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譯者: Marie Wu
審譯者: Terry Lin
00:25
If you haven't ordered yet, I generally find the rigatoni with the spicy tomato sauce
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如果你還沒有吃飯的話,我個人覺得蕃茄辣醬通心粉
00:32
goes best with diseases of the small intestine.
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和小腸感染疾病還滿配的。
00:35
(Laughter)
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(笑聲)
00:37
So, sorry -- it just feels like I should be doing stand-up up here because of the setting.
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很抱歉,這講台的配置會讓人以為我要講脫口秀,
00:41
No, what I want to do is take you back to 1854
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並不是。接下來的幾分鐘,我要帶各位
00:46
in London for the next few minutes, and tell the story --
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回到1854年的倫敦,我要講一個故事,
00:50
in brief -- of this outbreak,
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很短,關於疾病爆發的故事,
00:53
which in many ways, I think, helped create the world that we live in today,
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我認為這個故事幫助了我們建立現代人居住的環境,
00:57
and particularly the kind of city that we live in today.
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特別是我們所居住的城市。
00:59
This period in 1854, in the middle part of the 19th century,
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在1854年,也就是十九世紀中葉,
01:03
in London's history, is incredibly interesting for a number of reasons.
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那時的倫敦在許多方面都非常有趣。
01:07
But I think the most important one is that
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我認為最重要的是
01:10
London was this city of 2.5 million people,
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那時的倫敦有二百五十萬人居住在內,
01:13
and it was the largest city on the face of the planet at that point.
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那是當時世界上最大的城市,
01:18
But it was also the largest city that had ever been built.
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也是歷史上曾經出現過最大的城市。
01:20
And so the Victorians were trying to live through
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維多利亞女王時代的人希望能建立一種
01:23
and simultaneously invent a whole new scale of living:
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新的居住模式,
01:27
this scale of living that we, you know, now call "metropolitan living."
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這種居住模式,我們現在稱之為都市生活。
01:32
And it was in many ways, at this point in the mid-1850s, a complete disaster.
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這在許多方面來說,尤其是在1850年代前後,簡直就是個大災難。
01:38
They were basically a city living with a modern kind of industrial metropolis
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他們所謂的都市生活,其實就是將現代工業都市的模型,
01:42
with an Elizabethan public infrastructure.
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套用在伊莉莎白女王時代所留下來的公共建設上。
01:45
So people, for instance, just to gross you out for a second,
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舉例來說,讓你們體會一下,
01:50
had cesspools of human waste in their basement. Like, a foot to two feet deep.
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他們就把糞坑建在地下室裡,大約就是一、二呎深吧。
01:56
And they would just kind of throw the buckets down there
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然後他們就把穢物丟進去,
01:59
and hope that it would somehow go away,
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希望穢物有一天會自己消失,
02:01
and of course it never really would go away.
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這當然是不可能的。
02:04
And all of this stuff, basically, had accumulated to the point
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在堆積了這麼多穢物後,
02:07
where the city was incredibly offensive to just walk around in.
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就算你只是走進這個城市,也會有令人作嘔的感覺。
02:11
It was an amazingly smelly city. Not just because of the cesspools,
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倫敦變得很臭,不只是因為糞坑的問題,
02:15
but also the sheer number of livestock in the city would shock people.
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還有令人咋舌的家畜數量,也讓問題雪上加霜。
02:18
Not just the horses, but people had cows in their attics that they would use for milk,
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不只有馬,還有人在頂樓飼養乳牛,以便擠奶。
02:22
that they would hoist up there and keep them in the attic
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他們把乳牛趕到頂樓,關在那兒,
02:25
until literally their milk ran out and they died,
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然後一直到榨乾乳牛的奶,直到乳牛死去,
02:27
and then they would drag them off to the bone boilers down the street.
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他們再把乳牛拖下來,送到街底的屠宰場去。
02:33
So, you would just walk around London at this point
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所以,在那個時代走在倫敦的街上,
02:36
and just be overwhelmed with this stench.
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你恐怕會被惡臭薰死。
02:39
And what ended up happening is that an entire emerging public health system
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到後來,公共衛生部門讓大家開始相信,
02:44
became convinced that it was the smell that was killing everybody,
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就是這股惡臭害死了大家,
02:48
that was creating these diseases
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這股惡臭製造了瘟疫,
02:50
that would wipe through the city every three or four years.
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而且每三到四年會大流行一次。
02:53
And cholera was really the great killer of this period.
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而霍亂,正是那個時代最兇惡的殺手。
02:55
It arrived in London in 1832, and every four or five years
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霍亂在1832年開始侵襲倫敦,而後每四到五年會再流行一次,
03:00
another epidemic would take 10,000, 20,000 people in London
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每次都會奪走倫敦一萬至二萬條人命,
03:04
and throughout the U.K.
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並且擴及全英國。
03:06
And so the authorities became convinced that this smell was this problem.
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政府當局開始相信,這股惡臭就是原兇,
03:10
We had to get rid of the smell.
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必須清除這股惡臭。
03:12
And so, in fact, they concocted a couple of early, you know,
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所以他們開始在倫敦
03:15
founding public-health interventions in the system of the city,
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建立幾個類似公衛介入的系統,
03:19
one of which was called the "Nuisances Act,"
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其中一個叫做「干涉法案」,
03:21
which they got everybody as far as they could
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公共衛生部門會將人們趕出住宅,
03:23
to empty out their cesspools and just pour all that waste into the river.
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好將他們的糞坑清空,再把穢物倒入河裡。
03:28
Because if we get it out of the streets, it'll smell much better,
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因為他們覺得只要把街道清理乾淨,臭味就會消失 --
03:32
and -- oh right, we drink from the river.
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噢,對了,我們的飲用水是來自河水耶...
03:36
So what ended up happening, actually,
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這些行動最後反而
03:38
is they ended up increasing the outbreaks of cholera
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造成霍亂的大流行,
03:40
because, as we now know, cholera is actually in the water.
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因為--我們現在已經知道--霍亂是經由飲用水傳染的。
03:44
It's a waterborne disease, not something that's in the air.
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霍亂的傳染的媒介是水,而不是空氣;
03:47
It's not something you smell or inhale; it's something you ingest.
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不是你所聞到或是吸入的空氣讓你生病,而是你喝下去的水。
03:50
And so one of the founding moments of public health in the 19th century
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當公共衛生部門在十九世紀開始運作的時候,
03:54
effectively poisoned the water supply of London much more effectively
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反而在倫敦居民喝的水裡下了毒,
03:58
than any modern day bioterrorist could have ever dreamed of doing.
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那個規模簡直是現代恐怖份子夢寐以求的生化戰。
04:01
So this was the state of London in 1854,
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這就是1854年倫敦的狀況,
04:05
and in the middle of all this carnage and offensive conditions,
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有令人作嘔的惡臭,也有不為人知的大屠殺;
04:11
and in the midst of all this scientific confusion
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政府對科學一知半解,
04:14
about what was actually killing people,
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根本不知道人們死去的真正原因。
04:17
it was a very talented classic 19th century multi-disciplinarian named John Snow,
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十九世界有一位非常有才華的專業人士John Snow,
04:23
who was a local doctor in Soho in London,
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他是住在倫敦蘇活區的一位醫生,
04:26
who had been arguing for about four or five years
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他高唱霍亂是經由飲用水所傳染
04:28
that cholera was, in fact, a waterborne disease,
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已經有四、五年了,
04:31
and had basically convinced nobody of this.
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但沒有人相信他。
04:34
The public health authorities had largely ignored what he had to say.
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公共衛生部門也沒有把他的話聽進去。
04:38
And he'd made the case in a number of papers and done a number of studies,
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他還針對這件事發表了數篇論文,也做了好幾項研究,
04:42
but nothing had really stuck.
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但沒有一項被採納。
04:44
And part of -- what's so interesting about this story to me
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我覺得這個故事最有趣的地方在於,
04:46
is that in some ways, it's a great case study in how cultural change happens,
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這個事件在許多方面都是文化變革最好的教材。
04:51
how a good idea eventually comes to win out over much worse ideas.
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一個好的建議要怎樣才能擊敗其他的爛建議?
04:56
And Snow labored for a long time with this great insight that everybody ignored.
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Snow花了許多時間與精力在這上面,但是沒有人注意到他偉大的發現。
05:00
And then on one day, August 28th of 1854,
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然後有一天,在1854年的八月二十八日,
05:05
a young child, a five-month-old girl whose first name we don't know,
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一個嬰孩,五個月大的小女嬰,我們不知道她的姓,
05:09
we know her only as Baby Lewis, somehow contracted cholera,
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只知道她叫露意絲,感染了霍亂,
05:13
came down with cholera at 40 Broad Street.
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她住在博德街四十號。
05:16
You can't really see it in this map, but this is the map
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這張地圖上沒有特別標示出來,
05:19
that becomes the central focus in the second half of my book.
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但這張地圖是我書中後半部的重點。
05:24
It's in the middle of Soho, in this working class neighborhood,
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這個地點在蘇活區的中央,附近是工人群聚的住宅。
05:26
this little girl becomes sick and it turns out that the cesspool,
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這個小女嬰病了,儘管政府發佈了「干涉法案」,
05:30
that they still continue to have, despite the Nuisances Act,
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但她的家人還在繼續使用他們的糞坑,
05:33
bordered on an extremely popular water pump,
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而這個糞坑緊鄰著這個住宅區最多人使用的汲水幫浦,
05:37
local watering hole that was well known for the best water in all of Soho,
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那還是蘇活區住民公認最好的水質,
05:41
that all the residents from Soho and the surrounding neighborhoods would go to.
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所以蘇活區和其他附近的人都會來這裡取水。
05:45
And so this little girl inadvertently ended up
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結果這個小女嬰
05:48
contaminating the water in this popular pump,
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不慎污染了公眾水源,
05:50
and one of the most terrifying outbreaks in the history of England
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二到三天之後,爆發了英國有史以來
05:56
erupted about two or three days later.
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最恐怖的瘟疫。
05:58
Literally, 10 percent of the neighborhood died in seven days,
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七天之內,蘇活區有百分之十的人死於霍亂,
06:02
and much more would have died if people hadn't fled
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如果不是有人在霍亂爆發初期就逃跑了的話,
06:04
after the initial outbreak kicked in.
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死傷的人會更多。
06:07
So it was this incredibly terrifying event.
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那時真的很可怕,
06:09
You had these scenes of entire families dying
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你會看到某個家族在霍亂開始傳染
06:12
over the course of 48 hours of cholera,
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的48小時內全部死亡,
06:14
alone in their one-room apartments, in their little flats.
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死在他們那間只有一個房間的公寓裡。
06:19
Just an extraordinary, terrifying scene.
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那是你無法想像的恐怖。
06:22
Snow lived near there, heard about the outbreak,
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Snow住在那附近,他知道霍亂開始流行了,
06:26
and in this amazing act of courage went directly into the belly of the beast
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他鼓起驚人的勇氣直搗黃龍,
06:29
because he thought an outbreak that concentrated
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因為他認為這次霍亂的流行很集中,
06:32
could actually potentially end up convincing people that,
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或許可以說服人們
06:36
in fact, the real menace of cholera was in the water supply and not in the air.
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霍亂的真實傳播媒介是飲用水,而不是空氣。
06:42
He suspected an outbreak that concentrated
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他懷疑這麼集中的霍亂傳染,
06:44
would probably involve a single point source.
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應該可以找到某個特定傳播霍亂的水源,
06:48
One single thing that everybody was going to
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這個水源是那區居民都會使用到的,
06:50
because it didn't have the traditional slower path
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因為這次的傳染並不像人們所預期的
06:53
of infections that you might expect.
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緩慢地流行。
06:56
And so he went right in there and started interviewing people.
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所以他跑到了傳染集中地,開始訪問附近的人。
06:59
He eventually enlisted the help of this amazing other figure,
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最後他得到了一位傳奇人物的協助,
07:03
who's kind of the other protagonist of the book --
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這個人算是這本書中的另一個主角。
07:05
this guy, Henry Whitehead, who was a local minister,
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Henry Whitehead是當地的區長,
07:08
who was not at all a man of science, but was incredibly socially connected;
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他不是什麼科學家,但是卻很瞭解基層人民的生活方式。
07:11
he knew everybody in the neighborhood.
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他認識他區裡的所有住民,
07:13
And he managed to track down, Whitehead did,
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他開始追蹤看有什麼人
07:15
many of the cases of people who had drunk water from the pump,
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喝了那個汲水幫浦裡的水,
07:18
or who hadn't drunk water from the pump.
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又有誰沒有喝。
07:20
And eventually Snow made a map of the outbreak.
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最後Snow為這次大流行畫了一幅地圖。
07:25
He found increasingly that people who drank from the pump were getting sick.
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他發現許多喝了那個汲水幫浦裡的水的人,最後都生病了;
07:28
People who hadn't drunk from the pump were not getting sick.
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但沒有喝那裡的水的人,卻沒有生病。
07:31
And he thought about representing that
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他本來想為住在不同區域的人
07:33
as a kind of a table of statistics of people living in different neighborhoods,
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繪製一張統計圖表,
07:36
people who hadn't, you know, percentages of people who hadn't,
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看看哪些人沒有得到霍亂;
07:38
but eventually he hit upon the idea
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但最後他想到了一個點子,
07:40
that what he needed was something that you could see.
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他要做的是讓人可以一看就明白的東西。
07:42
Something that would take in a sense a higher-level view
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他要讓人一看就知道,
07:44
of all this activity that had been happening in the neighborhood.
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這個區域究竟發生了什麼事。
07:47
And so he created this map,
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他最後畫出了這幅地圖,
07:50
which basically ended up representing all the deaths in the neighborhoods
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他用黑線來代表死去的人,
07:54
as black bars at each address.
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並在街道圖上的每一個門牌標識出死亡人數。
07:57
And you can see in this map, the pump right at the center of it
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在這張地圖上你會看到,汲水幫浦在地圖的中央,
08:00
and you can see that one of the residences down the way
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在它旁邊的住家
08:02
had about 15 people dead.
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就死了十五個人。
08:04
And the map is actually a little bit bigger.
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這幅地圖本來比現在看到的大一點,
08:06
As you get further and further away from the pump,
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離汲水幫浦愈遠的住家,
08:08
the deaths begin to grow less and less frequent.
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死亡人數就呈現遞減狀況。
08:11
And so you can see this something poisonous
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你可以從這張圖清楚地看到毒物擴散的狀況,
08:14
emanating out of this pump that you could see in a glance.
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也就是以汲水幫浦為中心的發散狀況。
08:18
And so, with the help of this map,
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然後,靠著這張地圖,
08:20
and with the help of more evangelizing
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他以宣講福音的熱情,
08:22
that he did over the next few years
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又宣導了好幾年,
08:24
and that Whitehead did, eventually, actually,
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Whitehead也幫忙宣導,
08:26
the authorities slowly started to come around.
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政府當局終於慢慢瞭解這是怎麼一回事了。
08:28
It took much longer than sometimes we like to think in this story,
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他們所花的時間比我們想像的還要久,
08:31
but by 1866, when the next big cholera outbreak came to London,
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但是在1866年第二次霍亂大流行在倫敦爆發的時候,
08:36
the authorities had been convinced -- in part because of this story,
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政府當局終於相信--部分是因為上一次的教訓,
08:40
in part because of this map -- that in fact the water was the problem.
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部分是因為這幅地圖--問題出在飲用水上。
08:44
And they had already started building the sewers in London,
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那時倫敦正在興建污水下水道,
08:46
and they immediately went to this outbreak
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所以政府當局立刻來到霍亂爆發點,
08:48
and they told everybody to start boiling their water.
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要求每一個人要飲用煮沸過的水。
08:50
And that was the last time that London has seen a cholera outbreak since.
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自從那次之後,倫敦就不曾再發生過霍亂大流行了。
08:55
So, part of this story, I think -- well, it's a terrifying story,
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所以,這個故事,嗯,是有點嚇人,
08:58
it's a very dark story and it's a story
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而且有點恐怖,
09:00
that continues on in many of the developing cities of the world.
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但是這個故事卻成了世界上許多城市發展的教材。
09:04
It's also a story really that is fundamentally optimistic,
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這個故事基本上還是有樂觀的一面,
09:07
which is to say that it's possible to solve these problems
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它告訴我們問題是可以解決的,
09:10
if we listen to reason, if we listen to the kind of wisdom of these kinds of maps,
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只要我們找到原因、只要我們看看這幅地圖背後所隱藏的智慧、
09:14
if we listen to people like Snow and Whitehead,
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只要我們聽取像Snow或是Whitehead這類人的意見、
09:16
if we listen to the locals who understand
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只要我們尊重瞭解狀況的
09:18
what's going on in these kinds of situations.
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當地人的聲音,
09:21
And what it ended up doing is making the idea
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最後我們一定能讓
09:24
of large-scale metropolitan living a sustainable one.
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這麼大規模的城市穩健地發展起來。
09:28
When people were looking at 10 percent of their neighborhoods dying
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當人們在七天內目睹了百分之十
09:31
in the space of seven days,
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的鄰居死亡,
09:33
there was a widespread consensus that this couldn't go on,
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大家都知道不能再這樣下去了,
09:36
that people weren't meant to live in cities of 2.5 million people.
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也就是城市不應該擠進二百五十萬人口。
09:40
But because of what Snow did, because of this map,
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但由於Snow製作出了這張地圖,
09:42
because of the whole series of reforms
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也因為這張地圖喚醒政府當局
09:44
that happened in the wake of this map,
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進行了一連串的改革,
09:46
we now take for granted that cities have 10 million people,
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我們現在對於擁有千萬以上居民的城市,早已司空見慣。
09:50
cities like this one are in fact sustainable things.
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這種規模的城市可以持續存在,
09:52
We don't worry that New York City is going to collapse in on itself
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我們不會擔心紐約有一天
09:55
quite the way that, you know, Rome did,
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會像羅馬帝國那樣瓦解,
09:57
and be 10 percent of its size in 100 years or 200 years.
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在100或200年之後縮小到只有原來百分之十的規模。
10:00
And so that in a way is the ultimate legacy of this map.
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這或許是這幅地圖所留給我們最好的遺產,
10:03
It's a map of deaths that ended up creating a whole new way of life,
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雖然這是一張死屍地圖,但卻為我們創造了全新的生活方式,
10:08
the life that we're enjoying here today. Thank you very much.
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讓我們在今日得以享受人生。謝謝各位。
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