If you haven't ordered yet, I generally find the rigatoni with the spicy tomato sauce goes best with diseases of the small intestine.
注文がまだなら、リガトーニのスパイシートマトソースと 小腸の病気は最高にあいますよ
(Laughter)
(笑)
So, sorry -- it just feels like I should be doing stand-up up here because of the setting. No, what I want to do is take you back to 1854 in London for the next few minutes, and tell the story -- in brief -- of this outbreak, which in many ways, I think, helped create the world that we live in today, and particularly the kind of city that we live in today. This period in 1854, in the middle part of the 19th century, in London's history, is incredibly interesting for a number of reasons. But I think the most important one is that London was this city of 2.5 million people, and it was the largest city on the face of the planet at that point. But it was also the largest city that had ever been built.
失礼 舞台という設定上、芝居をすべきだと感じまして さて 今日はこれから数分間で皆さんに 1854年 ロンドンの話をしようと思います 大流行した疫病にまつわる話です 今日私達が暮らす世界に寄与する出来事で 特に今日の都市に影響を及ぼしました 19世紀の中頃、1854年という時代は 理由は多々あれ、ロンドン史上かなり興味深い時代でした 中でも 私の思う最も重要な点は ロンドンは250万の市民を有す都市で 当時世界中で最大の都市だったことです しかも史上最大の都市でした
And so the Victorians were trying to live through and simultaneously invent a whole new scale of living: this scale of living that we, you know, now call "metropolitan living." And it was in many ways, at this point in the mid-1850s, a complete disaster. They were basically a city living with a modern kind of industrial metropolis with an Elizabethan public infrastructure. So people, for instance, just to gross you out for a second, had cesspools of human waste in their basement. Like, a foot to two feet deep. And they would just kind of throw the buckets down there and hope that it would somehow go away, and of course it never really would go away. And all of this stuff, basically, had accumulated to the point where the city was incredibly offensive to just walk around in.
ビクトリア時代の人々はこの時代を生き抜き 同時に新たな住環境の構築を目指していました 今日この新たな住環境を 俗に大都市と呼んでいます 1850年当時の住環境づくりは、色々な意味で大失敗でした 当時の人たちはエリザベス朝の社会インフラと 今日の様な工業都市機能の下暮らしていました 例えば地下には皆さんの気分を少し害すような 30cmから60cm程の深さの汚水溜めがありました 人々は何となくバケツをそこでひっくり返し そのうち消えてなくなるだろうと思っていました 勿論なくなることはありません この様な習慣が積み重なって 歩くだけで気分を害す 最悪な街になったのです
It was an amazingly smelly city. Not just because of the cesspools, but also the sheer number of livestock in the city would shock people. Not just the horses, but people had cows in their attics that they would use for milk, that they would hoist up there and keep them in the attic until literally their milk ran out and they died, and then they would drag them off to the bone boilers down the street. So, you would just walk around London at this point and just be overwhelmed with this stench. And what ended up happening is that an entire emerging public health system became convinced that it was the smell that was killing everybody, that was creating these diseases that would wipe through the city every three or four years. And cholera was really the great killer of this period.
とてつもなく臭い街でした 汚水溜めだけでなく おぞましい数の家畜もその原因の一部です 当時は馬だけでなく乳牛も屋根裏で飼っており まさに牛乳がでなくなって死ぬまで そこに閉じ込めておいて 死んだら焼却炉まで道を引きずって行きました 当時のロンドンを歩こうものなら その悪臭に驚愕したことでしょう 最終的には新興の公共保健当局が 人々の大量死の原因と、3, 4年の周期で 街中に蔓延する病の原因は この臭いだと確信したのです コレラは当時最大の死因でした
It arrived in London in 1832, and every four or five years another epidemic would take 10,000, 20,000 people in London and throughout the U.K. And so the authorities became convinced that this smell was this problem. We had to get rid of the smell. And so, in fact, they concocted a couple of early, you know, founding public-health interventions in the system of the city, one of which was called the "Nuisances Act," which they got everybody as far as they could to empty out their cesspools and just pour all that waste into the river. Because if we get it out of the streets, it'll smell much better, and -- oh right, we drink from the river. So what ended up happening, actually, is they ended up increasing the outbreaks of cholera because, as we now know, cholera is actually in the water. It's a waterborne disease, not something that's in the air. It's not something you smell or inhale; it's something you ingest.
ロンドンでの1832年のコレラ波及以来 4, 5年ごとに、ロンドンや英国全土で 1万から2万人規模の大流行が起こりましたから 当局は臭いこそが問題だと思い込むようになりました 悪臭を解消しなくてはいけません そこで実際、都市機能整備の一環として 公衆衛生策を構想しました その一つが迷惑防止条例で 当局は可能な限り汚水溜めを 空にする為、川へ流すよう促しました 理由は汚水が路上になければ、悪臭は改善され… その通り、私達は川の水を飲みます 要するに結果としてコレラの流行を 助長しただけでした、理由はご存知の通り コレラ菌は水中に潜んでいるからです 臭いを感じたり、呼吸時に吸入するタイプではなく 水中に生息し、飲み水を介し進入します
And so one of the founding moments of public health in the 19th century effectively poisoned the water supply of London much more effectively than any modern day bioterrorist could have ever dreamed of doing. So this was the state of London in 1854, and in the middle of all this carnage and offensive conditions, and in the midst of all this scientific confusion about what was actually killing people, it was a very talented classic 19th century multi-disciplinarian named John Snow, who was a local doctor in Soho in London, who had been arguing for about four or five years that cholera was, in fact, a waterborne disease, and had basically convinced nobody of this. The public health authorities had largely ignored what he had to say. And he'd made the case in a number of papers and done a number of studies, but nothing had really stuck. And part of -- what's so interesting about this story to me is that in some ways, it's a great case study in how cultural change happens, how a good idea eventually comes to win out over much worse ideas. And Snow labored for a long time with this great insight that everybody ignored.
つまり19世紀の公衆衛生策の1つが 事実上 今日の生物兵器テロよりも効果的に ロンドンの水資源に毒を盛ったのです これが1854年のロンドンです 多数の人が犠牲となり苦難が続く中 本当の死因が何であるか 科学的にも解明できていない状況でした 19世紀の高名な学際者、ジョン スノウ 彼はロンドン、ソーホーの医師で 4, 5年間の間ずっとコレラは 実は水を通じ感染する、と主張したのですが 誰もこれを信じませんでした 保健当局は往々にして彼の意見を無視しました 彼はこれについて多く研究を行い、論文をまとめましたが ほとんど効果は上がりませんでした この話で特に興味を引く点は どの様に文化的変革が起こるか示している点です 優れた意見が劣った意見にどう打ち勝つか示しています スノウは皆が無視したこの優れた病識に
And then on one day, August 28th of 1854, a young child, a five-month-old girl whose first name we don't know, we know her only as Baby Lewis, somehow contracted cholera, came down with cholera at 40 Broad Street. You can't really see it in this map, but this is the map that becomes the central focus in the second half of my book. It's in the middle of Soho, in this working class neighborhood, this little girl becomes sick and it turns out that the cesspool, that they still continue to have, despite the Nuisances Act, bordered on an extremely popular water pump, local watering hole that was well known for the best water in all of Soho, that all the residents from Soho and the surrounding neighborhoods would go to.
更に時間を注ぎました 1854年8月28日 名前は知られていない、姓をルイスという 生後5か月の赤子がコレラに感染しました ブロードストリートの40番地に住んでいた赤子です この地図ではよく見えませんが、この地図が 私の著書の後半部で焦点になる部分です ソーホーの中心、労働者階級の街です この少女が病を患ったことにより発覚したのですが 条例に反し続いていた汚水溜めが 実は 頻繁に利用されるポンプに隣接していたのです このポンプはソーホーで一番きれいな水が出ると評判で ソーホー住人に加えて近隣からも利用者が来ていました
And so this little girl inadvertently ended up contaminating the water in this popular pump, and one of the most terrifying outbreaks in the history of England erupted about two or three days later. Literally, 10 percent of the neighborhood died in seven days, and much more would have died if people hadn't fled after the initial outbreak kicked in. So it was this incredibly terrifying event. You had these scenes of entire families dying over the course of 48 hours of cholera, alone in their one-room apartments, in their little flats. Just an extraordinary, terrifying scene. Snow lived near there, heard about the outbreak, and in this amazing act of courage went directly into the belly of the beast because he thought an outbreak that concentrated could actually potentially end up convincing people that, in fact, the real menace of cholera was in the water supply and not in the air. He suspected an outbreak that concentrated would probably involve a single point source. One single thing that everybody was going to because it didn't have the traditional slower path of infections that you might expect.
その結果この少女は意図せず この給水所の水を汚染し 英国史上最も恐ろしいコレラ大流行を 2, 3日の後に引き起こしました 文字通り、10%の市民が7日間で命を落としました 大流行勃発時に市民が逃げずにいたら 計り知れない数の人が死んでいたでしょう こんなにも恐ろしい出来事だったのです 人々は48時間の内に 一部屋しかない家の中で 家族がバタバタと死んでいく光景を目の当たりにしました 震えあがるような恐怖体験です スノウは近くに住んでおり、流行を聞きつけ 超越した勇気で直接魔物の腹に飛び込みました 彼は局所的な流行であるという観点から コレラは空気でなく水を介し感染している と人々を説得できると考えたのです 彼はこの流行の発端は ある1つの地点だと予想しました つまり皆が足を運ぶような場所です なぜなら皆さんの想像するような 低速の感染経路はなかったからです
And so he went right in there and started interviewing people. He eventually enlisted the help of this amazing other figure, who's kind of the other protagonist of the book -- this guy, Henry Whitehead, who was a local minister, who was not at all a man of science, but was incredibly socially connected; he knew everybody in the neighborhood. And he managed to track down, Whitehead did, many of the cases of people who had drunk water from the pump, or who hadn't drunk water from the pump. And eventually Snow made a map of the outbreak. He found increasingly that people who drank from the pump were getting sick. People who hadn't drunk from the pump were not getting sick. And he thought about representing that as a kind of a table of statistics of people living in different neighborhoods, people who hadn't, you know, percentages of people who hadn't, but eventually he hit upon the idea that what he needed was something that you could see. Something that would take in a sense a higher-level view of all this activity that had been happening in the neighborhood.
彼は実際に足を運び人々に問いました さらにある実力者の協力も取り付けました 彼もまたこの本の主人公です ヘンリー ホワイトヘッド、彼は牧師です 科学は全くでしたが、地域とのつながりは深く 彼は地域の人ならだれでも知っており ポンプの水を飲んだ人の状況も 飲んでいない人の状況も つかんでいました 遂にスノウはコレラ流行の地図を完成させて ポンプの水を飲んだ人は発症し 飲んでいない人は発症しないことが分かってきました 色々な地域の 水を飲んでいない人の割合を 表で示そうかと考えましたが 視覚的に把握できるものが必要と 考え至りました この地域で起きていることが 視覚的にはっきりと把握できるものです
And so he created this map, which basically ended up representing all the deaths in the neighborhoods as black bars at each address. And you can see in this map, the pump right at the center of it and you can see that one of the residences down the way had about 15 people dead. And the map is actually a little bit bigger. As you get further and further away from the pump, the deaths begin to grow less and less frequent. And so you can see this something poisonous emanating out of this pump that you could see in a glance. And so, with the help of this map, and with the help of more evangelizing that he did over the next few years and that Whitehead did, eventually, actually, the authorities slowly started to come around. It took much longer than sometimes we like to think in this story, but by 1866, when the next big cholera outbreak came to London, the authorities had been convinced -- in part because of this story, in part because of this map -- that in fact the water was the problem.
そこで彼はこの地図を作成し この地域で死亡した人を全て 住所ごとに黒い印で示しました ご覧の通り、中心にはポンプがあり その下の区域で15人が亡くなったことが この地図から確認できます 実際の地図はもう少し大きめですけどね ポンプから離れれば離れるほど 死者数の数は減少傾向にあります 一目でこのポンプから何か迫りくる 有毒なものを感じることができます この地図を製作したり 続く2, 3年程 スノウとホワイトヘッドが この考えの普及に努めた結果 事実 後に当局が少しずつ動き出します 我々の推測よりだいぶ長くかかりましたが 次にロンドンでコレラが大流行する1866年までには 保健当局はこの話や、この地図のおかげもあって 実は水に原因があると信じるに至ったのです
And they had already started building the sewers in London, and they immediately went to this outbreak and they told everybody to start boiling their water. And that was the last time that London has seen a cholera outbreak since. So, part of this story, I think -- well, it's a terrifying story, it's a very dark story and it's a story that continues on in many of the developing cities of the world. It's also a story really that is fundamentally optimistic, which is to say that it's possible to solve these problems if we listen to reason, if we listen to the kind of wisdom of these kinds of maps, if we listen to people like Snow and Whitehead, if we listen to the locals who understand what's going on in these kinds of situations. And what it ended up doing is making the idea of large-scale metropolitan living a sustainable one.
ロンドンでは下水設備が作られ始め 第二次コレラ大流行にすぐに対応し 水を熱消毒するよう人々に命じました これがロンドン史上最後のコレラ大流行になりました この話はとても恐ろしい面を含んでいます とても暗い話ですし、発展途上にある 世界中の多くの都市で今なお続く問題でもあります しかし本質を見れば実は楽観できる話でもあります つまり原因を知り 地図から情報を読み取り スノウやホワイトヘッドの話を受け入れ 状況を知る地元住民の話を聞けば 解決できる問題だということです こういったことから最終的に 大規模な都市生活が可能と考えられるようになりました
When people were looking at 10 percent of their neighborhoods dying in the space of seven days, there was a widespread consensus that this couldn't go on, that people weren't meant to live in cities of 2.5 million people. But because of what Snow did, because of this map, because of the whole series of reforms that happened in the wake of this map, we now take for granted that cities have 10 million people, cities like this one are in fact sustainable things. We don't worry that New York City is going to collapse in on itself quite the way that, you know, Rome did, and be 10 percent of its size in 100 years or 200 years. And so that in a way is the ultimate legacy of this map. It's a map of deaths that ended up creating a whole new way of life, the life that we're enjoying here today. Thank you very much.
7日で10%の隣人が死んでいく光景を見たときには 250万人が大都市に暮らすなんて 不可能だという共通認識が 広まっていましたが しかしスノウの行い、この地図 そしてこの地図のおかげで実現した 一連の改革の成果によって 人口1000万を有す都市が 今では当たり前になっています この様な大規模な都市も存在可能なのです 今日、誰もニューヨークがローマみたいに 滅亡するとも、100年後や200年後に 10%の規模に縮小するとも思っていません これがある意味この地図から得た遺産なのです 今私たちが全く新しい生活を満喫できるのは 死者を示した 地図のおかげなのです ご清聴ありがとうございました