The 34 years between the epidemics of 1832 and 1866 brought innumerable changes, but three stand out. First, British physician John Snow showed in 1854 that cholera was spread through the excreta of infected patients. At first, he had his doubters, but he proved his thesis by looking at customers using the two main water companies in London. He showed that Londoners drinking polluted wastewater from one company were faring much worse than those drinking from the other.
The second change was that scientific method had gripped medical communities meaning Snow’s theories could be met with an open mind among doctors.
The third major change was a journalistic one. American newspapers were starting to shed their partisan baggage and embrace firsthand reporting and an open-minded and empirical relationship with the world — and this extended to coverage of public health. In fact, even before evidence of Snow’s study emerged, the independent New York Herald chastised doctors for avoiding the firsthand investigations of the topic. No “physician or student of medicine had made his appearance at any of the cholera hospitals for the purpose of observing and investigating the disease,” wrote the Herald in 1849. The paper criticized doctors’ “dislike of anything like attentive study of the disease.”
By the time the final major epidemic hit in 1866, both medicine and news had transformed fundamentally, forcing political leaders and citizens alike to confront hard facts about the disease.
In the months leading up to the epidemic, the city’s political leaders began empowering health experts and assembling offices to gather and disseminate reliable data, and to clean up the city’s messes. “During the coming Summer,” announced the New York Times in the late spring of 1866, “the City is, for all practical purposes, to be governed by the ‘Board of Health.’” The board was charged with reporting efficiently and quickly, using the latest science and medicine, to stop the disease.
The newspapers of the era dutifully reported fact-driven updates every day, citing statistics not superstition. Newspapers became less concerned with sin than with behaviors dangerous to public health, like a report in the New York Tribune that an infected woman had emptied the sewage from her house into her garden. The Tribune noted that the woman’s neighborhood was marred by the “foul effluvia of … overflowing privies.”
No longer were doctors and journalists looking up to the heavens for signs of God’s grace or the prevailing atmosphere. Instead, they looked down at, in the words of the New York Times, “privies, water-closets, and cess-pools connected with the sick.” This is not to say that journalists, doctors and politicians were unified in their approaches — the newspapers of the day are filled with discussions and debates about best practices — but they tended to embrace a common set of facts and a scientific worldview, underpinned by a sense of shared purpose.