Cough, Hack: Germs in the City

Amid the current stories about the traveling TB-infected lawyer, this article by Peter Huber on germs and the city may be of interest. An excerpt:

The Mao of microbes was smallpox, which killed 300 million people in the twentieth century alone. Sometimes called the first urban virus, it probably jumped from animals to humans in Egypt, Mesopotamia, or the Indus River Valley, at about the same time that the rise of agriculture began drawing people together in towns and cities. Smallpox has also been called nature’s cruelest antidote to human vanity. Princes broke out in the same pustules as paupers, reeked as foully of rotting flesh, and oozed the same black blood from all their orifices. Alongside millions of nameless dead lie kings of France and Spain, queens of England and Sweden, one Austrian and two Japanese emperors, and a czar of Russia.

While the germs reigned, there wasn’t much rest-of-medicine to speak of: infections eclipsed every other cause of illness but malnutrition. And when monarchs were dying, too, language and politics honestly tracked medical reality. The “social” in “social disease” reflected an epidemiological fact. It also pointed to a practical, collective solution. Disease arose and spread when people converged to create societies. It was caused by invisible agents that individuals could not control on their own. It could be eradicated only by social means—public sanitation, slum clearance, education, and, above all, a robust, germ-hating culture. It took a city to erase a cholera.