Academic journal article Historical Journal of Massachusetts

Cholera in Worcester: A Study of the Nineteenth-Century Public Health Movement

Academic journal article Historical Journal of Massachusetts

Cholera in Worcester: A Study of the Nineteenth-Century Public Health Movement

Article excerpt

Abstract:1 This study compares the municipal, medical, and social responses in Worcester to two national cholera outbreaks: the epidemics of 1849 and 1866. While public attitudes towards both epidemics demonstrate the misguided idea that cholera was a disease of moral intemperance, the medical and municipal responses to the later epidemic reveal a shift in emphasis from finding a cure to preventing the disease. When confronting the later epidemic, Worcester's municipal leaders mobilized resources to promote sanitation. Worcester's response to these two epidemics offers a case study of the important role cholera played in the rise of the public health movement in America. Alan Ira Gordon teaches in the Urban Studies Department at Worcester State University and is an urban planner.

Cholera is the classic epidemic disease of the nineteenth century. In successive waves of epidemics, it appeared in almost every part of the United States. Three major cholera pandemics swept across Asia, Europe, and North America in the mid-nineteenth century: in 1832-34, 1848-49, and 1865-66.2

The symptoms of cholera are both spectacular and terrifying. The onset of the disease is marked by diarrhea, acute spasmodic vomiting, and painful cramps. Dehydration accompanied by cyanosis, discoloration of the skin .caused by poor blood oxygenation, often gives the sufferer a blue complexion. Death may occur any time from a few hours to within a day of the first symptoms. Cholera can spread from any pathway leading to the human digestive tract. While unwashed hands or uncooked fruits and vegetables have at times been responsible for transmission of the disease, sewagecontaminated water supplies have been the major cause of the most severe cholera epidemics. The disease results from the colonization of the small intestine by the bacterium Vibrio cholerae?

This study is an examination of the effects of the cholera epidemics of 1849 and 1866 on the nineteenth-century urban community of Worcester, Massachusetts. The purpose of this study is not to merely detail the ravages of this dread disease upon a particular community. Rather, by analyzing municipal response to the epidemic, local social attitudes, and the response of the local medical profession, this study offers a broader picture of the evolution of the public health movement and the practical utilization of medical science techniques within the nineteenth century urban environment.

The connection between cholera and public health movements in America is documented in the historical literature. In his seminal study of general American medical history, Medicine In America-Historical Essays (1966), Richard Shryock argues that cholera was the vital catalyst that inspired public health measures in the mid-nineteenth century.4 It was largely fear of this disease that prompted the organization of health departments in cities throughout America between 1830 and 1880. According to Shryock, the most alarming epidemic diseases of the nineteenth century were yellow fever, limited to the South after 1825, and cholera. It was these two diseases that aroused terror, and which therefore inspired public health measures to a greater degree than did the more devastating tuberculosis.5

In The Cholera Years: The United States In 1832, 1849, and 1866 (1962), Charles E. Rosenberg argues that cholera epidemics of the nineteenth century provided much of the impetus needed to overcome centuries of government inertia and indifference in regard to problems of public health. According to Rosenberg, the cholera epidemics were transitory phenomena during which advances in public health and medical science were catching up with parallel evolutions in U.S. urbanization and the growing transportation revolution in U.S. metropolitan areas. Cholera represented a recurring stimulus against which the varying social and medical beliefs of Americans toward health could be judged.6 The public responses in Worcester to the 1849 and 1866 outbreaks offer an intimate portrait of municipal, medical, and social responses to disease. …

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