Death in the Air
But another disease was rising to urban prominence: tuberculosis.
A Matter of Life and Breath
Throughout much of the 19th century, it was thought that tuberculosis was constitutional, not contagious. It was regarded as a cross to bear in urban society, manifesting in the suffering of those with congenitally weak, consumptive constitutions.
Eventually, health practitioners, identifying tuberculosis as a respiratory illness spread through airborne droplets, realized that it was another piece of the microbiological puzzle. Tuberculosis thrived in the unsanitary conditions of cities, especially those with industrial air pollution like Pittsburgh. By the dawn of the 20th century, TB was a leading cause of death.
The disease was no respecter of age, afflicting young, old and everyone in between. Its mortality rate was colossal. Hospitals refused to admit tuberculosis sufferers for fear of contagion of the rest of their patient populations. As cultural values were influenced by increasingly progressive worldviews, cities were pressured to address the social ills that created conditions facilitating the spread of diseases and to provide dedicated tuberculosis treatment facilities or sanitaria. "Climatic cures" of exposure to cold, fresh air were considered effective treatments, and so sanitaria featured open-air classrooms and sleeping quarters.
A nephew of Adelaide Howard Childs Frick figured prominently in the fight against tuberculosis: Otis H. Childs, son of her oldest half-brother Otis B. Childs. Following the death of his wife Louise Dilworth Childs of tuberculosis in 1901, steel executive Otis H. Childs founded the Childs Sanitarium in Lake Placid, New York. This corresponded with efforts by former Pittsburgher and philanthropist Henry Phipps, who founded a tuberculosis research and treatment institute in Philadelphia in 1903.
Otis Hart Childs.
The Encyclopedia of Pennsylvania Biography, 1911.
It was common to locate facilities for TB treatment on hillsides to access whatever fresh air might float above the urban grit. The Tuberculosis League of Pittsburgh first modified the old McConway mansion in the Herron Hill neighborhood to admit 40 patients, but soon expanded with the addition of several so-called open-air “shacks” to house twice that number. Decades later in a Pittsburgh Press interview, one former patient recalled: “In 1907 we slept in open shacks. I remember one Christmas Eve. It was cold but clear, so we decided not to close the sliding doors. When we awoke on Christmas morning we were buried in snow up to our chins.”
Pittsburgh’s first Tuberculosis Sanitarium, Herron Hill, Pittsburgh, 1907.
Journal of the Outdoor Life, Volume 4, October 1907.
Supplemental housing for tuberculosis patients in 1907 at Pittsburgh’s first Tuberculosis Sanitarium.
Journal of the Outdoor Life, Volume 4, October 1907
Won’t You Please Help Me
Though their wealth isolated them from the conditions that allowed tuberculosis to foster, the Frick family could not escape reminders of the disease.
In June 1908, Adelaide Howard Childs Frick received a letter from a former maid at Clayton named Bridget Conroy. Born in Galway, Ireland in 1854, Bridget supported herself in Pittsburgh as one of the many “Irish maids” working in domestic service. She was employed by the Frick family at Clayton in the late 1890s.
Never married, at age 54 Bridget found herself unemployed, destitute, and gravely ill with tuberculosis. She wrote to her former employer in June 1908 (transcribed exactly):
Your old servant
Daughter Helen Clay Frick, who at age 20 would make her gala societal debut later that same year in Pittsburgh, was moved to respond to this plea. Acquiring her father’s permission first, she forwarded Bridget’s letter to F.W. McElroy, Henry Clay Frick’s personal secretary in Pittsburgh. Helen instructed McElroy to help Bridget and to “kindly give her what you think is necessary.” McElroy accordingly gave Bridget $25 cash from general office funds the day he received Helen’s instructions, and followed up with local health officials.
Bridget Conroy wrote again to Mrs. Frick two months later in August 1908:
My dear Mrs. Frick I write a few lines to thank you very much for the help I got by your order Mr McElroy gave me $25
I was in to see him a week ago to see if he had a little help to give me. But he said he had no orders
I thought I could get in this sanatorum on Bedford Ave Pittsburgh 2 months ago but every room was taken the nurse was to see me a few days ago & she said it would be winter before I could get a bed & maybe not then. If I could get to Philadelphia Hospital free I would go
I am paying $5.00 a week for my board and room & I buy a quart of milk every day Dear Mrs. Frick I thank you again for your help
Mrs Frick wont you please help me
Your Old Servant
Brigid was not exaggerating her plight. A note by secretary McElroy recorded details from a conversation with the Pittsburgh Sanitarium director, who confirmed that a waiting list of 50 people existed in June 1908 for a room at the old McConway mansion or one of its recently constructed “shacks.“ While awaiting admission, Bridget was receiving weekly home visits from a Tuberculosis League nurse.
Women shown “taking the cure” in 1907 as Bridget Conroy sought to do, bundled up in one of the open-air “shacks” at Pittsburgh’s first Tuberculosis Sanitarium in the Hill District.
Journal of the Outdoor Life, Volume 4, October 1907
Records indicate that Bridget Conroy was admitted to the Pittsburgh Sanitarium in early August, shortly after writing her second letter to Adelaide Frick. Bridget died a month later, on 18 September 1908. Her nieces and nephews honored her final resting place at Pittsburgh’s Calvary Catholic Cemetery with a fine grave marker. It is not known whether her estate allowed for the additional expenditure of $40 as her will requested “for having Masses said for repose of my soul.”
Letters from former Clayton servant Bridget Conroy, 1908.
Courtesy of The Frick Collection/Frick Art Reference Library Archives.
If Henry Clay Frick’s early life was characterized by advancements in medical knowledge in the aftermath of the Civil War, it was bookended by the despair of the deadly influenza outbreak of 1918.
Archival evidence indicates that the Frick family was not in Pittsburgh during the worst of the outbreak. That was fortunate for them—and likely deliberate. This area was exceptionally hard-hit, losing between 4,800 to 6,600 residents to influenza during the 1918 pandemic.
Where were the Fricks in the fall of 1918? Fifteen years earlier they had built a palatial summer residence called Eagle Rock, located in the Prides Crossing neighborhood of Beverly, Massachusetts north of Boston. As the flu epidemic raged in the fall of 1918, the aging Henry Clay and Adelaide Frick and their 30 year old daughter Helen divided time between Eagle Rock and their palatial Manhattan home on East 70st Street. Mr. Frick made one trip from Eagle Rock to Pittsburgh in early October 1918, remaining here for only a few hours to deal with business matters. Son Childs Frick was an officer in the Signal Reserves Corps Aviation Section during World War I and is understood to have been stationed in Dayton, Ohio from August to December 1918. While he would not have been out of harm’s way if a flu outbreak occurred in his unit, luck was presumably with Childs. It is not known where Childs’ wife Dixie and their three very young daughters were sequestered during the worst of the outbreak.
None of the Fricks are known to have suffered from influenza in the fall of 1918. Their wealth once again afforded them the privilege of mobility, isolation, and social distance, all of which combined to reduce their risk of contracting the deadly flu.
But their hometown of Pittsburgh suffered.
The local Board of Health issued a bulletin in mid-September 1918 with recommendations in advance of the flu's anticipated arrival in Pittsburgh which included such sage advice as "Don't cough; don't sneeze; don't spit in public places." But Board of Health officials also attempted to minimize the flu's reach by claiming that as the virus moved west, Pittsburghers would likely suffer from the less serious "Boston variety" and not the deadly "Philadelphia strain." (There was, of course, only one “strain” in 1918, and it was deadly everywhere).
Pittsburgh Daily Post, 16 September 1918.Reluctance by local officials and Mayor Edward V. Babcock to publicly acknowledge the full extent of the epidemic, along with their power struggles with state government, left Pittsburghers at the mercy of the deadly virus. City leadership initially refused to accept offers of aid from the state Red Cross, even as reports about the disaster in Philadelphia escalated. As the community spread of influenza expanded in October 1918, Pittsburgh's political leadership complained of arbitrary and unnecessary interference from state-mandated gathering bans and closures. Pittsburgh businessmen who relied upon revenue from local saloons, hotels, restaurants, theaters, dance halls, pool rooms, and sports events exerted pressure for their establishments to stay open. Ban enforcers were encouraged to look the other way so businesses could continue to operate.
Local and state authorities exchanged testy words throughout the epidemic, each struggling to assert authority whilst containing the disaster. The state won in the end and prosecuted with stiff fines those Pittsburgh businesses caught defying the ban.
Meanwhile, more people got sick. More people died. Having lost nearly 1% of its total population, the Pittsburgh region is commonly cited as having one of the highest death rates of any city in the United States.
The Past Speaks to the Present
As we struggle today to navigate the collective grief and trauma inflicted by the COVID-19 pandemic, we are faced with circumstances that allow us to empathize with people of the past and their responses to the pestilences they endured.
The past speaks to the present when we consider the 1918 influenza pandemic and realize that quarantine for respiratory disease is nothing new, even in a city like Pittsburgh where breathing has never been easy.
The past speaks to the present with the recognition that, even a century removed from the Frick’s Gilded Age Pittsburgh, there is still an unequal gap in infection and mortality rates between rich and poor thanks to combinations of living circumstances, job security, access to health care, and mobility.
So much of what we see playing out in the modern COVID-19 response mirrors the worst of what was experienced in past responses to infectious and contagious diseases. The news was, and is, filled with tales of officials deflecting blame and misrepresenting the seriousness of the disease; of resistance to quarantine and recommended preventative measures; of premature declarations that the crisis is over; of disproportionate socioeconomic-based suffering.
But the past also speaks to the present in hopeful ways. Scientific advances enabled the eventual eradication of diseases like smallpox, cholera, diphtheria, typhoid fever, polio, and tuberculosis in the modern era. It is to everyone’s benefit that continued investment in solid scientific research and preparedness are supported. The global health system that is enhancing effective COVID-19 responses was not created until after World War II, but today its potential to align approaches, facilitate sharing of medical information and resources, and encourage international cooperation is invaluable. Historical hindsight about the course of disease cycles reminds us of the benefits of good judgment, even as we struggle to balance quarantine and its economic impact, to sustain prudent social distancing in the face of virus-fatigue.
Young female Red Cross volunteers at Fifth Avenue High School in Pittsburgh rolling bandages for the war effort in June 1918. Red Cross assistance was invaluable just a few months later during the influenza outbreak.
Pittsburgh Public Schools Photographs, Detre Library & Archives, Heinz History Center.
Helen Clay Frick, c. 1917.
Courtesy of The Frick Collection/Frick Art Reference Library Archives.
Pandemics can bring out the worst in us by exacerbating social, economic, and geopolitical divides. But crises like this also have the power to draw out our better natures.
To learn more about disease and illness in Gilded Age Pittsburgh, read Part One: The Sanitary Home and Part Two: The Fricks Afflicted.