What does smallpox have to do with American history? According to David Rosner, Ph.D., Co-Director, Center for the History and Ethics of Public Health at Columbia University, advisor to the exhibition BE SURE! BE SAFE! GET VACCINATED! Smallpox, Vaccination and Civil Liberties in New York, everything. In this three-part series, written by Rosner, we’ll take a look at the impact smallpox has had on our social fabric.
Not only do we react to disease but I would make the claim that the diseases we suffer from are in many ways emblematic of the very worlds we create. If you have ever walked around the Trinity Church graveyard you can see reflections of the ways in which death and dying shaped early colonial era New York. One thing you might notice immediately is that the gravestones reflected a different experience than we might imagine from the story we all grew up with: that the story of health is one of steady improvement, a story of progress, a story of conquest. Of course, in many ways this is accurate for we certainly benefit from modern medicine and the technologies that have led to declining fear of bacterial infections and the like. But it is much too facile.
A close look at the gravestones will reveal a complex history of disease, where many gravestones from the earliest decades of New York, and certainly of New England, show that many people lived very long lives. The gravestones reveal that men often lived into their 70s, 80s and even 90s and women who escaped the ravages of childbirth, might also expect a long time on this planet. The isolated worlds of colonial society meant that when infectious disease struck it would often never emerge as a danger to anyone outside the local community.
Yet, contrary to our general story line about the ever-improving experience that modernity has brought us, this was not to last. In the nineteenth century, with the growth of cities, the emergence of a national commercial economy with goods being brought up and down the coast and from the interior of the nation by an ever expanding canal and then rail system, the nature of disease shifted and the toll epidemics took literally lowered the average length of life for New Yorkers, the emerging center of the country’s economic life. And disease took an ever-more threatening aspect.
The crowded, poorly ventilated tenements, lacking fresh air, a pure water supply, or a sewer system, literally became breeding grounds for epidemic diseases. Smallpox epidemics, once a fierce localized event, now emerged as national threats; cholera, rarely identified at any period of colonial era New York, began to visit the city regularly, sweeping away thousands of our citizens and creating panics that led to the migration away from the city of those that could afford to leave. Typhoid took away thousands and diarrhea, diphtheria, measles and mumps, along with a variety of “fluxes” and miasmas, led to infant mortality rates that shocked those who could recall an earlier, seemingly healthier period. Tuberculosis always took a terrible toll but now became an endemic condition that yearly cost thousands of New Yorkers their lives. We literally built the slums that became breeding grounds for disease. We literally built the worlds that killed us.
How do we keep these epidemics from spreading? Rosner gives his theory in our third installment!