Cholera and Constructed Vulnerability

Cholera and Constructed Vulnerability

 

New York City’s 1832 Epidemic

Cholera, a severe diarrheal disease, was a common, fear-inducing, and often fatal occurrence in the United States in the nineteenth century. Improvements in sanitation and water supply have since eliminated cholera epidemics in the industrialized world, but the impact of the disease in the U.S. during its most formative years should not be underestimated. Cholera began its history as a disease endemic to India, and in 1817 it began to spread across the globe, causing the first of seven identified cholera pandemics.1 It was the second cholera pandemic that, in 1832, traveled by way of Asia, Europe, and Canada before making landfall in the United States.2 Upon its arrival, cholera flourished in large cities due to a new era of urbanization and crowding, and it simultaneously spread to rural nooks of the country as a result of recent expansions in transportation.3 

New York City faced the worst of the 1832 epidemic, where the disease left 3,515 dead out of a population of 250,000.4The outbreak spread rampantly in lower Manhattan, where tenement buildings and immigrant enclaves housed the lower classes in crowded, filthy conditions. Cholera is—and has historically been—recognized as a disease of the poor, as contaminated water, unsanitary sewerage conditions and crowding are several determinants of disease spread, and the outbreak in New York City was perhaps the starkest example of this. The fact that cholera severely and disproportionately impacted people of few means in New York is universally agreed upon and amply discussed in the historical literature. However, little investigation has been done to offer a nuanced understanding of this reality, avoiding questions of how certain vulnerabilities came to be and how these vulnerabilities influenced cholera outcomes. I argue that examining the cholera epidemic of 1832 in New York City within a framework of vulnerability, a framework used primarily by scholars of disaster, may refine our understanding of how social and institutional structures influenced the cholera epidemic. 

The study of vulnerability as a conceptual framework with which to understand disaster risk has emerged in the last decades in contrast to (what was once) the dominant paradigm, which analyzed the impact of disasters as a function of nature only.5 While the definition of vulnerability is contested across fields, the concept implies that the magnitude of a disaster is not defined merely by the natural hazards themselves, but by the conditions and “socio-ecological systems” which affect the amount of harm that a natural or human-caused hazard is capable of causing.6 In other words, the use of vulnerability analysis in scholarly work seeks to describe not merely the disaster itself but the preexisting societal conditions which created the risks of the disaster. The concept of vulnerability in disaster work assesses the “various dimensions in which vulnerability might be manifested: for example, social, economic, environmental and institutional.”7 These dimensions work together to explain why disaster impacts individuals and communities so differently. The concept of vulnerability has been used primarily in the field of disaster risk reduction as well as in fields of climate change and sustainability. However, it has been used to a far lesser degree to study infectious disease as a disaster. The little research in the field that does employ the concept of vulnerability does so in order to understand current and future disease risk, not to make sense of the past. However, using a framework of vulnerability to comprehend historical outbreaks of disease merits consideration; doing so may elucidate the complex interactions between social status, constructed vulnerability, and disease outcomes, offering lessons for future outbreaks. 

Firstly, since not every definition may include disease outbreaks within the scope of natural disaster, it is prudent to provide convincing evidence that the Cholera outbreak of 1832 did, without a doubt, constitute a disaster in New York City. Its first appearance in the United States was fearfully anticipated, as the disease had a violent presence in Europe and Canada throughout 1831 and 1832.8 Finally, on June 26, an Irish immigrant in the city fell ill, and by that next Monday the city’s Medical Society officially reported nine cholera cases (only one of whom survived). The disaster and panic that ensued is best described by Charles E. Rosenberg, an American historian who has written extensively on cholera: mass exodus of wealthy New Yorkers to the countryside rapidly followed, and “nearly everyone who could afford to had left the city” by the next week.9 The New York Evening Post reported that, “The roads, in all directions, were lined with well-filled stagecoaches . . . all panic-struck, fleeing the city, as we may suppose the inhabitants of Pompeii fled when the red lava showered down upon their houses.”10 The city remained eerily quiet throughout the summer, and business stagnated, leaving the poor even poorer. The economic impacts of cholera were severe, a personal letter written on July 8th reports that the “Savings Bank had paid out $20,000.”11 Another letter from a New York resident to the Boston Masonic Mirror notes that “the merchants say they might as well close their stores as to keep them open; there is comparatively nothing doing.”12As cases grew in the following weeks, the city built five cholera hospitals, to little avail and several weeks too late.13 By the mid July, 

cartloads of coffins rumbled through the streets, and when filled, returned through the streets to the cemeteries. Dead bodies lay unburied in the gutters, and coffin makers had to work on the sabbath to supply the demands. Houses stood empty, prey to dust, burglary, and vandalism.14

On July 20, the epidemic hit its peak at over a hundred deaths that day, and cases slowly trickled down throughout the next months. Finally, the city’s Special Medical Council announced the city to be safe on August 28, though cases sporadically continued into the winter. Cholera disappeared, for the time being, but unquestionably left its mark; overall, 3,515 gruesome deaths were counted, which would be the equivalent of over one-hundred thousand adjusted for today’s population.15 The impacts of the cholera epidemic, no doubt, constituted a disaster, both in the personal lives of many residents, and for the city as a whole. 

This disaster, however, was far less detrimental to the city’s upper classes, and apart from having to leave the city for a few months, many wealthy New Yorkers returned to their normal lives. In contrast, neighborhoods such as Five Points (an area which now contains parts of Chinatown and the Civic Center) where the city’s poorest populations lived, experienced the highest mortalities, and nearly all of the deaths that occurred were concentrated among the most vulnerable neighborhoods. Of one hundred people who died on one day in July, it was reported that ninety-five were buried in Potter’s Field, where unclaimed bodies or those who could not afford a burial were laid to rest.16 These discrepancies may be understood through the dimension of social vulnerability, which seeks to understand how “some groups in society are more prone than others to damage, loss, and suffering in the context of differing hazards.”17 That is to say, it is not cholera itself that was so deadly for the working class and less so for the upper class, nor did the cholera-causing bacteria “decide” to infect some over others. Rather it was the complex set of social structures that defined living conditions, determined health, and individualized both personal and community experiences during the outbreak. In assessing the social vulnerabilities of early-nineteenth century New Yorkers, several distinct patterns emerge as to how social status, such as class and immigration, shaped the experience of cholera. 

One of the pervasive themes throughout the epidemic was the debate regarding religion, morality, and disease. Prior to the understanding of germ theory and the contagious nature of disease, it was widely believed that cholera was a disease to which only the immoral and intemperate were susceptible. One letter writer to the New York Spectator explained that cholera was “a scourge which the Almighty is inflicting upon nations . . . Let every suitable preparation be taken . . . by a reformation of bad habits among the vicious; and by temperance, regularity, and caution among people of all habits and classes.”18 These comments were tame in comparison to others, such as one explaining “the Five points . . . are inhabited by a race of beings of all colours, ages, sexes and nations, though generally of but one condition, and that . . . of the vilest brute.”19 John Pintard, a well-regarded and influential individual who stayed in the city during the outbreak, urged calmness and remarked that the disease was  “almost exclusively confined to the lower classes of intemperate, dissolute and filthy people huddled together like swine in their polluted habitat.” .”20 Even among medical establishments, the belief stood that cholera was a risk primarily to the morally impure; the Special Medical Council announced that “the disease in the city is confined to the imprudent, the intemperate.”21 Moreover they believed that it was not coincidental that the impoverished were affected so significantly by cholera; poverty, it was thought, was caused by and inextricably linked to immorality. Rosenberg describes that “the very vices—intemperance, irregularity, and immorality—which doomed a man to poverty,” it was believed, “were the same ones which predisposed him towards cholera.”22 These beliefs did not simply exist in the minds and in the writings of New Yorkers but had massive implications in the response to the disaster. 

For one, these ideas greatly contributed to anti-immigrant sentiment, which had already been growing in prior years, particularly toward Irish immigrants. In the minds of most, it was clear that “the Irish and Negroes seemed [cholera’s] foreordained victims.”23 New York’s Board of Health elaborated on this, explaining that “the low Irish suffered the most, being exceedingly dirty in their habits, much addicted to intemperance and crowded together into the worst portions of the city.”24 In other words, it was understood that Irish immigrants were getting sick in part because of their environment and impoverishment, but that their own moral failings were to blame for these factors. This dogma extended to outcasts of society, particularly the “prostitute, drunkard, and glutton.”25 In the minds of the wealthy class, the rates at which these groups contracted cholera served as evidence of their moral depravity, making open discrimination permissible.

As a consequence of the poor’s supposed sinful and immoral nature—which had allowed the lower ranks to become infested with cholera—it was also felt that they were undeserving of charity or aid. Efforts that the city did attempt, such as improving sanitation and building hospitals, failed in part because of ideological disagreements with the city’s upper classes.26 For example, when the Board of Health rented buildings and built shanties to reduce the crowded conditions, the city’s Executive Committee was quick to critique the problems with providing housing, food, and clothing to the poor on the basis that that doing so would breed idleness. An official report expresses concern about allowing the lower class to “wander about the city all day in great measure indifferent whether they should find employ or not.”27 Further funding, they declared with these remarks, would have to go through the Commissioner of Alms-Houses, an early welfare department that was already overburdened. As such, continuing government efforts thinned, and heavily relied on private citizens, churches, and aid societies.28 

Moreover, the principle of the relationship between morality, disease, and class also held that the wealthy owed their prosperity to their virtues and righteousness. Therefore, many of the upper classes, at least on paper, claimed to be unconcerned by cholera. One member of the Board Health explained in the early stages of the outbreak there was no cause for alarm because the disease only “attacked the intemperate and filthy, and if proper actions were adopted to purify the city, all alarm would soon subside.”29 The Board of Health’s official statement, even toward the end of outbreak, was that it was “a very rare thing for the temperate and uniformly prudent to be attacked” John Pintard urged calmness at the height of the pandemic, because “no deaths occurred but among the dregs of society.”30,31 A few days later, in the wake of “a very heavy report this day” of cholera deaths, he explains that this does not necessitate cause for further alarm, and that “those sickened must be cured of or die off, and being chiefly of the very scum of the city, the quicker the dispatch the sooner the malady will cease.”32 Ironically, this feeling of protection from the disease and apathy toward the disease’s rampage of the lower class bred idleness among the upper class, the same thing they so greatly feared creating among the lower classes with charity. Because so many had left the city, distance from the disaster bred great apathy, and the deaths of the morally impure seemed to be of little concern to those with the power to do something.

Another form of vulnerability that had been created among New York’s lower classes concerned environmental and physical conditions. These took the form of crowded tenement buildings and basement dwellings, poor water infrastructure, and a lack of sanitation, which worked together to drastically increase the risk of cholera for the most vulnerable. New York City’s neighborhood segregation had already developed by this time, like many other early American cities, by its nature as a walking city; individuals lived close to where they worked and shopped.33 By 1832, spatially distinct neighborhoods had formed with significant class divides. One study, using a geographic information system analysis of mid-nineteenth century New York, identified that the closest proximity to cholera cases also overlapped with the areas of highest population density and back-lot dwellings in the slums of Five Points, the tenements housing of the Lower East Side, and flood-prone waterfront industrial zones further south. Those who lived in Greenwich Village and what is now Wall Street were farthest from instances of cholera, though the latter was not a significant residential area. What constituted the upper boundaries of Manhattan at the time, Greenwich Village, had been developed in stark contrast to crowded tenement regions of New York, instead modelling a city “that fostered improved ventilation and sanitary conditions.”34 Comparing careers with these locations, the analysis found that laborers, most often living in between tenement districts and the waterfront area, were the most exposed to cholera, while bankers, lawyers, merchants, and other elites were farthest from cases of cholera, in more northern areas of the city.35 

Moreover, within neighborhoods, basement dwellings, most often inhabited by the poorest of the poor, created an important form of vertical segregation in addition to the horizontal (i.e. neighborhood) segregation aforementioned. Even though lower-middle income families may have lived in or in close proximity to the most at-risk neighborhoods, they likely lived in better accommodations on higher floors. In contrast, basement dwellings, often inhabited by the city’s Black population and immigrants, were archaic, inhumane, and, most significantly, prone to flooding and therefore to cholera.36 One historian described that cholera bloomed “when the sick used their privies or cesspools and the waste overflowed into the nearby wells and basements.”37 Rosenberg aptly summarizes the conditions that the poor suffered:

[The poor] lived in the worst houses in the most crowded portions of the city and could not afford to flee when threatened by the epidemic. In New York, for example, it was not until death and public removal had thinned their ranks that the epidemic began to subside. Basement apartments were from six to four feet below the surface of the ground, and from these warrens came the “greater proportions and worst forms of cases.”38

Moreover, though the city attempted to remedy crowding problems by constructing poor houses in which to evacuate residents, these were often just as bad and crowded as individual homes, and as previously discussed, the efforts were short lived. Those that the city built were shoddily constructed at best; one was so leaky that it was reported a rainstorm had completely soaked its inhabitants and their belongings, likely posing a cholera risk as well.39 The effects of these conditions were profound; one report in the New York Spectator at the height of the outbreak states that “at Bellevue (City Poor House), there have been 211 deaths out of a population out of 1650. In other words, more than one eighth of the whole number have died in less than 20 days.”40 It seemed that regardless of the city’s (short-lived) efforts, environmental risk factors remained a problem for the impoverished. Housing laws and reforms only came much later in the century, sparked by Jacob Riis’s book How the Other Half Lives (1890) which publicized the horrid conditions of the working class. 

Additionally, sanitation in New York City in the nineteenth century constituted a massive environmental risk factor, particularly in already vulnerable neighborhoods. As the city’s population grew, the heaps of waste, mud, and manure filling the city streets became insurmountable to maintain with the minimal sanitation infrastructure in place; goats, dogs, and swine infested the streets. One commenter to the New York Post wrote that “New York was the ‘filthiest city in the United States, if not the world.’”41 This concern was widely shared by citizens, and sanitation measures were lacking throughout the city. However, Katherine McNeur, in her book Taming Manhattan, describes the struggles that the city’s waste system imposed particularly on the lower classes. The system of sanitation was such that “New York’s property owners were responsible for sweeping the street and sidewalk” before a cartman would come to collect waste twice a week. While wealthier New Yorkers relied on slaves or servants to perform this task, working-class New Yorkers had to find time to do this “before their workday began,” posing a burden that didn’t always get accomplished. In addition, landlords often neglected their rental properties, which left tenants of worse buildings at particular risk.42 Consequently, McNeur explains, “working-class neighborhoods were even filthier than their wealthy but still grimy counterparts.” Moreover, while “the councilmen thought they could solve this inequality by hiring sweepers,” the sweepers were highly contested by residents due to the annoyance and noise they caused.43 Private contractors, too, often failed to remove trash in a timely manner, and it seemed that there was no effective solution to New York’s sanitation problem, and debates between the city and its residents persisted. The decomposing soup of waste in the roads became endearingly nicknamed “corporation pie,” Rosenberg writes, noting that New Yorkers often referred to their municipal governments as the Corporation.44 Overall, sanitation of the city’s streets posed a massive problem in already crowded neighborhoods, one which disproportionately impacted those with fewer resources. 

Related to sanitation and housing, water infrastructure was perhaps the most important factor in cholera vulnerability. Because cholera is passed through feces, water remains an important mode of transmission, which was first understood when John Snow discovered the link between cholera transmission and London’s Broad Street Water Pump in 1854. Even though this was not understood at the time of the 1832 epidemic, the significance of clean water and sanitation was not lost on city residents. By the 1830s, debates about water supply had been ongoing for years with little result, and the condition of the water supply was infamous even beyond New York.45 The Manhattan Company, founded by Aaron Burr, held a private monopoly over the city’s water supply. However, the company was far more concerned with money than water quality, and surplus funds of the company went to creating the bank known today as Chase Manhattan. The company’s water system consisted of water collected from a shallow pond near Five Points and distributed through poorly built wooden pipes to a few pumps throughout the city.46 These inadequate water sources were extremely contaminated, and large volumes of street waste seeped into them. When cholera-infested “privies or cesspools” overflowed, they flew into nearby wells and contaminated the drinking supply.47 As such, by 1832, the wealthiest New Yorkers had begun to buy imported water from cartmen, while only the poorest used local pump water for drinking.48 This was perhaps the greatest inherent risk to the impoverished; the poor were, quite literally, drinking cholera due to the inadequacies that had been allowed by the privatization of a public good. While of course this mode of transmission was not necessarily known at the time, the city was fully aware of the state of water supply. Only in the aftermath of the 1832 outbreak did city leaders finally take action on the issue of water, abolishing the private water supply and eventually creating reservoirs outside of the city.49

Taken together, the experiences of the lower class reveals a highly interconnected matrix of vulnerabilities, which differentially modulated the impacts of the 1832 outbreak. The complicated relationships between these vulnerabilities might be understood best by using a specific model of framework, such as Piers Blaikie et. al.’s Pressure and Release (PAR) model.50 This model suggests that vulnerability can be understood as layers that build upon each other. “Root causes” such as economic and demographic power structures, as well as ideologies, impact how resources are distributed amongst people. These causes are translated into unsafe conditions by “Dynamic Pressures,” which may be more contemporary and specific manifestations of underlying causes. For example, rapid population changes, conflict and war, and local markets all constitute types of dynamic pressures. Finally, these dynamic pressures are borne out in the form of unsafe conditions, which include physical environments, local economy, social relations, public actions and institutions. These unsafe conditions are the forms of vulnerability that directly interact with the hazard itself to determine risk (articulated by the equation Risk = Hazard x Vulnerability). 

Applying this framework to cholera in New York allows us to differentiate the historical research and define vulnerabilities more explicitly. Working backward, it is clear that the unsafe conditions that enabled cholera to spread so rampantly were plentiful. The physical infrastructure of housing, particularly tenements, basement dwellings, and even the city’s attempts to reduce housing, in addition to waste and poor sanitary conditions on the streets, as well as water infrastructure and pumps, directly contributed to the risk of cholera. In addition, while only briefly mentioned, it is worth noting that lack of financial means also created vulnerability to the secondary hazard of cholera’s effect on the economy. With the minimal demand for business services, those who had little safety net were made even more vulnerable. Finally, lack of preparedness on the part of the city contributed to these problems; the city’s housing and hospital efforts were too little and too late.51

The PAR model allows for further investigation into the conditions of the 1832 cholera outbreak by asking what dynamic pressures contributed to these conditions. For instance, rapid urbanization and the resulting population changes, such as immigration, occurring in the city leading up to the epidemic greatly influenced patterns of settlement. A large influx of immigrants, particularly the Irish, allowed for the growth of crowded tenement housing and slums. Moreover, the PAR model reminds us that it’s not merely that the poor had unsafe conditions that made them vulnerable to cholera, but that a lack of institutional regulation and municipal oversight enabled the growth of these conditions. Prior to housing reforms of the latter part of the century, the city failed to ensure the safety of housing conditions. It also failed to provide its residents with clean water, which was particularly significant for the lower classes, who could not afford to purchase imported water. Finally, the city failed to keep its streets clean, and massive inefficiencies in the city’s early sanitation system lead to piles of waste and roaming hogs in the streets, disproportionately in the poorest neighborhoods. Finally, scientific misunderstanding of the nature of disease and the fervent religious and class-based beliefs of their era worked hand in hand with municipal government to create barriers to improving the situation of the lower class. The high rates of cholera among immigrants, the poor, and other outcasts only stood to prove the belief that the disease was for the morally impure, creating a further barrier to relief efforts. General lack of benevolence and a detached apathy among the upper classes meant that pathways for potential control of the course of the outbreak were never attempted, and any efforts that the city did try were blocked funding sources. 

Finally, the PAR model allows the assessment of the broadest root causes which shape these dynamic pressures. One might hypothesize that the most significant root cause at play during this outbreak was capitalism. While a seemingly broad claim, the ways in which capitalism shaped the early Republic and New York City in the early nineteenth century, ways which contributed to these dynamic pressures, are profound. The dynamic pressures previously described—an era of rapid, unregulated, urbanization across the United States—were fueled by the nation’s capitalistic behaviors. Lack of government oversight into private enterprises allowed for the crowding of immigrants into slums, where landlords squeezed in individuals in order to make as much profit as possible. The city’s privatized and corrupt water system, managed by the Manhattan Company, was allowed to exist for so long because of unregulated, profitable privatization, and the problems that had plagued the city’s residents for so long were fixed for good once the city built the public Croton water system.52 Capitalism not only shaped the economy, influencing how municipal institutions regulated and responded to conditions, but expressed itself in the form of power structures and political capital. The views of the wealthy elite controlled the mainstream medical and political thought regarding charity and the city’s response to cholera, even though many of this class were not even present in the city at the time. Additionally, the perceived social mobility enabled by capitalist narratives at the beginning of the nineteenth century contributed to beliefs about morality, disease, and poverty; poverty was understood as something that you could lift yourself out of if you worked hard enough, so those who were impoverished could only blame their own moral failings. The ways that capitalism influenced the “dynamic pressures” and “unsafe conditions” in New York City are many, and this serves as a brief, although non-exhaustive, summary of ways in which this root pressure may have influenced the vulnerabilities and experiences in an era of cholera. 

It is also worth noting that it is in this analysis of root causes that employing a vulnerability framework diverges from analyzing disease outbreaks from a social medicine perspective. The social medicine framework often used by historians of disease, Rosenberg aptly describes, allows for the understanding that disease is “not an alien visitation, but rather as the consequence of social organization and especially of social inequity and social change.”53 In this definition, it may seem that social medicine is merely a type of vulnerability framework specific to disease. However, while these two frameworks are highly related and employ the same ideology, vulnerability frameworks such as Blaikie’s model seek to dig deeper. A thorough analysis of vulnerability seeks not only to understand who were the most vulnerable and why their status created vulnerability, but where and how these vulnerabilities originate. 

While not an exhaustive review, this research seeks to use a vulnerability framework in order to understand the 1832 cholera outbreak in a novel way. While significant research has assessed the conditions of New York’s working class in 1832 and documented the ways in which cholera differentially impacted the poor and socially outcast, less has been done to understand why these conditions existed and how institutional and broader factors contributed. Using Blaikie et. al’s model, it can be understood that the unsafe conditions experienced by the city’s lower class interacted with an otherwise ‘natural’ disaster and created differential risk. More significantly, this model explains that these conditions came to existence through municipal failures and, more broadly, unregulated capitalism. This research presents a unique tool to use in infectious disease analysis, particularly in infectious disease history. Applying a vulnerability framework to other outbreaks and epidemics may help to understand inequitable patterns of disease and improve preparations for future outbreaks. 

  1. Global Epidemics and Impact of Cholera,” World Health Organization, December 2010.
  2. Sandra Hempel, The Strange Case of the Broad Street Pump: John Snow and the Mystery of Cholera (University Of California Press, 2007), 2.
  3. Charles E Rosenberg, The Cholera Years (Chicago: Chicago University Press, 1968), 45.
  4. Stefan C. Schatzki, “Cholera,” American Journal of Roentgenology 204, no. 3 (March 2015): 685–86.
  5. Deborah S.K. Thomas et al., Social Vulnerability to Disasters (Crc Press, 2013), 5.
  6. Jörn Birman, “Measuring Vulnerability to Promote Disaster-Resilient Societies and to Enhance Adaptation: Discussion of Conceptual Frameworks and Definitions,” in Measuring Vulnerability to Natural Hazards: Towards Disaster Resilient Societies (Second Edition), edited by Jörn Birkman (United Nations University Press, 2013), 10.
  7. Birman, “Measuring Vulnerability,” 25.
  8. Rosenberg, The Cholera Years, 14.
  9. Rosenberg, The Cholera Years, 28.
  10. John Noble Wilford, “How Epidemics Helped Shape the Modern Metropolis,” The New York Times, April 15, 2008.
  11. John Pintard, “N York, Bank for Savings, Sat 7th July, 1832,” in Letters from John Pintard to His Daughter, Eliza Noel Pintard Davidson, 1816-1833, edited by Dorothy C Barck (The New York Historical Society, 1940), 68–73.
  12. “Article 4—No Title: New York July 7th, 1832,” Boston Masonic Mirror (1830-1834), July 14, 1832, 2.
  13. Rosenberg, The Cholera Years, 29.
  14. Rosenberg, The Cholera Years, 29.
  15. Rosenberg, The Cholera Years, 29.
  16. Charles E. Rosenberg, “The Cholera Epidemic of 1832 in New York City,” Bulletin of the History of Medicine 33, no. 1 (1959): 37-49.
  17. Thomas et al., Social Vulnerability to Disasters, 17.
  18. “For the Commercial Advertiser,” New York Spectator, July 23, 1832, Nineteenth Century U.S. Newspapers.
  19. qtd. in Rosenberg, The Cholera Years, 33.
  20. John Pintard, “N York, Bank for Savings, Sat 7th July, 1832,” in Letters from John Pintard to His Daughter, Eliza Noel Pintard Davidson, 1816-1833, edited by Dorothy C Barck (The New York Historical Society, 1940), 68–73.
  21. qtd. in Rosenberg, The Cholera Years, 30.
  22. Rosenberg, “The Cholera Epidemic,” 4.
  23. Rosenberg, The Cholera Years, 59.
  24. Rosenberg, The Cholera Years, 61.
  25. Rosenberg, “The Cholera Epidemic,” 41.
  26. Lisa N. Warning, “Comparing and Contrasting Social, Political, and Medical Reactions to 19th Century Cholera Epidemics in London and New York City” (Senior thesis, University of New Hampshire, 2015), 36.
  27. Rosenberg, The Cholera Years, 98.
  28. Rosenberg, The Cholera Years, 98.
  29. J. R. Rhinelander, J. R. “CHOLERA IN NEW YORK: TO THE PUBLIC,” Boston Masonic Mirror (1830-1834), July 7, 1832, 2.
  30. Questions of the Board of Health,” New York Spectator, August 27, 1832.
  31. Pintard, “N York, Bank for Savings, Sat 7th July, 1832,” 69.
  32. Pintard, “N York, Bank for Savings, Sat 7th July, 1832,” 69.
  33. Sarah Shah, “Contagion in New York City: 1832,” Pulitzer Foundation, November 10, 2014.
  34. Warning, “Comparing and Contrasting Social, Political, and Medical Reactions,” 31.
  35. Baics, “The Social Geography.”
  36. Baics, “The Social Geography.”
  37. Catherine McNeur, Taming Manhattan: Environmental Battles in the Antebellum City (Harvard University Press, 2017), 25.
  38. Rosenberg; NYC Board of Health, Reports of Hospital Physicians, 1832, quoted in Rosenberg, The Cholera Years, 33.
  39. Rosenberg, The Cholera Years, 87.
  40. Multiple News Items, New York Spectator, July 23, 1832, Nineteenth Century U.S. Newspapers.
  41. qtd. in McNeur, Taming Manhattan, 96.
  42. McNeur, Taming Manhattan, 100.
  43. McNeur, Taming Manhattan, 100.
  44. Rosenberg, The Cholera Years, 17.
  45. Rosenberg, The Cholera Years, 17.
  46. McNeur, Taming Manhattan, 116.
  47. McNeur, Taming Manhattan, 116.
  48. McNeur, Taming Manhattan, 120.
  49. David Soll, Empire of Water: An Environmental and Political History of the New York City Water Supply (Cornell University Press, 2013), 140.
  50. Piers Blaikie et al., At Risk: Natural Hazards, People’s Vulnerability and Disasters (Taylor & Francis Group, 2003).
  51. Rosenberg, The Cholera Years, 17.
  52. McNeur, Taming Manhattan , 100.
  53. Charles E. Rosenberg, “Cholera in Nineteenth-Century Europe: A Tool for Social and Economic Analysis,” Comparative Studies in Society and History 8, no. 4 (1966), 453.
 
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