I was born in 1944 soon after the Allied invasion of Hitler’s Fortress Europe. While we know now that it was the “beginning of the end” in that theater of war, my mother, who had just given birth, and my father, who was on a cruiser in the South Pacific, did not know when the nightmare of war would end. While I have no memories of those terrible times, there are events that marked my childhood with fear and uncertainty. “Duck and cover” and polio come to mind, and as a boy there was mumps. There was also the time when I had measles and the health department put a quarantine sign on our house. The childhood diseases of my generation, thankfully, are now mostly memories to share with grandchildren who, through the miracle of vaccines, have been spared.
Like all of humankind, the residents of Indianapolis have experienced the scourge of deadly diseases not unlike the present contagion. The city was barely a settlement of scattered log cabins populated by a handful of hardy pioneers when it was confronted with its first health challenge.
The state commissioners who selected the site of the new state capital chose the “finest piece of land…level as a barn floor” along the east bank of White River at the confluence of Fall Creek. Pogues Run along with numerous rivulets crossed the plain that was surrounded by higher ground; in essence Indianapolis was the bottom of a bowl, when in the rainy season water collected, creating a swamp. The topography was ideal for breeding bull frogs and mosquitoes, creating “miasmatic vapors” in the summer of 1821 that swept through the settlement and surrounding farms “of one thousand souls” afflicting “at least nine hundred” with malaria, commonly known as “ague.” About twenty-five residents, mostly children, succumbed to the disease necessitating the creation of the first Indianapolis burying ground — “the plague cemetery.” Over the ensuing years, cases of malaria were generally not fatal unless a patient had underlying complications, and the illness decreased as land was cleared in and around Indianapolis. Today a boulder and plaque near Emerson Hall on the Indiana University Medical School campus marks the site of the final resting place of those who succumbed to the city’s first epidemic.
Lack of sanitation and the knowledge of the underlying causes of diseases led to frequent outbreaks of smallpox, scarlet fever, measles, diphtheria, whooping cough, pleurisy, typhoid fever, and dysentery among the early inhabitants of Indianapolis, resulting in much sickness and death. Treating an illness with home remedies was generally used to ease the suffering, while the use of some drugs and treatments only aggravated the patient’s condition.
Cholera was one of the most feared diseases, first appearing in the Hoosier capital in 1832. Later during the winter of 1848-49, a cholera epidemic in New Orleans found its way among passengers aboard crowded steamboats, carrying the disease to inhabitants in towns and villages along the Mississippi and Ohio rivers. Recently arrived travelers from southern Indiana brought the first case to Indianapolis by the end of July and the illness remained in the community through 1852. Dysentery prevailed along with cholera and was often fatal among the established resident population, while the mortality from cholera was “very great” among the mostly German emigrant population “crowded into other families already scantily provided with room.”
While cases of smallpox, “the grim King of Terrors,” were a frequent occurrence in Indianapolis, it was not until an outbreak of the pestilence in 1855 that city leaders were seriously prompted to build a hospital. Land was acquired where the current Eskenazi Hospital stands and construction started, but when the danger had passed completion of the hospital slowed. When it finally opened four years later, the future care of those who contracted a contagion was assured.
Season after season deadly maladies infected any number of residents of Indianapolis, carrying away a few. However, the deadliest of infections planted its seed deep within its victim and over time wasted the body, gradually consuming its vitality until death. Consumption — tuberculosis — was the leading cause of death in Indiana, and the United States, from 1850 through the early years of the twentieth century with young adults the most likely victims. This insidious disease hid in spit and sputum and was transmitted through person to person contact killing one in every seven of those infected while one in 100,000 died of smallpox. Through the aggressive efforts of Dr. John Hurty, head of the Indiana State Board of Health, sanitary laws were enacted, and other measures implemented that over time contained the “White Plague” and saved lives.
Maintaining a supply of pure water was a challenge, particularly in urban areas. While the Indianapolis Water Works Co. began providing “pure, filtered and wholesome water” from deep wells to a small customer base in 1871, most of the public could not be convinced that their backyard wells, usually located near the outdoor privy, were dangerous and the source of water borne illness — diarrhea, dysentery, and typhoid fever. Dr. Moses Runnels conducted scientific sampling of well water in Indianapolis and surrounding communities in 1881 and reported wells being polluted “by soakage from privy” and filth. Annual city-wide clean-up campaigns of alleys, backyards, and refuse piles in the early years of the twentieth century gradually reduced the instances of typhoid fever, and “swatting the fly” was another way to combat the disease. In 1911, the Indiana state board of health estimated typhoid fever costs $2,000,000 (2019: $55,573,779) annually in “doctors’ bills, extraordinary household expenses…and funeral expenses.” A health board circular noted, “some will certainly scoff at the fact that a particular germ borne in polluted water or borne by flies causes the disease. It is all true, nevertheless, and so we must be patient with those who think they know more about the subject than doctors and sanitarians…” With the development of a vaccine, good sanitary practices, and indoor plumbing, typhoid fever became a bad memory.
Today more than ever, no truer words were ever spoken than those of former British prime minister Benjamin Disraeli, “The public health is the foundation on which rests the happiness of the people and the power of a country. The care of the public health is the first duty of a statesman.”
