As Newton puts it "his early admission into the restricted governing class of a cathedral city is a measure of his personality, as well as of his political and religious orthodoxy".

Newton states that his departure from the city was under something of a cloud "His reputation seems to have suffered locally from the injudicious acceptance of a legacy from a mental patient under his care".

The book describes the arrival of cholera in the city, the reactions of the citizens and authorities to the disease and the efforts of the Board of Health in coping with the outbreak.

It clearly describes the problems faced by nineteenth-century towns with their inadequate administrative arrangements, organisation and financial resources in trying to cope with the cholera outbreak.

John Snow is well known for his study of the cholera outbreak in London and his use of a map to illustrate the locality of deaths to a public water source on Broad Street.

The so-called "Ghost Map" is cited as a kind of watershed moment in the history of epidemiology and to some extent also in Information Design and GIS.