Historical essay
Huddled Masses Yearning to Breathe Free: Tuberculosis in Progressive Era New York City

Huddled Masses Yearning to Breathe Free: Tuberculosis in Progressive Era New York City

Since January, Americans have grappled with the implications of the Trump Administration’s continued efforts to suspend immigration from six (originally seven) predominantly Muslim countries. The tones of fear and moral outrage sound eerily similar to those from more than a century earlier, when anxious nativists sought to halt the flow of millions of impoverished Jews fleeing persecution and death in Eastern Europe. Much like many of today’s Syrian refugees, Jewish immigrants arrived with limited skills and resources, and maintained distinctive appearances and cultural practices that aroused the suspicions of many mainstream white Protestant Americans. Then as now, early-twentieth-century policymakers and social commentators debated these newcomers’ fitness for citizenship while subjecting their physiques, intelligence, occupational skills, and moral standing to rigorous, and often biased, scrutiny.

As germ theory gained wider acceptance in early-twentieth-century popular culture, communicable diseases loomed large among the dangers that immigration restrictionists associated with the foreign-born. They especially feared tuberculosis, a bacterial infection that killed more people during the previous century than any other communicable illness.1 Many anti-Semites perceived strong parallels between the pale and wasted look of tuberculosis patients and the sedentary, puny stereotype of the Jewish tailor or scholar.2 Little wonder that in crowded cities like New York, home to the majority of Jewish immigrants and the site of thousands of TB deaths each year, tuberculosis became alternately known as the “Jewish disease” or “tailor’s disease.”

A WPA Federal Health Project poster, dated between 1936-1941, titled “Fight tuberculosis – obey the rules of health” (Library of Congress | Public Domain)

From within these stigmatized communities, Jewish immigrant physicians emerged to counter this “sick” and contaminated image. One of them was Maurice Fishberg, a New York doctor and physical anthropologist who published articles in prominent medical journals citing Jews’ low tuberculosis mortality in cities all over the world. He attributed this lower mortality to a “peculiar resistance” that Jews had accumulated through generations of natural selection in the filthy, crowded urban ghettos where they were often compelled to live. “Only those most resistant to the effects of disease,” Fishberg declared, “the healthiest who could easily adapt and acclimatize themselves to new external conditions on short notice—in brief, only the fittest have survived.”3

He also credited common Jewish cultural practices, such as moderate alcohol consumption, strict dietary laws, and regular cleansing rituals, with strengthening their natural defenses against disease.4 Using tuberculosis as a framework, Fishberg worked to recast Jewish immigrants as biologically hardy survivors whose values and behavior patterns suggested a good fit with white native-born Americans.

Fishberg’s writings on Jews and tuberculosis reached a wide popular audience during the 1900s through newspapers, journals, and public lectures. Physicians and social reformers often cited his work when ranking Jews more favorably among America’s racial and ethnic groups. Irish and Italian immigrants suffered higher TB mortality rates, these experts argued, because their rural, fresh-air lifestyles had prevented them from undergoing the same natural-selection process that Jews had.

Taking the argument further, they often conflated this vulnerability with stereotypical cultural flaws like filth, ignorance, and immorality. With only slight variations, these experts employed the same lines of reasoning to explain skyrocketing TB mortality among American Indians and African Americans, suggesting that their critiques of Irish and Italian immigrants carried a racial component as well.5

In reality, Fishberg’s natural-selection argument rang false for tens of thousands of Jews who became sick with tuberculosis after arriving to America. Theodore B. Sachs of Chicago and Charles David Spivak of Denver, both Russian Jewish immigrant physicians in charge of tuberculosis sanitariums, concluded that Jews’ “peculiar resistance” did not hold up under the harsh living and working conditions they encountered in American cities.6

Moreover, Fishberg himself picked up on this disturbing trend while examining thousands of Jewish immigrants who were applying to charitable agencies. Instead of revising his stance, however, Fishberg adopted a dual approach: he joined Sachs and Spivak in raising the alarm about tuberculosis when communicating with Jewish audiences, while continuing to promote Jewish resistance to tuberculosis in mainstream publications with large numbers of gentile readers.

Physicians examining a group of Jewish immigrants in 1907 (Underwood & Underwood/Library of Congress)

As Fishberg’s conflicting arguments gradually merged during the years leading up to the First World War, he began to acknowledge more publicly the inroads tuberculosis was making among the poorest Jews who lived “on bread, herring, and tea alone.”7 When anti-Semitic hostility spiked during the postwar Red Scare, however, Fishberg reverted to stressing the role of natural selection in Jewish resistance to tuberculosis, citing strong parallels with the low TB mortality rates of English and German immigrant populations.8

The timing of these shifts suggests that natural selection provided a way for Fishberg to deflect anti-Semitism by aligning Jews scientifically and medically with nationalities of “Anglo-Saxon” extraction. It also reveals the difficulties that Fishberg and other Jewish immigrant physicians and scientists faced in maintaining professional objectivity while millions of their co-religionists continued to suffer and die across the ocean. For them, America’s harbors did not represent portals of contamination, but lifelines that nativist hysteria could sever at any moment.

By the mid-1920s, their apprehensions had become reality: tighter filters on immigration slowed the flood of eastern European Jews to a trickle while favoring newcomers from England, Germany, and other northwest European nations. These filters remained in place during much of World War II, dooming future waves of prospective Jewish immigrants to persecution and death under Nazi rule.

As refugees from war and persecution once more encounter closing doors in America, Fishberg’s conflicting arguments on Jews and tuberculosis provide an intriguing glimpse into the perspective of the stigmatized immigrant who watched and waited as policymakers’ competing agendas decided the fates of millions of his former compatriots. His work offers a timely reminder of the humanitarian stakes in America’s present-day struggle to chart a course between fear and justice.


  1. Alan M. Kraut, “Plagues and Prejudice: Nativism’s Construction of Disease in Nineteenth- and Twentieth-Century New York City,” Hives of Sickness: Public Health and Epidemics in New York City, ed. David Rosner (New Brunswick: Rutgers University Press, 1995), 75. Return to text.
  2. Hermann Biggs, “Tuberculosis and the Tenement House Problem,” The Tenement House Problem, ed. De Forest and Veiller (New York: Macmillan, 1903), 448, 455. Return to text.
  3. Maurice Fishberg, “Health and Sanitation: New York,” The Russian Jew in the United States, ed. Berkheimer (Philadelphia: Winston, 1905), 294. Return to text.
  4. Ibid., 287-88; “Health and Sanitation of the Immigrant Jewish Population,” Menorah 33, No. 2 (August 1902), 179. Return to text.
  5. Thomas D. Coleman, “Tuberculosis Among the Dark-Skinned Races of America,” in Tuberculosis: A Treatise by American Authors, ed. Arnold C. Klebs (New York, 1909); Ales Hrdlicka, Tuberculosis Among Certain Indian Tribes of the United States (Government Printing Office, 1909); Lillian W. Betts, “The Italian in New York,” University Settlement Studies Quarterly, 1 (1906); Woods Hutchinson, “Varieties of Tuberculosis According to Race and Social Condition,” New York Medical Journal 86 (October 12, 1907); Lillian Brandt, “The Social Aspects of Tuberculosis Based on a Study of Statistics,” A Handbook on the Prevention of Tuberculosis (New York, 1903). Return to text.
  6. Theodore B. Sachs, “Tuberculosis in the Jewish District of Chicago,” Journal of the American Medical Association, 43: 6 (August 6, 1904), 393; Charles David Spivak, First Annual Report of the Jewish Consumptive Relief Society (1905), 32; Second Annual Report, 21. Return to text.
  7. Fishberg, “Health and Sanitation: New York,” 289. Return to text.
  8. Fishberg, Pulmonary Tuberculosis (New York: Lea & Febiger, 1919), 67–9; New York City Department of Health, Annual Report (1914), 104. Return to text.

Featured image caption: Pneumothorax treatment for tuberculosis at the municipal sanitarium on the South Side of Chicago, Illinois (Russell/Library of Congress| Public Domain)

Adrienne deNoyelles is a PhD Candidate in the Department of History at the University of Florida. Her dissertation, currently titled "'The Lung Block': Tuberculosis and Reform in Progressive-Era New York," examines the public-health and social factors that shaped the rise and eventual defeat of a 1903 campaign to destroy an immigrant slum and replace it with a park.