The 1832 worldwide epidemic of cholera showed the efficacy of developing local boards of health to monitor environmental conditions and to track the spread of epidemic disease. Toledo, like many American cities, filled its Board of Health with prominent citizens; these men, however, did not necessarily possess any particular expertise as doctors or scientists, and typically came from the ranks of commerce.
The Board did not officially begin to announce cholera cases until 13 July 1849. Toledo mayor Daniel O. Morton, President of the Board, moved to add one or more physicians to the group as the 1849 cholera outbreak unfolded:
The President suggested the appointment of one or more physicians to the Board of Health...but it was decided that it was inexpedient [emphasis aded] to make the appointment.The actions of the Board in denying a motion to add physicians into the mix of public servants are not surprising; their presence might lead to the declaration of the presence of commerce-killing cholera in the community. Seeking the advice of physicians, however, was not all that Morton wanted in the Board of Health:
The President also suggested that a special committee be appointed to procure a suitable building for a hospital, and to furnish the same. Upon consideration, the Board declined to raise the committee.The cost of maintaining even a small community hospital could be a cumbersome financial burden on a community, and Toledo officials were reluctant to commit to such an endeavor. Moreover, given that they considered the disease to be the province of the intemperate, there seemed to be little need to pass along to taxpayers the costs of caring for people of questionable morals. The best that Morton could initially get the Board to agree to was the creation of special committees, which were charged with inspecting the city’s wards for any sign of cholera.
The Board released a report on 16 July 1849 that noted “9 cases of Cholera and no deaths within the last 48 hours.” Despite the official recognition of nine cases in the previous two days - and at least 26 official cases since the Board decided to announce the presence of cholera in Toledo – the members of the special committees presented a quite rosy scenario at the nest Board meeting on 16 July 1849:
Mr. Saxton, of the First Ward, from the special committee for visiting and examining houses, reported that the committee performed said duty, and found no cases of cholera in his ward.The observations of the businessmen-turned-cholera inspectors are worthy of further analysis. None of the men saw – or chose to report – anything resembling a cholera case in their respective wards. In fact several of the committee representatives seemed to go out of their way to make their wards seem like the veritable pictures of perfect health (“very little sickness of any kind,” “but few of other diseases”).
Mr. Bennett, from the same Committee, 2d Ward, reported that he had visited nearly every house in the Ward, and that there was no cholera, and very little sickness of any kind. The boy who was reported dying is well.
Mr. Babcock, from the same Committee, 3d Ward, reported that the Committee had been active in the discharge of their duty that they found no cholera, though there were five persons sick in a house with water standing under the floor - a very filthy, dirty place.
Mr. Nichols, from the same Committee, reported that he, assisted by Street Commissioner Crane, had examined the buildings in said ward, and found no cholera, and but few of other diseases, and these where water stands and stagnates. Saw several very filthy places, and served the necessary notice.
The members of the special committees also seemed keen to report any houses or facilities that seemed substandard and thus the sort of buildings in which lived disreputable sorts (“a very filthy, dirty place,” “several very filthy places”). Finally, the miasmic theory of putrefying matter in stagnant water also runs through the observations of the inspectors (“where water stands and stagnate,” “water standing under the floor”).
Left: Nineteenth-century poster touting cholera prevention measures
Within a matter of days, however, even the optimistic men of commerce could no longer ignore the cholera in their midst. The Board, which had previously dismissed the anti-cholera initiatives of Mayor Morton, suddenly changed its positions on proactive public health measures by 19 July 1849:
Board of HealthThroughout the remainder of July, and the months of August and September 1849, the Toledo Blade and the Board of Health dutifully reported the “cases,” although rarely did either organization actually use the word “cholera” in the information presented to the public. In all, 80 cholera deaths were officially noted by the Board of Health in the 1849 outbreak, while over 200 people were sickened by V. cholerae that year. The Board, however, differentiated between official and unofficial cases, not counting any that were reported by “private” sources:
Since yesterday there have been 16 [cholera] cases and 5 deaths.
Mayor reported that he had directed the Marshall to take possession of the Draper House, corner of Summit and Locust streets for a Hospital - approved.
Street Commissioner reported that he had contracted for furniture for the Hospital - approved.
Mr. Bennett reported that he had procured a supply of Dr. Hawthorn's Cholera Remedies to be put up and kept on hand at all the drug stores - approved.
The Board recommended that the use of green vegetables be carefully avoided, and that veal and fresh pork be excluded form every table. Particular attention should be paid to personal cleanliness, to which frequent bathing is indispensable. Every kitchen and the grounds around every building and elsewhere, where filth is likely to accumulate should be cleansed and thoroughly limed. No tenement should be without a quantity of lime on hand.
Since 4 o'clock P.M. yesterday, no cases have been officially reported to the Board. From private sources of information the Board feels authorized to report 7 cases and 4 deaths during the last 24 hours. Of the deaths, 3 were children and on an adult.These “private” reports were not counted as part of the official death and disease tally, but rather left in a bureaucratic category unto themselves. The Board and the regional press used every means at their disposal to under-report cholera cases, as the potential economic losses from a panicked citizenry were apparently deemed more important than public health and safety.