This blog post will take a look at a historic pandemic in Ohio. As our lives change to fight COVID-19, this can be a tough topic. Please put this post aside for later if the topic is too heavy to carry at the moment.
As we live through our own historic public health moment, you may have seen many reflections on the Spanish Flu pandemic that took hold of Ohio, and the world, just over 100 years ago. In fact we detailed Ohio’s experiences during the Spanish Flu here on the blog.
But what if we look back a little further? During the course of the 19th century, the world underwent multiple cholera pandemics, at least four of which significantly affected Ohio. Cincinnati, often the hardest hit of Ohio’s cities, regularly lost thousands of citizens each time a cholera pandemic arrived.
Cholera is built into the landscape of Ohio, from cholera cemeteries, like this one in Sandusky, to a small town still named Mount Healthy, where Cincinnati residents fled to safety during an outbreak. So why don’t we talk about cholera?
Pioneer Jewish Cemetery of Cincinnati where many cholera victims were buried.
The simplest answer is this: cholera is gross. Cholera is a bacterial infection, contracted when the bacteria Vibrio cholerae is ingested from contaminated food, or most often, contaminated water. We won’t get too far into the details here, but cholera kills, and spreads, through dehydration from vomiting and diarrhea.
We also tend look back on the cholera pandemics of the 19th century as a failure of historic medicine, because, while the disease still exists, modern scientific understanding makes it a lot less scary. Because we now know how cholera is spread, it is much easier to control- according to the World Health Organization about 80% of modern cases can be treated.
It is very easy to look back on people of the past as being ignorant or backwards- but they had to build the scientific understanding that we enjoy today. If we can put ourselves in the shoes of the 19th century Ohioans who did not yet understand the disease taking hold of their communities, there is quite a bit more to the story, and quite a few similarities to what we are experiencing today.
Cholera affected most parts of Ohio at one point or another. It traveled through the state’s canal system from city to city, or in the case of Cleveland, arrived on a military ship. Often one city would become infected and then its residents would flee, taking the disease with them to a new home. Cholera even provided some road bumps when updating Ohio’s constitution in 1850 (the convention had to be rescheduled and moved).
Although cholera spread throughout the state, the city worst hit was always Cincinnati. In fact, during the 1849 Cholera Pandemic, Cincinnati suffered more deaths than both New York and London.
Why was Cincinnati so hard hit? The Ohio River conspired to be sure cholera always took hold of the Queen City. Travel on the river to Cincinnati’s docks made the city a prosperous trade town, but prosperous trade centers are crowded and have a lot of visitors coming in and out every day- two recipes for the spread of disease. The reliance on docks (and the prevalence of nearby hog slaughterhouses) also meant many lower class residents were living and working in dirty and damp conditions- the breeding grounds of cholera.
A view of Cincinnati’s waterfront in the 1860s
In addition to the natural issues that Cincinnati faced, the city did very little to protect its residents through any sort of large-scale sanitation (during the earliest cholera pandemics, no one actually knew that water contamination was causing the disease). In 1826, the Cincinnati Water Company established a network of pipes to bring water from the Ohio River to many locations around the city. However, without a proper sewer system to keep dirty runoff from contaminating the river, the company was essentially just pumping bacteria filled drinking water into everyone’s homes. Even families that skipped the services of the water companies and used wells were at huge risk. Wells often picked up all kinds of dirty drainage. Many of Ohio’s cholera outbreaks can be traced back to a contaminated community well.
Because of the way that cholera spread, it affected Ohio’s working class residents first and most heavily. The poor had no choice but to live in places that naturally attracted cholera- such as the dirty docks that provided the jobs they needed to survive. They lived in close quarters and had the least access to clean water, safe food, and opportunities to separate themselves from ill family members to avoid spreading the disease.
Americans noticed that cholera specifically seemed to target lower class residents of their cities and towns, and without a knowledge of the actual causes of Cholera, they began to blame victims for their own suffering. The poor were often blamed for living in dirty places or eating unhealthy foods, two social determinants of health that lower class individuals have very little control over. In many cases, including in Cincinnati, many of the lower class individuals were Irish immigrants, adding a hostile anti-immigrant sentiment to the already unfounded victim blaming.
In Springfield, Ohio, the local newspaper reported during the pandemic of the 1850s that cholera deaths were due to the “gross imprudence” of the deceased and “anything like decent cleanliness and care,” could have protected them. In Cincinnati, one man wrote to his wife that she shouldn’t worry about him during an outbreak because the dead were “mostly German and Irish. Very few whom we knew have died.” Here the newspaper reported that because the typical lower class person “pays no attention to diet or regiment, is not particularly attentive to personal cleanliness, and eats anything that comes before him,” he was a “fit subject for the disease.”
Sandusky City Hospital Cholera Register, 1849.
Some Ohioans also believed that cholera victims were suffering for their own immorality. During the epidemic of the 1830s John W. Scott, a professor at Oxford, Ohio’s Miami University gave a talk titled “The cholera, God’s scourge for the chastisement of the nations.” In this speech, trying to rationalize the pain cholera had caused, Scott purported that the disease was a retribution from God for America’s many sins. His proof of this? Cholera’s “discriminating character.” He said, “It hunts out with extraordinary precision the abodes of vice,- the haunts of intemperance, debauchery, and every moral and physical pollution….the vicious and the intemperate are its proper subjects, and have been its principal victims.”
Of course the poor and immigrant class were not being struck down with cholera because of their own poor moral code or lack of interest in hygiene. The lower class just happened to live closest to the moral vices that men like John W. Scott felt were causing the pandemic. Like dirty docks and stinky slaughterhouses, the wealthy often don’t choose to live near places of evening entertainment, even if they choose to patronize them. Cholera was breaking out near “abodes of vice,” because this was where the poor were located, and the poor didn’t have the resources to avoid cholera.
The success of medical science during the 19th century cholera outbreaks was mixed, but the efforts of Ohio’s officials to calm the pandemics did lead to well-established Boards of Health that have aided citizens throughout nearly two centuries. The leader of Cincinnati’s cholera response, Daniel Drake, often missed the mark with efforts to save face and deny the disease, suggestions that the disease was airborne, and support for ideas like bleeding or calomel. However, he also helped the city build a Board of Health in 1832, and went on to help build a medical college in the city (now attached to the University of Cincinnati).
Medical College of Ohio, 1835
Contributions like Drake’s helped create further scholarship and preparedness for new outbreaks. In fact, towards the end of the 19th century, one of the contributing causes to the slowing of cholera pandemics was the ability of new Boards of Health to use advancing technology to communicate and track outbreaks on a larger scale.
During an 1854 outbreak of cholera, a British physician named John Snow (no relation to the character from Game of Thrones), tracked the disease to a water pump. Once the pump was removed, the disease slowed down in the area. It took about a decade until the world started to believe Snow’s new ideas about waterborne bacteria, but eventually large-scale sanitation came into practice, helping fight off cholera outbreaks more permanently.
Henry Boyd, a free black man who ran his own furniture store in Cincinnati, had suggested a similar solution during the 1832 outbreak, positing that the disease was waterborne and all drinking water should be boiled. Boyd was ignored by the white men that monitored Cincinnati’s response to the disease.
Cholera often turned Ohioans against immigrants in their communities, but in one small community in Putnam County, it was an immigrant that saved the day. In Gilboa, Ohio, when cholera struck in 1852, many of the residents fled, but three doctors remained to treat the ill. One of these doctors was named Gustav Thayte. Thayte, a political refugee from Hungary, had been taken in by a local family before the outbreak, but he stayed to help his new community.
Unfortunately, Thayte fell ill while treating cholera victims and succumbed to the disease himself. The family who had hosted the refugee, the Kisseberths, made sure that a headstone was placed for Thayte at the local cemetery. The headstone can still be found in Gilboa, bearing the poem the Kissberths wrote for Thayte:
On Hungary’s sunny plains,
He bore the standard high.
But death the exile claims,
Beneath this stone he lies.
Today we can thank past Ohioans like Dr. Thayte, Henry Boyd, and Daniel Drake for modern sanitation and Boards of Health. When we think of Ohioans who fought through the cholera epidemics of the 19th century, we can also take strength from our shared experiences across time, as we again face a great disease.
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