Word: cholerae
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...business opportunity to the 100,000 or so toshers (copper salvagers), mudlarks and bone-pickers who crammed the city's margins, scavenging its corpses or sifting through its effluvia on the banks of the Thames. The air in parts of the capital was so appalling that when, in 1854, cholera struck on Broad Street in the Soho district and quickly developed into the worst epidemic in the city's history, it was hard to doubt the official line - let alone the evidence of the senses - that the stink was to blame...
...Ghost Map, Steven Johnson gives a ground-zero account of the outbreak that would take 50,000 lives before it was done. "Imagine the terror and panic," he writes, "if a biological attack killed 4,000 otherwise healthy New Yorkers over a 20-day period. Living amid cholera in 1854 was like living in a world where urban tragedies on that scale happened week after week...
...center of his tale is John Snow, the doctor who overcame the medical establishment's entrenched belief that cholera lurked in the city's "miasma," its bad air, and proved the true cause by painstakingly charting the contagion against London's water supply. The resulting map provided a founding case study for epidemiology. But as readers of previous books by Johnson might expect - among them Mind Wide Open and last year's defense of popular culture, Everything Bad Is Good For You - the author has also chosen his subject for the light it can shine into other corners...
...midst, it stops soaking up fluids and disgorges its contents in a watery rush of stools. The consequence is what we know as dehydration. Oral rehydration treatment can reverse dehydration in more than 90% of patients, even in cases of the severe diarrhea caused by bugs like rotavirus and cholera. When the solution reaches the small intestine, the sugar is moved from the hollow part of the intestine into its mucosal lining through the villi, small fingerlike projections on the intestinal wall. "It's like having a chemical needle in the intestinal tract," says William Greenough, a professor of medicine...
...fluids were administered to the most severely ill. Still, skepticism about the effectiveness of oral rehydration continued. Several journals refused to publish Mahalanabis' paper about the outbreak. But Dhiman Barua, then head of WHO's bacterial diseases unit in Geneva, Switzerland and a survivor of the massive 1932 cholera epidemic in Bangladesh's southern port city of Chittagong, had visited Mahalanabis' camp. He was converted and pushed oral rehydration through all the U.N. health agencies. who rolled out its diarrheal-diseases control program in 1978. "The simplicity and power of this tool gave it its own momentum," Mahalanabis says. Power...