Comment: New York defeated cholera by abandoning superstition

By David T. Z. Mindich / The Washington Post

“Dr. Fauci’s a nice man, but he’s made a lot of mistakes,” President Trump recently told Sean Hannity of Fox News. Fauci, who has served as director of the National Institute of Allergy and Infectious Diseases since 1984 and who led the fight against AIDS in the 1980s, has been sidelined by the Trump administration, which has attacked him publicly and through anonymously leaked smears.

In contrast to Fauci’s stellar reputation as a man of science, the administration has made Fauci a target in its effort to push questionable medicines and force Americans to learn to live with the coronavirus pandemic.

We’ve seen this tension among science, journalism and public health before.

The first wave of cholera came to New York City in July 1832. In less than two months, at least 2,000 New Yorkers had died, more than 1 percent of the city’s population. Residents hurried past the graveyard of St. Patrick’s in horror; the poorly buried bodies brought clouds of flies and a ghastly stench. In a familiar historical refrain, the well-to-do fled the city and managed to escape, but other communities; the poor, the newly immigrated and people of color were devastated.

Two more major cholera epidemics would hit the city, in 1849 and 1866. But from 1832 to 1866, medicine, science and journalism transformed American society and destroyed cholera. This transformation reminds us in the midst of the coronavirus pandemic of the importance of science over superstition.

In 1832, the medical profession was dominated by a “philosophical” approach that rejected observable data, according to Charles Rosenberg, who has explained how ” ‘Empiric’ was — as it had been for generations — a synonym for quack.” Doctors rejected signs that the disease might be contagious. Instead, they and public officials sought an explanation for God’s wrath. They looked to the heavens for answers and blamed sin, the poor, immigrants and bad “atmosphere” for the illness. Public officials sought to assure worried residents that the “atmosphere” was improving, that this too would pass.

The antebellum cures were ineffective when they weren’t actively harmful: rubbing mercury into patients’ gums, and giving patients ice water baths, leeches and something called tobacco smoke enemas. Leading 19th-century figure Charles Grandison Finney explained that it wasn’t just cholera he battled. “The means used for my recovery, gave my system a terrible shock, from which it took me long to recover,” he wrote.

Media coverage reinforced these ideas because the majority of American newspapers were partisan and were supported financially by political parties. In turn, their editorial content was predictably partisan and focused on advancing local economic interests. New York’s Morning Courier and New-York Enquirer, a newspaper with strong mercantile ties, assured its readers that business should go on as usual, and that the disease would abate: “A very severe thunderstorm passed over the city yesterday morning, which will, we hope, have the effect of purifying the atmosphere,” the newspaper wrote.

Suggesting that cholera was no big deal was important for maintaining political power for the party that then ran the city. Partisan ideology trumped an analysis of the facts.

The 34 years between the epidemics of 1832 and 1866 brought innumerable changes, but three stand out. First, British physician John Snow showed in 1854 that cholera was spread through the excreta of infected patients. At first, he had his doubters, but he proved his thesis by looking at customers using the two main water companies in London. He showed that Londoners drinking polluted wastewater from one company were faring much worse than those drinking water from the other.

The second change was that the scientific method had gripped medical communities, meaning Snow’s theories could be met with an open mind among doctors.

The third major change was a journalistic one. American newspapers were shedding their partisan baggage and embracing firsthand reporting and an open-minded and empirical relationship with the world; and this extended to coverage of public health. In fact, even before evidence of Snow’s study emerged, the independent New York Herald chastised doctors for avoiding the firsthand investigations of the topic. No “physician or student of medicine had made his appearance at any of the cholera hospitals for the purpose of observing and investigating the disease,” wrote the Herald in 1849. The paper criticized doctors’ “dislike of anything like attentive study of the disease.”

By the time the final major epidemic hit in 1866, medicine and news had transformed fundamentally, forcing political leaders and citizens alike to confront hard facts about the disease.

In the months leading up to the epidemic, the city’s political leaders began empowering health experts and assembling offices to gather and disseminate reliable data, and to clean up the city’s messes. “During the coming Summer,” announced The New York Times in late spring 1866, “the City is, for all practical purposes, to be governed by the ‘Board of Health.’” The board was charged with reporting efficiently and quickly, using the latest science and medicine, to stop the disease.

The newspapers of the era dutifully reported fact-driven updates every day, citing statistics, not superstition. Newspapers became less concerned with sin than with behaviors dangerous to public health, like a report in the New York Tribune that an infected woman had emptied the sewage from her house into her garden. The Tribune noted that the woman’s neighborhood was marred by the “foul effluvia of … overflowing privies.”

No longer were doctors and journalists looking up to the heavens for signs of God’s grace or the prevailing atmosphere. Instead, they looked down at, in the words of The New York Times, “privies, water-closets, and cess-pools connected with the sick.” This is not to say that journalists, doctors and politicians were unified in their approaches — the newspapers of the day are filled with discussions and debates about best practices — but they tended to embrace a common set of facts and a scientific worldview, underpinned by a sense of shared purpose.

Doctors, journalists and political leaders eschewed superstition, relied on facts and science, and worked together to end the menace of cholera. The streets became cleaner, the water became purer, and the disease was defeated. The epidemic of 1866 was New York’s mildest and its last. This triumph can serve as a lesson for our desperate time, too.

David T. Z. Mindich is chairman of the journalism department at the Klein College of Media and Communication at Temple University.