“The Good Old Days”

 

“The Good Old Days”

 Just in case we begin to pine for simpler times and “the good old days”, I’ve extracted some commentary on life in nineteenth century America. After reading about diseases, sanitation and what horses contributed to society, maybe our fast-paced, seemingly narcissistic life and addiction to our electronic devices doesn’t seem quite so bad.

Nineteenth Century

Spreading Diseases

As American cities industrialized throughout the nineteenth century, infectious diseases emerged as a real threat. The introduction of new immigrants and the growth of large urban areas allowed previously localized diseases to spread quickly and infect larger populations. Towns grew into cities as industrialization sparked urban migration from rural communities in both the United States and Europe. The increased demand for cheap housing by urban migrants led to poorly built homes that inadequately provided for personal hygiene. Immigrant workers in the nineteenth century often lived in cramped tenement housing that regularly lacked basic amenities such as running water, ventilation, and toilets. These conditions were ideal for the spread of bacteria and infectious diseases. Without organized sanitation systems, bacteria easily passed from person to person through the water and sewage. As a result, many of America’s largest urban areas like New York, Boston, Philadelphia, and Washington DC fell prey to a rash of infectious diseases in the middle and end of the nineteenth century.

 

Understanding Diseases

Urban Disease and New York City

Large waves of immigration in the nineteenth century, made New York City America’s largest and most diverse city, but also its most unhealthy, as the large spike in population made it more susceptible to disease.16 Compared to other large urban areas, such as Boston or Philadelphia, New York’s death rate due to disease was considerably higher.17 It was not until the middle of the century that New Yorkers realized that their poor living conditions might be the cause of the city’s poor health. By the 1840s, high rates of disease were ascribed to the housing many of New York’s poverty-stricken immigrants lived in. Fear spread that while disease was rooted in the polluted living conditions of New York’s poorer communities, disease could easily spread to the more well-off citizens too. Public health officials realized that the city’s soiled streets and polluted sewers were a health risk to all New Yorkers.18 In the mid-nineteenth century, New York possessed a primitive sewage system. Poorly planned sewers spanned the city, but most citizens’ homes did not connect to these pipes. Instead, most New Yorkers relied on outdoor outhouses and privies. These outhouses were usually poorly maintained and covered in filth. Poorer families did not even have the luxury of an outhouse. They simply dug a small trench into the ground outside of their homes. Trenches and outhouses were both unsavory solutions as waste was rarely removed from them and frequently flowed into the streets of the city.

 Because of the high levels of unmanaged waste, epidemics of infectious diseases were commonplace in New York. The city battled outbreaks of smallpox, typhoid, malaria, yellow fever, cholera, and tuberculosis. In 1849, a rash of cholera struck the city, killing more than five thousand people. A wave of typhoid in the mid-1860s resulted in a similar amount of deaths.20 Port cities and transportation hubs, like New York, were especially prone to outbursts of infectious diseases because of the high volume of travelers that passed through the city. Cholera, for instance, was never a problem in New York until the overseas shipment of goods and persons between Asia and New York drastically increased in the mid-nineteenth century.

These epidemics were particularly deadly to children. In 1840, almost two percent of New York’s newborns failed to reach their first birthday. Especially in the summer months, infants and children were extremely susceptible to diarrheal diseases. These infections led to severe dehydration and, frequently, death. Young adults also faced many health risks. Between 1840 and 1870, nearly twenty-five percent of twenty-year-olds did not make it to the age of thirty. People in their twenties were often the most exposed to infectious diseases because of the long hours and dirty conditions they were expected to work in. The high death rate for children and young adults also had an impact on how nineteenth-century parents planned their families. Urban families realized that most likely at least one of their children would not reach the age of five. It was even more unlikely that parents would have most of their children survive their twenties to have children of their own. As a result, many working-class families adopted a sense of fatalism and planned on having large families so that at least some of their children would survive.

 This fatalist attitude was largely caused by the fact that Americans realized that they were contracting and dying from infectious diseases at an alarming rate, but weren’t entirely sure of why or how. The answers to these questions came later in the nineteenth century with the emergence of germ theory.

The Spread of Germ Theory

Towards the end of the nineteenth century, people sought to better understand and manage infectious diseases. A large part of this process was the widespread acceptance of germ theory.25 It was evident that poor living conditions—polluted water, overcrowding, spoiled food, etc.—were contributing to the spread of disease, but the science behind this could not be explained. It seemed that the only way to solve New York’s health problems was a massive investment in social programs for better housing and sewage systems, but also an expressed emphasis on personal hygiene. By stressing personal hygiene, however, responsibility for sickness was placed on the individual. This caused many people to blame the poor and infected for spreading their diseases.

It was not until the 1870s and 1880s that Americans began to realize that an individual was not entirely to blame for the spread of disease. As scientists analyzed transmission patterns of infectious diseases, they began to understand how specific pathogens were the causes of specific diseases. At first, many doctors doubted that something as small as a single bacterium could cause such deadly diseases. However, by the end of the nineteenth century, germ theory gained widespread acceptance in the medical community. The work of scientists such as Louis Pasteur and Robert Koch helped convince doctors and the public that the ideas proposed by germ theory were in fact true. Their work focused on testing the spawning of infections from bacteria, proving that specific pathogens were the causes of specific diseases. Convinced of the science behind germ theory, doctors and public health officials began testing water, food, and blood samples for traces of specific diseases. Using this data, government officials scrapped the old plan that emphasized simply ridding cities of waste and introduced a new strategy based on germ theory. Highlighting that diseases were often spread by individual contact, the new public health strategy focused on educating people on how they could prevent the transmission of diseases. These practices included recommendations as simple as frequent hand washing and ensuring that food was fully cooked before serving. The introduction of germ theory shifted the focus of public health and disease prevention away from citywide waste control towards an emphasis on personal contact and the individual spread of disease.

“Typhoid Mary”

The most infamous case of germ theory at work is the story of “Typhoid Mary.” Typhoid fever was a common problem in many nineteenth-century urban areas. A water- and food-borne bacteria, the disease spread easily and caused about a ten percent fatality rate. Typhoid typically struck hardest in cities without proper water sanitation systems, such as New York. However, by the end of the nineteenth century, when most American cities had built water treatment facilities, typhoid fever was still an issue and public health officials did not understand why. The answer was that many people remained typhoid carriers, without showing symptoms of the disease. Carriers showed no signs of illness themselves, but were host to the typhoid bacteria and could spread the disease to others.

 Mary Mallon, otherwise known as “Typhoid Mary,” is the most famous of these carriers. An Irish immigrant cook living in New York City, Mary was the first recorded carrier of typhoid fever. As a cook, Mary unknowingly spread the disease to many of the wealthy families she worked for across the city. In 1906, Mary began working in a summer rental home for a New York banker. Over the summer, typhoid fever struck over half of the people living in the home and the banker became worried that he would not be able to rent out the house again until he found the source of the disease. The banker hired George Soper to investigate the outbreak. ref]Evelynn Hammonds, “Infectious Diseases in the 19th-Century City” Soper determined that none of the food or water was contaminated so it must have been a cook who spread the disease. After tracing Mary’s work records back to 1900, Soper realized that Mary not only infected this family, but many others as well. Soper attempted to explain the situation to Mary, but she refused to believe him. In 1907, Soper turned over his findings to the New York City health department. The health department proceeded to apprehend Mary and quarantine her in a hospital. By this point, Mary was extremely untrusting of any health officials and frequently acted aggressively towards them. Tests performed on Mary confirmed the assumption that she was a carrier. For three years, Mary was forcibly held in health department custody. Mary was eventually released under the condition that she never cook again. However, she was recaptured shortly thereafter when another outbreak of typhoid was traced to her kitchen. Mary lived in forced isolation for the rest of her life, until her death in 1938.

 The story of “Typhoid Mary” has remained popular to this day, not because Mary Mallon was terribly unique as a carrier of typhoid fever, but because her tale epitomizes an entire era. Mallon was the first known healthy carrier of typhoid fever, but definitely not the last. At the beginning of the twentieth century, approximately one hundred New Yorkers became carriers of the disease each year. Mallon was neither the most deadly carrier nor the only carrier to disobey the health department’s guidelines. A man named Tony Labella is attributed to spreading typhoid fever to almost three times as many people as Mary and Alphonse Cotils, a bakery owner and typhoid carrier. “Typhoid Mary”, though, has found a prominent place in America’s history books because her story is the same story of thousands of others in the late nineteenth century. Mallon immigrated across the Atlantic to America’s largest city in search of a better life. What she found was a dirty and crowded city that offered work that came with low pay and long hours. Mary’s contraction and subsequent spread of typhoid fever is the perfect example of the cramped living quarters, poor working conditions, and poor hygiene that many late nineteenth-century immigrants faced.

What horses left behind in the 19th century city

Without the estimated 170,000 horses pulling street cars and delivery wagons at any given time in the late 1800s, the city would never have become an economic powerhouse.

But all those equines created a filthy mess. Each horse produced several pounds of manure and more than a quart of urine a day—much of it deposited on city streets and sidewalks.

 “Despite the presence of animals, the city had no systematic street-cleaning efforts,” wrote Columbia University professor David Rosner in an article called Portrait of an Unhealthy City: New York in the 1800s.

 “During winter, neighborhoods sometimes rose between two and six feet in height because of the accumulation of waste and snow.”

 “Dirt carters” would pick up the manure from the streets and haul it to specially designated “manure blocks,” where the waste attracted massive numbers of disease-transmitting flies.

Then there was the problem of working horses dropping dead in the street. “When a horse died, its carcass would be left to rot until it had disintegrated enough for someone to pick up the pieces,” wrote Rosner. “Children would play with dead horses lying in the street.”

 In 1880, the city picked up 15,000 abandoned horse carcasses off the streets. With that in mind, the noise and pollution from vehicular traffic doesn’t seem so bad.

[photo at right: the last horsecar run in the city, July 1917, on Bleecker Street at Mercer]

The 1918 Pandemic

The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918. It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.

Mortality was high in people younger than 5 years old, 20-40 years old, and 65 years and older. The high mortality in healthy people, including those in the 20-40 year age group, was a unique feature of this pandemic. While the 1918 H1N1 virus has been synthesized and evaluated, the properties that made it so devastating are not well understood. With no vaccine to protect against influenza infection and no antibiotics to treat secondary bacterial infections that can be associated with influenza infections, control efforts worldwide were limited to non-pharmaceutical interventions such as isolation, quarantine, good personal hygiene, use of disinfectants, and limitations of public gatherings, which were applied unevenly.

 

So, think about it. Notwithstanding the politics, and the nonsense barraged at us daily, we can truly be grateful that we live in our modern 21st century. Even 100 years ago, the Spanish Flu Pandemic killed 50 million people world-wide and 675,000 in the U.S. No Trump ‘warp speed” vaccines or antibiotics or therapeutics then. People just died.

And 150 years ago, 15 years before Gottlieb Daimler invented the automobile, if we wanted to travel somewhere, we got our buggy whip, hitched the horse to a buggy, and off we would go through the smelly, horseshit covered streets.

So much for “the good old days”.

Ray Gruszecki

December 26, 2020