Midwest America has been the same for most of its
history. In the nineteenth century was a peaceful, agriculture-focused area, as
it still is today. It is an area commonly associated with being rural and
industrial. Interior lowlands gave this area the common names of “corn belt”
and “breadbasket” of the nation.[1] Automobile
and steel industries which had been central to the economy slowly faded away,
calling the Midwest a rustbelt. This physical environment influenced the way
regional culture developed. Rich topsoil and many water bodies made it possible
for the Midwest to become a heavy agriculture area and prone to great
industrial developments.[2]
Many cities were formed along rivers because rivers were
the main mode of transportation; later railways were added and these cities
became even more of transportation hubs. Saint Louis, located on both the
Mississippi and Missouri Rivers, was one of these cities. During the nineteenth
century, the concept of suburbs went through a major change. Before this area
was a place for social outcasts and lower classes, now it was a place for the
social “elites”[3].
The countryside was becoming somewhere elite people wanted to live to escape
the unwanted loudness and pollution of cities. As elites moved out of the
cities, new immigrants and working poor citizens were moving in. Cities were
places they could easily find work to support their families. Suburbs were, in
a sense, off limits due to the discriminating real estate and zoning practices.
[4]
The multiple outbreaks of cholera changed the way of the
Midwest as well the rest of the United States. Cholera killed thousands of
people living in the Midwest. The disease swept though towns like a storm,
infecting and killing people in a mere matter of days. The “germ theory had not
yet been accepted; instead, the debate over the cause was between Contagionism
and Miasmatism.[5]
Miasmatism was the idea that epidemics occurred because of harmful fumes in the
air and that contact with these fumes would cause illness. The generation of
these fumes was thought to be the decomposition of dead plant and animal
matters along with hot temperatures in dirty and ill ventilated cities.[6]
The Contagionism theory is just as it seems. One could contract the disease
from interaction with another person or the environment cholera was present in.
This theory was a precursor to the “germ theory” which would not be discovered
until late 19th century.[7]
However there were many points that limited the conditions in which cholera was
contagious. For example, as stated by Daniel Drake, M.D. in his book “History,
Prevention and Treatment of Epidemic Cholera”, cholera cannot be contracted by
a person carrying the disease alone. He also writes, “Actual exposure, then, to
the atmosphere of the sick, is indispensable; but such exposure, it is admitted
by all, will affect a very small number only”.[8]
Treatment was divided into four stages that corresponded
to the four presumed stages of the cholera disease: premonitory; cramps,
diarrhea, and coldness; collapse, and consecutive fever. [9] However,
as the actual causes of cholera were not known, symptoms were often mistaken
for less serious diseases such as upset stomachs, food poisoning, common
diarrhea, and dysentery. So many of the stages of cholera were treated the same
as one would be treated for any of these lesser diseases. Blood-letting was a
common form of treatment as it was believed symptoms were caused by an
inflammation in the lining of the stomach and bowels. Fevers were treated with
mixtures of Rochelle powders, castor oil, Epsom salts, or magnesia and
lemonade.[10]
Patients were also advised to adhere to special diets and take tonics. As patients
progressed through the stages of cholera, the same treatments were administered,
but more frequently and at intensified amounts.[11]
Modern medicine has discovered the true cause of cholera.
“Cholera is an acute, diarrheal illness caused by infection of the intestine
with the bacterium Vibrio cholera”.[12]
This bacterium comes from food and water sources that have been infected with cholera.
It is found in places with inadequate water treatment, poor sanitation, and
improper hygiene. The disease was easily spread among areas with these
conditions in the nineteenth century because sewers were the same places people
got their drinking water.[13]
So as people contracted the disease from the contaminated water, they put their
infected feces back into the water and spread it to others, creating a vicious
cycle where the only escape was death or to flee the area.
When Cholera came to the Midwest for the first time in
1832, it was a place of complete panic. Cholera was a disease that no one
really knew anything about. It was thought to be caused by miasmas and filthy
living conditions. Drinking water was drawn from places near waste dumping
sites, so often the contents of each became mixed. However, during these times,
since people knew nothing about how cholera worked, they did not do anything to
change sanitation problems in cities.[14] People
were unaware of their illness until they were suddenly subjected to
stomach-cramps, nausea, fever, and diarrhea. The bacterium, although not
discovered yet, could live outside the human body; this was how the disease
traveled.[15]
By the time it was learned water was affecting the outbreaks and the spread of
cholera, it was too late for victims in the 1832 and 1849 outbreaks. However,
this did not completely fix the issue, as there were just as terrible epidemics
in 1866 and 1873.[16]
Cholera was not restricted to the United States. In
fact, it began in the Ganges Delta Region. Until the arrival of Europeans and
their new methods of transportation, railroads and steamships, cholera had been
isolated to India. By 1827, cholera had followed the trade routes from Russia and
in 1831, all of Russia’s major cities had been infected. Cholera continued
moving west and by 1832 had reached Paris.[17] The
response to this outbreak was significant in that the Central Board of Health
in Great Britain was founded along with smaller local boards of health that
were directly under the former. These boards set up hospitals in which patients
were placed as soon as they were detected to be infected with cholera. Boards
also were in charge of mandating a cleansing of the households from which sick
persons had lived. Clothing and furniture were washed, if not burned; walls and
ceilings were lime washed; doors and windows left open to air out for days.[18]
Cholera hit the hardest in small towns. Already these
towns had small populations reliant on themselves and each other for business;
so when cholera infected their people, entire families were wiped out. Deaths
were reported in years, but when on a scale of weeks or days, the actually time
it took one to die of cholera, the numbers were outstanding. A total death toll
for a year could outnumber the actual town’s population. The case was the
opposite in big cities. Although the total number of deaths was higher, cities
were able to keep running. In both outbreaks 1832 and 1849, Saint Louis lost
5,057, Cincinnati lost 6,701, and Detroit lost 1,022. In each outbreak, the
number of deaths was only five to ten percent of the total population. [19]
Business in these big cities slowed during the worst
parts of cholera, but ultimately they were able to continue on as usual.
Indiana economy was affected quite badly however. When people are scared to
leave their houses for fear of dying, businesses are not going to run. In 1850,
the only railroad in Indiana, between Madison and Indianapolis, shut down.[20]
The newspaper in Salem, Indiana stopped its publication. Newspapers that did
keep up with publication however, were very quick to hide what was really going
on. They would reveal information about cholera in neighboring towns, but never
said anything about its population suffering. As history has proved, when a
population panics, the entire situation worsens. People were already scared of
cholera, so when they learned it had started killing people in their hometowns,
they fled. However, they had already been exposed to cholera, so while they
fled to escape it, they only took the disease with them.[21]
While the disease began in southern Asia, it moved west,
infecting London, then New York and finally the Midwest. In June of 1873,
cholera was in full effect, infecting and killing people daily. Cholera tended
to have a higher mortality rate in slum areas inhabited by the poorer citizens,
often being Irish and blacks. “Irish lived in the worst housing, under the most
crowded circumstances, and were least able to afford good water, medical care,
or flight from the epidemic.” It was also believed that blacks suffered from
cholera because of their “social and genetic inferiority.” [22] Keeping true to these ideals, blacks suffered
immensely from cholera, not because they were genetically inferior, but because
they were subject to the worst hygienic conditions. The conditions in which
these people lived made it very easy for cholera to become prominent. Filth,
bad air, and narrow, badly-paved streets mad it almost impossible for one to
avoid contracting cholera. [23]
These conditions were tied directly to their wealth. Rich people died of
cholera, but nowhere close to the extent of which poor families did. Poor families
lived in a crowded manner with little concern to keeping the streets clean. The
lifestyle of the people living here was regarded as “drunkenness and squalor of
the vicious and degraded.”[24]
Mount Vernon, Indiana is located on one of the highest
points along the Ohio River between Louisville and Cairo. In 1873, it was surrounded
by farmlands, had excellent natural drainage and clean dry air, and the people
living there had unusually good health. When it was heard cholera had made its
way to cities surrounding Mount Vernon, no one was concerned, although they did
pay special attention to their diets and cleanliness.[25]
One man died of cholera in another town, but spread the disease among his
brother’s household when his body was brought home. Five family members ended
up dying of cholera.[26]
Another man, Mr. Russel, came down with cholera after visiting a steamboat. He
and his wife started displaying symptoms of cholera, so she moved to her
father’s house as he recovered. Her father caught it and died and so the
process of spreading cholera began. A farmhand, Pickles, who visited often
caught it and died of it in a hotel. The woman who washed the sheets at that
hotel, Mrs. Schwalm, caught it and both she and the woman who helped her died.
A Mr. Koonce came to get Mrs. Schwalm’s children after her death. He put them
in the bed she had died in and took them away. Later all three children died
from Cholera.[27]
It can be assumed that the constant steamboats in and out of the port were
bringing in supplies and people suffering from cholera. One interaction with
cholera and it spreads through a town like wildfire.
Indianapolis, Indiana is in central Indiana, built
around a major railroad-center. There was a constant in-and-out of trains
during 1873. The first case of cholera
was a bartender in a restaurant located across the street from the rail
station. The next day, another man fainted and began vomiting. However, both
men recovered from this. Throughout the next several days, people showed
symptoms of cholera and died. It took almost three weeks before the Board of
Health recognized these cases as cholera. The cholera epidemic had seized
cities within hourly communication on Indianapolis, and thus it was
acknowledged that travelers who ate at this restaurant brought cholera with
them.[28]
In Lizton, Indiana 1874, Allen Davis worked at a railroad
station and was exposed to all that traveled along the rail line. He came down
with cholera and spread it to his wife, who both recovered. However, Heelmic, a
man who worked with Davis, caught cholera and both his infant and he died. His
married daughter, Mrs. Christie, and her husband and two of three children died
of cholera as well. The attending doctor died as well as another couple he
looked after. A young woman who had visited Allen Davis brought cholera back to
her family. She, her mother and two sisters all died of cholera; her father the
sole survivor.[29]
The main form of treatment for cholera, as advised by
the New York Health Department in 1873, was simply to constantly disinfect
everything that came into contact with a person infected with cholera. Water
closets, drains, seats and floors, containers holding discharges, clothing,
sheets, towels etc. were all to be disinfected and aired out. Damp cellars were
advised to have fresh stoned lime inside to absorb any and all moisture; doors
were to be kept open to promote air flow. Good health required one to drink
pure water, be exposed to fresh air, eat substantial food, rest often and bathe
frequently.[30]
The first outbreak of cholera pushed cities to clean up
their water systems. In New York, the Croton Aqueduct was completed in 1842 to
bring clean water from upstate. Doing this slowly got rid of private wells that
were often polluted. Although there were still major out breaks of cholera in
1866 and 1873, a London physician, Dr. John Snow, discovered that cholera was
connected to contaminated water. In 1854, he plotted cholera cases on a map
which showed him that most of the victims drew their water from the same public
pump. This well was located very close to a cesspool where incidentally a baby’s
diaper, infected with cholera, had been dumped. [31]
“Historians of medicine credit Dr. Snow with advancing the modern germ theory
of disease and laying the foundations of scientific epidemiology.” After a less extreme outbreak of cholera in
1866, the Metropolitan Board of Health was established. Doctors had roles and
powers to clean the city, and make sure it did not become as it once was again.[32]
A book by Daniel Drake, M.D., written in 1832, provides
very good reasoning on how to prevent spreading cholera. He divides these
points into public and private precautions. His first public point is to say
that quarantines and shutting off access to the city have not proved helpful in
containing the disease. He also says that taking patients to large hospitals
has not been effective either. Too often the patient dies on the rough carriage
journey to the hospital. His next point is to clean up the filth from the
cities. This includes the streets, the chlorine gas being emitted, and any sort
of water collection area.[33] Drake
sates that municipal corporations should do a better job at providing medicines
to people who are sick, especially to those who cannot afford it. His last
preventative strategy for families to retreat to the country, as it is the
cities where the majority of people are dying of cholera. Although he does warn
that if families do decide to retreat, they must do so at the onset of cholera,
before the city has become infected. Otherwise they would be taking the disease
with them. [34]
As for the private matter of preventing cholera, Drake
cannot stress enough how important it is to keep all parts of one’s self and
home clean. The house should be disinfected, and aired out. At night the
windows should be closed, as the damp night air is a perfect environment for
cholera to attack. He advises for each person to wash daily with cold water and
dry off well, also taking a warm bath once or twice a week. Wearing clean
flannels to bed will help prevent the night air from seeping in.[35]
Drake also addresses the diets one should upkeep. “To ward
off the Epidemic, our diet should be temperate but generous. All extremes are
to be avoided.”[36]
This means food and drink. People should eat plain, but healthy foods. They
should also not drink lots of alcohol. However, if their body is accustomed to
drinking daily, they should not change, but also not “indulge in fits of
drunkenness”.[37]
Cholera
has forever changed the United States of America. A once growing population was
stricken with a terrible disease, killing thousands over a short period of
time. But the US has become a better nation because of it. We have discovered
the germ theory. This theory has made modern medicine the way it is. Because of
cholera we also have Boards of Health all over the world, looking out for its
entire people. Streets and water sources are kept clean. Medicine has become
available to those even in poverty. The changes the United States made to
preventing diseases has, and will continue to protect citizens for a very long
time.
[1] Countries and Their Cultures, "United States
of America." Last modified 2014. http://www.everyculture.com/To-Z/United-States-of-America.html.
[2]
Countries and Their Cultures, "United States of America."
[3]
Countries and Their Cultures, "United States of America."
[4]
Countries and Their Cultures, "United States of America."
[5] Beardslee,
G. William. Archiving Early America, "The 1832 Cholera Epidemic."
Last modified 2000.
http://www.earlyamerica.com/review/2000_fall/1832_cholera_part1.html.
[6] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
Cincinnati: Corey and Fairbank, 1832.
https://ia600206.us.archive.org/3/items/39002086311520.med.yale.edu/39002086311520.med.yale.edu.pdf
[7]
Beardslee, G. William. Archiving Early America, "The 1832 Cholera
Epidemic."
[8] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[9]
Beardslee, G. William. Archiving Early America, "The 1832 Cholera
Epidemic."
[10] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[11] Beardslee, G. William.
Archiving Early America, "The 1832 Cholera Epidemic."
[12]Centers for Disease Control and Prevention, "Cholera
- Vibrio cholerae infection ." Last modified July 30, 2013.
http://www.cdc.gov/cholera/general/index.html.
[13] Centers for Disease
Control and Prevention, "Cholera - Vibrio cholerae infection ."
[14]Walter Daly,
M.D., "The Black Cholera Comes to the Central Valley of America in the
19th Century - 1832, 1849, and Later," Transactions of the American
Clinical and Climatological Association, no. 119 (2008): 143-153,
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394684/.
[15] Beardslee, G. William. Archiving Early America, "The
1832 Cholera Epidemic."
[16] Noble Wilford, John. "How Epidemics Helped Shape
the Modern Metropolis." The New York Times, April 15, 2008.
http://www.nytimes.com/2008/04/15/science/15chol.html?_r=4&8dpc&.
[17]
Beardslee, G. William. Archiving Early America, "The
1832 Cholera Epidemic."
[18]
Beardslee, G. William. Archiving Early America, "The
1832 Cholera Epidemic."
[19] Walter Daly, M.D., "The Black Cholera Comes to the
Central Valley of America in the 19th Century - 1832, 1849, and Later,"
[20] Walter Daly, M.D., "The Black Cholera Comes to the
Central Valley of America in the 19th Century - 1832, 1849, and Later,"
[21] Walter Daly, M.D., "The Black Cholera Comes to the
Central Valley of America in the 19th Century - 1832, 1849, and Later,"
[22]
Beardslee, G. William. Archiving Early America, "The 1832 Cholera
Epidemic."
[23] "Death Rate in Tenement Houses- Condition of the
Streets- The Progress of Cholera." The New York Times, June 25,
1873. http://query.nytimes.com/mem/archive-free/pdf?res=9A07E0DC1331E43ABC4D51DFB0668388669FDE.
[24] "The Prey of Cholera." The New York
Times, June 28, 1873.
http://query.nytimes.com/mem/archive-free/pdf?res=9402E2D6143CE63ABC4051DFB0668388669FDE.
[25] John Woodworth, M.D. , The Cholera Epidemic
of 1873 in the United States, (Washington: Washington Government Printing
Office, 1875)
http://books.google.com/books?id=LIYaAAAAMAAJ&printsec=frontcover
[26]
John Woodworth, M.D. , The Cholera Epidemic
of 1873 in the United States
[27]
John Woodworth, M.D. , The Cholera Epidemic
of 1873 in the United States
[28]
John Woodworth, M.D. , The Cholera Epidemic
of 1873 in the United States
[29]
John Woodworth, M.D. , The Cholera Epidemic
of 1873 in the United States
[30] "The Prevention of Cholera." The New
York Times, June 29, 1873.
http://query.nytimes.com/mem/archive-free/pdf?res=9B04E6DF153CE63ABC4151DFB0668388669FDE.
[31]
Noble Wilford, John. "How Epidemics Helped Shape the Modern
Metropolis."
[32]
Noble Wilford, John. "How Epidemics Helped Shape the Modern
Metropolis."
[33] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[34] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[35] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[36] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
[37] Drake, M.D., Daniel. A
Practical Treatise on the History, Prevention, and Treatment of Epidemic
Cholera, Designed Both for the Profession, and the People.
