Cholera: Being Blue in New York with Baylee Browning-Atkinson

Cholera is a disease that has a long and deadly history. A cholera-like disease is described as early as the 5th and 4th BC in ancient sources, such as the Greek physician Hippocrates and the Sushruta Samhita medical text. It crops up again in 1543 in the Ganges Delta. The disease was endemic to the Ganges Delta, until 1817, when contaminated rice spread from the Delta to the rest of India and beyond following trade routes and military troops to the rest of Asia, Europe and eventually the Americas. A disease which is endemic is native to or regularly found in an area or among a specific group. The WHO claims that “Cholera is now endemic in many countries.” Since this initial spread there have been six cholera pandemics. According to the World Health Organization, we have been in our seventh cholera pandemic since 1961, this one originating in Indonesia, though most of us might not know this. The United States in particular has not been affected since the fifth cholera pandemic, which occurred between 1881 and 1896.

A quick Google search will tell you that cholera is not endemic to the United States. The disease is rare here, with an annual average of less than 1,000 cases. Cholera is a diarrhoeal infection caused by ingesting contaminated food or water. The skin of cholera victims can develop a bluish tint because of fluid loss, hence the nickname Blue Death. The disease is more common in impoverished and underdeveloped countries and in refugee camps, where groups of people can be exposed to materials or individuals contaminated by the Vibrio cholerae bacteria. In order to prevent the initial infection and further spread of cholera good hygiene, sanitation programs, and access to clean water are essential. As cholera can lead to death because it rapidly depletes the body of fluids, rehydration is the key to treatment and recovery.  Specifically the WHO recommends an oral rehydration solution.

Cholera first appeared in the United States in 1832 during the second pandemic. Much like any disease it probably spread from an infected area through trade, military movements, and or travel. As per the New York Times, approximately 3,500 people, a disproportionate number of them being impoverished immigrants and minorities residing in crowded tenements and slums, died from cholera in 1832. In some ways it was a scene eerily similar to what we hear on the news. Doctors were ill-equipped, lacking the supplies, numbers, and knowledge to properly handle the epidemic. Today we understand how diseases are transferred. It was not until 1854 that a connection between contaminated water and cholera was made by Dr. John Snow in London. Prior to Dr. Snow’s discovery, it was widely believed that disease was caused by miasmas, bad noxious vapors or air. According to the miasmas theory, airborne fumes from rotting material could not spread contagion.

To further explain the contemporary medical theory I found a very interesting article/advertisement published on October 5, 1833 in the Corrector, a Sag-Harbor newspaper. In very poetic language, the author of “Health” explains how his forward thinking remedy, “HYER’S PILLS, The American Improved Hygeian Vegetable medicine” is the only medicine which is “warranted to be superior to ALL OTHERS” for the curing of the cold, a fever, and cholera. The credibility of his claims and cure aside, this writer provides a very interesting look at the basic understanding of disease in rural Long Island. As he explains:

When the juices of the body – or the blood – is deteriorated in quality and consistence, the solids participate in the evil, in the same manner as those inanimate productions of nature perish from the vitiated qualities of peculiar soils. Hence the origin of disease, for which physicians grope in vain among the solids, instead of ascending to the source – the blood. Purify this pabulum – this stream of life, and the whole system becomes pure (The Corrector, “Health”)

Hyer’s Pills seem to offer an alternative means of purifying the blood to the traditional bloodletting.  To combat the cholera epidemic, doctors in 1832 relied on traditional methods of bleeding and on medicines such as calomel and laudanum or poultices made of vinegar and cayenne pepper, according to the New York Historical Society.  While cholera can kill within a day or two from rapid dehydration, bleeding patients probably worsened their chances of survival. Additionally, urban spaces in general, New York City in particular, was crowded and unsanitary. This was an ideal environment for cholera to take root and spread.  It was not until 1849 that an upwards of 20,000 roaming pigs, formerly used to manage waste as well as for food for the poor, were successfully banished from the main city (previous attempts to banish the pigs had failed because of rioting).

Cholera reached the New York region again in 1849, when infected passengers escaped a ship quarantined off Staten Island. Approximately 5,000 people died. In 1854, cholera killed 2,000 people. Only 1,137 people died of cholera in the city in 1866, a relatively low number especially when considering that the population kept expanding throughout the period. What changes over this period is the understanding of disease and how to control spread.  We see New York specifically gradually learn to prepare for epidemics, specifically cholera, by eventually securing access to cleaner water, clearing the city of waste and roaming pigs, and enacting preventative measures such as quarantining potentially contaminated vessels.

What I have just laid out is my understanding of cholera and how the New York region, New York specifically, learned to manage the epidemic over time. I did not know much about cholera setting out on this project, I hope you found it interesting as well. This is all context for a particular incident which occurred on Long Island. In 1892 the Cephus was prevented from unloading passengers at a quarantine site on Fire Island because the dock was blockaded by Long Islanders in their catboats. It is a very interesting story. Much of this information was new to me. If you are interested in reading more about cholera pandemics a quick Google search will give you a lot of information.

Further Reading:

New York Historical Society
History.com
World Health Organization 
Wikipedia, Miasma Theory
Wikipedia, Cholera
NYCdata (Sponsored by the Weissman Center for International Business at Baruch College)
New York Times
 New York Historic Newspapers