How to Fight Disease in the 1880s: Fresh Air

(Bloomberg Opinion) -- America’s ambivalence about wearing masks has played a part our Covid-19 woes. But there’s another factor beginning to receive a closer look as the virus tears through some of the hottest parts of the U.S.: Our zealous – and rather unusual – insistence on living and working in spaces that are largely sealed off from the outdoors.

It wasn’t always so. In the nineteenth century, a growing number of people lived and worked in cramped, airless quarters in the nation’s growing cities. As disease ran rampant, the solution was simple: better ventilation. A growing number of medical professionals prescribed “natural disinfectants” – fresh air and sunshine – to counter the threat of disease.

In his 1882 book “How We Ought to Live,” a doctor named Joseph Edwards argued for outsized windows and doors in homes, claiming that “the larger you make your openings, the nearer will your house approach a tent.” A tent? He explained: “I am sure we would all enjoy better health, if houses were unknown, and we lived in tents or in the open air, as animal life in a state of nature is accustomed to do.”

But Edwards and other like-minded reformers were backed up by another recent discovery. During the Civil War, doctors noticed that wounded soldiers treated in open-air settings had higher rates of survival than those in cramped hospitals.

The acceptance of the germ theory of disease helped buttress these prescriptions. In time, medical advice helped drive reforms instituted in the nation’s cities. In 1901, the New York State Tenement House Act required buildings housing the city’s working class to have outward-facing windows and other features that promoted ventilation.

There was another reason for the growing obsession with fresh air: the continuing threat of tuberculosis. Though it had declined somewhat by the turn of the century, the respiratory disease remained the third most common cause of death after heart disease and influenza.

Soon, a growing number of middle-class Americans embraced the idea that the only way to prevent it – and perhaps even cure it — was to spend as much time as possible outdoors. As medical historian Katherine Ott has observed, the fundamental point of what became known as the “rest cure” was, as one proponent put it, “to make our rooms indoors, as nearly as possible, parts of all outdoors.”

And they meant it. In the early twentieth century, patients began sleeping with their bodies cantilevered on beds sticking out of windows. Many of those afflicted with tuberculosis left cities for sanitariums established in the territory of Arizona, land of sunshine and dry desert air.