Disability in Pre-Modern New York
In Image No. 1 – a 19th Century illustration from London, depicting a man identified as Samuel Horsey, sitting on and belted into some sort of platform, and holding what seem to be extremely short improvised crutches.
What did it mean to be disabled in early New York?
For the City’s first few centuries, until a generation or two after the Revolution, disability here probably meant something similar to the rest of the colonies/states. That is, disability barely mattered so long as the individual could perform a socially useful purpose—that is, if they could work.
Primitive medical care meant that most people who were too disabled to work probably perished fairly quickly, but those who survived generally found a place among their families and in their communities, and since these tended to be small and self-contained, even people with disabilities were known and recognized as individuals.
A few references to England (where the field of disability history seems better developed than in the United States), will help illustrate the integration of people with disabilities into the traditional economy. A 1789 image from the city of Bath depicts an amputee cobbler. A writing from about 1700, in the Shropshire village of Myddle, describes Anne Parkes, a resident who was unable to walk until age 19 due to rickets. She made a living by kitting gloves and stockings. A hundred years later, a survey of the poor of Cumwhitton near Carlisle described a 45 year old man with lameness who made baskets and beehives to support himself and his elderly mother.
That way of life came under increasing pressure as the 18th Century yielded to the 19th Century. As the nation’s founding generation faded away, an economic transformation began. Under the emerging imperatives of a cash-based economy and the Industrial Revolution, the relatively gentle relationships of extended family and master craftsman/apprentice/customer were replaced by more distant encounters--between producer and consumer, employer and employee, and bourgeoisie and proletariat.
Amplified by the first waves of mass immigration, which began around the same time, in the 1820s the older more community-minded way of life broke apart. Grinding poverty appeared and mushroomed, quickly marking the Lower East Side of Manhattan as the nation’s first slum. Meanwhile, the City’s population increased 250% in just twenty years, reaching 312 thousand by 1840.
There was little love lost between the growing masses of rich and poor, native and immigrant, so as the City exploded and the chaos grew, the official reaction was harsh. Massive jails and tough jailhouse punishments appeared. So did the first police force.
Just as in the story of Ebenezer Scrooge, published in 1843, a hard and unfeeling environment emerged. It is said that the first wave of refugees from famine-ridden Ireland endured infant mortality rates of as much as 75 percent, but there was practically no public response.
Among those most injured by these changes were people with disabilities. Disability rendered them uncompetitive for wage work, so the stigma of disability escalated. Yet in many cases they could no longer turn for support to families and communities that were themselves barely clinging to survival.
In Image No. 2, a postcard from England circa 1900, showing a disabled young man begging from two girls.
At the same time, the percentages of people with disabilities likely began to increase, as a result of injuries incurred while working in often dangerous new workplaces known as “manufactories;” because of growing rates of malnutrition; because of horrendous living conditions in the tenements that were rising by the hundred; and because of epidemic disease, which began a devastating rise in frequency and intensity in the 1830s.
Dickensian misery had befallen the poor of New York City, and there it remained for generations on end.
What followed was a scramble to maintain social order. Asylums for the blind, the deaf, and the “insane” began segregating segments of the disability population, often in rural areas. Asylum inmates, however, were expected to work and contribute to the cost of their support, and that typically meant agricultural and stoop labor which many people with mobility impairments simply could not perform. Asylums tended to avoid taking such cases, so mobility disabled people were largely left to their own devices. Many wound up in poorhouses, or on the street.
New York City’s streets had long been infamous. There were no sewers, no running water, and no trash collection--street cleaning was mostly performed by droves of pigs that roamed for edible scraps. Contemporary reports speak of dead horses left to rot where they fell, two- and three-foot high rills of garbage, and tons and tons of human and animal waste. Something like five hundred livestock yards, piggeries and slaughterhouses were threaded throughout lower Manhattan.
As one Scottish businessman put it, “the streets of New York are not to be perambulated with impunity by either the lame, or the blind, or the exquisitely sensitive in their olfactory nerves; to use an American phrase, a person must be ‘wide awake’ not to dislocate his ankles . . . or break his legs.”
And what if you were disabled? What if you were unable to walk—if you couldn’t step over all that muck?
Well, you’d scrounge up something to put beneath you, and something to protect your hands as they propelled you on your way. A 19th Century image from England shows a mobility impaired man, identified as Samuel Horsey, sitting on and belted into some sort of platform, and holding what seem to be extremely short improvised crutches. Others used what were known as “hand trestles,” to protect their knuckles.
Either way, between the obvious difficulty of any sort of travel, the worsening stigma of disability, and the exceptional (even for then) level of filth that clings to you because of your proximity to the streetbed, there was little chance of landing much of a job. So unless you hailed from a family with some financial resources, there was a good chance you had no home.
All of which meant you had to beg in order to eat. But beggars lined the streets of mid-19th-century Manhattan. How would you as a person with a disability edge out the competition? You had to outdo the guy next to you, who was maybe faking his disability—that may have been pretty common in those days (think of Eddie Murphy’s character at the beginning of the film Trading Places). If you wanted to beat out the faker, you’d have to flaunt your disability. You’d have to play it up. Better not overdo it, though—you might scare people away.
By 1860 New York City had reached a crisis. Every year filthier, every year more overcrowded, it is said that inbound sailors could smell the City before they could see it.
New York City was the subject of the nation’s first in-depth survey of public health. Published in 1866, its findings were worse than alarming. More than half the City’s children failed to reach age five. The City’s death rate was fifty percent higher than Philadelphia or London—it was, perhaps, the highest of any city in the world. The death rate actually exceeded the birth rate, so the City would have been depopulating if not for the constantly arriving waves of immigrants from Europe.
In Image No. 3, detail from an 1875 illustration, depicting a class for disabled girls (one in a wheelchair, others using chairs as walkers), run by the New York Society For The Relief Of The Ruptured And Crippled.
There was crisis of disability too.
Take tuberculosis. It was then the City’s most lethal disease, responsible for more than eight thousand deaths, close to one percent of the population, every year (considerably higher than COVID’s multiyear total, so far).
If the 1866 survey correctly estimated twenty cases for every death, then something like 1500 New Yorkers were coming down with severely disabling tuberculosis of the spine—every year. That was just one disabling condition, out of many.
These weren’t new problems. But an extreme public health crisis came out of the Panic of 1857, an economic depression so severe that it bears directly on our story. In just a few months, breadwinners for a fourth of the City’s poor households lost their jobs. Wages fell by a third, at the same time that Civil War inflation soon caused coal and food prices to double and triple.
Already underfed masses’ health took a nosedive; desperate men took unfamiliar jobs and became injured; epidemics ransacked whole neighborhoods. Many families could not cope when spouses, breadwinners or children became too disabled to carry on in the expected ways, so they ended up separated, or on the streets. For the seventy percent that were poor and lived in tenements or worse, the chaos that was life in New York got even more severe.
How many disabled beggars were there, in the aftermath of this calamity? My best estimate is that there may have been as many as ten or fifteen thousand, out of a population of 800 thousand, tightly crammed into Manhattan below Forty-Second Street.
Consider that today we regard ourselves as living with a crisis of homelessness. Current estimates are that the unhoused population is about sixty thousand (excluding migrants), out of a population of 8 million. To make that proportionate to my estimate for 1860, you’d have to increase that number to ONE HUNDRED FIFTY THOUSAND.
Imagine 150,000 mobility-disabled people begging, starving and expiring on the streets of New York City.
So, by the 1860s life for New Yorkers with disabilities was quite literally nasty, brutish and short. But there were so many of them that, finally, something had to be done.
On April 13, 1863, two physicians, James Knight and Robert M. Hartley, filed incorporation papers for a new project, resoundingly titled “The New York Society for the Relief of the Ruptured and Crippled.” Established two years and a day after Fort Sumter was shot at by Southern rebels, you might think that Ruptured and Crippled was mainly about injured veterans of the Civil War—but it was not.
No, as Dr. Knight explained at the inaugural meeting of Ruptured and Crippled, his objective was to provide “relief of maladies of the laboring population” of the City. Knight described those conditions this way:
“Persons afflicted with ruptures [or] ulcerated legs, [and] . . . Poor families having crippled children, suffering from spinal and paralytic affections, [they] thronged our streets, dwellings and places of business, making revolting displays of their infirmities and misfortunes . . . for the purpose of exciting sympathy . . .”
Ruptured and Crippled began distributing Knight’s cutting-edge crutches, braces, canes and trusses. It opened a hospital (initially in Knight’s living room) that offered a combination of medical care and what we’d now call social work.
Ruptured and Crippled was the first organized effort to acknowledge and try to address the fact that there was a population of people with disabilities—specifically, orthopedic or mobility impairments—living in the general society.
Then came the Draft Riots in July, 1863, when for four days the City was overridden by hundreds of thousands of poor people and immigrants. The spark was the federal government’s new Civil War military draft, but the result was the largest insurrection in the history of the United States, apart from the Civil War itself.
The Draft Riots were widely seen as a warning to the respectable—woe unto New York! Unless the social order was reformed and the poor were mollified, worse riots were surely in store. And for a few years in the wake of the Draft Riots, there came some modest efforts to change the social contract. The beginnings of the modern Fire Department, the Board of Health, the Department of Buildings, and the first tenement reform laws, all followed. So did quite a few new disability-related organizations, like the New York Orthopedic Dispensary (co-founded by Theodore Roosevelt Senior, Teddy’s father).
This social-contract moment didn’t last long. Soon an opposite point of view, so called Scientific Charity, took over, and by 1875 the City had eliminated welfare for anyone but blind people, on the theory that that it helped the least rather than the most fit to survive.
Nonetheless, Ruptured and Crippled, the New York Orthopedic Dispensary, and others were able to continue. And over the next fifty years, through the Progressive Era, the First World War and into the 1920s, these efforts would gradually build to a mammoth campaign that I call the Dickensian Disability Movement.
The Dickensians were high society do-gooders, and their efforts were a bit class-blinkered, but their effectiveness was undeniable. They established many of the medical, social, and social work fundamentals we take for granted today. By the 1890s the movement had even produced the first disability activists.
The path from the dismal mid-19th Century to the present is clear yet crooked. It is filled with many brave starts and much repetition. But at least, at last, the journey had begun.
A version of this entry appeared in Able News.
by Warren Shaw