Cholera

Cholera. No disease, with the possible exception of yellow fever, aroused more fear in nineteenth‐century America than cholera, a deadly affliction that attacks the gastrointestinal system and causes a copious, watery diarrhea. Before the development of intravenous fluids in the twentieth century, cholera victims could dehydrate and die within a matter of hours after an attack. Although long present in Asia, cholera remained relatively rare in America until 1832. After that date, the Atlantic Ocean ceased to play its traditional role of buffer to the spread of epidemic diseases, as steamships transported growing numbers of emigrants from impoverished and unhealthful regions of the world to the United States. Domestic industrialization and urbanization, as well as the rudimentary nature of public health institutions, also contributed to the propagation of cholera.

The major U.S. epidemics occurred in 1832, 1849, and 1866, when thousands died from the disease. The 1849 epidemic claimed more than 5,000 lives in New York City alone. The last visitation came in 1892, when fewer that 150 deaths resulted nationwide. Prior to the advent of the germ theory of disease, which gained widespread credibility after the identification in 1882 of the tubercle bacillus as the cause of tuberculosis, physicians and laypersons alike attributed cholera to such factors as air polluted with rotting organic waste and refuse (called miasma), imbalances in the equilibrium of bodily fluids, and divine punishment. Well‐off Americans who escaped the disease often targeted particular social groups as the source of the scourge: the intemperate, the wicked (particularly in 1832), and the impoverished (especially Irish immigrants in 1849 and 1866 and East European Jews and southern Italians in 1892).

In 1866, the newly created Metropolitan Board of Health in New York City blunted an impending cholera epidemic by imposing sanitary measures on the city and thereby slowing the spread of the disease through the food and water chain. New York's success inspired other cities to create their own permanent boards of health. In 1883, the German bacteriologist Robert Koch discovered the etiologic agent of cholera, Vibrio cholerae, and its mode of transmission. In 1887, the Americans T. Mitchell Prudden and Hermann Biggs applied this knowledge at the Quarantine Station of the Port of New York to prevent the entry of the disease into the United States. That same year, William T. Sedgwick used improved water‐filtering methods to ensure a clean supply of pure and safe water in Lowell, Massachusetts. By the early twentieth century, most urban areas claimed a modern filtered water system and a sanitary sewage works, both bulwarks against the spread of cholera. By the end of the twentieth century, cholera was virtually unknown in the United States and other developed countries.
See also Medicine: From 1776 to the 1870s; Medicine: From the 1870s to 1945.

Bibliography

Charles E. Rosenberg , The Cholera Years: The United States in 1832, 1849, and 1866, 1962.
Howard Markel , Quarantine! East European Jewish Immigrants and the New York City Epidemics of 1892, 1997.

Howard Markel