Reading the Historical Geography Research Group’s summer newsletter led me (via a piece by David Beckingham) to look at an interesting moment in the history of medical cartography: a map by Dr. Edward H. Barton that was included in his “Report upon the Sanitary Condition of New Orleans” (part of the famous Report of the Sanitary Commission of New Orleans on the Epidemic Yellow Fever of 1853).
As Stevenson (1965) points out, this actually wouldn’t qualify as a spot map of disease, nor does it fulfil the claim for “presenting the localization of all the cases of yellow fever of the year”, though it does show the general locality. Indeed, he points out that this would have been a graphic challenge, given that there were nearly 30,000 cases in that year. Yet the map is important for the history of social cartography for two reasons: First, it presents an apparent association between locale and the clustering of disease, showing (in glorious detail), the location of “various Nuisances and other causes affecting the Salubrity of the City. . . . ,” such as cemeteries, slaughter houses, “vacheries,” [“nasties”] livery stables, sugar depots on the levee, factories of various kinds, open basins and unfilled lots, canals, drains, and gas works, not omitting “fever nests” and crowded boarding houses. It also shows pavements of stone, plank roads, and unsurfaced streets, as well as regions where soil had been disturbed and overturned, alongside information on the seven ships that – it was thought at the time – were the source of the disease. Second, it provides evidence of an association between topography and spatial layout.
Barton’s report showed how a plague spot “exists here on the river bank, because at this season (August and September) the river is low and the bank exposed, leaving an extensive surface—the common receptacle of all kinds of filth—and here, or not far distant, we find the large amount of unacclimated population; but it [the disease] first breaks out and spreads in St. Thomas and Madison streets, St. Mary street, about the Markets, at the triangle, Gormley’s Basin, &c. Sec. . . . — all filthy, crowded and badly ventilated localities.” (quoted in Stevenson, 1965, 257-258)
According to the European Centre for Disease Prevention and Control, yellow fever is spread via Aedes (Stegomyia) aegypti, commonly known as the Yellow fever mosquito. It is a known vector of several viruses including yellow fever virus, dengue virus chikungunya virus and Zika virus. It thrives in densely populated areas which lack reliable water supplies, waste management and sanitation.
In fact, as Willoughby (2018) maintains, the construction of the city 300 years ago, which entailed draining the swamps and building flood walls against the Mississippi, shaped its landscape for the long term. In addition, massive demographic change that brought about a large influx of workers, including slaves, contributed to the emergence of New Orleans and its surroundings as a zone of yellow fever. The map featured above captured the city shortly after the most devastating epidemic of the disease, that killed nearly 15% of its inhabitants.
Barton was an anticontagionist – rather than supporting the idea of disease being spread through human contact – anticontagionists believed that contagion occurred due to the locale, namely – that the environment of the locale itself was blamed for the disease. (See full explanation in Gilbert, 2002). The local stench was supposedly a sign of this, though confusingly there was the added element of incomers (“foreign elements” bringing the disease with them via the ports. This was a theory that had barely progressed from Seaman’s yellow fever maps of New York, 1799 (see image below), which had similarly showed the apparent association between “the fever” and the port. Yet, the report is significantly more sophisticated, with detailed descriptions of sanitary conditions, along with tables of statistics.
The spatial ecology of the disease is clear from Barton’s report. What is saddening to note is the preponderance of cases having occurred close to the water, in low-lying areas. That same spatial patterning can be seen 100 years later in the redlining map of New Orleans, pictured below, which designated the districts by the water as being most at risk for defaulting from loans. It is no coincidence that the city surveyor coloured as red, namely “hazardous” vast tracts of areas inhabited by “Negroes”, who were spatially segregated from the white inhabitants of the city due to racial zoning laws from decades earlier. It is also a sad truth to find that the devastating effects of Hurricane Katrina in 2005 also disproportionately affected the city’s African Americans, still living in the flood plain 60 years after the city’s spatial patterns of poverty had been fixed on a map.
Gilbert, Pamela K. 2002. The Victorian Social Body and Urban Cartography. In Imagined Londons, edited by P. K. Gilbert: State University of New York Press.
Stevenson, Lloyd G. 1965. Putting Disease on the Map: The Early Use of Spot Maps in the Study of Yellow Fever. Journal of the History of Medicine and Allied Sciences 20 (3):226-261.
Willoughby, Urmi Engineer. 2018. The Ecology of Yellow Fever in Antebellum New Orleans: Sugar, Water Control, and Urban Development. Environment & Society Portal, Rachel Carson Center for Environment and Society Spring 2018 (1).
See also: Chapter 2. Disease: The city as organism in Vaughan, L. 2018 (IN PRESS). Mapping society: the spatial dimensions of social cartography. London: UCL Press.