The Ghost Map: a walk to London’s most terrifying epidemic

Skolastika Cynthia, Khalif A. Ghifari, Joshua Nathan, Muhammad A. Fikri / Environmental Infrastructure Engineering, Faculty of Civil and Environmental Engineering, Institut Teknologi Bandung

The Ghost Map, written by Steven Berlin Johnson, recounts London’s most terrifying epidemic: the cholera, and the story of how John Snow and his associates defeated the disease. How it changes science, cities, and the modern world with prospects from ideology, science, and case study. One intriguing section of the book revolves around a presumably correct theory (miasma) and their believer. What is interesting is the strong headedness and faithfulness of people in those times in miasma theory. A theory that has been proven to be wrong-albeit by statistics, basic science, and logic, not by scientific data. A theory that can even be proved to be wrong by these people themselves who are the leading figure in their field, if they had chosen to pursue all the facts regarding this very incident. They are at the forefront of science who do not abide by mere status quo. It is interesting how these very people can be so sure of something and yet so wrong that they drove a city to a dangerous direction, which comes to the authors’ analysis/argumentation that pride, limited knowledge, and isolated experiences are all the defining factors of errors and misled theories by even experts in their scope of studies. All these factors would be explained and further elaboration will be provided in this essay.

In the 1800s, London was attacked by a deathly disease, cholera. The transmission and mortality rate are mortifying to say the least. Cholera has been thought for so long to be caused by miasma to the point that even an attempt to get rid of the smell was made centered around that theory, which ironically increased the spread of the disease itself. That is until John Snow and Whitehead’s long and arduous fight came to fruition and they were able to refute the miasma theory. It slowly convinces more people and public figures that it is not the smell that causes everything. It was in the water.

This is not the first time a theory has crumbled upon its inconsistencies. Numbers of theories and principles have been taken down and replaced by much better ones that make better sense and answer for more questions. It is not the first time someone’s theory is proven to be wrong. The problem here is not only were they wrong, but when a probable (and correct) theory that makes more sense with proven logic and statistical reasoning was presented, they still reject the proven theory. As the downfall of their arrogance, they pursued this false theory, leading to the deaths of thousands. So, what factors weigh in their mistakes? Why does someone of immense logical reasoning and extensive knowledge could have unshakable faith in a misguided theory?

The first would be none other than pride. Sometimes, when people, especially renowned ones, have openly adopted a belief in a system/theory, it is hard to acknowledge that they are mistaken. In arrogance, they take pride in their knowledge, feeling they can never be wrong. By admitting their theory is mistaken, they would also be admitting the actions that have been taken in the past based upon the misguided theory, and may have caused deathly impacts. This can be seen in the case of Chadwick. He was not, by any means, a man of superstition. He was a reformer and a man of science, but he fell to the trap of miasma theory nonetheless. Pursuing it as if he was wearing a horse blinder, he was very adamant and stubborn to do everything to get rid of the smell, being very focused on his way while inadvertently fueling the disease to spread even further. This would be a good trait only if the cause and effect is on the right track. From the book by Wayne Riggs, “to be open‐minded is to be aware of one’s fallibility as a believer, and to acknowledge the possibility that anytime one believes something, one could be wrong” (Riggs 2010). At the time, Chadwick believed what he believed and did not acknowledge that he could be wrong. His pride made him wrong. If Chadwick were to admit that he had been wrong in his belief, it would mean to admit that he had unknowingly caused a lot of deaths indirectly. His pride would not let him do that.

Knowledge was supposed to be the core of problem solving, but during 1850’s London, not one person had been able to find out exactly where cholera came from. This would be attributed to the lack of technology and understanding of the disease itself in those times. Limited technology will lead to limited knowledge. Without the proper technology, there would be many stones unturned and variables unknown, making it harder to reach the right answer/solution to a problem and easier to be misled to the wrong conclusion. Aside from that, the scientific publication network was not as outstanding as it is today that even when the breakthrough of a microscopic organisms Vibrio cholerae had been identified by Pacini, it was mainly ignored by the public and scientists alike. Limited views, and lack of interest would be to blame in this case. They were simply not ready for Pacini’s discovery yet. The right momentum was needed for such discoveries, regarding the superstition and public knowledge that goes around society. Knowledge about public health was very limited in those times that the theories they came up with were just wrong and failed to address the real problem.

The last factor also plays an integral part in one’s belief. Experts may have hands-on experience relating to a certain topic in their field of work with specific situations. From prolonged exposure to certain condition, they draw conclusions based on their personal, isolated experience and perception. Their conclusions might become flawed because what they see is not all there is to it. There is no further pursuit of research and investigations regarding the topic itself. We can take a look at the case of Nightingale. She sided on the miasma theory because in her line of work, the environment was ridden with poor air and foul smell, emanating from sewers and bad ventilation. This indeed was bad for patients trying to recover from whatever illness they might had, but due to her unawareness of all the facts and statistics regarding a specific disease (in this case cholera), while only drawing conclusions on her experience and what she sees without doing proper further research, her conclusion became invalid.

It would be well to be reminded that even leading figures and experts in the medical and epidemiological field could be wrong, that even they have their own limitations. We should not take everything at face value, but to always question and analyze. Always remember these reasons while working on something, especially (though not only limited to) epidemiology, to always be open minded, and to pursue every fact there is, every connection and every possibility. Refrain from any dismissal behavior without considering every aspect and approach. Do not shut down an idea completely unless there is a certain, scientific proof to do so.

References      :

  • Harris, B., Helgertz, J. (2019, June 10). Urban sanitation and the decline of mortality, The History of the Family, 24:2, 207-226. [Google Scholar]
  • Vanderslott, S., Phillips, Maile T., Pitzer, Virginia E., and Kirchhelle, C. (n.d.). Water and Filth: Reevaluating the First Era of Sanitary Typhoid Intervention (1840–1940). [Google Scholar]
  • Aiello, Allison E., Larson, Elaine R., Sedlak, R. (2008, December). Hidden heroes of the health revolution : Sanitation and personal hygiene. [Google Scholar]
  • Nightingale, Florence. (1992, January 01). Notes on Nursing: What It Is, and What It Is Not. Philadelphia: Lippincott William & Wilkins, [Google Scholar]
  • Riggs, Wayne. (2010, January 11). Open Mindedness. [Google Scholar]

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