New York City is no stranger to deadly outbreaks. By the 19th century, the city experienced several deadly outbreaks, including smallpox, yellow fever, measles, and malaria. In fact, these diseases recurrently plagued New York City residents due to its role in trade between the American interior and the rest of the world. Sailors and traders from overseas brought with them fresh strains of familiar diseases. New settlers also added to the city’s problems in dealing with new outbreaks. Most of these diseases became epidemic and ran amok for a short period of time before burning out.

Medical knowledge in the early 19th century was not sufficient to deal with these epidemics. Differing opinions regarding the cause of diseases arose, which slowed and scattered communal responses to the outbreaks. Before the establishment of modern medicine, many people who claimed an understanding of medical treatment were given room to experiment on plague sufferers. Unfortunately, this stunted the development of legitimate treatments that would help patients recover. A weak city government also contributed to the spread of the disease by failing to investigate and pursue methods of eradicating the disease. In fact, few municipal efforts arose to meet the threat of disease beyond the occasional quarantine. Nobody acknowledged the link between disease and the lack of proper sanitation.

When cholera arrived in New York in the summer of 1832, many experts failed to address the cause of the disease. Cholera spreads through contaminated food and water and causes severe diarrhea and vomiting. If left untreated, victims may experience severe dehydration and die. Thousands of citizens died within weeks after cholera arrived on U.S. shores. The same epidemic occurred in 1849 and 1866 before New Yorkers learned how to contain the disease. The slow reaction came with notions that poor New Yorkers somehow caused the disease through a lack of morale. Luckily, this changed as the 19th century progressed and modern medicine developed.

Cholera in 1832

During the early 1830s, New York grew exponentially in population and wealth. The completion of the Erie Canal that linked the city with vast agricultural resources solidified New York’s central role in the nation’s economy. By the 1830s, nearly 250,000 people lived in New York City. Traders, bankers, shipbuilders, craftsmen, canal-diggers, and general laborers all occupied the city. Unfortunately, this came with divisions in social class that prompted a lack of response to the epidemic that soon was unleashed on the city.

• Class differences were partly to blame for the lackluster response to the cholera epidemic of 1832.
• Many Americans believed that the United States would not suffer from diseases transmitted from the Old World.

The epidemic started in Eastern Europe and then made its way across the continent before finally reaching the United States. When cholera hit the city in 1832, it affected the working class the hardest. The upper class viewed this as further proof of moral depravity among the poorest of New Yorkers. Even physicians upheld moral stature as paramount to the health of an individual. Unfortunately, this caused the spread of cholera to intensify within the city limits. By the end of the summer of 1832, roughly 3,000 New Yorkers had died from the disease.

• Religion and moral uprightness were thought to be the saving grace of the upper class.
• Nearly 100,000 people fled to the countryside to escape the epidemic that killed roughly 3,000 New Yorkers.

Cholera in 1849

New York City grew more densely populated between 1832 and 1849. Immigration exploded due to a famine that occurred in Ireland. This caused the downtown wards to become overcrowded. When cholera ravaged Europe in 1848, it soon made its way back to the United States. The disease arrived in December aboard a ship carrying ill passengers. Some of the passengers escaped to Manhattan, where the illness began to spread before the arrival of the new year. The freezing winter limited the spread of cholera. Few cases were reported during the first few months of 1849, but once the weather warmed, the outbreak grew, reaching epidemic proportions by June.

• Cholera arrived aboard a passenger ship carrying 300 people in December of 1848.
• The disease did not spread until mid-May and reached epidemic proportions by June of 1849.

The majority of the medical field accepted the belief that cholera was “portable.” This idea became widespread as cities and nations braced themselves for the spread of the disease when adjacent locales became infected with cholera. Some medical researchers believe that microscopic organisms spread the disease; however, the majority believed that it spread through an atmospheric shift. This belief continued until 1854, when John Snow discovered that the waste of cholera victims contaminated the water, which spread the disease.

• The majority of the medical field acknowledged that the disease was “portable” but not contagious.
• John Snow discovered that cholera was transmitted through contaminated water in 1854.

The government published updates regarding the progress of cholera; however, it seemed far less active than it did during the first epidemic. This suggested that public health policy had failed to adapt to the city’s population growth. New York had grown exponentially, but it did not keep up with the sanitation demands that came with an influx of immigrants. The cholera crisis should have sparked government intervention, but New Yorkers received the exact opposite reaction from their city government. As a result, cholera killed thousands. Forty percent of those who died were Irish immigrants. Cholera remained a constant threat until 1854 when the disease again reached epidemic proportions. It killed 2,509 that year alone before disappearing for a dozen years.

• The city government failed to address sanitary issues that caused the spread of the disease.
• Cholera killed 5,071 New Yorkers by the time it finished running its course.

Cholera in 1866

Cholera struck again in 1866 after the Civil War ended and three years after the Draft Riots. Demographic changes in the city mirrored those seen between 1832 and 1849. The city grew densely populated, and immigration expanded. In fact, one in four New Yorkers had been an Irish immigrant by 1860. Despite the Draft Riots and interruption of trade with the South during the war years, the city prospered. As a result, city leaders took a different approach to repair the city’s deepest problems. Armed with John Snow’s research, the city was better prepared to address the spread of diseases, especially cholera.

In 1864, a group of physicians convened to survey the sanitary conditions of the city. Their efforts formed the Citizens Association. This eventually turned into the Council of Hygiene and Public Health. In 1865, the group completed the sanitary report, which solidified the link between sanitation and public health. This led to the formation of the Metropolitan Board of Health in 1866. With word of cholera’s spread through Europe in 1865, the newly formed organization was better prepared to address any spread of the disease in New York City. By the end of March, the board began investigating health nuisances and began making sanitary orders to help clean up the city.

• The newfound prosperity after the Civil War and Draft Riots prompted city leaders to make changes to help address the city’s deepest problems.
• A sanitary survey linked the unsanitary conditions of the city to the spread of disease.

In spite of these measures, cholera appeared and spread throughout New York City. Unlike the two previous epidemics, the spread of cholera affected the wealthier areas of the city as well, and more than a thousand New Yorkers lost their lives by the time the disease ran its course. The death toll was significantly lower than in the previous two epidemics, mainly due to the efforts to help clean the city of unsanitary conditions. New York would continue to face public health crises in the 19th century and beyond.

• Despite city involvement, cholera still spread to infect thousands of city residents.
• The disease took 1,137 lives, which was significantly fewer than in the previous two epidemics.

Cholera had a significant impact on the way the government intervenes to stop the spread of disease. The medical establishment abandonment of a faith-based approach to the spread of disease helped contain cholera in 1866, which helped save lives. John Snow’s research helped promote the scientific approach of eliminating unsanitary conditions that spread cholera. Today, this approach to sanitary measures continues to help save lives in the aftermath of a deadly epidemic.

• Cholera in New York
• The Cholera Years: The United States in 1832, 1849, and 1866 (PDF)
• The Epidemic of 1832
• Contagion in New York City: 1832
• How Epidemics Helped Shape the Modern Metropolis
• The Diffusion of Cholera in the United States in the Nineteenth Century (PDF)
• Cholera Comes to New York City
• Cholera Epidemics in the 19th Century
• The Cholera Years
• 1832 Letter: Cholera in New York City
• Mapping Cholera: A Tale of Two Cities
• Cholera Facts
• The 1849 Cholera Epidemic
• Origins of Cholera
• Cholera Studies: History of the Disease
• The Encyclopedia of Greater Philadelphia: Cholera
• Public Health Timeline of the Cholera Epidemic of the 19th Century
• Cholera Epidemics
• What Is the History of Cholera?
• What Is Cholera?
• Mayo Clinic: Cholera Causes