Cholera in Boston's Irish tenements, 1849

Cholera killed more than 500 of Boston’s Irish immigrants in four months during the summer of 1849, and the dying was not spread evenly across the city. It gathered almost entirely in one district. The 1849 cholera epidemic in Boston struck hardest in the tenements of Fort Hill, where thousands of famine emigrants had crowded into the cheapest, worst-drained housing the city had to offer, and where a formal investigation afterward put a number and a description to what the poorest quarter of Boston had become.

The 1849 cholera epidemic reaches Boston’s Irish tenements

The outbreak was not Boston’s first brush with the disease. Cholera had already crossed the Atlantic once, in 1832, arriving in North America on ships out of Ireland and Britain. By 1849 the city had 17 years of half-formed experience with it, and none of that experience stopped the epidemic that opened that June.

The first recorded death was on 3 June 1849, on Hamilton Street. The last came on 30 September, at the temporary Cholera Hospital the city had set up to receive the sick. In between, the Committee of Internal Health counted 611 cholera deaths in Boston that summer, and more than 500 of them were Irish immigrants, a share far beyond the Irish proportion of the city’s population. By the 1850 census Boston held about 136,000 residents, of whom roughly 35,000, about a quarter, were Irish-born, most having arrived in the famine years after 1845.

Irish tenements at Fort Hill and Half Moon Place

Fort Hill stood where Boston’s Financial District stands today, a rise of streets, among them Broad, Batterymarch, Hamilton, Bread, Oliver, Atkinson and Wells, that had gone from a respectable address to the most crowded Irish quarter in the city within a decade. The Committee of Internal Health’s investigators, touring the district as the epidemic ran its course, wrote of tenements where whole families occupied a single room “from garret to cellar,” and where cellar dwellings without light or drainage were rented out as housing rather than storage.

One court off Fort Hill drew a description sharper than the rest. Half Moon Place, a narrow, enclosed alley walled in by tall buildings on every side, was called by the 1849 report probably the worst locality in the city, its 12 or 14 privies constantly overflowing, the sewage running down exposed outdoor staircases into the rooms below. Investigators recorded dwellings there holding up to 100 people between a single sink and a single privy, and described the crowding in terms meant to shock a Boston readership: families huddled together, they wrote, without the comforts or even the common necessities of life, sometimes wife and husband, brothers and sisters, sharing the same bed for want of any other space. Half Moon Place stood until 1866, when the levelling of Fort Hill itself began, a project that erased the district by 1872 and left the tenements only in the reports written about them.

The same investigators, working from the assumptions of their day, blamed much of the disease on the “degradation and intemperance” of the people living in these conditions rather than on the conditions themselves. That framing has not aged well, and historians reading the report now read past it to the physical facts the investigators still had to record: the overflowing privies, the standing sewage, the absence of any working drainage across an entire district. Those facts explain the outbreak better than the moral judgment laid over them.

Who died, and where

Cholera in the nineteenth century spread through contaminated water and food, not through the air or through contact with the sick, though nobody treating patients in Boston in 1849 yet had John Snow’s proof of that. Without clean water, without functioning sewers, and without anywhere to isolate the sick from a shared water supply, a Fort Hill tenement was close to the worst possible setting for an outbreak the era had no way to stop at its source.

The death toll fell on people who had already survived a great deal to reach Boston at all. Many of the Irish dying in Fort Hill in 1849 had crossed the Atlantic in the famine years on badly provisioned emigrant ships, a passage covered in more detail in what the coffin ships of Black ‘47 were actually like. They had arrived into a labour market that would soon post “no Irish need apply” against them, a hostility documented on Boston’s own hiring notices of the period, and into housing priced for people with no better option. Cholera in 1849 was one more hazard layered onto an arrival that had already cost many of them everything they had.

A statistic reported from Boston’s public health investigations of the following year has been cited ever since as a measure of just how hard that arrival fell on Irish immigrants: the average age at death recorded for the city’s Irish-born population did not exceed 14 years, a figure driven by catastrophic infant and child mortality in exactly the kind of housing the 1849 report described. The same wave of inquiry counted 586 Boston cellars in use as dwellings, without light or ventilation, some sheltering as many as 15 people apiece.

The city’s response while the epidemic ran

Boston’s mayor and Board of Health did not wait for the outbreak to run its course before acting, even without any working theory of how cholera actually spread. The mayor issued a public notice urging residents to collect household waste and rubbish on set days so the city could carry it away, and newspapers printed advice on symptoms and treatment through the summer. The Board ordered house drains flushed with salt water and the common sewers washed at intervals through June, July, August and September, and it had the Back Bay flooded from the harbour and held at as high a level as the drains running into it would allow, in an attempt to flush out stagnant water near the city.

Ships arriving in the harbour carrying fruit or other perishable cargo were required to report to the hospital physician stationed at Deer Island, who inspected them and had anything decayed or spoiled thrown overboard before the vessel was allowed to come up to the city wharves. Police were sent to whitewash houses and cellars across the poorer districts, and the Board distributed disinfecting substances free of charge to households that asked for them. None of it addressed the actual cause, since the germ theory of disease was still decades away and Boston, like every other city that summer, was guessing at sanitation rather than working from a diagnosis. The one measure that did the sick some direct good was the Cholera Hospital itself, an old warehouse fitted out with 20 beds at first and expanded to 40 as the summer went on, offering comfort and nursing rather than a cure, set up in Fort Hill so the dying did not have to be carried far to reach it.

The Shattuck report and Boston’s response

The cholera summer helped push Massachusetts toward a wider reckoning with public health. In 1849 the governor appointed Lemuel Shattuck, along with Nathaniel Banks Jr and Jehiel Abbott, as a Sanitary Commission charged with surveying health conditions across the state. Their findings, presented on 25 April 1850 as the Report of the Sanitary Commission of the State of Massachusetts and known ever since as the Shattuck report, drew on birth and death records in a way no earlier American document had attempted, and it named housing, drainage and overcrowding, not individual failing, as public health problems the city and state had a duty to address.

The disease did not disappear with the report. Boston recorded a second, smaller cholera outbreak in 1854, with 218 deaths, and a much smaller return in 1866, 39 cases and 19 deaths, the year Half Moon Place itself began to come down. Each outbreak arrived into a city slightly better equipped than the last to trace it, count it and, eventually, argue for the sanitary reforms the 1849 epidemic had made impossible to ignore indefinitely.

The engineering answer took decades to arrive. Boston did not commission a serious study of its water pollution and sewage problem until 1875, and a fully modern sewerage system, built around the Calf Pasture Pumping Station and the Moon Island treatment works, was not finished and running until 1884, 35 years after the summer that first made the case for it. Between the 1849 report and the 1884 system lay two more outbreaks and a generation of Bostonians who went on living over cesspools the city already knew, on paper, needed to be replaced.

What historians cannot know

The 611 names behind Boston’s 1849 death toll were not published as a list, and most of the individual dead of Fort Hill cannot be traced today to a specific family, room or grave. The investigators who toured the tenements recorded conditions and totals, not biographies, and the nativist framing running through their own report means some of what they attributed to character rather than circumstance should be read with real caution.

It is also not possible to say with confidence how complete the count of 611 actually was. Families afraid of the Cholera Hospital, or of the stigma attached to the disease, had reason to keep a death quiet rather than report it, and a tenement holding 100 people to one privy was not a place where every death necessarily reached an official register. The scale of the disaster in Fort Hill is documented. The exact edges of it are not, and no surviving record closes that gap.

After Fort Hill

Fort Hill’s tenements are gone, its streets built over by the district that now holds Boston’s banks and law firms, and the summer of 1849 survives mainly in the report the Committee of Internal Health left behind. The Irish community the epidemic struck hardest did not leave with the hill. It went on to fill the trades and the docks Boston depended on, into a decade that brought its own reckonings, including the financial panic of 1857 that hit Boston’s Irish workers before almost anyone else in the city. The cholera summer was a single, brutal chapter in a longer settlement, and the sanitary reforms it forced were paid for by the people who suffered first.

Sources and further reading

• Committee of Internal Health, City of Boston, Report of the Committee of Internal Health on the Asiatic Cholera (Boston: J. H. Eastburn, 1849), the primary account of the outbreak, deaths and tenement conditions, digitised by the National Library of Medicine.
• Lemuel Shattuck, Nathaniel P. Banks Jr and Jehiel Abbott, Report of the Sanitary Commission of the State of Massachusetts, 1850, presented 25 April 1850, digitised copy held by the Internet Archive.
• Massachusetts Historical Society, “Course of Cholera in Boston in 1849,” a map first printed opposite page 178 of the 1849 Committee of Internal Health report, MHS Collections Online.
• Global Boston, Boston College, “Irish” and “Cholera Report” entries, Eras of Migration and Ethnic Groups sections, drawing on the 1849 Committee of Internal Health report.
• HUB History, “Boston in the Time of Cholera,” episode 161, a researched account of the 1849, 1854 and 1866 Boston cholera outbreaks with dates and death tolls drawn from the city’s own health records.