A Study Of Yellow Fever,Cholera And The Development Of American Public Health(1793-1905)

Since the founding of the United States,Yellow Fever and Cholera had been prevalent,becoming terrible nightmares in the minds of people.Especially in the 19 th century,the American social environment began to undergo drastic changes.As the process of urbanization accelerated,the population of the United States continued to grow and rapidly concentrated in cities.The urban population density rose sharply,making the lagging urban administrative and sanitation infrastructure unbearable.This led to the deteriorated urban water resources,sharply increasing drainage pressure,crowded housing.Population concentration had provided sufficient food sources for potential pathogens,and water,drainage,and housing problems had become important contributors to the Yellow Fever and Cholera epidemic.To make matters worse,with the unfolding of the Industrial Revolution,the “Transportation Revolution” in the United States and the increasingly frequent trade exchanges between regions had caused the frequency of interpersonal communication to rise sharply,which resulted in the wide spread of Yellow Fever and Cholera.In other words,the drastic changes in the American social environment in the 19 th century broke the originally balanced ecosystem among humans,the environment,and pathogens.Therefore,the spread of epidemics of Yellow Fever and Cholera was more and more common.Facing the epidemics of Yellow Fever and Cholera,the United States usually adopted countermeasures based on mainstream medical theories.The 19 th century was a period when traditional medicine evolved to modern medicine.Before the mid-19 th century,Malaria Theory and Contagion were important medical discourses explaining infectious diseases and guiding the prevention and treatment of epidemics during this period.In the late 19 th century,modern medicine theories advanced all the way,and the mysteries of many infectious diseases were uncovered one by one.With the update of medical knowledge,the goals,measures and procedures of infectious disease epidemic management also changed significantly.As far as Yellow Fever is concerned,the early prevention and control of it was mainly based on the Miasma Theory,advocating improved hygiene,and focusing on infected persons and Fomites based on Contagion.During this period,American people's cognition and response to Yellow Fever were mixed with religious factors.By the beginning of the 20 th century,Mosquito Theory replaced the above-mentioned medical theories and became the scientific cognition explaining the law of transmission of Yellow Fever.Starting from the Mosquito Theory,the Yellow Fever epidemic management focused on preventing and killing mosquitoes,and controlling the cross-regional movement of Yellow Fever-infected persons and Aedes aegypti.It cannot be ignored that in this process,the role of the US government and society in fighting the epidemic has gradually changed.Like Yellow Fever,with the advent of new medical explanations,the American Cholera prevention and control measures in the 19 th century also changed.In the early19 th century,most doctors believed in Miasma Theory and some firmly believed that Cholera was a contagious disease.The disagreements of the medical community on Cholera had also left room for ordinary people and church members to express their opinions.The poor,prostitutes,alcoholics,and even immigrants have become scapegoats for the Cholera epidemic.In response to the Cholera epidemic,based on the recommendations of the medical community at the time,municipal authorities in various regions focused on improving urban hygiene and personal hygiene,and adopted quarantine measures.In addition,in the eyes of most church members,Cholera is God's judgment on the sins of the world.If someone wants to escape the judgment,he must convert to God through fasting and prayer and repentance.In the late 19 th century,the microbiological theory of Cholera turned out to be a bleak ending for other medical theories.Guided by microbiological theory,the logic behind them is different,although the epidemic prevention measures still focused on urban hygiene and personal hygiene.At this time,the focus of the epidemic was on Vibrio cholerae,and the specific actions were to isolate the infected and eliminate the source of infection.It is worth noting that in terms of the prevention and treatment of the Cholera epidemic in 1892,epidemic prevention was not only a purely medical issue,but sometimes closely intertwined with social,cultural and political issues.In the face of the Yellow Fever and Cholera epidemics,the United States not only constantly sought effective solutions during the epidemic,but even after the epidemic,it thought about how to prevent the two from existing for a long time.Improving the public health situation came to its mind.In the first half of the 19 th century,the early public health movement in the United States officially kicked off.Under the impact of Yellow Fever and Cholera,sanitarians actively appealed and campaigned to promote the development of public health in the United States.The development is mainly reflected in two aspects: one is the construction of urban sanitation facilities;the other is the increase in the health power of governments at all levels.As for the former,cities including Chicago,New York,and Memphis were the first to adopt urban health reforms to improve urban health and prevent repeated epidemics.Regarding the latter,on the one hand,the health powers of state and local governments were constantly strengthened,and the prevention and treatment of infectious diseases such as Cholera and Yellow Yever had gradually changed from temporary affairs to routine responsibilities of health institutions.On the other hand,the federal quarantine power was also expanding.According to the U.S.Constitution,health powers including quarantine belong to each state.However,in the context of Yellow Fever and Cholera epidemics,transforming from state quarantine facilitators to important performers of quarantine work,the federal government continued to expand its quarantine powers,with the result of sharing the quarantine power exclusively owned by the state and local governments before.