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cholera would be contained. But in early nineteenth-century London, when five of the city’s nine water companies drew drinking water from the great cesspool of the Thames, cholera was in its element. The first epidemic of 1831 killed 6,536 people. In the 1848–1849 epidemic, 14,000 died in London alone and 50,000 nationwide. Cholera’s increased murderous performance was due, ironically, to sanitary reform.
    The Victorian century gave us many wondrous things, but one of my favorites is the now-lapsed vocation of
sanitarian
, a word taken by men who occupied themselves with the new discipline of “public health.” The most famous was Edwin Chadwick, a difficult character who left a legacy of reforms that were magnificent—the 1848 Public Health Act, for one—but also mistaken and deadly. In Chadwick’s landmark 1842
Report on the Sanitary Condition of the Laboring Population of Great Britain
, a Victorian bestseller, he condemned the filth in whichworking classes were forced to live, its effects on their health, and the consequent losses to the economy. (Henry Mayhew, in a letter to the
Morning Chronicle
, wrote of meeting a woman in cholera-ridden Bermondsey who said simply, “Neither I nor my children know what health is.”)
    Chadwick decided the solution was to organize and expand the sewer system, but to use it for
sewage
—a word newly invented—and to discharge the sewage into the Thames. It might hurt the river, he reasoned, but it would save people’s health. Sewers were built and did as he said they would. And the Thames ran browner and thicker, and people drank it, and cholera loved it. There were fulminations against filth in newspapers and Parliament, but nothing was done. The medical establishment, in these pre-Pasteur times, was still convinced that disease was spread by contagion via miasmas, or bad air.
    It took a long dry summer to force change, and because of the foulness of the air, not of the water. In 1858, the weather and the sewage-filled Thames came together disastrously to form the “Great Stink,” when the river reeked so awfully that the drapes on the waterfront windows of the Houses of Parliament were doused with chloride to mask the smell. Politicians debated with their noses covered by handkerchiefs. After prevaricating for years, parliamentarians debated for only ten days before signing into law the Metropolis Local Management Act, which set up a Metropolitan Board of Works to sort out the “Main Drainage of the Metropolis.”
    Joseph Bazalgette was the board’s chief engineer. He was a small man with excessive energy. His plan was grand: enormous main sewers would run parallel to the river on upper, middle, and lower levels. They would be fed by a vast network of smaller sewers, and the whole flow would be conducted by gravity and sometimes by pumps (London is partly low-lying) to two discharge points, Barking and Crossness, in London’s eastern reaches. There, the city’s sewage would continue to be dumped into the river, but suitably far from human habitation. Dilution, as the engineer’s mantra still goes, would take care of pollution. Construction lasted nearly twenty years. By then, Bazalgette had used 318 million bricks, driven the price of bricks up 50 percent and spent £4 million, an enormous sum (£6 billion in modern money). He hadalso built the Victoria Embankment along the way, reclaiming land from the river near Westminster and running a sewer through it. For all this, as Stephen Halliday writes in
The Great Stink of London
, he should be considered the greatest sanitarian of all. His sewers may have saved more lives than any other public works. Yet his efforts have only been rewarded with a small plaque on his embankment, a mural in some nearby public bathrooms, and two streets named after him in the far-off London suburb of New Malden. There is no statue or public thoroughfare celebrating his