Disease in Places and Bodies: Miasma, Immorality and Poverty – Amanda Strano

The individual is dehydrated, has sunken eyes and cheeks, wrinkled hands and skin, body tremors, nausea, cramps, and projectile vomiting, and he or she ultimately dies in about twenty-four hours or less.

What exactly was the disease that caused in humans all of these and more? In the 1830’s New York City was forced to face public health’s worst nightmare – cholera. In the U.S. Navy’s brief film Cholera Can Be Conquered, we learn that cholera is a contagious disease that originated in India, which comes as no surprise. Overpopulation, squalor, and filth plagued the country long before the 1800’s, and the same water was used for drinking, bathing, and getting rid of waste. The water was then pumped back into the streets of the cities, where food was sold daily. India created a prime environment for cholera to not only plant its roots but also to continue to spread. Countries such as France and the United States (New York City specifically) were hit hard with the cholera epidemic and thousands died as a result.

In France, public health in the early to mid 1800’s was largely influenced by Louis René Villermé, a French hygienist who initially served as an army surgeon. Villermé studied what Coleman in Death is a Social Disease: Public Health and Political Economy in Early Industrial France called “social diagnosis,” meaning that he often did numerical work and wrote a lot about issues in society. One of his works in particular deals with the cholera epidemic of 1832. In it, he explored the disease as it occurred in both the luxurious lodging houses and the slums of France, for it was believed that the likelihood of becoming ill with cholera had to do with one’s economic status (link between poverty and disease). In other words, the poorest individuals who lived in the filthiest of conditions were the ones who suffered from cholera the most. Nevertheless, hundreds of French citizens were dying everyday.

Like France, New York City also lost many of its citizens to cholera. During the 1830’s, the city was overcrowded and flooded with immigrants. Many lived in dirty, dimly lit apartments that reeked of horrible odors. The outhouses, called privies, were shared by several families and were places for the waste to be collected…and hardly ever emptied. In The Cholera Years: The United States in 1832, 1849, and 1886, Rosenberg notes that pigs, goats, and dogs were found running in the streets and were the cities own personal street cleaners. Also like France, cholera tended to strike New York City’s poor and working class neighborhoods the most. Efforts were taken to try and control the epidemic, such as quarantine and attempts to purify the city that came a little too late, but the disease continued to harm all in its path.

Overtime, effective treatment methods for cholera have been found (the injection of blood plasma, for example), and there has not been a case of cholera in years. While public health has put that issue to rest, there have been many others to deal with since then. In Chapter 2 of Colgrove’s Epidemic City entitled “Public Health and the People,” three issues that New York City faced in the 1960’s and 1970’s were the poisoning of children due to lead based paint, the increasing heroin addiction associated with crime and theft, and NYC’s switch from a rigid to a more liberal stance on abortion. The issues are different from cholera in 1832 in that they are representative of a different, more modern society. However, they are the same because the link between poverty and disease is still present. Children who are eating the paint off the walls and are falling out of windows and fire escapes more often than not come from lower class families. Most of the individuals addicted to heroin were poor males who constantly committed crimes to fund their addiction. Whether it is cholera in 1832, the problems faced in the 1970’s, or the issues of the future, public health will always be needed in order to promote the overall health and well being of society.