(This is the third of three stories that look at how cities and their economies recovered from historic epidemics. You can read the first one on Amsterdam here and the second one on Paris here.)
For mid-19th century refugees escaping to Boston from Ireland’s Great Famine, the journey across the Atlantic must have seemed like one from frying pan to fire.
Those who survived the more than 40 day-long voyage to Massachusetts in one of the so-called “ coffin ships” arrived in a water- and marsh-bound peninsula city with sparse building land, where they had little option but to live in unsanitary, rickety wooden housing, cramped at densities notably higher than New York or London.
Predictably, disease soon erupted — leading to a severe outbreak of cholera. A health commission investigating this epidemic in 1849 visited some of the city’s worst slums swollen by the Irish exodus. The commission declared themselves so shocked at the conditions that they wondered “how the lamp of life under such circumstances holds out to burn, even for a day.”
Boston was hardly alone. Across North America, cities reeled as they were hit by public health crises exacerbated by rapid urbanization and faster travel. The Third Cholera Pandemic killed as much as 5% of Chicago’s population in the 1850s, while typhus devastated Montreal and reached New York in 1847. Deaths from an outbreak of yellow fever in 1853, meanwhile, killed so many in New Orleans that the city earned the nickname “ Necropolis.” While these outbreaks froze urban economies for their duration, they were nonetheless followed by a powerful rebound.
In Boston, this process arguably went further than anywhere else, sparking one of the most ambitious urban renovation projects in American history — the filling in and development of the Back Bay. With Boston’s robust economy and lack of space, the project would have likely happened at some point. But the actual form it took was nonetheless shaped by epidemics and a fear that was increasingly dominant in the 19th century: that urban life was, across classes, inherently unhealthy.
That view has changed with a greater understanding of the transmission of disease via germs, and a realization that this can be controlled even at high densities. As we reach back into history for clues about the trajectory of today’s pandemic, it becomes clear that Boston’s recovery follows a similar path to ones in Amsterdam and Paris, where disease sparked major rethinks about how cities were planned and built.
Dirty Old Towns
At the time of Boston’s cholera outbreak, cities weren’t just seen as key intersections along the pandemic highway. They were thought of as factories of the infection itself, places whose congestion, density and decay promoted not just the transmission of diseases, but their actual creation. Cities did this by producing what, in the mid-19th century, most medical opinion still thought was the primary cause of infections: noxious vapor, or miasma.
The influence of this false (if not entirely unhelpful) theory lingered on for a decade or so even after microbiologist Robert Koch’s work on anthrax in 1876 confirmed the transmission of disease by microorganisms. It proposed that infections could spontaneously generate from rotting matter as miasma, or foul-smelling gases, rising from sources such as feces or rotting animal corpses.
It’s easy to see why this idea seemed plausible. As industrializing cities grew at rates faster than their infrastructure could keep up with, increased dirt and stench did indeed create unhealthy conditions, sometimes even when improvements were attempted. In New York and Boston, for example, the introduction of piped water to homes in the 1840s initially made sanitation worse, because households converted their old rainwater-catching cisterns into cesspits for sewage, which started to seep into groundwater and basements, spreading disease. Filth theory may not have revealed the true source of these infections, but it did at least serve to highlight a genuine problem.
Meanwhile, cholera seemed to suggest a false narrative that disease was environmental rather than germ-based since it sometimes spread quickly even in places with strict quarantines. That’s because separating people did little to affect its true, but as yet un-located cause: bacteria-contaminated drinking water. With such anxiety about dirt and crowding, it was only a small step to worrying, as some American planners did, that any heavy concentration of people at all could be toxic.
“With every respiration of every living thing a quantity is formed of a certain gas,” wrote the great park planner Frederick Olmsted in the 1870s. "If not dissipated, [it] renders the air of any locality at first debilitating, after a time sickening, and at last deadly.”
‘Children of Pollution’
By the 1850s, Boston’s Back Bay seemed just the sort of place to produce this harmful miasma in large quantities. Sheltered at the back of the Shawmut Peninsula , it had been blocked off from the rest of the Charles River in 1814 by a mill dam, creating tidal basins between which water could be channeled to power watermills. The advent of steam power had slackened demand for these, leaving the bay’s basin as a sewage trap.
With the city still fighting cholera, a board of city aldermen warned that this rotting waste was poisoning the air. In an 1850 report on the condition of the Back Bay, it described the wind blowing “pestilential exhalations across the entire city” and the water “bubbling, like a cauldron, with the noxious gases that are exploding from the corrupting mass below.” The fact that the terrain was marshy and damp — conditions long associated with unhealthiness — made the danger seem ever greater.
The board was of course partly right. Damp, industrial parts of cities and their hinterlands did tend to have high rates of illness. Without fully understanding how pollution and poor sanitation caused outbreaks, however, cities tended to confuse the sources of disease with those most likely to suffer from them.
“There was a theory that a solution to pollution was dilution, that if you put things into water and never saw it again, it was fine.” says Sara Jensen Carr, author of the upcoming The Topography of Wellness: How Health and Disease Shaped the American Landscape, due to be published in September 2021. “Slaughterhouses and other dirty trades did indeed congregate around bodies of water, and of course, pollutants in fact built up in the water over time. Cities knew that the worst outbreaks of disease were by these industrial areas. These were often places where workers lived, especially immigrant workers, because they were closest to the jobs. This is how you get into a problematic association between immigration and health.”
Fears that immigration, like miasma, risked destroying Boston were also a factor in the Back Bay’s development. By 1850, the city’s census revealed that the “foreign-born” portion of the city’s population (a category that also included migrants’ American-born children) had, due to Irish settlement, increased to 46%. Joining a heavily segregated population of African Americans (who then comprised around 1.3% of Bostonians), this influx alarmed the white protestant elite who saw their demographic and social dominance under threat.
These fears tainted sanitary investigations of the period, which combined revulsion at filth with disgust for those who have to live with it. While investigating poor housing in the wake of the cholera pandemic, the health board noted not just a “stercoraceous putrescence” in Boston’s dingiest slums, but also residents the board considered scarcely human. Instead of refinement, the report thundered, it found “coarseness and vulgarity. Instead of politeness, rudeness of action and of speech. Instead of a generous moral and intellectual culture, the education of the rum hole and the brothel. Here congregate the children of poverty and sin and shame, poor children of pollution.”
These “children of pollution” weren’t just growing in number, they were living in very close proximity to the elegant hillside streets that housed Boston’s elite. If the city couldn’t create some new district of high quality, socially segregated housing within its limits, Boston’s establishment risked losing this elite — and their votes — for good. This helps to explain what happened to the Back Bay next. Drained, filled-in and widely planted with trees, it became a place whose design didn’t just lessen the chances of urban health crises. It also allowed Boston’s wealthy to escape their dangerous proximity to the poor without leaving the city altogether.
Paris on the Charles River
Between 1857 and 1880, these anxieties played out in the filling-in of the Back Bay, and in its subsequent development on lines that are unarguably impressive. The State of Massachusetts dictated that the newly solid land should be laid out, “to prevent this territory from becoming the abode of filth and disease,” preventing the lingering of miasma through a broad street plan of squares and avenues that allowed good ventilation and the corrective effects of abundant light. In doing so, architect Arthur Gilman, who devised the area’s street plan, followed the example of the city that was then the world leader in sanitary renovation: Paris.
Following the lead set by Baron Haussmann in Paris, the reclaimed land was laid out with exceptionally wide avenues — some monumental in scale — lined with trees believed to counteract toxic vapor. The air of spacious upper class refinement was enhanced by concentrating all the regular business of the district’s houses, such as deliveries or clothes drying, to (still spacious) alleys behind the main houses.
This Parisian influence was a marked departure from the British garden square model that had previously provided a template for the city’s higher-end housing, and it helped to create one of the most ambitiously scaled, elegant areas of any American city. Even the grid plan itself was a form of sanitary measure, making it easier to route sewers and water pipes in straight lines.
But while the area became a new living room for Boston’s wealthy, bolstered by cultural institutions stipulated in the state’s plan, conditions in the older lower-lying parts of Boston remained poor and cramped, and still particularly prey to deadly outbreaks of smallpox, typhus, typhoid and scarlet fever, all of which raged through the city during the Back Bay’s early years.
These conditions did ultimately improve too, albeit later and at a notably slower rate. Thanks in part to the influence of the Back Bay’s development, Boston’s South End — another area of higher-income housing built on reclaimed land — started to slide down the social scale as wealthier residents moved west, a process that made its homes more affordable. And in the aftermath of the Great Fire of 1872, Boston also spread out into new areas constructed with working class residents in mind, often in the form of so-called “ three-decker” tenements expressly designed to provide occupants with more light and air at an affordable price. Finally, the creation of the Emerald Necklace park system towards the end of the 19th century gave the city a large swath of green space open to everyone.
As the U.S. starts to emerge from today’s pandemic, Boston’s experience with previous outbreaks might thus provide both encouragement and a warning for cities. Rather than losing its economic momentum following its 19th century health crises, Boston used its crises as impetus for some of the grandest, most admired urban planning of its period. What it did not necessarily do — or try to do — was to lessen the inequality and poor conditions that were such an important driver of the crises in the first place.