Disease Maps

Disease wants to be information–specifically, visual, spatial information. That’s the best way our brains can ingest the scientific facts and reach fresh conclusions. Whether it be the symptoms afflicting an individual projected onto the schematic of a single body (such as we see in the groundbreaking work of Vesalius, with his De Humani Corporis Fabrica), or the agglomerated cases of a rampant disease charted across a geographical region, the most efficient and useful way to comprehend, control, and forecast sickness is to establish a relation between biology and cartography. Such is the thesis of Tom Koch’s Disease Maps, a fascinating historical study of how humanity has come to understand epidemics in terms of maps.

Koch begins his three-part survey with the sixteenth century, a period when numerous factors came together to permit an unprecedentedly accurate mapping of illness. New revelations in the realms of record-keeping, medicine, and cartography joined with improved printing processes to produce the earliest disease maps, mostly focused on outbreaks of the traditional plague. The spread of Yellow Fever in the 1700s generated further sophistications. But it was the outbreak of cholera across the globe in the 1800s that saw disease mapping reach new heights of utility and ingenuity. To this period Koch devotes Part II of his book, nearly half his text, letting this finest moment of disease mapping stand as an “exemplar” for the whole science.

Vividly summoning up the colorful shades of great doctors and public health experts–John Simon, Henry Whitehead, William Farr, John Snow–Koch depicts a thrilling Victorian-era medical detective story. As cholera spreads westward from India across Europe, with England as its inevitable terminus, rival theories and datasets attain cartographic reality, leading to a better understanding of the roots and reaches of the disease. Koch makes certain that we always keep the human elements in sight, outlining how biases and expectations and scientific rivalries can distort the data. But eventually, objective rationality wins out, aided by the incontrovertible power of mapping.

Koch’s scrupulous, well-documented, propulsive prose attains poetic heights at times, as he chronicles the creative brainpower and determination and eureka moments of his mappers. “We learn as we were taught to learn. We see, we count, we theorize and then assemble what we think we know to propose a disease in its uniqueness, constructing it as we go.”

Part III, “The Legacy and Its Future,” focuses on modern mappings of cancer to show where these immemorial techniques can be useful in the days to come, in a digital age where data can potentially flow in from Google’s Streetview cars and the smartphones of every citizen.

What cannot be overlooked about this book is something incidental but overwhelming: the visual beauty of these maps. Colored and drawn by hand in most cases, with exquisite calligraphy, they offer aesthetic joys divorced from their mortal reality. Seldom has mass death looked so graphically alluring.

The Speculator

Paul Di Filippo’s column The Speculator appears monthly in the Barnes & Noble Review.  He is the author of several acclaimed novels and story collections, including Fractal Paisleys, Little Doors, Neutrino Drag, and Fuzzy Dice.