Lehigh Valley Public Health and the Great Influenza Epidemic of 1918: Enduring Lesson or Forgotten Episode
By James Higgins
At the turn of the 20th century, the health infrastructure of Allentown and Bethlehem defied any easy generalization. The cities combined the adoption of modern theory and practice in medicine and sanitation with a desire to cling to traditions like cesspools and an unfiltered, spring-fed water supply, all with mixed results. This mix reflected the larger matrix of new technologies and the pre-modern that prevailed throughout society. Standing in the center of the cities in 1900, an observer would notice telephone and telegraph cables crisscrossing madly overhead, electric trolleys clanking past, and doctors on their rounds. At the same instant, citizens were relieving themselves in holes in their backyards, horses rather owned the streets, and immigrants were stuffed into apartments that were almost indescribably cramped and dirty.
The rapid and unplanned growth of cities had contributed to periodic epidemics of disease, especially those caused by waterborne pathogens. Indeed, some of the foulest drinking water in the state flowed through Allentown and South Bethlehem. Allentown's 45,000 residents had constructed some 9,000 cesspools over porous limestone. Human excrement percolated through the ground and into the springs that served as the city's water supply. Allentown suffered two major typhoid outbreaks, the last of which, in 1902, sickened hundreds and killed nearly 70. Try as it might, the health department could not persuade the city to build a water treatment plant or sewage system that would preclude the need for the cesspools. South Bethlehem, meanwhile, experienced the incongruity of possessing a hospital that rivaled many big-city institutions of that era, but saw many of its possible community-wide benefits nullified by over-crowding and a near-absence of sanitary measures. Bad water made the city almost the worst place in Pennsylvania to deliver and raise children as many died from summertime dysentery caused by untreated water. Unfiltered drinking water from the Lehigh River was a mix of Allentown's upstream runoff and anything else, including sewage, the Two Bethlehems could dump into the overburdened body of water. Further, industrial operations, unconstrained by any safety mandates, appeared to produce almost as much human wreckage as pig iron or lumber. And one must remember that epidemics and industrial disasters were set against a backdrop of common, but deadly childhood diseases like measles, pertussis (whooping cough), and scarlet fever.
To combat these scourges, Allentown and Bethlehem, in fits and starts that mirrored efforts by cities across the country, adopted public health measures and built hospitals. In 1873, Bethlehem's leading citizens, with money-raising efforts kept alive by prominent women, had constructed, equipped, and staffed, adjacent to South Bethlehem, St. Luke's Hospital, an institution whose reputation for excellence and modern techniques made it an incongruent addition to the rough and tumble community.
Its greatest non-paying customer was Bethlehem Steel which annually transported hundreds of men to the hospital without paying, a situation St. Luke's regarded as intolerable by the turn of the century. After 1910 Bethlehem had community nurses visiting the sick at home, private doctors who could use the facilities at St. Luke's, and a baby milk station that did double duty as a pre- and postnatal clinic for the children of the city's poor.