for instance, feed the hungry rather than be snarky and rude to total strangers on the Internet.
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written by Willy K, July 04, 2009
written by GeekGoddess, July 03, 2009 - What they feel about their religion may guide specific actions to, for instance, feed the hungry rather than be snarky and rude to total strangers on the Internet.

Feeding the hungry is part of basic Human altruism. It wasn't invented by any religion, it was already there.
There are many very wonderful people doing wonderful things, if they learned how to be wonderful, they learned if from another wonderful person.
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written by Willy K, July 04, 2009
written by BillyJoe, July 03, 2009 - Many religious people cannot shed their religion. It is, in fact, an integral part of who they are.

That's certainly true.... many schizophrenics can't shed their schizophrenia!

My point is that what is sold as "religion" is not integral to Human behavior. Delusion is a common property among Humans that other Humans will drape fairy tales over. Many people try to force their delusions on others. That's what many of the JREF articles are about!
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written by BillyJoe, July 04, 2009
My point is that what is sold as "religion" is not integral to Human behavior.
That was not clear form your original post.

But, if you are saying that religion is not the basis of ethical behaviour, I wouldagree. Yes, it seems to be the case that altruism was "invented" by evolution to improve survival. Religion merely developed as a consequence of that, possibly first as an adaption but certainly later as a maladaption. An appendix was usefull at some stage, now it no longer is useful and it can be the cause disease or even death. It should them be cut out.

BJ
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written by Willy K, July 06, 2009
written by BillyJoe, July 04, 2009 ...An appendix was usefull at some stage,, now it no longer is useful and it can be the cause disease or even death. It should them be cut out.


I would venture to say that an appendix is more useful to a Human being than a belief in a supernatural being. I'd bet that more people died from that screwy idea that those who succumbed to appendicitis. smilies/wink.gif
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