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Original Research Article
“The Hoist of the Yellow Flag”:
Vulnerable Port Cities and
Public Health
Dirk Schubert
1
, Cor Wagenaar
2
, and Carola Hein
2
Abstract
Port cities have long played a key role in the development, discovery, and fight against diseases. They
have been laboratories for policies to address public health issues. Diseases reached port cities
through maritime exchanges, and the bubonic plague is a key example. Port city residents’ close
contact with water further increased the chance for diseases such as cholera. Analyzing three
European port cities, this article first explores the relevance of water quality for public health
through the lens of the Dutch city of Rotterdam. It then examines plans and projects for London that
were shaped by social Darwinism and stressed the moral failings of slum dwellers as a major cause
for their misery. It finally explores the case of Hamburg as the perfect example of a city that cul-
tivated ideals of purity and cleanliness by addressing all issues at stake in public health. This article on
urban hygiene in three port cities shows how remarkably rich this field of study is; it also demon-
strates that the multifaceted aspects of public health in port cities require further attention.
Keywords
public health, port cities, Rotterdam, London, Hamburg
In the evolution of public health, port cities play a remarkable role.
1
This article explores how port
cities became laboratories for policies that proved to be very effective. In public health, everything is
about the collective body of citizens. Public health is about statistics—life span, types of diseases,
causes of death, and whether all these aspects can be related to age, gender, social status, and a
myriad of other parameters. Improving public health, obviously, requires political action, and in the
nineteenth and early twentieth century, the need for it was felt most urgently in port cities because
they were proving to be particularly vulnerable to contagious diseases and epidemics. Although
today these account for only about 85 percent of all health problems, they were much more dan-
gerous in the period that is the focus of this article.
The spectacular death toll they could cause in a matter of only a few months gave them the power
to disrupt social life, and the economy called for action—nowhere more so than in port cities.
1
HCU Hamburg, Germany
2
TU Delft, the Netherlands
Corresponding Author:
Carola Hein, TU Delft, Julianalaan134, 2628 BL Delft, the Netherlands.
Email: c.m.hein@tudelft.nl
Journal of Planning History
1-23
ª2021 The Author(s)
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/1538513221998716
journals.sagepub.com/home/jph
Medical professionals took the lead. Already in the eighteenth century, it was clear that it was out of
the question to improve public health by concentrating on individuals. What was also clear beyond
doubt is that people’s living environment had a big impact on their health. This finding perfectly
coincided with one of the principal arguments of enlightenment thinking in the late eighteenth
century: people’s physical, spatial, and social environment determines their quality of life. Improv-
ing public health, therefore, should target the environment. What scholars, as well as laymen, had
suspected for centuries proved to be true: living in large cities has a negative effect on people’s
health status, especially for poor people.
Statistics, however rudimentary, were quite convincing. Inspired by medical scholars, politicians,
architects, and urbanists initiated campaigns to clean and purify cities, install decent sewage
systems, provide clean drinking water, and remove slums. Like other sciences, medicine looked
to the latest innovations in order to expand the envelope of its expertise. In later periods, scientists
often proved these innovations and the concepts on which they were based to be wrong. That is the
way it is supposed to work—but in the case of public health, some claims may not only be beside the
point from a scientific point of view but also extremely problematic from a moral and political
perspective. In this article, two aspects of public health policies in the nineteenth and early twentieth
centuries appear to be particularly problematic: the links between public health and social Darwin-
ism and the way political elites in cities used public health to discipline the citizens under their
control. At the same time, the public health measures that many cities introduced were very effective
and prolonged the life span and the quality of life of hundreds of thousands of people—especially
those among the working classes.
This article focuses on three cities. It shows how scientific developments impacted the scope of
urban projects meant to improve public health. In Rotterdam, the earliest large-scale public health
interventions focused entirely on the quality of the water in the city’s canals, resulting in the so-
called water projects of 1841 and 1854. The plan was based on the physical qualities of the
environment, notably so-called miasma: foul-smelling vapors that were believed to be the main
cause of diseases. Towards the end of the century, influential scholars such as Herbert Spencer
expanded the enveloped of science with moral, social and even racial issues. This allegedly justified
the use of slum clearance campaigns to erase the ‘race’ of slum dwellers as well. The plans and
projects for London date from this period and stressed the moral failures of slum dwellers as a major
cause for their misery—which should be eradicated because it was believed to impact the entire
urban community. For a while Hamburg was the perfect example of a city that cultivated the ideals
of purity and cleanliness, culminating the ideal of an urban Gesamtkunstwerk that, however, also
contained programs for social exclusion. Afterwards all public health issues at once and it developed
into the cleanest city on earth – but at what cost?
Port Cities – Hubs of trade and migration
Port cities are nodes in the global networks of freight transportation. Before the 1960s, when
commercial, jet-propelled airlines took over, ports were also hubs in the intercontinental journeys
of passengers—mostly of business people and immigrants. In the nineteenth century, the intensity of
these movements began to accelerate, reaching levels never seen before. Ports became access gates
not only for all kinds of goods and growing numbers of people but also for contagious diseases.
2
Many port cities opened quarantine facilities for people who wanted to disembark from the ships but
were ill. Immigrants who arrived in New York’s Ellis Island were subject to medical tests before
they were allowed to enter the promised land, and this was standard procedure in many countries
until not so very long ago. Freight could also be the source of epidemics.
The large number of incoming ships from all parts of the world was also associated with a “rat
plague,” as there was fear of the spread of unknown diseases with the transfer of rats from ship to
2Journal of Planning History XX(X)
land.
3
In the 1910s and 1920, for instance, a bubonic plague caused large numbers of casualties in
Java, in the Dutch Indies, and it was believed to have entered the country by way of rats that traveled
on board ships carrying rice.
4
For most of the nineteenth and early twentieth centuries, port cities
were especially vulnerable. Authors have described port cities as the “portal of death,” as “the
gateway for epidemics that were introduced via the shipping system and quickly spread to the port
cities and the economically dependent hinterland.”
5
A series of cholera epidemics in the nineteenth
century drove the point home. Conditions were made worse by the rapid growth of port cities;
loading and unloading goods and storing them in warehouses required hard menial labor, and as port
cities grew, they became hotbeds of a new, urban proletariat that often lived in slums. The question
arises whether the vulnerability and the connection between social stratification and sickness in
seaport cities were promoted by working conditions (e.g., among casual laborers) and living and
housing conditions and whether the well-being of the port workers played a role in the evolution of
port cities.
6
The need for flexibly available labor, depending on the workload for loading and unloading
incoming and outgoing ships, required residential accommodation near the port. The work in the
port was difficult and dangerous, but the irregular work also gave unskilled newcomers a chance on
the job market. The port cities were permanent abodes of residents and temporary abodes of
immigrants, travelers and seafarers and thus a kind of a melting pot. The seamen (“Jack ashore”),
many of them not (yet) married, had their wages and were looking for pleasure after a long journey
ashore.
7
In addition, there were special quarters in port cities, “contact zones”, a kind of diaspora for
all kinds of entertainment, nightclubs, drinking, drugs, bars, prostitution and other exotic pleasures,
which were also visited by the locals (if possible unnoticed).
8
In port cities, creative milieus of business people, entrepreneurs, financing, and insurance insti-
tutes—often based on “command centers” in seaport cities—drove interwoven relationships inter-
nationally and ultimately globally.
9
Globalization processes facilitated by port cities had an
increased impact on local developments (“glocalization”). The maritime networks were locally
integrated and at the same time operated internationally. An integral part of the port structure was
also “special” districts close to the harbor (“sailor towns”).
10
With a highly international orientation,
they formed a conglomerate of functions and services, shops for clothing, luxury goods and sou-
venirs, seaman’s churches, accommodations, inns, tattoo parlors, dance palaces, and brothels. Peo-
ple from diverse parts of the world came together in the seaports. Port districts were considered
“dangerous” and often had a reputation for being unsafe and “immoral.”
11
In Spanish-speaking
countries, the name “Barrio Chino” is used for these harbor districts and corners of otherness, which
already conceptually relates to internationality—in this case to China (“Chinatown”).
12
The new-
comers sought contact with relatives and acquaintances and promoted the emergence of special
ethnic enclaves and small-scale segregation.
13
Their presence also fostered prejudices about other-
ness. They were often stigmatized and blamed for crime and the spread of diseases and epidemics.
Locals and visitors to port cities were confronted with diverse races, languages and cultures that
were not known in the hinterland. They promoted distinctive features of port cities as “different”
from other types of cities. Also working, living and housing conditions and whether the well-being
of the port workers played a role in the evolution of port cities, when the urban elites triggered
reforms and improvements.
14
Once contagious diseases had entered the port city, overcrowded
working class neighborhoods made it easy for them to spread. Because of their vulnerability, port
cities provide interesting cases from the perspective of public health.
In the 19th century port cities had become hubs of world trade. With urbanization, problems with
street cleaning, waste handling, rubbish, and feces increased exponentially. Cleanliness and morality
were established as elements of the lifestyle in the phase of rapid industrialization. “Health” was
politicized, and public health was seen as a factor in stabilizing the existing social order. In the
context of rationalization spurts, health demands were also reflected in urban planning. In the
Schubert et al. 3
process, state and municipal measures changed from repressive and disciplinary approaches to those
that emphasize incentives. This resulted in the creation of institutions with a special focus on matters
of hygiene, such as in Germany, the Verein fu
¨ro¨ffentliche Gesundheitspflege (Association for
Public Health Care; founded in 1869) and the German Quarterly Journal for Public Health Care,
and the Royal Sanitary Institute (founded 1834) and the Journal of the Royal Sanitary Institute in
Britain. Technical excursions and reports promoted international exchange. In particular, the Eng-
lish experience served as a blueprint for other countries. Well-known medical professionals, health
experts, and town planners such as Joseph Stu
¨bben, Reinhard Baumeister, and James Hobrecht were
represented in these institutions and tried to bring in experiences of public health and technical
concepts of action. For example, a detailed report in German of Whitechapel in the East End of
London in 1873 said: “These cramped, filthy, poorly ventilated apartments are breasts and the hearth
of poverty, disease and crime. With less money one could help build things up here than later
becomes necessary for poor houses, hospitals, penitentiaries.”
15
As urban reformers and select institutions started to pay more attention to urban hygiene, infra-
structure problems and accelerated growth of cities as well as unregulated building and expansion,
they also sought means of directing, controlling and regulating development. One could smell the
places of poverty and the locations of misery. The stench evoked impressions of miasma, dangers,
and centres of infection. With the slums, the bourgeois public associated and registered dirt, moral
damnation, and drunkenness as well as an aimless, uncontrolled life and other perceived dangers.
They saw their own lives in contrast to this image as clean, pure and orderly. Above all the
increasing concentration of poverty in so called “slums” was seen as a side effect of urbanization
processes and considered a new challenge.
16
The first to seek out and describe the living conditions
in these areas of poverty in the cities were engineers, architects, judges, journalists and medical
professionals, but also philanthropically oriented entrepreneurs. The housing conditions received
less attention than the behavior of the residents. The first reformers therefore concentrated on
lowering mortality rates instead of improving housing conditions of the poor. According to them,
public health conditions were the inducement for improvement measures. “Clear away the filth,
clear away disease, clear away the paupers”
17
was the logical sequence of argumentation.
Investments by the state in improving public health—so it was argued—would save money in the
long term. Epidemics would affect local prosperity and increase the hardship and misery of
the poorer population groups. Often voluntary poor relief and moral behavior controls that forced
the lower population groups to accept improved hygienic standards went hand in hand with
educational measures of voluntary or forced social discipline.
Rotterdam: The Battle for Clean Water
In the Netherlands, medical scientists began to urge for hygienic measures only in the mid-
nineteenth century, starting a movement that became known as “the hygienists.”
18
Child mortality
among the poorest layers of the population caused growing concern. There were no signs that things
were going to improve—to the contrary, industrialization and the urbanization only made things
worse. The average life span of poor people was eighteen years shorter than that of the wealthy. The
hygienists were convinced that intervention by the state was indispensable. What was desperately
needed was a public health law. It was meant to replace the rather vague clauses in the Municipal
Law of 1851, which forced municipalities to invest in public health measures. Since these had to be
paid out of the municipal budget, they were reluctant to do anything, sometimes pointing to the lack
of scientific evidence.
Why spend money on measures that might not even work? Only in 1865 did the hygienists
manage to get a law passed. This “Law regulating medical inspection” resulted in a network of
regional inspectors who were appointed and paid by the state. Trying to prevent clashes with the
4Journal of Planning History XX(X)
municipalities, and respecting local autonomy, the inspectors could not do much. According to one
author, the law that did most to improve public health was not even inspired by the ambition to do so:
the Fortification Law of 1874 finally allowed cities to demolish the straightjacket of bulwarks that
made expansion outside of them impossible. Once they were allowed to do so, it helped to diminish
overcrowding in older parts.
19
Municipalities began, however reluctantly, to introduce sewage
systems and networks providing clean water (initially often run by private companies). Municipal
Figure 1. The first water project. Source: W. N. Rose (City Archive Rotterdam, 1841).
Schubert et al. 5
building codes did a lot to improve the quality of the newly built housing stock, though private
investors usually opposed them. The pinnacle of public health policies based on architectural and
urban interventions was a set of twin laws that were approved in 1901: the Public Housing Law and
the Public Health Law (which replaced its 1865 predecessor).
20
The first revolutionized working-
class housing and slum clearance policies; the latter introduced municipal health committees in
which architects and medical professionals worked together, checking, among other things, all urban
expansion and reconstruction plans.
Rotterdam is representative of all these trends, but its nineteenth-century sanitation efforts began
with a series of exceptional plans. When Josef Stu
¨bben was looking for Dutch examples to include in
his famous handbook, the only suitable example was Rotterdam. First published in 1890, Der
Sta¨dtebau, part of the monumental series Handbuch der Architektur, shows a typical building block
of the type that marked Rotterdam’s rapid growth since the Nieuwe Waterweg (New Waterway).
This canalized lower stretch of the River Rhine triggered a process of unprecedented growth (which
ultimately transformed its port into the largest in the world in the second half of the twentieth
century).
21
In the last two decades of the nineteenth century, the number of inhabitants increased
Figure 2. The second water project. Source: W. N. Rose with park design by J. D. Zocher Jr. (City Archive
Rotterdam, 1858).
6Journal of Planning History XX(X)
from 170,000 to 315,000. No other city in the Netherlands grew as fast as Rotterdam, and therefore,
no other city qualified for Stu
¨bben’s book. Stu
¨bben was looking for planning principles to tackle the
manifold problems caused by urban growth, a phenomenon never before witnessed at this scale.
Strategies were badly needed to address overcrowding, slums, violence, vandalism, criminal beha-
vior—and rapidly deteriorating health conditions that affected the entire urban community.
Proudly presenting itself as the Maasstad (“City on the Meuse” since the Nieuwe Waterweg
coincides with the historical mouth of this river), Rotterdam’s emergence as a major player in
international trading networks resulted in major problems.
22
Here, too, catastrophic health condi-
tions were a reason for concern. They were highlighted by a series of epidemics, notably of Asiatic
cholera, which, as the name suggests, originated in the Far East and entered Europe by ship—which
may be one reason why port cities were among the first to suffer the consequences. In 1832, 1848,
1853, 1859, and 1866, the epidemic hit the city; in 1832, 1,700 people died, and in 1848 no less than
2,000. Various theories evolved as to the origins of the epidemic; conclusive evidence could be
found for none of them. What was clear, however, was that the disease it caused was extremely
contagious. What was also clear was that some parts of the city were hit harder than others. One of
the peculiarities of the urban composition of Rotterdam was the distinction between the old medieval
part, which was protected against flooding by a dike that cut its triangular plan neatly into two, and
the seventeenth-century expansion plan, the so-called water city, which was largely made up of
harbor basins with open access to the river.
The “water city” was much more spacious than the medieval “land city”; moreover, the contin-
uous rhythms of high and low tides guaranteed fresh water twice a day. Although the influx of people
Figure 3. W. N. Rose, Coolpolder project (City Archive Rotterdam, 1858).
Schubert et al. 7
looking for work in the growing city caused overcrowding in all parts, conditions in the medieval
part were much worse than in the water city, allegedly proving one of the medical theories that were
popular at the time: dirty vapors (the “miasma”) were seen as the origin of the all contagious diseases
and of health problems in general. Although medical doctors already guessed that other causes could
also impact health—diets and living conditions—they urged the authorities to do something about
the miasma.
This led to one of the Netherlands’ most interesting infrastructural projects, the so-called water
project in 1841. It was designed by W. N. Rose (who happened to be the grandson of the personal
physician of Frederick the Great of Prussia).
23
His parents lived in Utrecht and, honoring a long-
standing tradition among the Dutch elite, also had a country estate where they stayed during most of
the summer. Rose pursued a military career, studied military and civilian architecture as part of it,
and designed a citadel for the city of Ghent in what is now Belgium but between 1815 and 1830 was
part of the Netherlands. He got to know the city of Rotterdam when he was asked to design a new
hospital; his project for the Coolsingelziekenhuis stands out for its technical innovations, notably a
system of heating and climate control that, at the time, was seen as revolutionary (and illustrates the
importance attributed to fresh air). In 1839, he was appointed city architect. At that time, seven years
had passed since the first cholera epidemic had caused havoc in the city, but the memory of this
disaster was still very much alive. Rose was also well aware of the worsening hygiene conditions, a
consequence of the need to accommodate more people than the city could cope with. And he knew
what needed to be done: the city should safeguard its inhabitants from the dangers inherent in
stinking, polluted air. Miasma had to be banned.
Trying to solve this problem, he encountered yet another of Rotterdam’s peculiar qualities.
Rotterdam joined the rank of Holland’s leading cities only very late. Before the economic boom
of the seventeenth century, which culminated in the construction of the water city, the city ranked
quite low in the hierarchy of urban centers. Nearby Dordrecht was much more powerful and so was
Delft (which also had a direct connection to the sea: Delfshaven, only a few kilometers west of
Rotterdam). One of the consequences of its relatively late rise to dominance was that it had no
jurisdiction over the hydraulic conditions of soil on which it sat. Rotterdam emerged in a polder
landscape that was, like most of the Netherlands, entirely artificial and for the most part below sea
level. Managing the water level required a huge infrastructure of canals, dikes, and the famous
windmills but most importantly a decision-making structure that manages this entire apparatus.
In the Middle Ages, so-called water boards emerged to take care of everything related to water:
including protection against the sea, but above all, the regulation of the water level in the polders.
There were several of these boards, all presiding over their own region. Rotterdam was part of the
area that was administered by the water board of Schieland. Water boards are reputedly among the
first democratic institutions in Europe. Decisions were made by way of voting. Everybody who
owned land was allowed to vote, but the relative weight of votes depended on the size of the land
they possessed. Thus, a relatively small number of landowners in the polders could outvote the much
large numbers of inhabitants of the city.
As long as the interests of the citizens coincided with those of the rural landowners, this inequity
did not matter. Conflicts became inevitable, however, since the owners of rural properties preferred
low water levels, which made working the land a lot easier. The city, on the other hand, opted for a
much higher level, the advantages being that it made the mixture of water and waste less toxic, and
allowed it to flush polluted water into the river at low tide. The only way to solve this conflict was to
separate the urban part of the polder from the rural areas. Rose managed to do this by proposing a
dike and a number of planted canals, called “singels” in Dutch, which were used to control water
levels in the built-up area.
This is the gist of the so-called water project that he proposed in 1841 (Figure 1). The dikes
marked the new border of the city, which was to be enlarged in order to accommodate further
8Journal of Planning History XX(X)
growth. Rose decided to stick to the historical triangular shape of Rotterdam’s urban plan. At high
tide, clean water from the river was let into the canals of the medieval part of the city, and from there
to the as yet empty farmland, where the new expansion plans were to be realized. Polluted water
could flow back to the river at low tide. Superfluous narrow canals in the medieval city were to be
filled in; they no longer served any purpose: if the water did not flow fast enough, it might add to the
problems instead of to their solution. Not surprisingly, nothing came of this plan. Although it made
clever use of the unique features of the Dutch landscape, the authorities deemed it way too expen-
sive. Seven years after this ominous decision, another cholera epidemic struck the city, costing even
more lives than the one of 1832. The municipality asked Rose to redesign his plan, which resulted in
his second water project (Figure 2). In order to embellish this new piece of technical infrastructure,
he asked J. D. Zocher, the Netherlands’ best-known landscape and park architect at the time, to make
plans for what looks like an English landscape garden. It is very similar to the ones introduced in
many Dutch cities when they were allowed to demolish the lines of fortification surrounding them—
the only difference being that the land between the singels and the existing cities was, for the time
being, completely open. The second project was approved in 1854 and endowed the city of Rotter-
dam with a number of luxurious singels.
The water project resulted in a peculiar form of social segregation: the poorer classes lived in
closed urban blocks between them. These were of the type Stu
¨bben showed in his famous handbook.
The first of these blocks lined streets at the center of the relatively narrow, long plots; for a time, the
ditches between them served as open sewages. The water project contributed to a solution at the scale
level of the entire city; among the next steps to be taken was the introduction of a sewage system and
building regulations that made sure that the new housing stock was actually connected to it.
While Rose was working on his revised water project, he began work on one of the most
ambitions projects of the mid-nineteenth century. His Coolpolderplan added a new port with canals,
quays, warehouses and housing (Figure 3). Its most striking feature was its rigid grid – it appeared to
emulate the checkerboard pattern of the typically Dutch polder, while ignoring the structure of the
existing polders. Another remarkable feature was that, again, it referred to the historical city: it was
divided in a land city (corresponding with the medieval city), and a water city (referring to the
seventeenth century ‘water city’. Again, Rose looked to the past as much as he looked to the future.
That may very well be the reason why this project failed. Economic realities in the nineteenth
century had no need for merchants who bought their merchandise, stored it, and sold and shipped
it when they could get a good price. Nor was there a need for ports that accommodated this now old-
fashioned way of doing business. Moreover, space for expansion of the port was very limited at the
northern shore of the Meuse. Recognizing this, Rose also prepared plans for expanding the port on
the southern shore. That is where the future of the port of Rotterdam took shape. Since the late
nineteenth century, huge harbor basins were dug, transforming the areas in between into huge piers.
One of them was Katendrecht, named after the small village that used to be here. Cheap housing for
the people working in the port was built instead, and in the 1910s and 1920s the Netherlands’ first
China town emerged in what not long before had been an Arcadian, pastoral landscape.
London: Cleaning the Pigsty
Urban hygiene would become the Janus-headed companion of urbanization. As early as the 1840s,
studies on housing, living conditions, and the state of health in cities had been carried out under
Edwin Chadwick in Britain. His utilitarian Benthamian approach was based on cleanliness and
morality as a norm of behavior.
24
He “was concerned to strengthen social discipline, to cut the
redistribution of wealth to the non-working population and to enlarge the national economy by
forcing the poor to work in it.”
25
With a mixture of fear, hope, and pride, medical professionals tried
to analyze the dangers and develop solutions. The biggest problem turned out to be the uncontrolled
Schubert et al. 9
discharge of feces into rivers from which drinking water was also obtained (Figure 4). The con-
struction of the sewer system in London under Joseph Bazalgette since the 1840s was an unprece-
dented engineering achievement.
26
It was a response to the “big stink” and the devastating cholera
epidemic of 1832, which also caused havoc in Rotterdam, Petersburg, Berlin, and Hamburg. In
London, the overcrowded slums in the East End near the river suffered most.
27
Bazalgette’s project
fostered the belief that all urban problems could be solved by engineering innovations.
High residential density, dirt, polluted water, poor nutrition, and alcoholism were spatially
clustered but considered as the result of individual behavior: dirt is immoral while cleanliness is
moral. The quantitative process of increased population density in urban areas was in the following
decades coupled with a qualitative change in urban lifestyle, connected to modernization processes
such as the formation of the class system, increasing bureaucratization and participation, the grow-
ing significance of law, and the expansion of mass communication.
28
A study by the US American
Adna Ferrin Weber (1899) provided an impressive piece of evidence of the advanced international
state of city studies at the turn of the century.
29
The empirical study of cities, urban hygiene, housing
conditions, and slums especially in Great Britain was marked by a systematic description of social
realities with its manifestations of poverty, slum misery, and lack of affordable housing. The studies
of Charles Booth (1902) and B. Seebohm Rowntree (1901) are exemplary; they are based on a
thorough quantitative analysis of the problem.
30
Their angle was not an attempt to universally and
theoretically penetrate the problem, as was the case in continental city studies, but instead to offer
analyses of reality to master reality, which is the pragmatic theme of English city studies.
31
Figure 4. Monster soup, commonly called Thames, Caricature 1828 (Paul Pry). Source:Metropole London. Macht
und Glanz einer Weltstadt 1800-1840, Kulturstiftung Ruhr Essen (Recklinghausen, 1992).
10 Journal of Planning History XX(X)
Philanthropists such as Rowntree and the Lever Dynasty, who sponsored the first Chair in Town
Planning in Liverpool later in 1909, were members of the Eugenic Society and other institutions that
were ultimately concerned with interdependencies of health, economic effectiveness, and produc-
tivity.
32
Other reformers proposed to solve the problem by spatially relocating part of the population,
following a strategy of decentralization. This was also the gist of the garden city movement. In 1899,
the Garden City Association was founded in England (following on earlier proposals by Theodor
Fritsch in 1896). The garden city idea must be recognized as one of the most important reform
concepts of the late nineteenth century.
33
It emerged against the background of housing problems in
Figure 5. Map by John Snow with cholera-dead entered in the form of bars in London 1854 (reprint 1874).
Source:Die Zeit (November 12, 2020).
Schubert et al. 11
London and promoted an international model for decentralization and healthy living and housing
conditions. This established an interpretative sovereignty and definatory power that is reproduced
until now with positive and life reformatory connotations.
Representatives of the cultural elite, among them John Ruskin and William Morris, also culti-
vated aversion to big cities and the “masses” who lived there. Anti-urban solutions such as the
relocation of people were suggested as a solution to housing problems and slum misery of big cities.
Fears of “degeneration” and “physical inefficiency” of some of their inhabitants formed the back-
ground of anti-urban movements. In England, the debate developed against the backdrop of social
Darwinism and racist ideologies. The conviction that the processes of natural selection and the
struggle for life might not lead to a healthy population was widely accepted. This prompted argu-
ments that increased state intervention must be organized to renew slum areas and improve living
Figure 6. Drinking water for the poor from wells in London, 1860. Source: Stephen Halliday, The Great Stink of
London and the Cleansing of the Victorian Metropolis (Phoenix Mill, 1999).
12 Journal of Planning History XX(X)
conditions. All in all, though, in England, a realistic and pragmatic approach to the urban problems
prevailed.
34
The negative aspects of urban life city were seen as “unpleasant side effects,” temporary
phenomena that would “go away of their own accord” or be cured with appropriate treatment.
The behavior and bad character of the residents were seen as the major causes of the poor living
conditions in slums. The opponents of reform in England propagated the “pigsty theory” which
stated, “Give a pig a clean sty and he will soon turn it into a muddy, smelly den.”
35
It was generally
believed that “the pig makes the sty and not the sty the pig.” Even so, the concentrated poverty in the
prospering metropolitan cities remained a problem that was difficult to understand.
36
Until well into
the mid-nineteenth century, the belief that poverty was a result of failing morality of the poor, and
thus their own fault, was widely held. The residents of slums, the poor, and the ill were no longer
considered an expression of the will of God but rather the morally reprehensible result of a society
that gave everyone an equal opportunity (Figure 5).
In England, there was a great amount of legislation dealing with common lodging houses (Acts in
1851 and 1853), then with public health (1858, 1860, 1866, 1872, and 1875) and finally with housing
and, in parts slums (1868, 1875, and 1879). In the mid-eighties, the Royal Commission for Housing of
the Working Classes and the Housing of the Working Classes Act introduced more effective national
instruments; it opened ways to work on larger neighborhoods with unhealthy living conditions. Local
idleness, however, prevented the law from being as effective as it promised to be (Figure 6). Nettlefold
stated that there had been twenty-eight housing laws in England in the past half-century, with the
result: “We have to-day comparatively few good houses and a mass of slums.”
37
The first goal of these legislative efforts was aimed at “improving living conditions” through
clearance of large areas and rebuilding, at the same time guaranteeing that the number of housing
units would not decrease. The Boundary Street project, executed by the London County Council since
1896, provided 1,044 new dwellings for about 5,700 people after demolishing all old structures.
When Queen Victoria died in 1901, London was the largest metropolis in the world with 4.5
million inhabitants—without a forward-looking urban development plan—with Balkanized respon-
sibilities and fragmented individual plans. Growth and prosperity contrasted with unsanitary living
and housing conditions and the concentration of people. While London was a metropolis and capital
with a port, Hamburg was a port city in which port and trade dominated the local economy. If
“seaport city” is used as a distinguishing mark for a comparative consideration of the city types here,
specific formative structures and path developments must be taken into account in relation to
characteristic features in each case.
Hamburg—“The Cleanest City in the World”
In Germany, conservatives and reformers, medical professionals, engineers, and architects also
agreed that the big city was unnatural, inherently unhealthy, and unmoral. In parts of Hamburg,
after the Great Fire in 1842, the British engineer William Lindley, a friend of E. Chadwick,
introduced a filtered water supply and alluvial sewerage system (Figure 7). Hamburg’s approach
to improving urban hygiene was seen as modern and progressive—it made the city “the cleanest city
of the world,” according to an author in 1885.
38
The new sanitary facilities were only installed in the
burned down part of the city and at first benefited only the upper and middle classes who lived there;
later, they were introduced to working-class households as well. To “heed nature’s call” in the
privacy of one’s own home meant increased sensitivity, civilization, or refinement of urban life. The
required technology was available from the mid-nineteenth century onward, but mass distribution
failed for one main reason: the lower class could not afford the rent for flats with water closets. The
filtration plant that could ameliorate things had already been decided upon in 1890, but completion
was not planned until 1894.
Schubert et al. 13
In Hamburg, there had been a smallpox epidemic in 1871 and outbreaks of cholera infections in
1831/1832, 1848, and 1873. However, tuberculosis and typhus were the dominant infectious dis-
eases. The Senate mostly hushed up the danger and distinguished itself by inaction.
39
Two contra-
dictory theories circulated in public health care until the end of the nineteenth century: the miasma
and the contagion theories. According to the first, diseases were caused by dirt and miasma;
according to the second, pathogenic organisms and infection were to blame.
40
The miasma theory
became the main basis of the reform of public sanitary conditions and for good reason: in contrast to
the contagion theory, the concept of miasma suggested effective interventions that promised to make
cities much healthier. Preventing close contacts between people in overcrowded slums, which would
have been necessary if the authorities embraced the contagion theory, was much more difficult to
realize than interventions in the urban layout. The initiatives to improve public sanitary conditions
were accompanied by a thrust of modernization and rationalization,
41
the reason being the
Figure 7. Expansion of the sewer system in Hamburg from 1844 to 1863 according to plans by the Englishman
William Lindley. Source: Rolf Spo
¨rhase, Bauverein zu Hamburg Aktiengesellschaft. Entstehung und Geschichte im
Werden des gemeinnu
¨tzigen Wohnungswesens (Hamburg, 1940).
14 Journal of Planning History XX(X)
conviction that health and environment could be manipulated, planned, and controlled. From repres-
sive policies to stimulating measures, discipline was enforced in the name of health behavior.
42
Public health combined two contradictory elements: on the one hand, the positive, innovative
approach that was based on scientific methodology and knowledge and, on the other hand, the views
inspired by social Darwinism and its obsession with inequality and degeneration.
43
The effects of urban hygiene could be statistically underpinned; they inspired urban measures that
promised to be quantifiable as well. If the miasma and “air that makes ill” could be avoided by urban
interventions, this would justify less density in the urban fabric. The physician Max von Pettenkofer,
the German “hygiene pope,”
44
observed that a healthy person consumes five to six cubic meters of
air in his sleep. If the person was prevented from doing so, his organism would be weakened and his
susceptibility to diseases would increase. This led to the idea to fix minimal sizes for bedrooms.
These remained in effect even after scholars found out that polluted water, not miasma, was the main
cause of diseases such as cholera.
45
In 1892 there was another outbreak of cholera in Hamburg.
While in the 19th century, over 10,000 people died of cholera in London, and over 8,000 in Hamburg
in the hot summer 1892. Cholera caused panic and mass exodus from the city. Some people blamed
social minorities, especially Jews from Eastern Europe leaving Europe by boarding ocean liners
docked in Hamburg—thus, fear of plagues could fuel anti-Semitism.
Insufficient information about the spread of cholera was given “mouth-to-mouth” and via daily
newspapers and notices. This spread rumors about contagion and protection options. Panic spread,
Figure 8. Disinfection of ships on the River Elbe. Source:Hamburg in den Zeiten der Cholera, Beho
¨rde fu
¨r Arbeit,
Gesundheit und Soziales (Hamburg, 1992).
Schubert et al. 15
obscure disinfectants and medicines were sold, and people fled from the city (Figure 8). One year
after the catastrophe, the hygiene professor Ferdinand Hueppe summed up: It is an art “to expect and
supply such unqualifiable water to a city.“ [] He also referred to the “relatively strong infestation of
boatmen and workers who use little water but drink the port and tap water”.
46
In 1893 the Senate was
supposed to assume “that in the last cholera epidemic the water was primarily the carrier of the
contagious substance”. But in relation to reforms, this was put into perspective: "Not only sanitary
aspects may not be decisive, but the economic interests of the population must also be taken into
account".
47
Some people blamed social minorities, like the “yellow peril” and especially Jews from the Eastern
Europe on their way to leave Europe by embarking ocean liners in Hamburg—thus, fear for plagues
could fuel anti-Semitism. Between 1850 and 1939, Hamburg formed the “gateway to the world” for
over five million emigrants.
48
While fleeing political or religious persecution, poverty and hunger,
they tried to leave the “Old World” via Hamburg. On the Elbe island of Veddel, next to the port, 30
buildings with space for 5000 people were built for them, a “city within the city” with a synagogue,
church, washrooms and dining halls and rail connection. Before leaving, the emigrants had to spend 14
days in quarantine. Against the background of the experience with the cholera epidemic, an area had
been chosen for the emigrant accommodation that was on the city limits and was easy to isolate.
Faced with all these problems, the authorities of Hamburg were forced by the public opinion all
over Germany to improve the sanitary and housing standards for the majority of its inhabitants.
Beginning in the 1850s, they invested in the infrastructure for clean drinking water and the con-
struction of sewage systems. The mortality rate decreased, and at the turn of the century, urban areas
had a lower mortality rate than rural areas—for many centuries, it had been the other way around.
The metropolis, a new phenomenon, managed to support its inhabitants—those who believed it was
doomed were proven wrong.
What still needed to be solved was the housing problem of low-income groups. In Germany, the
slums—the most notable manifestation of the housing problem—were a relatively new phenom-
enon that only appeared at the end of the nineteenth century. What was new was the extent and
concentration of poverty that had resulted from industrialization processes. People flocking to the cities
were accommodated in older buildings from the preindustrial area and later in small, overcrowded
apartments in rented flats (tenements—“Mietskasernen”). These had a significantly higher urban den-
sity than was common before, and many more people lived in the apartments than ever before. The
tenants of these new buildings, coming from the country, found it difficult to adjust to the standardized
urban mode of behavior: “In their roughness they often smashed [ ...] everything that was not nailed
down to get firewood; their dirty habits, their misuse of water-pipes, toilets etc. were only part of their
mischief that made the life of the landlord hell.” Landlords complained that the rent was paid late. “The
need for a decent, roomy, clean flat was overshadowed by the needs of the stomach.”
49
Households with low incomes, often depending on casual labor, were not able to raise the money to
pay rent for even a small flat. If they aspired to join the ranks of the middle classes and their “self-
contained family housing,” they faced the fact that they could not afford it. Especially highly mobile
workers, such as seasonal workers and workers with shifting schedules, had to be satisfied with renting
beds or parts of rooms. In general, the moral appeals of the bourgeois reformers were not directed at the
“lowest classes” but rather on preventing the lower middle class from sinking into poverty.
Poverty was considered an individual failure in the nineteenth century. In slum clearance proj-
ects, hygienic measures represented a basic strategy of urban health; they often resulted in slum
clearance policies. Apart from embellishment strategies for inner cities and the introduction of
sewage systems, cutting new streets through the urban tissue determined planning and construction
in many cities. Often, these streets were introduced in the oldest, overpopulated quarters where
mainly low-income groups lived. They were realized at the expense of cheap, centrally located
housing and were counterproductive in terms of housing policy. Since there was hardly ever enough
16 Journal of Planning History XX(X)
budget to clean up entire slums, the sanitation policies usually stopped short at the construction of
these new streets.
In Germany, the combined interests of house and landowners, land speculators and banks, and the
electoral law prevented a housing law from being passed until 1918. The Reichstag referred to the
diversity of circumstances and denied responsibility.
50
Nor was there was any legislation on slum
clearing at the national level, though some cities (like Hamburg) carried out slum clearance policies
on their own initiative. Among the lessons learned was the growing awareness that changes in the
status of the inhabitants were imperative for the improvement of living conditions; this called for the
involvement of private market initiatives alongside public interventions.
In Hamburg, the area of Su
¨dliche Neustadt, often flooded and with insanitary housing conditions,
was filled with old buildings that were demolished and replaced by 4,500 new (more expensive) flats
for about 21,000 people.
51
In inner-city areas, old buildings (mainly housing) were replaced by new
buildings that were mainly used for tertiary uses. The No¨rdliche Altstadt was reconstructed and
endowed with a subway line that created a better connection with Town Hall; it included a modern
central business district.
52
With the clearing of all old buildings in the “Ga¨ ngeviertel”—where
prostitution, crime, and dissent were common, about 17,000 persons were forced to look for new
accommodation.
The German Otto Schilling was one of the first to identify the emergence of a new type of city
center in his work on “inner urban expansion.” “The old town remains the site of trade and becomes
Figure 9. Field hospital with Cholera barracks 1892 in Hamburg (to the left of the Eppendorf hospital)
Source:Ausstellung des Museumspa
¨dagogischen Dienstes Hamburg (Hamburg, 1992).
Schubert et al. 17
more of a commercial center as the growing outer neighborhoods expand. [ ...] This restructuring
process is generally called the emergence of a city centre, after the typical example of the city center
of London. In London’s city center all roads cross, and not just those of the city of London or of all of
England, but of much of the world.”
53
Immense costs and implementation problems caused the
failure of many ambitious clearance projects in large areas. In England and Germany, only a few
projects were carried out. “The activity of German cities will generally be limited to clearance of
small areas for new streets for transportation and canalisation purposes as well as to level areas,”
wrote Josef Stu
¨bben.
54
The phenomenon of emerging city centers was thus already identified and
studied before the First World War: “City center emergence means the conversion of the inner city
from a housing area to a business area. [ ...]. ‘Agglomeration,’ and ‘accumulation,’ is not only
apparent, but rather a distinct differentiation of the evolution of the metropolis within the city can be
observed.”
55
In inner urban expansion projects, the displacement of the original inhabitants was, as a
rule, not considered a problem.
56
On the contrary, it was often even a declared goal. “The emergence
of a city centre seems to be a necessary, or at least useful effect of urban agglomeration.”
57
Offering
housing as compensation, when it was even considered, usually meant that the original inhabitants
had to move to another part of town to housing that was developed by the market.
Medical narratives of order and disorder, planned and unplanned, and healthy and sick found their
way into urban development. It is no coincidence that the concept of renovation (“Sanierung”)
comes from medicine, and the German concept of urban health (“Stadtgesundung”) is also borrowed
from medicine. At the beginning of the twentieth century, new paradigms were added to the debate
Figure 10. Defined slum areas (black) after the cholera epidemic 1892 in Hamburg with around 21,000 people
affected, the implementation took more than thirty years Source:Hygiene und Soziale Hygiene in Hamburg
(Hamburg, 1928).
18 Journal of Planning History XX(X)
on urban hygiene. Military suitability and racial discussions began to play a role. The urban way of
life with its outgrowths, the slums, was classified as the cause of degeneration.
The First World War was not over, when the Spanish flu raged around the world - including
Hamburg.
58
Dragged in from overcrowded barracks in the USA, the soldiers were sent to the front,
mainly via the port in Brest in France.
59
In Germany over 250,000 flu deaths were counted, in 1918/
19 and worldwide the flu should claim more deaths than the world war.
60
There were German
defeats at the front, last offensives ended with high losses and after the capitulation thousands of
soldiers returned to their homeland, where the revolution had broken out and events rolled over. In
Hamburg, the Senate had learned no lessons from the cholera epidemic in 1892 and cases of illness
were not isolated early on (Figures 9 and 10). Press censorship prevented education about the deadly
flu. The first wave was soon to be followed by a second wave and the Spanish flu ultimately claimed
more deaths than the First World War. It is estimated that almost 2,000 people in Hamburg suc-
cumbed to the flu-related pneumonia.
Conclusion and Outlook
This article focuses on urban hygiene in port cities. Successful though these operations undoubtedly
have been, there are also some aspects that need critical assessment. From a methodological point of
view, the discipline of urban planning—still in its formative years—leaned heavily on the scientific
approaches of medicine on the one hand and social and cultural ideas inspired by Darwinism on the
other. These allegedly gave planning a solid base in science. However, from today’s perspective,
many of these ideas were false and unfounded. Their use in urban planning projects resulted in the
destruction of slums, with, in some cases, the clear goal to erase the “race” of slum dwellers as well.
As long as it was assumed that the slum dwellers were a “low race” who passed on their “inferior
genome,” eugenic measures had to be a perspective of “population improvement.”
61
Though no political constellation put them in practice as radically as Nazi Germany, a large part
of the international scientific community held these views. Social contexts were interpreted by a
biological school of sociology, which also partly adopted the conceptual apparatus of biology, as
organisms (society) with different cells (people) and cell structures. The theories of English thinkers,
Malthus’ population law, and Darwin’s struggle for existence were transferred to social phenomena
by Herbert Spencer and were very well received in Germany.
62
They underwent a reinterpretation
from the aspect of inheritance and natural selection, which examined urbanization processes pri-
marily from the perspective of racial selection. Social hygiene measures would counteract the
degeneration of people.
63
And so, hygienically based narratives provided scientific evidence for
the need to demolish or renovate backward slums.
Port cities are not “unhealthy” per se. Such discussions need to acknowledge the multitude of
peculiarities of the working world at the water’s edge.
64
Port cities were and are “laboratories of
modernity,” in which not only economic, social, political, and cultural but also health and epide-
miological dimensions of the globalization process are reflected.
Now, scholars are mainly interested in another question: Did it work? And if so, what made it
work? In order to find out, a clear analysis of the urban strategies and the built artifacts is needed.
What type of water control? Which system of sewages? How did the plans for slum clearance plans
impact the areas that they targeted? What can we learn from all these today? Most of the strategies
we described responded to epidemics—now, 85 percent of the burden of diseases associated with
so-called noncommunicable diseases like cancer and heart failure, and these are to a large extent
determined by lifestyles. The effects of the built environment can partly explain these: sedentary
lifestyles, lack of accessible and programmed greenery, social isolation, and food deserts.
COVID-19, however, disastrous its consequences, is only a temporary phenomenon that will not
have a lasting impact on public health—in the Netherlands, for instance, the number of people
Schubert et al. 19
expected to die of the consequences of smoking will be much higher, and the same is true for
unhealthy lifestyles. Even so, the COVID-19 pandemic does illustrate something important: very
often, the medical world can do very little, and we need to resort to tactics known in preindustrial
times such as isolation and quarantine. It is as if COVID-19 has transformed the entire world into one
big, global, vulnerable port city.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/
or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this
article.
ORCID iD
Carola Hein https://orcid.org/0000-0003-0551-5778
Notes
1. The hoisting of the yellow flag (“Q”) indicated that there were contagious diseases aboard a ship or that the
ship was coming from a contaminated port.
2. Carola Hein, “Modern Cities: Interactions: Port Cities,” in Oxford Handbook on Cities in History, ed. P.
Clark (Oxford, UK: Oxford University Press, 2012) 809–827; Carola Hein, Port Cities. Dynamic Land-
scapes and Global Networks, 1st ed. (New York: Routledge, 2011).
3. Richard J. Evans, Tod in Hamburg. Stadt, Gesellschaft und Politik in den Cholera-Jahren 1830-1910
(Reinbek: Rowohlt, 1990), 159.
4. Khattiya Pannindriya, “A Contest of Kampong Improvement Program amid the Plague in Java,” Groningen
2020 (Master diss., not published).
5. Jo¨rg Vo¨gele, “Tore zum Tod?: Sterblichkeit in europa¨ischen Hafensta¨dten des 19.Jahrhunderts,” in Panor-
ama maritime, ed. Schiff und Zeit (2020), 28–32; Jo¨rg Vo¨gele, Sozialgeschichte sta¨dtischer Gesundheits-
verha
¨ltnisse wa
¨hrend der Urbanisierung (Berlin, Germany: Duncker & Humblot, 2001).
6. Carola Hein and Dirk Schubert, “Resilience and Path Dependence—A Comparative Study of the Port
Cities of London, Hamburg and Philadelphia,” Journal of Urban History (2020): 1–31; Carola Hein and
Dirk Schubert, “Resilience, Disaster and Rebuilding in Modern Port Cities,” Journal of Urban History
(2020): 1–15.
7. Stan Hugill, Sailortown (London, UK: Routledge & Kegan, 1967); Timo Heimerdinger, Der Seemann: Ein
Berufsstand und seine kulturelle Inszenierung (1844-2003) (Ko¨ln, Germany: Bo¨hlau Verlag, 2005).
8. Robert Lee, “The Seafarers’ Urban World: A Critical Review,” International Journal of Maritime History
XXV, no. 1 (2013): 23–64.
9. Michael B. Miller, Europe and the Maritime World: A Twentieth Century History (Cambridge, UK:
Cambridge University Press, 2012).
10. Wolfgang Rudolph, Die Hafenstadt: Eine Maritime Kulturgeschichte (Erfurt, Germany: Edition Leipzig,
1979).
11. Doug Saunders, Arrival City: How the Largest Migration in History Is Reshaping Our World (New York:
Vintage, 2010).
12. Flemming Christiansen, Chinatown Europe: Identity of the European Chinese towards the Beginning of the
Twenty-first Century (London, UK: Routledge, 2003).
13. Alan Palmer, The East End: Four Centuries of London Life (London, UK: John Murray, 2000).
14. Hein and Schubert, “Resilience and Path Dependence,” 2020; Hein and Schubert, “Resilience, Disaster and
Rebuilding,” 2020.
20 Journal of Planning History XX(X)
15. Wilhelm Ruprecht, Die Wohnungen der arbeitenden Klassen in London (Go¨ttingen, Germany: Vanden-
hoeck & Ruprecht, 1884), 177–214.
16. Anthony S. Wohl, Endangered Lives. Public Health in Victorian Britain (London, UK: Dent, 1983).
17. Enid Gauldie, Cruel Habitations: A History of Working Class Housing 1780-1918 (London, UK: Allen &
Unwin, 1974), 132; John W. Burnett, A Social History of Housing 1815-1985 (London, UK: Routledge,
1986), 121.
18. E. S. Houwaart, De hygienisten: artsen, staat en volksgezondheid in Nederland, 1840-1890 (Groningen, the
Netherlands, 1991).
19. Henk van Zon, “Nederlandse Hygie¨nisten. Tussen droom en werkelijkheid, 1850-1875,” Groniek. Histor-
isch Tijdschrift 131 (1995): 176–86.
20. Cor Wagenaar, Town Planning in the Netherlands since 1800: Responses to Enlightenment Ideas and
Geopolitial Realities (Rotterdam, the Netherlands, 2015), 206–11.
21. Joseph Stu
¨bben, J. (1890): Der Sta
¨dtebau, Braunschweig-Wiesbaden, Reprint 1980, (3. ed. 1924). p. 299.
22. Carola Hein and Paul van der Laar. “The Separation of Ports from Cities: The Case of Rotterdam,” in
European Port Cities in Transition, ed. Angela Carpenter and Rodrigo Lorenzo (New York: Springer,
2020), 265–286.
23. Hetty E. M. Berens, W. N. Rose 1801-1877. Stedenbouw, civiele technie en architectuur (Rotterdam, the
Netherlands, 2001), 105.
24. Samuel Edward. Finer, The Life and Times of Sir Edwin Chadwick (London, UK: Methuan & Co., 1952),
35.
25. F. B. Smith, The People’s Health 1830-1910 (London, UK: Weidenfeld & Nicholsen, 1990), 350.
26. Stephen Halliday, The Great Stink of London: Sir Joseph Bazalgette and the Cleansing of the Victorian
Metropolis (Phoenix Mill: Sutton, 2001); D. Schubert, “William Lindley und London, ‘das riesenma¨ßige
Stadtungeheuer an der Themse’ im 19. Jahrhundert,” in William Lindley Konstrukteur der modernen Stadt
in Hamburg und Europa 1808-1900, ed. O. Pelc and S. Gro¨tz (Hamburg: Do¨lling & Galitz, 2008), 92–111.
27. Norman Longmate, King Cholera: The Biography of a Disease (London, UK: H. Hamilton, 1996).
28. Ju
¨rgen Reulecke, Geschichte der Urbanisierung in Deutschland (Frankfurt am Main, Germany: Suhrkamp,
1985), 13.
29. Adna Ferrin Weber, The Growth of Cities in the Nineteenth Century: A Study in Statistics (New York,
London, 1899, Reprint 1968).
30. Charles Booth. Life and Labour in London, 17 Vols. (1902), First Series Poverty, 4 Bd., Second Series
Industry, 5 Bd., Third Series, Religion Influences, 7 Bd., Final. Notes on Social Influence, Conclusion, 1
Bd., (London: Macmillan; and B. Seebohm Rowntree, 1901).
31. Elisabeth Pfeil, Großstadtforschung, Entwicklung und gegenwa¨ rtiger Stand (Hannover, Germany: Gebru
¨-
der Jaenicke Verlag, 1972), 96.
32. Greta Jones, Social Hygiene in Twentieth Century Britain (Beckenham, UK: Croom Helm, 1986), 51.
33. Stephen V. Ward, ed., The Garden City: Past, Present and Future (London, UK: Spon, 1992).
34. Andrew Lees, Cities Perceived, Urban Society in European and American Thought, 1820-1940 (Manche-
ster: Manchester University Press, 1985), 178.
35. Gauldie, Cruel Habitations, 27.
36. Anthony Sutcliffe, “Stadtpolitik und sta¨dtische Umwelt in Großbritannien zwischen 1875-1900: Zum
Siegeszug der Stadthygiene,” in Sta
¨dtebaureform 1865-1900, Von Licht, Luft und Ordnung in der Stadt
der Gru¨ nderzeit, ed. J. Rodriguez-Lores and Juan, G. Fehl (Hamburg, Germany: Christians, 1985), 64.
37. John Sutton Nettlefold, Practical Housing (Letchworth, UK: Garden City Press, 1908), 1.
38. Quoted by Evans, Tod in Hamburg, 186.
39. Ibid., 293.
40. Alfons Labisch, Homo Hygienicus. Gesundheit und Medizin in der Neuzeit (Frankfurt, Germany: Campus,
1992), 114.
Schubert et al. 21
41. Marianne Rodenstein, Mehr Licht mehr Luft. Gesundheitskonzepte im Sta¨dtebau seit 1750 (Frankfurt,
Germany: Campus, 1988), 13.
42. Labisch, Homo Hygienicus, 110.
43. Juan Rodriguez-Lores, “Stadthygiene und Sta¨dtebau: Zur Dialektik von Ordnung und Unordnung in den
Auseinandersetzungen des Deutschen Vereins fu
¨rO
¨ffentliche Gesundheitspflege 1868-1901,” in Sta
¨dte-
baureform 1865-1900, Von Licht, Luft und Ordnung in der Gru
¨nderstadt (Stadt-Planung-Geschichte Bd. 5
I und 5 II), ed. J. Rodriguez-Lores and G. Fehl (Hamburg, Germany: Christians, 1985), 27.
44. Dieter Schott, Europa¨ ische Urbanisierung (1000-2000) Eine umwelthistorische Einfu¨hrung (Ko¨ ln: Bo¨hlau
Verlag, 2014), 240.
45. Evans, Tod in Hamburg, 1990.
46. Ferdinand Hueppe, Die Cholera-Epidemie in Hamburg 1892: Beobachtungen und Versuche u¨ ber Ursa-
chen, Beka¨ mpfung und Behandlung der asiatischen Cholera (Berlin, Germany: Verlag August Hirschfeld,
1893), 4, 9.
47. Mitteilungen des Senats an die Bu
¨rgerschaft, Erster Bericht der Senats- und Bu
¨rgerschaftskommission fu
¨r
die Pru
¨fung der Gesundheitsverha
¨ltnisse Hamburgs, 27. Januar 1893 (Hamburg, Germany: Lu
¨tcke &
Wulff, 1894), 79, 94.
48. Simone Blaschka-Eick, In die Neue Welt! Deutsche Auswanderer in drei Jahrhunderten (Hamburg, Ger-
many: Rowohlt, 2020).
49. Clemens Wischermann, Wohnen in Hamburg vor dem Ersten Weltkrieg (Mu
¨nster, Germany: E. Coppen-
rath Verlag, 1983).
50. Lutz Niethammer, “Ein langer Marsch durch die Institutionen. Zur Vorgeschichte des preußischen Woh-
nungsgesetzes von 1918,” in Wohnen im Wandel, ed. L. Niethammer (Wuppertal: Hammer, 1979), 375.
51. Dirk Schubert, “Von der Katastrophe zur ‘Gesundung’, Stadthygiene, Sta¨dtebau und Sanierung nach der
Cholera 1892 in Hamburg,” in Stadthygiene und Abwasserreinigung nach der Hamburger Cholera-Epi-
demie, ed. Th. Hapke (Herzberg, Germany: Traugott Bautz, 1993), 11–40; Dirk Schubert, “Stadthygiene
und ‘Stadtgesundung’ in Hamburg nach der Choleraepidemie 1892—die Sanierung der Su
¨dlichen
Neustadt,” in Macht Stadt krank? Vom Umgang mit Gesundheit und Krankheit, ed. Dittmar Machule and
Arnold Sywottek (Hamburg: Do¨ lling und Galitz, 1996), 102–119.
52. Dirk Schubert, Stadterneuerung in London und Hamburg: Eine Stadtbaugeschichte zwischen Modernisier-
ung und Disziplinierung (Braunschweig, Germany: Vieweg Verlag, 1997).
53. Otto Schilling, Innere Stadterweiterung (Diss. Ko
¨nigl. Sa
¨chs. Hochschule Dresden) (Berlin: Der Zirkel,
1915), 1.
54. Joseph Stu
¨bben, Der Sta¨dtebau, Braunschweig-Wiesbaden, 3rd ed. (Braunschweig, Wiesbaden: F.
Vieweg1924; repr., 1890), 299.
55. Joseph Brix, Hugo Lindemann, Otto Most, Hugo Preuss , A. Su
¨dekum, Handwo¨ rterbuch der Kommunal-
wissenschaften: 4 Bd. und 2 Erga¨nzungsba¨nde (Jena: Fischer), 1918–1927).
56. Sigmund Schott, Die großsta
¨dtischen Agglomerationen des Deutschen Reichs 1871-1910 (Schriften des
Verbandes deutscher Sta
¨dtestatistiker Heft 1) (Breslau, Poland: W. G. Korn, 1912), 69.
57. Brix/Lindemann/Most/Preuss/Su
¨dekum, 1918-1927, ed., p. 520.
58. Alfred W. Crosby, Epidemic and Peace 1918 (Westport, CT: Greenwood Press, 1976), 38.
59. Harald Salfellner, Die Spanische Grippe: Eine Geschichte der Pandemie von 1918 (Prague, Czech Repub-
lic: Vitalis, 2018).
60. Laura Spinney, L1918 Die Welt im Fieber (Mu
¨nchen, Germany: Carl Hanser Verlag, 2018).
61. R. G. Davis, “Slum Environment and Social Causation,” Westminster Review CLXVI (1906): 251–55.
62. Alfred Grotjahn, “Soziale Hygiene und Entartungsproblem,” in Soziale Hygiene. Handbuch der Hygiene,
Vierter Supplement Band, ed. Th. Weyl (Jena, Germany: G. Fischer, 1904), 734.
63. Theodor Weyl, Soziale Hygiene. Handbuch der Hygiene. Vierter Supplement Band (Jena, Germany: G.
Fischer 1904), VI.
22 Journal of Planning History XX(X)
64. Jo¨rg Vo¨gele, “Hafenstadt und Gesundheit im 19,” Jahrhundert, Informationen zur modernen Stadt-
geschichte 2 (2003): 14–117.
Author Biographies
Dirk Schubert is professor for urban planning, comparative planning history, housing and urban renewal at
Hafencity University in Hamburg. His last authored and (co-)edited books are on Jane Jacobs, transformation of
urban waterfronts, on housing reform, urban renewal und urban planning history. Reform Housing in Hamburg
and Altona with a comparative perspective to other German and European Cities in the 1920, published on 2021
is his final book.
Cor Wagenaar studied history at the University of Groning before specializing in the history of architecture
and urbanism at the same university. In 1993 he published a PhD-thesis on the reconstruction of Rotterdam. In
1995 he joined the University Medical Center of Groningen where he was in charge of various research projects
in healthcare architecture; these culminated in a number books. In 2000 he joined Delft University of Tech-
nology, where he still works as an associate professor. In 2014 he was appointed Thomassen `a Thuessink
Professor at the University of Groningen, which focuses on the relation between architecture, urbanism and
health, and in 2016 he was appointed a full professorship in the history and theory of urbanism at the same
university; both chairs merged in 2019. He is head of the Expertise Center Architecture, Urbanism and Health
(a-u-h.eu), the unique quality of which is that it starts from the perspective of architecture and urbanism, instead
of public health. He lives and works in Groningen and Berlin.
Carola Hein is professor of history of architecture and urban planning at Delft University of Technology. Her
authored and (co-) edited books include Urbanisation of the Sea (2020), Adaptive Strategies for Water Heritage
(2019), The Routledge Handbook of Planning History (2018), Port Cities (2011), Cities, Autonomy and
Decentralisation in Japan (2006), The Capital of Europe (2004), and Rebuilding Urban Japan after 1945 (2003).
Schubert et al. 23
