New York City (NYC), throughout the 19th century, grew at an incredible speed. Each year thousands of immigrants were attracted to the opportunities it presented. However, this dramatic increase in population created problems for which its leadership had no experience. One of the many dangers of living in such a congested and unsanitary urban area was that of disease. At the beginning of the 19th century cholera, emanating first from the Asian countries, such as India, spread across Europe through sailors traveling from sea port to sea port. By 1831, the cholera epidemic had already struck England. In June of 1832, cholera had made its way to ports in Canada and traveled down from St. Laurence and the Hudson River to lower Manhattan, where it grew into an epidemic. Many wealthy Manhattan residents, aware of its approach, moved away to the country side to avoid infection. However, the poor who inhabited lower Manhattan had no choice but to stay and face the disease. With no effective method of treatment, 3,500 people, mostly poor immigrants, died during the course of the plague.
NYC was organized through a grid system made up of fifteen wards, or distinct neighborhoods. In 1832, about 250,000 people inhabited the area bellow 20th street. The majority of them lived below 14th street in dark dwellings, surrounded by the stench and filth of the city. An area known as five points (now located in Foley Square and Chinatown) was the first ward to be hit by an outbreak of cholera. Five points, inhabited by poor Irish catholic immigrants and African-Americans, created a negative perception of the poor amongst the wealthy classes. It was believed that God had brought the cholera epidemic to New York in order to punish the poor for their debauchery and indulgence in sin.
The doctors at the time were not at all equipped to deal with cholera. Many of them believed that cholera was caused by poisonous vapors from rotting matter and that it was not actually contagious. Without a clear understanding of how the disease worked, they attempted to treat patients using traditional methods. In addition to bleeding, most doctors gave them medicine such as calomel (mercury chloride) and laudanum which was an opiate. However, most infected people died within one or two days of admittance to hospitals. Out of panic, many private hospitals closed down and emergency facilities in schools had to be opened. Doctors treating cholera patients often got infected themselves and nurses became hard to employ.
The Board of Health, first established in 1805, had very little power and recourses. Despite this fact, during the worst of the plague, they opened up five emergency hospitals for the sick and began a cleaning operation throughout the city streets. However, their involvement was only temporary and after the cholera epidemic died out, they continued to take their usual passive role in the NYC council.