Abstract
In the fall of 1892, ten years into the fifth international cholera epidemic that lasted from 1881 to 1896, fear of cholera in North America, particularly in Toronto, was full blown. Cholera had been raging in the Middle East, India, and Europe, and in Russia alone there were an estimated 300,000 deaths, but the disease had yet to cross the Atlantic Ocean. Maritime traffic of immigrants from Europe was continuous, and each migrant ship potentially carried the disease. Doctors, government officials, and politicians were not asking ‘would cholera come?’ but rather, when. In the city of Toronto, no one actually got sick or died from cholera in 1892. However, the crisis and fears of imminent cholera were real. This article documents how future threats became immediate and dire concerns. My task here becomes how to write a history of an event that was shaped by urgency, immediacy, and speculation on the future. My argument will show how the geography of an epidemic is not limited to the presence of disease. How do you theorize a crisis in the absence of an actual disease outbreak? How do you theorize an event that didn’t happen? This article will answer these questions and contribute to recent literature in geography that engages with life, security, and the future. Predictions about both the present and the future were speculative statements, and these statements had effects on cities and nations.
IS THIS DREAD CHOLERA? KOCH ON THE SCENE. CHOLERA MAY COME. NEW YORK IS READY. NO CAUSE FOR ALARM. CHOLERA TO COME NEXT YEAR. WATCH JEWISH IMMIGRANTS. NEW CURE FOR CHOLERA. CHOLERA IS IN ENGLAND. SHIPS BOYCOTT. THE PLAGUE’S PATH. WAKE UP, TORONTO. COMING VIA CANADA. GROSSE ISLAND CONDEMNED. BARRIER AT DETROIT. THOSE JEWS COMING TO CANADA. QUEBEC CLOSES ITS DOORS. KEEP AWAY FROM US. GUARDING THE FRONTIER. IS CHOLERA HERE? GOOD NEWS ABROAD. A VOYAGE OF HORROR. FEAR IT’S CHOLERA. A BAN IS PUT ON NEW YORK. TORONTO IS READY. GRAVE STUPIDITY AT OTTAWA. TO CLEAN THE CESSPOOL.
Each statement above is a newspaper headline from the fall of 1892, compiled in chronological order. Headlines tell a particular story, a fearful account of panic and speculation. 1 Published in the Toronto Evening News, a popular, cheap, and sensational newspaper, these headlines followed the looming cholera epidemic of 1892. 2 At the end of that summer people began dying in Hamburg, Germany, and the alarm went out throughout the Atlantic Ocean. When ships carrying the sick arrived in New York City harbor, the anxiety increased. The Toronto editors threw around blame and made bold declarations. Fear sells newspapers. I have laid out the headlines in this manner to illustrate the urgency and immediacy of the impending cholera outbreak. This article will tell the story of ‘what happened’ in the fall of 1892 and will discuss how this cholera outbreak was framed as an urgent and sudden crisis. This article documents how future threats became immediate and dire concerns. Orthodox histories of disease outbreaks generally focus on locations where sick and dying people are found. 3 But the fear and conjecture of impending epidemics should be included in this history of disease. Predictions about both the present and the future were speculative statements, and these statements had effects on cities and nations. In the fall of 1892, ten years into the fifth international cholera epidemic that lasted from 1881 to 1896, the fear of cholera was intense in North America, particularly in Toronto. Cholera had been raging in the Middle East, India, and Europe, and in Russia alone there were an estimated 300,000 deaths, but the disease had yet to cross the Atlantic Ocean. In the case of previous Canadian outbreaks of cholera (at various times between 1832 and 1871), the bacteria had travelled from Europe on migrant ships. Maritime traffic of immigrants from Europe was continuous, and each migrant ship potentially carried the disease. Doctors, government officials, and politicians were not asking ‘would cholera come?’ but rather, when.
In the city of Toronto, no one actually got sick or died from cholera in 1892. However, the crisis and fears of imminent cholera were real. Countervailing tendencies marked the cholera outbreak of 1892. Cities were caught off guard. Urgency was pervasive. But at the same time, government officials postured as though they were completely prepared, especially if both human lives and their jobs were on the line. Local sanitary conditions had to be put in order, and national borders also needed securing since the disease would come from overseas. Health reformers were pulled to institute reforms both locally and internationally, yet the continued lack of scientific consensus over the causes and vectors of the disease confused what direct changes were necessary in sanitation and quarantine methods. Debate was thought to be inefficient; instead, experts recommended various reforms, the implementation of which had ‘obvious’ benefits. Government officials quickly declared plans that had previously been delayed due to politics or budgetary constraints as necessary and pressing. My task here becomes how to write a history of an event that was shaped by urgency, immediacy, and speculation on the future. My argument will show how the geography of an epidemic is not limited to the presence of disease.
If cholera did not happen in Toronto in 1892, why was there such fear and demand for reform? After the cholera outbreak of 1892, substantial changes took place in state institutions, science, international coordination, waterfront transformation, and the ideology of health experts. North American health experts and political authorities seized the moment to align their health borders, to reclaim the marshlands of cities, and to debate and reform immigration. These changes were all declared necessary. Despite this widespread change, cholera as disease crisis was a proportionally small event for Toronto. How then do crises produce this degree of activity?
How do you theorize a crisis in the absence of an actual disease outbreak? How do you theorize an event that didn’t happen? In answering these questions, I hope to define and articulate the difference between the interrelated terms of crisis and event, and contribute to recent literature in geography that engages with life, security, and the future. Michel Foucault’s writings have helped to theorize how events are secured and governed. However, I want to temper this Foucault, along with how his ideas have been taken up in geography. In the current literature: futures are sold; real and imagined threats are blurred; pre-emptive interventions take place; scenarios are played out; biology is speculation; risks emerge; and increasingly more forms of life are incorporated into security. 4 However, this literature—best framed as biosecurity—leans heavily on the present. I want to suggest the importance of future events histories that led to these present-day manifestations. I concur with Ben Anderson, who has written extensively on ‘current futures’ and declared that ‘processes of securing generate excess, that is they open up futures.’ In contrast, I want to contribute historical descriptions of ‘how “the future” is disclosed and made present.’ 5 I describe what took place when events didn’t happen according to predictions, and when anticipated crises failed to become catastrophes. Recent examples abound for unrealized epidemics (such as bird flu, swine flu, and SARS), yet my contention is that the failed crises of the past were productive in shaping the current landscape of knowledge regimes, common sense, and structures of political and economic power. I contribute to Stuart Elden’s take on governmentality (sovereignty–discipline–government), not as a liner model, but rather as ‘a space of political action [that] allows us to inject historical and geographical specificity into Foucault’s narrative.’ 6 The political action of intervening in the name of impending cholera allowed particular practices to emerge and persist, from a variety of competing futures that were invoked. In my case, what was the chance that cholera will circulate and become an event in Toronto? Was it the same chance that cholera would fail?
Cholera did not materialize in Toronto, but the fear of cholera transformed social relations and mobilized practices in anticipation of the crisis. The cholera crisis in 1892 validated a particular ideology. This ideology built upon the history of previous epidemics to articulate a future framework on how to manage healthy cities and nations. However, the institutions and practices that were produced came from the idea of a cholera crisis, along with the historical conditions and contingent actions that shaped this particular crisis. Cholera was a crisis, but this crisis was constituted through both the idea and the material reality of the epidemic. My case of Toronto uniquely sheds light on this because an actual outbreak never occurred. A crisis implicitly pushes for decisions to be made for the sake of the future. I want to ground how a crisis was articulated, or how the idea of a crisis circulates, within historical materialism. I do this because the definition of the object of ‘crisis’ is both imprecise and overdetermined.
Events overtake ideas: dying in the time of denial
To work towards my definition of crisis, I want to eliminate terms such as emergency, disaster, and catastrophe, as they don’t accurately reflect Toronto’s experience with cholera in 1892. 7 Since no one lost his or her life or suffered cholera, to frame this event with words like catastrophe is careless and distorts what took place. What then is the difference between a disaster event and a crisis? To be pedantic in formulating a general definition, I’d like to think through a range of disease events, from the perspective of a doctor or health expert. The first version of a disease event could simply be a situation where people die. A second version could be a situation where people get sick, and that includes instances when the cholera bacterium was found. In a more nuanced version, a medical expert looks back to past disease events and demarcates what was or was not an outbreak. This declaration of outbreak would be dependent on the fluctuations of death and sickness numbers during a bounded period, and that period would then be judged in comparison to other periods. This would distinguish the presence of cholera from the severity of cholera’s effects—cholera as an affliction versus cholera as an epidemic. However, Toronto in 1892 does not fit any of these typologies of a disease event. In Toronto, no one died of cholera, no bacterium was found, and no upsurge of sickness took place; there was no emergency. Despite this, the cholera pandemic caused activity in Toronto—indeed, throughout the world. To tackle the understanding of this event of 1892, Hamburg needs to be investigated, but not because this is where pandemic ‘started,’ rather, Hamburg is where cholera gained the force and intensity to become an emergency.
By August of 1892, Toronto’s newspapers, as well as news outlets around the Atlantic, were regularly reporting cholera outbreaks occurring in far off and foreign locales. For over sixty years, North American audiences had read updates and notices on the spread of cholera throughout the world. These outbreak events appeared to be increasing in frequency and were encroaching on western European cities. However, some reports dismissed these fears, suggesting the notices were false alarms—only diarrhea or ‘cholera infantum.’ Then, at the end of August, international attention was focused on the city of Hamburg, Germany. Port authorities in neighboring countries suspected for some time that Hamburg was in the middle of a serious cholera emergency. However, Hamburg’s city government publicly denied the outbreak. The city government tried to quell the fear and rationalized that, even if cholera was present, every precaution was being taken to keep the disease local.
There were doubts the disease could be contained, since Hamburg was one of the largest and busiest ports in the world. North America was particularly worried. New York and Hamburg had the highest volume of shipping between any two ports of that period. Hamburg’s direct shipping connections to Montreal worried Canadians. While Hamburg city officials denied cholera, the growing death count could not be ignored.
The cholera outbreak was confirmed in Hamburg when the famed German bacteriological scientist Robert Koch, the scientist who ‘discovered’ the cholera bacterium in 1882, rushed back from Persia where he was doing research and declared he had found cholera in the German city’s water supply. The Toronto Evening News reported, ‘The declaration of the renowned Professor Koch … is accepted without question by the physicians of Toronto.’ 8 By August 24 Hamburg finally admitted that there had already been 120 cases of cholera and 35 deaths. The city’s official telegraph notices were sent to every port to prepare for Hamburg ships. Toronto newspapers reported that people were dying in Hamburg within six hours, sometimes in as little as one hour after coming down with the disease. 9 Toronto headlines exclaimed: ‘CHOLERA MAY COME. The Asiatic Type is at Hamburg and Havre! America Has Direct Communication! Washington Warned to Beware of the Scourge—A Steamship on the Way From Havre Which is to be Fumigated—This Continent in Genuine Danger.’ 10 Ships began to boycott Hamburg, 11 and ships from Hamburg in other ports were no longer allowed to dock and were placed in quarantine. To deal with the crisis and clean their city, Hamburg’s city officials requested 38,000 gallons of disinfecting fluid from the London authorities. 12 As one newspaper headline stated: ‘The Epidemic in Hamburg Worse than Any of the Nineteenth Previous.’ 13 But Hamburg rationalized that the city was not at fault; it was merely a victim of the scourge of dirty migrants travelling through.
The Hamburg authorities denied culpability, saying that they were merely the gateway onto the Atlantic that unleashed the cholera crisis from its source in the Russian interior. Yet the cholera crisis re-established and confirmed for shipping and port authorities that pandemic outbreaks were a common problem. The coverage from London, England, claimed British authorities had suspected that cholera had infected Hamburg even before Hamburg’s senate admitted the outbreak of the disease. Concealing local problems had international ramifications. The orders were to inspect everyone from Russia and Hamburg and specific instructions were given: ‘Dirty clothing and all baggage suspected of being infected with cholera will be burnt.’ 14 Hamburg was the most recent port during that pandemic to have an outbreak; however, Hamburg was distinct in terms of scale and intensity of the outbreak and the city’s key position in international shipping routes. The tone of the newspaper articles suggested that, because Hamburg had such extensive international connections, it was only a matter of time before another city would become a new nexus in the spreading pandemic. Many predicted that the next city would be New York City, particularly because a ship with cholera passengers was already travelling toward the city and Hamburg would not allow the shipping company to return to its port. However, to inspire reforms the cholera bacteria did not need to travel from Hamburg in the steerage passengers’ stomachs. The idea of a cholera crisis had already landed.
The force of ideas
I need to directly face the power of the idea of a cholera epidemic. According to the Spinozian philosopher Hasana Sharp, ideas are not right or wrong, instead we should engage ideas in terms of their ‘force, vitality, and power.’ This ‘requires attention to the collective dimensions of thinking life, where “collective” refers to a transpersonal accumulation of ideal power that includes human as well as nonhuman beings.’ Ideas are strengthened and weakened by other ideas, but also by incidents that happen (or do not happen in the case of 1892 in Toronto). The imagination of the crisis affected the world in ways that went beyond a question of how these ideas were shaped, behaved, and interacted with other ideas. 15 The geographer Vinay Gidwani, working with philosopher Louis Althusser’s tension between ‘imaginary’ and ‘lived,’ suggests that ‘ideology exists in the obviousness—empirical immediacy—of our world and the actions we take, imagining ourselves to be the center of initiatives.’ 16 The health experts who feared the future provide an excellent example of this tension. In their words and ideas, they placed themselves at the centre of a large movement to produce a world without disease. But in the negotiation with their ideologies, these health authorities regularly failed, were frustrated, needed support, felt impotent, and derided the public they took up the responsibility to protect. My argument is they lived out the ideas and imagery they articulated (they were saving the lives of those around them whose demise they saw as imminent). However, their imagination was collective, as the cholera bacteria demanded a reshaping of their idea of the world. From a different perspective, the Italian philosopher Antonio Gramsci helps to explain this relationship: ideologies overtake events and shape histories; events overtake ideologies and ‘explode schema.’ 17 Gramsci speaks of the ‘living out’ of thought, even in spite of what can be predicted. While Gramsci emphasizes how doctrines rely on ‘the normal course of events,’ he makes clear that ideology does not follow the normal course of events, and neither do events. 18 To paraphrase the geographer Geoff Mann’s take on Gramsci, what is of interest here is more than the discursive production of a cholera crisis. Actors involved in contests over the meaning and controls of ‘disease’ often understand the movement of ‘health’ not as more than a normative standard, but as an active, material force in the making of the world—what Gramsci called an ‘idea-force.’ 19 The idea of health and the crisis of cholera was a force to be reckoned with.
The term ideology opens long-standing theoretical debates that I do not have the space to go into here. For my purposes, I do not seek a theory of ideology nor intervene in the debates over the ideology’s ‘obsolesce.’ Instead, I want to understand ‘ideology in the time of cholera.’ I want to articulate a ‘minor’ history of crisis ideology, as a problem and a way of writing on contingency. 20 Ideology is neither an illusion nor imposed ‘from above.’ Ideology is lived and spontaneous. In the archive, I follow ideology as a form of argumentation and speculation, rather than a set of ideas, beliefs, or knowledge. In the time of a cholera crisis, ideology was not a distortion of events, but a political space where speculative practices could engage with future events. Writing from this disposition, I follow how specific predictions created a unity of what needed to be done. As the cultural theorist Stuart Hall suggests: ‘[t]he whole purpose of what Gramsci called an organic (i.e., historically effective) ideology is that it articulates into a configuration, different subjects, different identities, different projects, different aspirations. It does not reflect, it constructs, a “unity” out of difference.’ 21 However, I want to assert that this unity cannot be reduced to homogeneity or uniformity. Rather, this ‘unity’ 22 was an assemblage—collective, while uneven—that contributed intensity and force behind this idea. The idea-force around a disease crisis emerged from: the speed and persistence of circulation of statements; the unity’s strength and coherence; the haste behind how these ideas were put into practice; and the fear of the future, illness, and death. For many health experts, the force of ‘ideology in the time of cholera’ came from the deployment of spontaneous and multiple practices. These experts relied on whatever health intervention they could muster. This unity accumulated into building ‘a cholera wall’ for North America, as this article will show. However, in writing a ‘minor’ history of this cholera crisis attention needs to be paid to how this accumulation emerged. To do so, I utilize Gramsci to understand this space of political action, the Spinoza tradition in describing the force of political ideas, and Foucault’s genealogy to write future event histories.
To further articulate this cholera crisis—as an idea, a history, and an event, and also as part of an ideological project—Foucault’s toolkit and methods allow me to trace the relations of power around the event. 23 Foucault frames the event in a very specific way when he states: ‘The event on which one tries to get a hold will be the reality of grain much more than the obsessive fear of scarcity.’ 24 This assessment of history accords with my archive. The microscopic biology of cholera (bacterium vibrio cholerae) was indeed isolated, ‘got hold of’ in the petri dish, well before the regulation of the modulations and transmission within international relations of the Atlantic (the epidemiology of cholera). In 1883, the microbiologist Robert Koch’s practices that ‘discovered’ the vibrio cholerae were validated before the disease was subject to international management and control. However, according to Foucault, we have to reject the idea of the irruption of a ‘real event’ from a secret origin. He suggests seeking origins drives the investigation back further and further into history, to search for a secret cause of events. In my case, following cholera back to its ‘birth in the Ganges’ was a powerful myth that had political and cultural ramifications. Foucault disparagingly suggested history’s intelligibility comes from assigning a cause, which is more or less a source of events; instead, he recommends searching for cumulative effects. Both statements and practices gain strength through repetition. One method I want to utilize is Foucault’s method of searching for a sudden irruption of a statement and what enabled this statement ‘to be repeated, known, forgotten, transformed, utterly erased, and hidden.’ 25 Foucault’s method was to look at statements, or the accumulation of statements, in which causation is neither direct nor obvious, but instead is seen to build up over time and draw in disparate actors and logics.
Circulation of statements and the accumulation of ideas
The newspapers repeatedly reminded their readers, the real cholera problem was, and continued to be, India. India was perceived and declared to be the origin of cholera, the source of previous pandemic crises by the international medical community. Doctors and scientists blamed cholera transmission throughout the Atlantic on Muslim pilgrimages travelling from India to the Middle East. Many of the previous cholera pandemics were said to have originated at the yearly Hajj pilgrimages to Mecca. The London Daily News reported that cholera had been discovered in ‘the East.’ Constantinople reported that although the Mecca pilgrims had shown clean bills of health up to the present, several new cholera cases had been found. 26 The Toronto Evening News gave a quick overview of ‘Meshad, the Sacred City of Persia, Home of the Scourge.’ Medical journals and the Western media repeatedly labeled India as the perpetual cause of cholera pandemics, even when this explanation did not adhere to the evidence in 1892.
The carriers of cholera from Hamburg were Russian Jews looking to cross the Atlantic, bound for North America in search of jobs and new lives. The European experience of Jewish migration was focused not just on shipping but also on rail transportation. By the 1890s, railway networks had spread across and connected western European nations with the Russian empire. These railways provided a swift new means of transportation for the disease. The 1892 the cholera pandemic had travelled overland from Afghanistan to Russia. The disease was in Moscow by July of that year. Jewish migrants bound for the United States via Hamburg were driven to migrate by famine, the pogroms, and the expulsion of Jews from Moscow. In response to these reports and the higher volume of Jewish passengers, the German Imperial Health Office sealed the border. Migrants were allowed to travel through the country but they could not stay in Germany. Jewish migrants were transported in sealed trains and no passenger was allowed to leave. If any migrant left the train, heavy disinfection of the train station and surrounding areas was required. 27 The migrants had paid for passage to cross the Atlantic on shipping vessels whose foremost destination was New York City. Therefore, they were ‘stored’ in Hamburg and not allowed to leave the shipping companies’ facilities.
Though Hamburg’s lack of clean water supply was responsible for the spread of the epidemic, cholera fed into the long-standing stereotypes and structural discrimination against the Jewish community in European cities. While in Paris, headlines blared the French authorities’ warning to Canadians: ‘WATCH JEWISH IMMIGRANTS. Those on Their Way are in a Terrible Filthy State.’ The news reports suggested that the combination of the condition of the Jewish emigrants and the city was a ‘fertile field for its spread.’ News reports from Paris called the city a disaster waiting to happen. The Paris Jewish Committees said that in August, 1,000 Jewish refugees from Russia passed through Paris, and most were on their way to the United States. The recent arrivals ‘have been in a most filthy condition.’ 28 The association between dirt and cholera had yet to be debunked, so these migrants were feared based on their appearance. A couple of days later, another report from Paris claimed that Russian Jews were planning to go through Canada to get into the US and avoid any quarantine measure.
Newspaper reports on cholera were sensational. Stories on the spread of the disease used a particular format. Newspapers constantly predicted which city would be the next site of infection. Toronto’s newspapers featured a sick city roll call: short reports from each major city and port stating the existing sanitary conditions or any cholera cases. As an example, Vienna was declared to be in a ‘[s]hocking state of filth and overcrowding’ with tons of rotting meat sausages and fruit, and if cholera reached Vienna, ‘the number of victims will run in the tens of thousands.’ 29 In contrast, for St. Petersburg on September 2, 1892, the report was just a listing of official cholera ‘returns:’ ‘5,273 new cases and 2,722 deaths as a total 15,900 have already died.’ 30 The daily newspapers’ reports on each city’s death toll and the event of a new city being added to the list of the infected must have had a tremendous effect on Toronto’s readers. Sometimes the reports would also declare false alarms and recant previous accounts; for example, the notices of cholera in Venezuela were false. These false reports would only lead to further confusion. There were also reports that doctors in Paris and London were misdiagnosing scarlet fever as cholera out of fear. Fear, confusion, and speculation were rampant.
Theorizing speculative statements
Accordingly to Deleuze, Foucault’s method specifies that only statements repeat, and how this repetition takes place is strictly limited by the conditions of the milieu. 31 Milieus must have some similarity to give a statement the material force to be uttered and repeated. But not all statements or all places are equal. Foucault defined the milieu as ‘a multiplicity of individuals who are and fundamentally and essentially only exist biologically bound to the materiality within which they live.’ 32 Does this consequentially mean everything depends on context? Or do external forces limit the making of declarations? No. Statements possess a necessary materiality that includes their context and what has enabled the speaker. 33
To illustrate statements and the milieu, take the headlines from the Toronto Evening News quoted in the introduction. Each in its own way expresses the same impending sense of doom. They are all different statements and they required Toronto’s milieu to give them traction. At other times in Toronto’s history, very similar predictive statements were ignored. Another example of how statements require a milieu and practices would be the telegraph notification system 34 between North American governments that circulated the existence of potential outbreaks. This communication infrastructure documented and stored statements of impending crises. These relations of statements illustrate how power is not a property that can be possessed; power must be exercised. And so for Foucault, this power cannot only be found in the state; the state itself is an effect of interacting structures and located at a different level at the ‘microphysics of power.’ As I deal with the microscopic realm, I have to clarify that the ‘micro’ for Foucault does not refer to small or minute but to ‘mobile and non-localizable connections.’ 35 The statement ‘cholera is coming’ was repeated and then it travelled to many different locations, attempting to become localized. Because of the way epidemics arrive from outside the local, the statement can never be entirely local, by an epidemic’s very definition. To summarize, cholera relations became a crisis in the variety of places where these statements were uttered: in Hamburg, where people died, but also in Toronto where the concrete materiality of cholera failed to become a biological object to eradicate locally. Power is not contained within those statements, or only in the microphysical relations. However, how these crisis processes became increasingly localized were through political and economic acts by local state governments and agencies, which shaped how the statements were uttered and heard.
To return this discussion to ideas and ideology, I read ideology as also having been built on statements that are similar but not equivalent to Foucault’s statements. To be clear, this work is not looking for a theory of ideology, but sees ideology as a problem. As Stuart Hall says, ‘The problem of ideology is to give an account, within a materialist theory, of how social ideas arise.’ 36 My question is how do social ideas—in this case, a genealogy of a cholera crisis—arise in relation to the material constraints and marshalling of productive forces between both the state and capital? 37 These social ideas of crisis did not persist because they were true or reflected the reality of the social conditions; instead, the idea of crisis required decisions to be made. While the ‘illusory core of bourgeois ideology’ is the notion that ‘ideas provide the motor of history, or proceed independently of material relations to generate effects,’ 38 this is not what I am doing with cholera and crisis. Instead, I look to show how each uttered and written statement depended on actors, institutions, and milieu. Had these abstractions not been validated and made necessary, different state authorities would not have taken up or consented to an idea or statement. The statement became true not because it was true, but because it was explanatory. How ideologies were lived out can be found throughout the archives, in newspaper articles, medical journals, policy documents, and especially theories of science. All these statements in the archive were not equal, and many statements had more force due to an accumulation of meaning, as I will illustrate below in Toronto. Ideologies and statements have a materiality; they are built from practices, spoken from within institutions, and circulate between cities through communications systems. Ideologies and statements accumulate and have effects beyond their utterance.
To further hone in my definition of this crisis idea-force, I want to follow how ideas became necessary, in terms of what Gramsci called the living out of thought. The insights of Christopher Hamlin, a historian of public health, help to form a definition of crisis. For him, there was no particular reason why sanitation and toilets became mandatory in Britain. Granted, there were urban sanitary conditions that called for a response; however, Hamlin believes that, ‘conditions do not determine responses.’ Just because urban sanitary conditions were appalling in Victorian England does not mean clean water and drains were just needed. Currently, sanitation and clean water is needed around the world, but whether or not infrastructures are built does not depend on need. The politics and rhetoric of crisis is rooted in implied need—an idea. However, declaring a crisis means nothing, since a crisis is always happening. 39 Statements of need are insufficient by themselves for change, like indoor plumbing in England, to be implemented. My questions then become: How are need and necessity negotiated in times of crisis? How was a declared crisis transformed into a particular form or process that enabled activity? In other words, how does the abstraction of crisis produce material effects? This can be illustrated through looking at how experts in North America lived out the thought of the impending cholera crisis.
Ideas overtake events: the living out of cholera speculation
A few Canadian officials made the astute judgment that if cholera was to enter North America in the fall of 1892 it would be through the United States, probably New York City. The United States delegates in Germany had been caught by surprise. Since Hamburg officials did not want other nations to know there was a cholera outbreak brewing, they hid the disease from the American Consul Charles Johnson who was stationed in their city. When the European consuls received the correct information, they immediately reported to Washington, according to procedure. The official notification was too late. Ships with sick migrants were already on their way across the Atlantic. But according to procedure, the outbreak notice was relayed to the Health Officer of the Port of New York, Dr. William Jenkins, along with directions for the customs officers to disinfect baggage from cholera-infected ports. 40 Washington’s official position was clearly stated: ‘The greatest danger to which this country is exposed is from the hordes of emigrants. More than 50,000 come into this country every month, Germany heads the list, with natives of the British Isles second and Russians a good third.’ 41 Ships with migrants from Europe were placed under high scrutiny.
However, New York City doctors and medical experts exuded confidence. Both city and port officials declared New York ready for the cholera patients that were to arrive any day. New York City’s Sanitary Superintendent Cyrus Edson declared, ‘There is positively no danger to New York … The European outpost of the disease is, to be sure, unpleasantly near us, particularly in view of the heavy tide of emigration from Northern Europe with flows from Hamburg.’ But he correctly declared that the incubation of the disease guaranteed that cholera would be discovered during the Atlantic transit. Public health officials in New York City would be aware of who was sick before the ships docked in the city. Edson knew that cholera had to get into your internal digestive system to cause illness, and he assured the public that the mere presence of a person with cholera within a community was not a danger. He spoke of holding a child suffering from cholera in his arms and walking away without getting sick. He suggested that cities must purify their water, as cholera in polluted water lived on organic matter that allowed the germ to multiply. He worried that, if New York City’s Croton watershed became ‘impregnated with cholera germs,’ a citywide epidemic could take place. The Toronto Evening News editors ended the story with Edson outlining how cholera followed in the wake of war, famine, or other misfortunes, and how the present outbreak was directly connected to the famine in Russia. The report concluded with a small history lesson on how New York City had had five outbreaks during the 19th century and how an estimated 15,000 people had died. 42
When cholera did arrive in New York City, three shipping vessels were put into quarantine. In Toronto, a constant detailed reporting on what was happening in New York City took place. As each ship with sick passengers arrived in its ports, the health officials restated their confidence of the city’s position. There were reports of the horror and panic of passengers who were quarantined on the ships in the harbor along with the sick. Many of the rich passengers begged the health commission to break quarantine and let them disembark. New York City policemen began patrolling the ships and port to make sure no one jumped ship to swim to shore. 43 Despite all these fears, the New York City and North American cholera crisis never materialized.
New York City isolated the disease and was the only North American city to be affected by this cholera pandemic. Thirty-two people died in New York, but the majority of the deaths were among the Russian Jewish migrants quarantined on the ships, and this halted the spread of cholera. But these quarantine measures were politically unpopular. From some liberal circles, the act of keeping everyone at bay in quarantine reflected poorly on both the city and the nation. There had been long-standing criticism against New York City’s quarantine practices. Since 1888, New York City’s Committee of Physicians had warned that the quarantine facilities were inadequate to manage an outbreak and the lack of reform, despite their warnings, was probably due to financial constraints. New York City’s quarantine islands and stations lacked adequate water supplies and sanitary measures. Dr. William Jenkins, the health officer of the port, instituted the politically unpopular practice of keeping all migrants on ships floating in the bay during the outbreak. When ships tried to land against the quarantine, riots broke out. Though the disease was contained, Jenkins was publicly attacked for his mismanagement of the cholera outbreak. 44 The condemnation was strange given that he had halted the spread of the disease.
However, federal authorities and medical experts throughout the United States called for reforms of the national quarantine measures. An editor of the Nation, E. L. Godkin, who had been forced to stay on one of the ships in the New York harbor, wrote influential pieces about his experiences in the Nation and the North American Review in a series called ‘Letters from the Normannia,’ the name of ship that he had travelled on. He attacked the quarantine measures as old fashioned, medieval, and even barbaric. Godkin supported his argument with expert opinions from The Boston Medical and Surgical Journal, which had declared the quarantine of New York a ‘national disgrace about which the less said the better.’ Yet Godkin extolled his readers to take up a public outcry. He said the United States was still unprepared for the threat of cholera. He claimed that with the Columbian Fair in Chicago scheduled for the following year, thousands of migrants would be travelling into the interior of the continent, and a disease crisis was waiting to happen. 45 Godkin asserted that people of his status, with either money or authority, who would be coming to the United States should not be kept for twenty days in quarantine before reaching the fair. Throughout the 1890s, in journals such as Harper’s Weekly, a regular discussion took place on immigration, quarantine, and the need for a national health agency.
Crisis averted: the future after the emergency
The 1892 cholera outbreak also became a national lightening rod in debates over immigration. President Benjamin Harrison was against immigration and had renewed the Chinese Exclusion Act in May 1892. Even he couldn’t stop the flow of migrants in the name of health concerns because ports were not under federal jurisdiction. If cholera and typhoid were found on migrant ships, neither the president nor any federal agency could bar entry. Quarantine was under state and city jurisdictions. With a number of strikes and labor disputes throughout the country at this time, the intersection of immigration and disease became a nativist rallying point. In the spring and summer before the cholera outbreak, many politicians railed against these new immigrants taking jobs. Senator William Chandler pushed for immigration reform, a nativist crusade masked as a health concern. Under the auspices of stopping cholera in the upcoming year, he called for the suspension of all immigration. He gathered his experts into an Immigration Committee to discuss the ‘public health evils of immigration.’ 46 This furthered his ‘alarm and danger of immigration’ line, which he’d used during the typhoid outbreak in the summer of 1892. 47 Immigration decreased by 95 percent during the five months after the cholera emergency was declared.
When President Grover Cleveland was elected on November 8, 1892, he continued President Harrison’s immigration policies. Twenty days of quarantine for all steerage was upheld, even while his opponents criticized him, saying that politics were being made into a public health issue. 48 By December, Cleveland declared quarantine to be a national issue, and acknowledged that the port of New York was the most important gateway for disease to travel into the United States. Even though the cholera epidemic was contained, the city’s quarantine was called ‘utterly inadequate.’ The federal government hoped to establish uniform regulations for the whole country. 49 In January 1893, Harris-Rayner’s National Quarantine Act was passed. It specified national regulations for medical inspections and disinfection of ships and immigrants. The act put the Marine Hospital Service in charge of these services. The act also required more specific medical documentation from shipping lines before they departed for North America. These new powers made up for the fact that the president couldn’t intervene during a health crisis like the cholera outbreak of 1892. 50 Now the Marine Hospital Service could intervene. For the United States, the 1892 outbreak had transformed quarantine laws and polices into a national concern within federal jurisdiction. 51
North America closes its borders
The fear of cholera produced profound jurisdictional tensions and political conflicts between different levels of government throughout North America. Paranoia and tension prevailed. Dr. Lachapalle, the chief of Quebec’s Provincial Board of Health, forbade any vessel from a suspected infected port to touch any piece of land in his province. In Canada, the federal government had exclusive jurisdiction over quarantine, and Lachapalle condemned them for not taking the necessary precautions. He took matters into his own hands and shut Quebec’s doors to all ships. 52 The Hamburg–American Packet Company in Montreal was so concerned that the manager told the Canadian authorities that they would take precautions on their own ships to help the effort. 53 A vessel containing only rags 54 from an infected European district was put in quarantine in the St. Lawrence (while rags cannot transmit the cholera bacteria, many authorities claimed that they could). Quebec had been warned that 4,000 Russian Jews were coming from Dieppe, France, to Canada in order to sneak across the border into the United States. In Detroit, reports stated the opposite, declaring that Jewish migrants had already bypassed the United States quarantine measures and were travelling to Canada to spread the disease. In response to these reports, the Ontario Provincial Board of Health held a special meeting on September 7 where it resolved that the province would establish a twenty-day quarantine. This new resolution was in conflict with Canadian procedures, but in accordance with the direct orders from the President of the United States. The Ontario doctors also put pressure on the federal government to establish the same quarantine and to appoint sanitary inspectors on all trains and vessels coming from New York to Canada. 55 Public health officials from cities and the provinces put pressure on the federal governments to coordinate North American quarantine procedures. 56 Simultaneously, doctors and health officials across Canada felt adequately justified by the 1892 cholera epidemic to demand a national role for epidemic controls.
In Toronto, predictions of outbreaks in the city started to circulate days after Hamburg officials finally admitted to the disease. Even before cholera reached New York City, Toronto headlines stated: ‘CHOLERA TO COME NEXT YEAR’ and ‘The Dread Scourge Altogether Likely to Visit Canada’ and ‘May Come This Year, but Not to be Epidemic—History of Past Outbreaks Leads to the Belief That it Will Come to Stay Next Season.’ 57 Local health experts fuelled and validated the reports. Again, while fear mongering was constant, there was a counter tendency, a national or new world pride that claimed Canadian quarantine facilities were strong and would hold. The doomsayers claimed that the ‘fair’ City of Toronto would be ‘plague smitten unless a beneficent Providence interfere[d].’ In Toronto, a schizophrenic tone can be found throughout the reports. On one hand, Toronto was filthy and ripe for a cholera outbreak; on the other, predictions of cholera’s impending arrival touted Toronto’s superior health and hygiene.
Amidst this fury in the press, Toronto health experts stepped onto both the national and international scenes. If cholera was going to come, then the ‘notoriously tardy’ federal government would be to blame. There were immediate demands by Toronto doctors to make the quarantine station on Grosse Island more efficient. Grosse Island, on the St. Lawrence Seaway, was Canada’s largest quarantine station and ships were inspected there throughout the 1800s. 58 But in comparison Toronto was much better equipped in terms of quarantine. The city had an isolation hospital and Dr. Allen of the city’s Health Department had recently purchased a steam disinfector. The city was celebrated as quite well prepared, though Toronto experts still looked to institute health reforms locally. Dr Allen’s steam disinfector, which could disinfect clothing for smallpox and diphtheria patients, was no longer declared a waste of city funds. Since the Dominion Government’s Grosse Island quarantine station did not have a disinfector and there was no time to construct one, Toronto loaned the station its machine. Dr. Norman Allen, the Toronto Municipal Health Officer, then directed the Polsons Iron Works Company in Toronto to make another one, which Ottawa then paid for. The papers declared: ‘It is pointed out by the Government that the stopping of cholera at the entrance to the Dominion is of even more importance than the stamping out of diphtheria in Toronto.’ 59 The crisis of cholera overshadowed chronic and endemic diseases like diphtheria, which predominately infected children.
Predictions of the coming pandemic were accompanied by calls for sanitary reforms. Despite Toronto’s existing health preparations, there was focus on more citywide sanitary reforms, including ‘the dire matter of the sewage’ being discharged into Toronto’s bay. The images in the newspapers described how underneath the waterfront and bay, the city’s pipes were ready to explode and spread cholera into the water supply. The papers warned that leaky pipes and sewage in the bay were the reason why cholera might spread throughout the city, with the Evening News writing, ‘Unless remedied the city is in the greatest possible danger.’ Practical recommendations that included all readers should boil their water were given. 60 Medical experts also offered a seasonal explanation of the crisis. Their opinion, based on previous outbreaks, was that winter stopped ‘the ravages of the disease.’ The newspapers and experts believed the activity of the undeveloped germs would be latent during the cold season. However, ‘recrudescence, as the wise men call it, is the process through which that activity will be revived, and the deadly comma bacilli will get to work again.’ 61 So, if Toronto avoided the cholera crisis in the fall, by spring, cholera could re-emerge. The health officials articulated an ambivalent attitude over the present urban sanitary conditions of Toronto. Even if no outbreak occurred, no matter what preparations were made, the potential for crisis would always be present; the disease was waiting to be unleashed.
Dr. Norman Allen, the Medical Officer of Toronto at the time, was worried, but did not want to start a scare. Allen described how in the past cholera infected cities for two to four years, pointing out that ‘nothing short of a miracle will prevent its visiting America next summer and remaining here for a couple years.’ At the same time, Dr. Peter Bryce, the secretary of the Provincial Board of Health, was even more concerned, stating that cholera was ‘getting too near to be comfortable … Hamburg is near in the sense that there is a great deal of traffic from there to America … All we can to do is to keep Canadian machinery as perfect as possible and I trust that the American sea board authorities will do the same … The question is what “we may expect in 1893.” I can only say the discussion must be viewed with alarm.’ Bryce told the Evening News readership he was worried that, in these summer months, the high temperature along with the humidity and moisture would be conducive to the spread of the disease. Bryce noted that when cholera arrived in New York in 1873, the disease did not spread to Canada. Full of hubris, Bryce suggested that the Canadian government health officers’ efficient quarantine regulations and the work of the city’s local health boards kept the disease from spreading to Canada. 62 Discussing the present, Bryce predicted, ‘The scourge may not get as far westward as Toronto this fall, but it is almost certain to be upon us with the opening of the spring. In any case every possible precaution should be taken at once to prepare for the attack, which may be looked for sooner or later.’ Accordingly, Bryce called on every household to do its part and that all ‘lurking places of disease be removed.’ Temperance was advised in eating, drinking, and the pursuit of pleasure. According to the provincial health authorities, Toronto’s greatest emergency in preparing for the coming cholera outbreak was Ashbridge’s Bay. On September 1, soon after Hamburg’s outbreak, the Toronto Evening News stated that the City of Toronto’s principal duties were to clean up Ashbridge’s Bay and to build a modern sewer system. These improvements were deemed immediately necessary. The paper championed City Alderman Daniel Lamb who had ‘already outlined a plan of improvement that will at once remove a sanitary evil and create valuable city property. Let immediate action be taken … There is no reason why considerable progress with the actual work should not be made before the beginning of winter.’ Dr. Bryce agreed and suggested that ‘the urgent necessity there is for placing our city in such a sanitary condition as will make cholera, should any appear amongst us, as little serious as the nature of the disease permits.’ 63 Bryce gave a more complete version of his sanitary reforms to transform Ashbridge’s Bay to be in the ‘best possible condition before 1893 when it is feared cholera may reach Canada.’ Bryce called for the purification of the bay; the removal of causes of future pollution; the placing of the shores in a sanitary condition; and the gradual extinction of the swamp. However, as Bryce’s actions demonstrated, local sanitary clean up was just one way the health experts dealt with the cholera crisis.
North America’s cholera wall
After chastising Toronto because of the local conditions, Dr. Bryce began to organize internationally against the impending pandemic. He was one of the primary founders of the International Conference of State Boards of Health. Bryce hosted Dr. Henry Baker of Michigan, J. N. McCormack of Kentucky, Dr. J. R. Laine of California, Dr. Joseph Holt of Louisiana, and Dr. Domingo Orvananos of Mexico. This Toronto meeting was merely the starting point. Before conducting a complete inspection of the Dominion and United States quarantine stations, the group stopped in Montreal. Their arrival galvanized Montreal city officials. The mayor of Montreal ordered the city to be cleaned and all citizens, whether tenants or owners, were ordered to clean their own yards and cellars. After Montreal, the delegates changed their name to the International Conference of Quarantine Inspection. 64 When they arrived at Grosse Island they found the sanitary conditions and disinfection equipment inadequate to protect Canada against cholera or any other contagious disease. Chief problems included no wharf adequate for the safe and speedy landing of passengers and their effects; no process for how the vessels were to be disinfected; no suitable disinfecting apparatus for baggage, cargo, or vessels; no proper accommodation for detained diseased suspects; and no adequate and safe water supply for washing, bathing, or drinking. 65 Because the station was in such poor condition, they recommended the complete exclusion of emigrants and their effects, in other words, basic and complete quarantine. The commissioners condemned the lack of federal funding for the quarantine station. But they expressed their appreciation of the efforts of Dr. Montizambert, the superintendent who had done so much with so little to keep smallpox and other diseases from entering Canada. The tone of the reports and much of the outrage from the state officials was due to the lack of funding and support from the federal government, both in Canada and the United States. During their time at the station, a steamship carrying sugar completely bypassed the quarantine station without stopping, particularly raising the group’s ire. After Grosse Island, the International Board of Health delegates moved on and travelled to New York City, Boston, Philadelphia, Washington, St. John, Halifax, and Portland, Maine, for similar assessments.
During this same period, the United States was pressuring Canada to improve its quarantine procedures. New York City’s Chamber of Commerce’s Special Committee on Quarantine appointed on September 9, 1892, stated that ‘Canada is … ready to make concessions to draw travel and trade from us.’ 66 The worry was that the United States–Canada border was too easy to cross, making it impossible to maintain a nationwide quarantine. The United States, in looking outward to secure its borders, targeted Canada specifically. In Washington, Postmaster-General John Wanamaker issued an order that all mail must be disinfected. Surgeon H. W. Sawtelle of the United States Marine Hospital Service was ordered to secure the inspection stations on the Canadian frontier at Island Pond, Vermont, and Ogdensburg, New York. Washington declared that it must take action, in particular ‘guarding the frontier’ against Canada. 67 The acting Secretary of the Treasury, Spaulding, wired Detroit that disinfection must be under the control of the state health officers, even though the Canadian Pacific Railway Company had already provided disinfection facilities. The Evening News stated that, despite the constant communication between the officers of the US Marine Hospital Service and the Canadian quarantine authorities, suspicion was rampant.
Toronto newspapers also reported on the quarrelling between US federal authorities, the state authorities, and the officials at Port of New York City. 68 The fear was that the cholera threat would move to the Canadian border. National quarantine measures, rather than relying on a city’s quarantine, were thought to be the best defence. 69 On September 10, 1892, the New York Times published an article entitled ‘Canada Poorly Protected: The Grosse Isle Quarantine Declared to be almost Worthless.’ The New York Times declared the quarantine a ‘farce:’ disorganized, permissive, and unhygienic. The reporter then asked Dr. Emmanuel Lachapple, the president of the Canadian Central Board of Health: ‘Do you expect cholera here?’ The reply was: ‘I do. I expect it here this week … The quarantine appliances at Grosse Isle at the present moment are utterly inadequate to prevent its entrance.’ The article goes on to assert that Canada was not dealing with cholera, and describes how European immigrants could enter the United States through Canada to avoid quarantine regulations. 70 This critique overlapped with the movement of the State Boards of Health led by Dr. Bryce.
However, the assessment wouldn’t last. By the beginning of March 1893, the international views on Canadian quarantine had changed; now the New York Times headline read ‘Canada’s Cholera Wall.’ The Dominion government had erected strong barriers that included nine quarantine stations with ‘excellent’ sanitary and disinfection technologies. By March, Grosse Island’s quarantine station had three steam disinfectors to sterilize the baggage of 600 immigrants a day, along with a sulphur oxide blaster to fumigate ships using a small steamboat. While both sides of the border were anxiously discussing this ‘dread disease’ in 1893, the Canadian federal government reformed the quarantine system to be equal to any in the world, implementing full precautions ‘stretching along the three-thousand-mile frontier.’ The New York Times reported on a Canadian National Sanitary conference convened the month before to standardize sea and rail connections and to coordinate actions with the United States. Also, if the US mandated a twenty-day quarantine, Canada would follow. 71 So this ‘cholera wall’ was not merely a Canadian institution; 72 rather, it coordinated efforts for standardization and notification across North America and was discussed and planned during the yearly meetings of the American Public Health Association. In very little time, a seemingly unprepared and uncoordinated set of local institutions of cities, ports, states, provinces, and nations, had been brought under one umbrella and had one mission: to make North America disease-crisis proof. That said, the wall had yet to be tested. Cholera would never threaten North America again as it did in 1892.
Future crises, future events
So was all that fear and anxiety for nothing? Was this activity and time wasted, all unnecessary work? In Anderson’s words this crisis ‘generated excess’ in Toronto and many places across the Atlantic, and that excess was capitalized on and struggled over by experts and the state. However, these excesses were not geographically equivalent and comparable; unevenness pervades these events. To distinguish my definition of crisis from the more general category of the event, I will be pedantic, but also do some violence to these concepts to clarify my intervention. In my crude division, an event invoked direct material responses. For Hamburg, the combination of deaths, outbreak, and cholera bacteria as an event overtook the ideology that the German city was modern and clean. Further, cholera was a disaster and an emergency in Hamburg. However, for Toronto, a crisis formed in the intersection of fear, distant pandemic, and cholera predictions. The crisis also invoked direct material responses. The idea of cholera overtook local events, as Gramsci would say. Toronto’s crisis was dependent on Hamburg’s event, but it never became the emergency that it was predicted to become. While I have parsed out the event and the crisis to work toward a definition, these concepts cannot be divided. Event and crisis intersect as a ‘concrete-in-thought.’ 73 Accordingly, the cholera pandemic of 1892 was, by definition, an international or trans-local phenomenon, in which Toronto had a part. Doctors, politicians, ship captains, colonial India, ironworkers, bacteria, and fear became assembled into a geographic imagination of a speculative future. Histories of this cholera pandemic crisis could be written about any one of the points where the crisis touched down. At each of these points, concrete practices and places (events) must deal with material relations and bodily sickness. Yet these acts of materially touching down are contingent on particular expressions and they intersected with abstractions and fears (crisis). For example, a newspaper article illustrates, but cannot contain, the excess of fear and speculation that was bound up in a crisis. Ideas such as ‘cholera may come’ determine the responses, which are predicated on the existing conditions. For an epidemic the object that triggers the crisis becomes an obsession. In this case, the object was the biological life form of cholera bacteria.
To further account for this distinction between the event and the crisis as political spaces, I will turn to Foucault in his different relations between discipline and security. On the one hand, the apparatus of discipline was an attempt to prevent and constrain in order to avoid the event. Security, on the other hand, attempted to create an apparatus that was able to work within fluctuations to prevent the crisis in advance. 74 Health and disease continuously illustrated Foucault’s ideas. The management of smallpox was Foucault’s example of a security apparatus. To understand smallpox and security, he distinguished between prevailing disease (epidemic) and the case (single death). This difference highlighted, for Foucault, the crucial notion of acceleration within a range of risks and dangers. Foucault defined acceleration, when death numbers and cases grew rapidly as ‘[t]he phenomenon of sudden bolting [as in “bolt out the door” or unexpected action], which occurs regularly and is also regularly nullified, can be called, roughly—not exactly in medical terminology, since the word was already used to designate something else—the crisis. This crisis is this phenomenon of sudden circular bolting that can be checked either by a higher natural mechanism, or by an artificial mechanism.’ 75 In this article, the cholera epidemic in the fall of 1892 became an international event because of the sudden bolting of cases in Hamburg—the rapid multiplication of cases that created an epidemic. On the ships in New York City’s harbor, the relationship of space and state power can illustrate the distinction between case and prevalence. A cholera outbreak existed on the ships. The prevalence of cholera depended on the context and the ability of the disease to circulate or bolt. Within the ship’s steerage, cholera was bolting; however, from the shores of New York City, the sick retained their status as ‘case’ because of the artificial mechanisms of the state that enforced quarantine. For New York City, the disease emergency event was checked as cases, which were due to the workings of artificial mechanisms like quarantine. While cholera was not prevented, the cholera fluctuations were prevented in advance. Because of this, the events of fall 1892 accord with Foucault’s definition of security. This explains the role, function, and emergence of an ‘artificial mechanism’ that deals with crisis. In this case that mechanism was the health state apparatus.
I should parse Foucault’s method of historical analysis and his description of the event, as distinct from his concept of power. The distinction between crisis and event is important to my work because Foucault gives my argument a sense of how the accumulation of statements (the crisis is coming, the crisis is coming, the crisis is coming) by health experts implied that a decision had to be made. Decisions are made in times of crisis, but these experts presupposed consensus rather than gaining consensus through political discussion. By implication, stopping cholera became an inherently good thing, and therefore anything to stop cholera deaths became an inherently good decision. I see my version of a crisis and its politics, informed by Foucault’s event, residing in the space between Antonio Gramsci’s notions of coercion and consent. But this leads to the question: Coercion of whom and consent to whom? I will leave this as an open question, because my claim is the idea of disease crises and the ideologies of health allowed authorities to evade the answers. Foucault helps to articulate the object of an epidemic crisis with a space of political action. Crisis, and the ways that ideology formed this crisis, must be actively constructed, but the crisis also fails, falls apart, and must be reformed. The crisis can be ignored. In the above account of the cholera crisis, a path was charted out between implicit consent around consensus of health reforms and the failure of health experts’ attempts to use coercion. A hegemony where consent is gained through the healthy good life and the coercion is threatened with fears of death. In this way, a version of Foucault can be integrated with the historical materialism of Gramsci. To acknowledge the particularity of the milieu makes Foucault’s power dependent and partial, and requires active construction and mobilization. Gramsci and ideology helps to distinguish which calls of impending crises have a force, within the widespread milieu of anxiety and rhetoric.
Conclusion: when and where do disease crises end?
These questions open up a broader question of history and geography: How do you mark the end of a disease crisis? Mike Davis asks as similar question to my own: ‘Where does the nightmare end?’ For Davis, imagined disasters and catastrophes, whose ecologies of fear simultaneously loom and threaten to loom, contain ideas of what might come. These ideas—from fiction, myth, or science—can shape landscapes. My larger project follows how the imagined cholera crisis fits into the larger landscape of the history of Toronto and the institutionalization of public health. 76 In 1892, the United States successfully contained the cholera pandemic and the disease never infected Canada during this international outbreak. But this didn’t end the nightmare. Conventional histories of international disease outbreaks suggest that the fifth cholera pandemic ended in the year 1896. However, the sixth pandemic was well underway by 1899 and continued until 1923. From the perspective of North America’s medical experts, the fear and speculation from one pandemic bled into the next. During the sixth pandemic, the disease was confined to Asia and no one in Western Europe or the Americas got sick or died from cholera. However, speculation over cholera’s arrival continued for decades. The spectre of cholera haunted North American and European states well into the 1930s. My argument is that the presence of disease does not indicate the effect or the geography of an epidemic. When looking at the reforms of Toronto’s public health, the debates are never simply local; experts and government officials situate their responses in the larger context of Atlantic-wide shifts in policy and disease crises. These responses were articulated into statements. The statements that circulated in 1892 around cholera crossing the Atlantic structured the response to health threats for years to come. This frightening, amorphous threat that lurked over the horizon of the ocean shaped politics and practices in cities and ports and became an epidemic event. The idea of future crises persists to this day, as the literature on avian influenza and biosecurity illustrates.
Cholera had illustrated the dangers of the free movement of goods and people under capitalism. The circulation of goods and people throughout the north Atlantic region had become potentially deadly. North America’s demand for workers also supplied unwanted diseases. Epidemics had become an unpredictable, but constitutive part of the management of cities and nations, as well as the relationships between nations. If a port was shut down due to quarantine, this stoppage had serious economic consequences, especially during cyclic depressions in the economy. However, the need to stop the circulation of goods and labor was often dismissed because the causes of and ways to prepare for cholera epidemics were still highly debated. Beginning in the 1910s and beyond, governments slowly instituted disinfection technologies and health-based immigration restrictions such as the bill of health and the passport. Even though health experts were still highly uncertain of how cholera became a crisis, they instituted massive changes to prepare for epidemics and pandemics—they made a ‘cholera future’ present. These changes came not only through dealing with bacteria, but also due to the failure of bacteria to arrive. The force of ideas around the cholera crisis allowed experts to unify and live out their thoughts and predictions.
Footnotes
Acknowledgements
My arguments have benefited from careful reading by Scott Prudham, Sue Ruddick, Mark Hunter, Robert Lewis, Matt Farish, and Bruce Braun. Additionally I must thank Tim Cresswell and the three anonymous reviewers for their thoughtful and productive comments. All mistakes are my own.
Funding
This research received funding from Social Sciences and Humanities Research Council of Canada (SSHRC).
Notes
Biographical Note
Paul Jackson is a Postdoctoral fellow at Dartmouth College’s Geography Department. The discussion above is elaborated further in his dissertation, Cholera and Crisis: State Health and the Geographies of Future Epidemics.