The Floating Hospital: A New York City Romance at Sea @thefloatinghospital - Tumblr Blog

From barge to beacon: the origin of The Floating Hospital’s name in 19th century New York

The latter half of the 19th century was marked by a wave of modern philanthropy—a focus on socio-centric voluntary efforts to extend aid to people experiencing poverty. And as one example of this noble display of benevolence, the New York Times  made an appeal on July 3, 1872, calling to provide impoverished children with a privilege experienced by their affluent counterparts: summer day trips away from the city. The plea, made to improve health and wellbeing, was met with overwhelming monetary support from the wealthy public. These funds allowed the publication to organize several seafaring excursions—providing children with salty fresh air, entertainment, and refreshments—and a relief program to keep the outings going. The venture expanded across the city and grew to involve several voluntary organizations, including St. John’s Guild.

While the Guild participated in the Times’ efforts, it also began to organize its own sea outings and relief program. In 1873, it hired a barge and ran two excursions, partially financed by the Times’ fund but more heavily supported by abundant direct donations. The following year, the Guild sponsored 18 more excursions that offered children and their guardians clean air, food, clothing, hygienic education, and one unique provision: medical care from physicians. By 1875, 17 physicians volunteered their services to the Guild, and it is said the barge they operated on was called the Floating Hospital. Feeling inspired, the Guild commissioned a ship—its own “Floating Hospital”—that accommodated 2,500 sick children and mothers and opened for sail in July 1875.

—CHRISTINA PERRIER

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The Seaside Nursery and Hospital

When The Floating Hospital plied New York’s waterways bearing families needing care and relief, its captains had the choice of a few ports of call. Most of these dotted the East River and the Hudson River. However, from the late 1899 to the 1940s, one essential destination for patients with more pressing medical needs brought them clear across the wide and choppy Upper Bay—Statue of Liberty to the right, mighty Atlantic to the left—to East Dorp Beach on Staten Island: The Seaside Nursery and Hospital. Erected in 1881 and dedicated in 1899, our star-shaped, five-winged sister hospital and its environs, which included spacious grounds to picnic on, screened porches to keep biting insects at bay and several hundred feet of sandy beach and shallow water perfect for a child to wade in, was a welcomed respite from the city where sick children could benefit from fresh air, recreation and medical care. Mothers and children were given baths after check-in and their arrival clothes were washed and sanitized before their return trip.

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When vegetables were unhealthy

Before the late nineteenth century, most Americans believed a healthy diet was rich in fat, starches, and salt. Many avoided fresh produce, assuming that fruits and vegetables would worsen their health and make them vulnerable to cholera and dysentery. Meat, potatoes, milk and bread made up the meals served aboard The Floating Hospital, and those meals were heartily appreciated by the often desperately hungry families sitting at the long wooden dining room tables.

Scientific and public thought about nutrition shifted dramatically near the turn of the twentieth century due to evolving science and the lobbying efforts of farmers and orchard owners.

In 1926, The Floating Hospital of St. John’s Guild was still invested in feeding hungry children and their family members, though vegetables had become the star of its nutritional program. The Guild’s Seaside Hospital in Staten Island set aside a portion of its seventeen-acre property for a produce farm. The hospital boasted, “Five acres of fresh vegetables, all for the children. No Canned food.”* Fresh vegetables had once been considered dangerous and unhealthy, but by the 1920s, they had eclipsed starch and fat to become an essential part of the Hospital’s meal plan.

Ideas about food and health have changed dramatically over time, and they will most likely continue to change. What foods do you think will be “healthy” or “unhealthy” fifty years from now?

* “Champions of Children” pamphlet, St. John’s Guild, 1926, 13.

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Not Another One of Those “Sink-holes of Charity”

To meet the large expense of operating a medical clinic, the Floating Hospital has always relied on the generosity of its supporters. Yet at some moments in history, the Floating Hospital has had the odds against it in the struggle to secure funding.

As the Floating Hospital was first launching its operations in the 1870s, it had to appeal for donations at a time when charity in general had a bad reputation. Many believed that charities misused funds, directing only a very small percentage of each donation toward people in need. A journalist suggested in 1874 that the huge amount of money that “was annually given to…sink-holes of charity” could end poverty in New York by paying “the entire expenses of the metropolitan poor” and could even house impoverished families year-round in apartments as lavish as those at the “Fifth Avenue Hotel.” The journalist was “morally certain” that charities “frittered away” large sums by paying for fancy offices, building “ornamental and pretentious edifices,” or by paying high salaries to “sleek officials” who did very little work.[1] Giving voice to an intense distrust that many felt towards charities, this article suggests that the Floating Hospital faced significant fundraising challenges during in its early years.

That the organization was able to expand and grow in such a context is a testament to the energy that its leaders put into sending appeal letters, releasing annual reports that presented sound budgets, and introducing journalists to the Floating Hospital’s work in order to build a good reputation with the public. The Floating Hospital also produced broadsides, or posters, that proclaimed the benefits of the organization and appealed to viewers’ sympathies. A broadside from 1874 asked,

Shall we turn a deaf ear to the cries of countless children stretched on a handful of rags on the floor, pleading, begging, as only dying children can beg, for cooling drinks, for air, for life, without an effort to save them, simply because they are poor? We know what the response of every one who possesses a spark of humanity must be.[2]

The tragic image that this broadside evoked was sure to draw some empathetic new supporters to the Floating Hospital’s cause. Yet the broadside also appealed to more selfish viewers. “We ask your help for your own sakes, as well as for theirs,” the broadside explained. Because “Contagion regards neither the squalid pallets of poverty nor the sumptuous homes of wealth,” disease could link the city’s impoverished populations with its elite citizens.[3] The broadside reminded wealthy viewers that if they cared about their own health, they must also care about conditions in the tenement districts. With the help of fundraising campaigns like this one, the Floating Hospital was able to appeal to an array of donors who together kept the organization alive in a moment of profound distrust towards charities.

As time passed, new barriers to securing donations arose. As the Floating Hospital’s president noted in the organization’s 1896 Annual Report, charities that offered free necessities and services to impoverished people were often accused of “foster[ing] pauperism.” To defend the Floating Hospital against such critiques, President Walter Stanton declared, “we help the helpless. The sick children we care for are not impostors, or even paupers; they are not old enough.”[4] By aiding children who were born into poverty, the Floating Hospital bypassed the public concerns about direct service charities that arose in a moment when the poor were often vilified. The Floating Hospital’s leaders insisted that, far from encouraging poverty, free healthcare would “make the sick children of to-day the healthy and strong men and women of to-morrow” who would capable of supporting themselves.[5]

The Floating Hospital’s fundraising strategies shifted over time. In 1910, Dr. A. Jacobi made an economic case for supporting the Floating Hospital. He suggested that when children took ill and passed away, society lost potential workers. Dr. Jacobi estimated that when half a million babies died, “at least a hundred million dollars [was] lost to private and national treasuries.” This provocative argument cast the Floating Hospital as an economic investment that society would be foolish to ignore.[6] For those who were less interested in financial projections, the Floating Hospital also released a summertime appeal letter in 1910 that asked, “Before leaving the city for the summer will you not aid in making provision for the relief of these sick children…who are compelled to remain in the hot city tenements, afflicted both with poverty and illness?”[7] The Floating Hospital worked to evoke in those about to leave the city for extended summer vacation a sense of empathy for impoverished neighbors who were stuck behind in the sweltering city.

In 1914, the Floating Hospital used the relatively new technology of motion pictures in order to publicize its work. The organization made a film that showed viewers what life was like in the tenement districts that its patients came from and also showed a voyage aboard the Floating Hospital. The film was shown in theatres, churches, schools, and in wealthy homes at private fundraisers and after seeing it, one journalist mused, “There is no longer any excuse for half the world remaining in ignorance of how the other half lives.”[8]

Throughout the Floating Hospital’s history, the organization has worked to educate New Yorkers who are able to make ends meet about the hardships that many of their neighbors face, to explain the importance of free healthcare for those in need, and to elicit the donations that makes its work possible. Though the Floating Hospital is no longer located on a boat, it still depends on donors’ generosity in order to stay afloat.[9]

[1] “The True Spirit of Charity,” New York Evangelist, October 29, 1874, 3.

[2] “Save the Poor little ones!” 1874, New York Historical Society, SY1877.

[3] Ibid.

[4] Floating Hospital. 1896 Annual Report, 6-7.

[5] Floating Hospital. 1897 Annual Report, 11.

[6] “The Cheerful Corner,” Brooklyn Standard Union, July 23, 1910.

[7] Floating Hospital. 1910 Appeal Letter.

[8] “How Motion Pictures Teach Kindness, Sympathy and Generosity,” American, February 15, 1914.

[9] You can become a part of the long history of supporting the Floating Hospital by giving a donation at http://www.thefloatinghospital.org/how-you-can-help/donate/

Elizabeth Taylor’s Voyage Aboard the Floating Hospital

For 101 years, the Floating Hospital only sailed during the summers because it was too cold to be on the water during the rest of the year. In 1975, however, the Floating Hospital bought a ship that had indoor heating, enabling the organization to operate year-round. While this change helped impoverished children get the care they needed when they needed it, year-round voyages created some financial challenges for the Floating Hospital. By 1979, the organization needed many more donations to support its expansion of service into the colder months. To meet this fundraising challenge, the Floating Hospital turned to its prominent supporter, Elizabeth Taylor.[1]

On October 29, 1979 guests gathered at the Roseland ballroom, paying $100 per ticket to share the dance floor with the guest of honor and honorary chairman, Elizabeth Taylor, and her then-husband Senator John Warner of Virginia.[2] Taylor wore a “jazzy black and purple design… created by Michaele Vollbracht” to the costume ball and other guests wore butterfly masks, gold turbans, or light-up jewelry and garters. Miss New York, Vonabell Roocke, was also present and she wore the white satin sash that bore her title. The journalist who covered the event reported that the night was full of “eye-bogglers.”[3] The photograph above was taken at the benefit, so you can see one of these “eye-bogglers” for yourself.

By spending her evening with the Floating Hospital, Elizabeth Taylor drew public attention toward the organization and its mission. Her support of the Floating Hospital helped bring in desperately needed funds so that children who got sick in December would not have to wait until June to receive free medical care.

[1] “The Floating Hospital is Ailing Financially; Benefit Patty Planned,” New York Times, October 7, 1979, 47.

[2] Ruth Robinson, “Future Events,” New York Times, October 21, 1979, 63.

[3] Enid Nemy, “It Was Not a Night Meant for Staying Home by the Fire,” New York Times, October 31, 1979, C13.

The Floating Hospital and the Rise of Pediatric Medicine

The Floating Hospital began its voyages at a time when pediatrics was still an emerging branch of medicine. Before the mid-nineteenth century, there were no pediatricians, no children’s hospitals, and very few parents brought their ailing children to physicians. Instead, family members, midwives, and community healers nursed sick youngsters.[1]

Though many today would question keeping children away from doctors, this decision actually saved the lives of many young people. Physicians at the time used the same treatments on children that they used on adults, just in smaller doses. These treatments were often unpleasant: doctors practiced bloodletting—cutting the skin with a knife or applying bloodsucking leeches—and gave their patients drugs that would cause them to vomit.[2] These procedures were often far more harmful than helpful to fragile young bodies. Children were therefore much more likely to survive their illnesses if they obtained tender, loving care from community members rather than receiving medical attention from physicians.

Things began to change in the mid 1800s. Reformers were horrified by the sky-high child mortality rate (more than 25% of American children passed away before the age of five, mostly from intestinal infections and contagious diseases, and impoverished neighborhoods were hit the hardest.) Anxious about the wellbeing of poor children in particular, these reformers organized themselves into the “child saving movement.” These advocates worked to enact education reform and child labor laws, to launch juvenile courts and child welfare programs, and to provide healthcare services to children in need.[3] At the same time, a small group of doctors was beginning to realize that there were significant differences between the bodies of children and adults.[4] Launching a new branch of medicine that aimed to study children’s health, doctors who called themselves pediatrists and pedologists (and were the ancestors of today’s pediatricians) argued that the same disease could look and act very differently, depending on the age of the patient. Diseases in children and adults should therefore be studied separately, these physicians insisted, and they counseled medical practitioners to stop treating children as very small adults who only needed reduced dosages of the same cures.[1]

Together, physicians concerned with children’s health, reformers, and philanthropists founded children’s hospitals that served to both alleviate the ailments of ill children and to provide a place to study their medical needs. The Floating Hospital was part of this path-breaking medical movement. When the St. John’s Guild launched its first ship of heath in 1873, the organization preceded the American Medical Association’s first formal recognition of pediatric medicine by more than five years.[5] In the 1880s, as the Floating Hospital expanded its operations and grew stronger, so did the pediatric health movement, as it gained legitimacy and began to attract more medical students.[6]

The Floating Hospital was also at the cutting edge of the new pediatric medicine because it had easy access to what doctors believed were the universal cures for ill children: fresh air and sunshine. Once physicians had realized that children’s bodies were different from those of adults, they were left confused about what to do for young patients. If bloodletting and purging treatments were dangerous to children, what could doctors do for young people in need of care? In 1849, Dr. Brodhead Bech wrote a book that advocated the use of environmentally based cures for children. Fresh air and sunshine, Dr. Bech insisted, plus rest and nutritious food, were the best prescriptions for young patients.[7] Bech’s insights stood firm decades later when doctors and reformers were organizing the first hospitals for children. Fresh air, in particular, would remain key to nursing practices well into the 20th century.[8]

Fresh air was something that the Floating Hospital had in abundance. As the ship sailed through the waters of New York, breezes whipped through its corridors, followed nurses and doctors as they made their rounds, and tangled hair and threatened hats on the Floating Hospital’s open decks. As children inhaled, the jars of leeches stayed on their shelves.

[1] Louis Joseph Tesoro, The Origin of the Floating Hospital of St. John’s Guild: The Retelling of a Story in Historical, Medical Perspective (New Haven: Yale University dissertation, 1985), 46.

[2] Tesoro, 48.

[3] Dorothy Pawluch, “Transitions in Pediatrics: A Segmental Analysis,” Social Problems 30 (1983), 451.

[4] Tesoro, 58.

[5] Pawluch, 451.

[6] Ibid.

[7] Tesoro, 53.

[8] Laura Hirshbein, ‘“Our Little Patients’: A Case Study of Hospitalized Children at the University of Michigan, 1890-2011,” Journal of Family History 38 (2013), 324.

Bathing: Hazardous or Healthy?

Taking showers and baths regularly is an unremarkable part of life for most New Yorkers today, but this was not always the case. In the early nineteenth century, few Americans bathed. Not only did they lack the technology that makes bathing easy (like showers, tubs, and plumbing), but many also believed that bathing was a threat to their health.[1]

Concerns about bathing were rooted in the humoral theory of disease, which is credited to the ancient Greek physician, Hippocrates, and remained a key tenant of Western medicine through the eighteenth century and into the nineteenth. According to humoralism, human beings were composed of four key fluids (black bile, phlegm, yellow or red bile, and blood) and the imbalance of these fluids was the source of disease.[2] Many of those who believed in the humors were concerned that bathing would disrupt the human body’s equilibrium.

Ideas about bathing and health began to change during the nineteenth century and some doctors even began promoting bathing as a therapeutic treatment. Some physicians argued that the physical pleasure of bathing was emotionally beneficial, others said cold baths could refresh and invigorate the body, some thought that removing odors cleaned both the body and the soul, and others felt that baths removed harmful substances from the skin.[3]

Baths became a luxury and then increased in popularity during the 1840s, as many American cities created or improved their plumbing and sewer systems. By the end of the century, most middle class families had bathtubs and plumbing and they bathed frequently. By then, doctors had accepted the germ theory of disease and they recommended bathing twice a week in warm water in order to kill and remove germs.[4] Sea bathing became an especially popular remedy in Western medicine, such that the British Medical Journal exclaimed in 1883, “it is unquestionable that bathing in the open sea is, in itself, a powerful restorative agency.”[5]

Though bathing was losing its bad reputation, few working class and impoverished Americans had bathrooms at home until after World War I, nor did those who lived in cities have the time or money to journey to the seashore. Some relied on public baths or swam in often polluted urban waterways, like rivers or harbors. Others did what they had always done and avoided bathing.

It was within this context of unequal access to bathing during an era of changing ideas about cleanliness and health that the Floating Hospital began offering sea baths to its young patients. The Floating Hospital’s boats were equipped with pumps that brought “the deep water of the Lower Bay”[6] into a bathroom so vast that journalist Margherita Arlina Hamm marveled that “a regiment could make its ablutions [there] without trouble.” She remarked on the “huge bathtub large enough for a seven-foot Vermonter” and the tubs

in which a small boy can splash with all the water he wants, thoroughly clean himself and not bother anybody. Then there are little tubs for babies, foot tubs and hip tubs, little shower baths and douche baths. There is a mountain of towels, a pyramid of soap, and brushes and combs unnumbered.[7]

Patients’ reactions to the bathroom reveal public ambivalence about the major shift in medical beliefs about bathing. Maura Foder Wagner wrote in the 1870s that some of the Floating Hospital’s patients were “actually afraid of the effects of soap and water” and she noted, “dismal howls come from some poor souls who think they are being led to slaughter.” Wagner recalled speaking with a patient’s mother, who exclaimed, “Give my child a bath? Why, she never had one in her life! It would kill her!” It is likely that these individuals still believed what doctors had only recently stopped telling them, that bathing was a dangerous activity that could make them sick. Other patients simply did not understand how to bathe, having never had the experience before. Wagner wrote, “Some little faces look blank—having hooks to hang clothes on is an unknown experience to them. One child takes her forlorn little garments in a bunch and tries to make them stay on the hook-in vain.” Yet other patients, Wagner saw, “embrace[d] the opportunity [to bathe] gladly.”[8] In this moment when ideas about whether bathing was hazardous or healthy were shifting radically, some patients welcomed the change, while others resisted it. The Floating Hospital worked, not only to clean their patients with the aim of improving their health, but also to help them adjust to the growing medical consensus on the benefits of baths.[9]

The Floating Hospital sent children who were especially ill to its land-based hospital in Staten Island, where they could benefit even more from bathing in salt water. Rather than being sprayed with water pumped from the bay, patients at the Sea Side Hospital could swim in the ocean itself. Doctors at the hospital prescribed sea baths for fever, cardiac cases, and general sickliness.[10] Belief in the healthfulness of bathing in the sea persisted for decades and doctors were still publishing studies on salt water cures into the 1920s.[11] As you can see in some of the photographs above, which show smiling children posing on the beach, this was a prescription that patients were happy to fill.

[1] Jacqueline S. Wilkie, “Submerged Sensuality: Technology and Perceptions of Bathing,” Journal of Social History 19 (1986), 649.

[2] For more on humoral theory, see: http://ocp.hul.harvard.edu/contagion/humoraltheory.html

[3] Wilkie, “Submerged Sensuality,” 651-652.

[4] Wilkie, “Submerged Sensuality,” 655.

[5] “Sea-Bathing,” The British Medical Journal 1 (1883), 1294.

[6] John P. Faure, “The Floating and Seaside Hospitals of St. John’s Guild,” New York Evangelist, June 10, 1897, 10.

[7] Margherita Arlina Hamm, “St. John’s Guild,” Peterson Magazine, November, 1896, 1133.

[8] Maura Foder Wagner, Account of a day on the Floating Hospital, attached as part of the Floating Hospital’s Petition for Incorporation, December 13, 1877.

[9] Floating Hospital. 1896 Annual Report, 23.

[10] Floating Hospital. 1922 Annual Report, 11.

[11] “The Science of Sea Bathing,” The British Medical Journal 2 (1926), 393.

Doctor-Ordered Milk Mustaches

Imagine being at your doctor’s office. After your physician has measured your height and weight and asked if anything ails you, she pulls out a prescription pad and writes “FRESH MILK” on it. You take the note to the pharmacy, where you are handed a cold bottle that you drink immediately, on doctor’s orders.

Though this scenario might be hard for us to imagine today, milk was the medicine prescribed most often onboard the Floating Hospital during the late nineteenth and early twentieth centuries. After evaluating their patients, doctors would prescribe milk that was fresh and cold, warmed, infused with pepsin (a digestive enzyme,) or mixed with lime water (a solution of calcium hydroxide that doctors believed prevented milk from curdling in young stomachs.)[1] Patients and their caretakers would then fill their prescriptions at the Floating Hospital’s “Milk Station,” shown in some of the photographs above.

As doctors prescribed fresh milk to their patients, they likely had the memory of the “Swill Milk” scandals of the 1850s fresh in their minds. Swill milk was a byproduct of New York’s booming distillery business. Alcohol producers often had stables attached to their factories, where they fed cows the grain mash, or “swill,” that was left over from the distilling process. Few of the distilleries supplemented their cows’ mash diet with the grass and hay they needed and the result was very sick herds producing weak and sometimes even bloody milk. Distillery owners added chemicals—like milk of magnesia, plaster of Paris, or chalk—in order to disguise their product and then marketed it as fresh milk coming from the countryside.[2] Without strong regulations on the milk industry, many New Yorkers were unable to tell whether the milk they drank came from a green pasture in New Jersey or from blocks away, in a crowded stable full of miserable cows producing milk that was not fit to drink. Though swill milk was most often sold in impoverished neighborhoods, it sometimes made its way into wealthy households too. Thousands of New York City’s children who drank swill milk became very ill and many passed away, causing a citywide panic.[3] Though the swill milk problem had declined by the time the Floating Hospital set sail in the 1870s, the healthiness of the urban milk supply was still very questionable and unsafe milk was often blamed for the still-high infant mortality rate.[4] The Floating Hospital’s doctors wanted to make sure that their patients could drink healthy and fresh milk, if only for a day.

When it came to feeding the Floating Hospital’s infant patients, doctors and nurses were part of an evolving conversation about what babies should drink. Beginning in the 1890s, the medical community began to advocate that very young children drink cow’s milk and formula instead of breast milk.[5] Though most physicians advised bottle-feeding until the 1970s, the Floating Hospital reported as early as 1896 that some of its doctors had noticed troubling trends among their infant patients who were fed from bottles. Dr. Byron V. Tompkins, who worked at the Floating Hospital’s sister facility in Staten Island noted,

Of the sick infants under one year of age, 156 were breast-fed. From this number only one died, and that one died from heat stroke; 91 were bottle-fed; of this number 15 died. These figures speak far more emphatically than any words that can be used of the great value of giving to infants the nourishment that Nature intended for them.[6]

Dr. Tompkins’ experiences with his patients led him to question the medical orthodoxy of the time. Those who read his unpopular, but deeply felt, opinion in the Floating Hospital’s Annual Report likely thought twice if their own doctors recommended bottles over breasts. Dr. Tompkins gave the Floating Hospital’s donors and patients advice that was more than 70 years ahead of its time.

While the Floating Hospital struggled to understand how to best nourish infants, its doctors enthusiastically continued prescribing milk to its older patients. These images span the years between 1915 and 1941 and they show the immense care that the Floating Hospital’s staff put into preparing and providing milk for their patients. Milk cartons, visible in the 1940s images, had come along way from the Floating Hospital’s early years, when

“everyone has a jar of some kind and when the milk dippers come by twice a day,” the children “they swarm[ed] around the milk cans with cups, whiskey bottles, beer bottles, even sugar bowls and Coney Island pails… The little red, white, and blue pails leak[ed] woefully, and [left] a ‘milky way’ behind them.”[7]

[1] A.W. Bosworth Foder and H.I. Bowditch, “Studies of Infant Feeding: Chemical Changes of Adding Lime Water to Milk,” Journal of Biological Chemistry 28 (1916): 431-435.

[2] Catherine McNeur, Taming Manhattan: Environmental Battles in the Antebellum City (Boston: Harvard University Press, 2014), 150-160.

[3] “Death in the Jug,” New York Times, January 22, 1853, 2.

[4] Louis Joseph Tesoro, The Origin of the Floating Hospital of St. John’s Guild: The Retelling of a Story in Historical, Medical Perspective (New Haven: Yale University dissertation, 1985), 22; J.W. Kerr, “The History, Development, and Statistics of Milk Charities in the United States,” Public Health Reports 25 (1910): 1351-1367.

[5] Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950 (Madison: University of Wisconsin Press, 1987).

[6] Floating Hospital. 1896 Annual Report, 22.

[7] Maura Foder Wagner, Account of a day on the Floating Hospital, attached as part of the Floating Hospital’s Petition for Incorporation, December 13, 1877.

Medicinal Melodies

As it sailed through the New York City harbor, the Floating Hospital made waves—not only out of water, but also out of sound. Musicians played throughout the voyages and the music that emanated from their instruments trailed the “ship of health.” Music was an important part of the Floating Hospital’s work because it entertained patients and because many believed that it could aid healing.

Music has long been associated with health. It is said that over 2500 years ago, the Greek philosopher and mathematician, Pythagoras, began prescribing music as medicine. As knowledge about the nervous system emerged and evolved during the 19th century, the medical establishment began to investigate music’s effects on the human body. Some doctors began to question whether music really soothed the nerves, or if it actually jangled them. Debates over whether music was beneficial or harmful to health escalated during the first World War, when many members of the medical establishment insisted that the loud sounds of the battlefield traumatized soldier’s brains, leaving them “shell-shocked.” Some doctors suggested that music could harm the mind in a similar way, while others insisted that soft and calming tunes could actually cure soldiers of the damage caused by the sounds of war.[1] One could argue that the debate persists today, as doctors and policy makers continue to weigh in on the effects of heavy metal music on young minds and bodies.[2]

Throughout decades of dispute over music’s connection with health, the Floating Hospital continuously cast its vote on the side of melodies. The hospital’s leadership believed that music benefitted their patients and they included musicians on its ships—from the first voyages until the last.

In 1877, a broadside advertisement for the Floating Hospital proclaimed, “music from a volunteer band enlivens the convalescent and insures the best results to all.”[3] According to the hospital’s leadership, musicians—like the accordionist in the above photograph—did more than alleviate boredom, they had an active hand in the healing process.

The sheet music above was printed in 1976, over a century after the Floating Hospital’s first voyage. Try to hum the melody, and imagine it mingling with the sounds of young voices, laughter, seagulls, and waves.

[1] Russell L. Johnson, “‘Disease is Unrhythmical’: Jazz, Health, and Disability in 1920s America,” Health and History 13 (2011): 13-42. [2] For examples of contemporary studies on the effects of music on bodies and brains, see http://medicalxpress.com/news/2011-10-heavy-metal-music-negative-impacts.html and https://www.psychologytoday.com/blog/the-athletes-way/201507/music-training-improves-adolescent-brain-development [3] “Save the Poor little ones!,” Floating Hospital, New York, 1877, New York Historical Society, Broadsides SY1877 no. 32.

Carefree Childhood, if Only for a Day

For many Americans who grew up before the late 19th century, childhood was not all that different from adulthood. Many children, especially those who came from impoverished and working-class families, were expected to work and they shouldered significant economic responsibilities.[1] A century and a half ago, the idea of childhood as a time of carefree play and innocence would have seemed quite strange.

Yet as the nineteenth century progressed, beliefs about childhood and children’s needs began to change. Around the time of the launch of the Floating Hospital in the 1870s, many began to believe that childhood was a sacred time in human lives. In order to become stable adults, experts insisted, children needed to be protected from responsibilities and should be free to play without worries.[2]

Though ideas about childhood had begun to change, many children’s realities remained the same. Struggling families still relied on the incomes that their young children earned by selling newspapers or fruit or by laboring in factories. Concerned about the burdens that its young patients faced, the Floating Hospital’s leaders understood that children’s wellbeing came, not only from health, but also from happiness. They therefore worked to create opportunities for children to relax and play aboard the Ship of Health.

As you can see in the images above, which were most likely taken between the 1880s and 1990s, games and arts & crafts were important parts of Floating Hospital voyages.[3] Music played during most of the trips and a journalist suggested in 1874 that jolly tunes drove “away the depression that rests on many sad and weary hearts.”[4]

The Floating Hospital reported in 1923 that it aimed to “combine the health, recreational and educational advantages” available on a sea-faring clinic.[5] For many children, simply being at sea was an exciting opportunity that sparked the imagination. The Hospital’s Annual Report of 1966 described a “boy who leaves our arts and crafts area with his hand-made fishing pole to vision whales and such as he dangles his line over the side of the boat.”[6]

As the belief in childhood as a special and innocent time became more entrenched in society and after the 1938 passage of laws that forbid formal child labor, the Floating Hospital continued to offer its patients the chance to play. The Hospital’s leaders knew that a childhood without worries was a privilege that many New York City children, whose families were struggling to make ends meet, could not access. For over a century of voyages, the Floating Hospital aimed to offer children the chance to experience carefree childhood, if only for a day.

[1] For a great discussion on shifts in American childhood, check out BackStory’s podcast, “Young Americans”: http://backstoryradio.org/shows/young-americans/

[2] Louis Joseph Tesoro, The Origin of the Floating Hospital of St. John’s Guild: The Retelling of a Story in Historical, Medical Perspective (New Haven: Yale University dissertation, 1985), 71.

[3] Floating Hospital, 1931 Annual Report.

[4] “Sayings and Doings,” Harper’s Bazaar, September 5, 1874, 7.

[5] Floating Hospital, Second Medical and Social Service Report, 1923.

[6] Floating Hospital. 1966 Annual Report, 6.

Ships of Health During Times of War and Peace

To most Americans in 2015, hospitals are made of brick and mortar or cement and they are located on solid ground. Yet to those who lived in the nineteenth century, the idea of a hospital being located on a ship was not unusual.

Floating hospitals were an important parts of military operations at least as early as 1853, when at least 100,000 sick and wounded Crimean War soldiers received treatment on ships.[1] In 1862 during the U.S. Civil War, the Union army launched the USS Red Rover as a hospital ship that would support the Western Flotilla (see above image.) The formerly commercial sidewheel steamer carried doctors and surgeons, nurses, and a crew that was made up largely of African American refugees—called “contrabands”—who aided the Union war effort after fleeing enslavement. The USS Red Rover served as a comfortable and sanitary place for soldiers to receive treatment at a time when land-based army tent hospitals were overburdened and full of disease.[2] The U.S. army continues to use hospital ships to this day.

Floating hospitals were also used during times of peace. During an outbreak of cholera in 1866, New York City’s Board of Health treated the sick on ships drifting in the city’s harbor. The agency turned to floating hospitals because it had been nearly impossible to find sites to treat cholera patients on land. In a moment of panic about cholera’s spread, New Yorkers objected heartily to having hospitals in their neighborhoods. But when hospitals were floating, they could move easily when neighbors became worried about the proximity of cholera patients.[3]

In 1873, St. John’s Guild began offering medical care to children onboard a rented steamboat and thus launched the Floating Hospital, which still operates on land today and publishes this blog. Unlike the hospitals of the cholera years that were chased to the sea by terrified neighbors, this ship of health floated in order to excite children and to give them access to plenty of fresh air. Though the Floating Hospital served ill children who were not contagious, New York City’s Board of Health continued to see benefits to caring for epidemic victims on boats. In fact, during the whooping cough outbreak of 1913, the Board used the St. John’s Guild’s Floating Hospital—the Helen C. Juilliard—as the center of operations in fighting the disease.[4]

The Floating Hospital grew as the years passed and word of its impact spread around the country and even around the world.[5] In 1894, a group of Boston reformers followed in the Floating Hospital’s footsteps to launch a ship of health for the children of their city.[6]

New York’s Floating Hospital continued to be a familiar sight in the city’s harbor until September 11, 2001. The twin towers fell close to the Floating Hospital’s pier and resulting changes at the waterfront led the organization to come ashore in 2002.[7] But until that point, children in New York City were able to continue in the long tradition of receiving medical care at sea.

[1] Richard Grunawalt, “Hospital Ships in the War on Terror: Sanctuaries or Targets?” Naval War College Review 58 (2005): 89-119.

[2] Steven Louis Roca, “Presence and Precedents: The USS Red Rover During the American Civil War, 1861-1865,” Civil War History 44 (1998): 91-110.

[3] Louis Joseph Tesoro, The Origin of the Floating Hospital of St. John’s Guild: The Retelling of a Story in Historical, Medical Perspective (New Haven: Yale University dissertation, 1985), 43.

[4] “New York Gossip,” Evening Star, October 22, 1913.

[5] “Le Bateau-Hopital Flottant,” L’Express Liege, July 8, 1905.

[6] https://www.floatinghospital.org/About-Us/History.aspx

[7] Diane Cardwell, “Long-Lived Floating Hospital is Still Going, Just Not Floating,” New York Times, September 1, 2003, http://www.nytimes.com/2003/09/01/nyregion/long-lived-floating-hospital-is-still-going-just-not-floating.html?pagewanted=1

When Vegetables were “Unhealthy”

Before the late nineteenth century, most Americans believed that a healthy diet was rich in fat, starches, and salt. Had there been a food pyramid in those days, there would have been no room in it for vegetables or fruit. Many Americans avoided fresh produce, believing that fruits and vegetables would worsen their health and make them vulnerable to the ravages of cholera and dysentery.[1] The photograph above of a child eating fruit aboard the Floating Hospital would never have been taken in the early 1800s. At that time, few believed that an apple a day would keep the doctor away.

Ideas about nutrition shifted dramatically near the turn of the twentieth century, due to evolving science as well as to the lobbying efforts of farmers and orchard owners. We can see this change reflected in the food served onboard the St. John’s Guild’s Floating Hospital and at its sister clinic, the Seaside Hospital.

When Maura Foder Wagner visited the Floating Hospital in 1877, the ship’s lunchtime meal was a “rich Irish stew,” full of meat and potatoes and served along with bread and milk. This meal likely looked very similar to the one depicted in the photographs above, which were printed in the St. John’s Guild’s 1894 Annual Report. Passengers seemed to appreciate this heavy and hearty lunch, and Wagner noted, “One old woman was actually discovered with a pocketful of stew, which she was saving to take home.” This passenger’s willingness to endure the mess of a cloth pocket leaking stew suggests that she, like many other impoverished New Yorkers at the time, was desperately hungry. The Floating Hospital’s lunch must have seemed incredibly bountiful to those who were used to scarcity.

In 1926, the St. John’s Guild was still invested in feeding hungry children and their family members, but vegetables had become the star of its nutritional program. The Guild’s Seaside Hospital in Staten Island set aside a portion of its seventeen-acre property for a “farm, where fresh vegetables are grown and eaten by the children brought down for the day by the Floating Hospital.”[2] The hospital boasted “Five acres of fresh vegetables, all for the children. No Canned food.”[3] Based on shifting ideas about healthful eating, the St. John’s Guild had transformed its food making practices in order to showcase vegetables, setting up the farm in order to ensure that the produce was as fresh as possible. Though fresh vegetables had once been seen as dangerous and unhealthy, by the 1920s they had eclipsed starch and fat to become the most important part of the hospital’s meal plan.

Ideas about health have changed dramatically over time and they will most likely continue to change. What foods do you think will be “healthy” or “unhealthy” fifty years from now?

[1] Ted Steinberg, Down to Earth: Nature’s Role in American History (New York: Oxford University Press, 2009), Chapter 11.

[2] “Champions of Children” pamphlet, St. John’s Guild, 1926, 9.

[3] “Champions of Children” pamphlet, St. John’s Guild, 1926, 13.

The Floating Hospital and Impoverished Mothers’ Fierce Dedication to their Children

The Floating Hospital began with a take on poverty and parenthood that was radically different from most other charitable organizations of its time and place. While much of the hospital’s leadership viewed impoverished mothers as dedicated advocates for their children’s health, many other philanthropists confronting the issue of poverty during the nineteenth century believed that the solution was to separate children from their impoverished parents. A number of charitable groups in New York City worked with this philosophy, aiming to expose poor children to wealthier and “better” role models. For some of these organizations, the separation between parents and children was temporary: one group sent children to live with rural middle and upper class families during the summertime. For others, the separation was permanent. In what has become known as the “Orphan Trains,” New York City philanthropic agencies sent children (many of whom were not actually orphans) to the West to live with new families. Some children certainly benefitted from the chance to experience another kind of family and a different way of life outside of New York City’s tenement districts. Yet, underlying activism that separated children from their families was often the assumption that poor parents were bad parents. Many organizations believed that the cycle of poverty could only be broken if children gained wealthier (and sometimes more religious or more Americanized) influences.1

The Floating Hospital, on the other hand, carved a significant role for poor mothers into its mission, inviting them onto the “Ship of Health” along with their sick children (grandmothers or aunts sometimes acted as proxy mothers, but fathers appear only very rarely in the Floating Hospital’s records from the nineteenth century.) Part of the reason for inviting mothers along was to provide them with information about nutrition and how to care for sick children. While hospital administrators recognized that many mothers had things to learn about pediatric health, poor mothers’ abilities to be good parents seem to have never been under question.

Descriptions of the Floating Hospital often included observations of mothers’ powerful love for and steadfast dedication to their kids. In 1874, Harper’s Weekly reported,

One poor woman held in her arms her third and only remaining child, dying from marasmus. She brought her into the cabin of the barge, and sat gazing steadfastly and tenderly into the baby’s wasted face. In reply to a question of the kindly stewardess, she said, her voice choking her...“I’ve not taken my clothes off nor slept a night in six weeks, but I’d gladly sit up six weeks more to save my little darling’s life.” 2

Heart-wrenching accounts like this one reveal how mothers’ devotion to their children would have been impossible to ignore onboard the Ship of Health. By including mothers, the hospital’s leaders acknowledged this devotion and cast moms as key participants in the project of reviving ill children.

When the Floating Hospital’s treasurer noted in 1910 that a “mother’s cry for her sick babe... throws open wide the doors” of the ship, he acknowledged that caring mothers were the reason why his organization had patients.3 Mothers sought treatment for their ailing kids and also worked hard to make the time for a voyage. One woman interviewed on the Floating Hospital noted, “I worked until two o’clock this morning to do my washing so that I could come here with baby.”4 Accounts like these portrayed how impoverished mothers’ fierce dedication to their children drove them to seek help onboard the Floating Hospital.

The Floating Hospital understood that these mothers also needed rest and rejuvenation. Working grueling schedules while caring for sick children, many of these mothers were on the brink of physical and emotional exhaustion. The Floating Hospital dropped especially ill infants and their mothers off at its sister hospital in Staten Island. When they arrived, mothers found wards full of beds with attached cribs where they could sleep while the nurses cared for their babies.5 Arranging the wards in this way, the hospital showed that, rather than viewing impoverished mothers as bad influences, it considered them to be a crucial part of pediatric health. Mothers needed rest in order to continue to care for their children, they were a crucial part of the healing process, and children need to be close to their loving presences.

The Floating Hospital viewed impoverished mothers as partners in, rather than obstacles to, its mission of healing the disadvantaged children of New York City—much as it still does today.

1 Marika Plater, “The Meanings of Fresh Air: Nature Vacations, Reformers, and the Reformed in Progressive-Era New York City,” unpublished; Stephen, O’Connor, “Orphan Trains: The Story of Charles Loring Brace and the Children He Saved and Failed” (Boston: Houghton Mifflin Company, 2001). 2 “The Floating Hospital of St. John’s Guild,” Harper’s Weekly, September 12, 1874. 3 “Floating Hospital Appeal Pamphlet,” The Floating Hospital, 1910, New York Academy of Medicine Library, FRA RA 982.S35 C66 1910 n. 3 4 “The St. John’s Guild, Outlook, August 4, 1894, 176. 5 “How to Save a Baby’s Life, Illustrated,” Floating Hospital, 1897, New York Historical Society, (F128 RA982.S35 A4 Non-circulating.)

Fresh Air and Sunshine

The Floating Hospital’s supporters testified about the beneficial effects of fresh air. After visiting the ship during the 1870s, Maura Foder Wagner wrote;

“the mother’s face is just aglow with gratitude as with the fresh air her baby begins to brighten. All about the deck the little flower-heads are lifting and the wilted little plants reviving in the cooler air.”

In Wagner’s eyes, fresh air had the power to revive children who had grown lifeless and sickly in their tenement homes. John P. Faure, who served as the chairman of the Floating Hospital Committee, agreed and he explained in an 1897 Annual Report that thousands of children were “better and stronger, and hundreds brought from death back to life” through the “inhalation of life-giving salt air” on board the Floating Hospital.

By the end of the nineteenth century, most doctors agreed that invisible germs—not miasma—were the culprits that caused disease. Though bad air was no longer seen as the cause of illness, fresh air retained its exalted reputation in the public imagination and it remained an important part of the Floating Hospital’s mission. The Evening Telegram cheerfully reported in 1911;

“When the floating hospital returned the grateful expressions and the tinge of the salt sea air in many cheeks was eloquent testimony of the boon of the outing.”[1]

Regardless of what medical journals had to say about how to cure illness, many onlookers noted that when children returned from their voyage aboard the Floating Hospital, they looked healthier. The Floating Hospital’s 1942 annual appeal letter to donors quoted one of the ship’s nurses, who insisted that many impoverished New York City children;

“don’t need medical treatment. They don’t look well, they are listless and pale, and examination shows they are just below par but ripe for something worse. They do need the fresh air and sunshine this ship affords. So we keep them coming day after day and watch the pallid skins disappear and a wholesome tan take its place.”[2]

This nurse reflected the belief that fresh air, along with sunlight, would strengthen children’s bodies and could, almost like an immunization, prepare them to withstand any germs or sicknesses that crossed their paths. To the leaders of the Floating Hospital, fresh air aboard the “Ship of Health” was a preventative treatment that would imbue young passengers with strength and vitality.

And what did the young patients themselves think? Many may have understood the medical meanings of fresh air and they may have inhaled deeply in the hopes of avoiding the next winter’s flu outbreak. Yet others may have simply enjoyed the smell of salt on the breeze and laughed as the wind whipped at their hair and clothing. When the Floating Hospital reached its pier and it was time for them to go to their homes—which may have been damp or dark or stuffy—many of these children likely carried with them sweet memories of the sun on their skin and the fresh air in their nostrils.

[1] “Floating Hospital Makes First Trip,” Evening Telegram, July 6, 1911.

[2] “Floating Hospital Appeal,” Floating Hospital, August 15, 1942.

Shown above is a page from a 1901 promotional (donation appeal) piece created by The Floating Hospital

The Lack of Fresh Air

For impoverished New Yorkers, fresh air was difficult to find, especially in the summer when the hot sun coaxed revolting odors from garbage piles, manure, and pools of standing water. They did not have the time or money to leave the city for the summer to breath the fresh air at ocean-side and mountain resorts, like many wealthy New Yorkers did. Central Park was breezy and cool, but it was difficult and expensive to reach in the days when horses powered the city’s limited public transportation system. [1]

This page of a 1901 promotional brochure for the Floating Hospital depicts the type of homes and neighborhoods that many passengers on the “Ship of Health” came from. In the tenement districts, apartments were very cramped, with poor ventilation.

The Floating Hospital provided days out on the water for impoverished New Yorkers who had few other chances to breathe fresh air. Unlike most other city hospitals, the Floating Hospital could not only provide patients with food, baths, and medical treatment, but it could also take them to ocean-freshened breezes. Many believed that boarding the “Ship of Health” and inhaling deeply while reposing on its sun-bleached decks was a matter of life and death.

[1] http://www.transitmuseumeducation.org/trc/background; “Things-Seen,” Harper’s Bazaar, January 8, 1898.

Dangerous Miasma

Fresh air was the necessary antidote to miasma, or bad air, which doctors at the time warned was sure to waft from dirty, rotten, or unfinished things. New York City’s impoverished neighborhoods, with their still unreliable sanitation and plumbing systems, were rife with sources of dangerous miasma. Many lived, crammed like sardines, in congested tenement apartments whose windows (if they had any) let in more soot and odors than they did breezes.

This illustration, drawn by the British cartoonist Robert Seymour in 1832, shows London health inspectors searching out the sources of a cholera outbreak. Because they believed in the miasmatic theory of disease, they were looking for noxious odors that were a sure sign of bad air. Robert Seymour, “A London Board of Health Hunting After Cases Like Cholera,” McLean's monthly sheet of caricatures, March 1, 1832.

Fresh Air as the Essence of Life

Standing at the rail of the Floating Hospital, this little girl felt the fresh, salty air of the New York Bay whipping at her cheeks and ruffling her hair. The date of this photograph is unknown, but if it reached viewers before the turn of the twentieth century, they would likely have seen multiple layers of meaning in this image. To them, this picture would depict a highly effective medical treatment, not simply a child marveling at the expansive sea and sky before her. To nineteenth-century Americans from across the class spectrum, fresh air was curative force that could clean lungs and strengthen weakened bodies.

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