For the Kids

In the second half of the 19th century, Atlantic City, New Jersey, became a popular destination for beach goers looking to escape the city. Many of these tourists came from nearby Philadelphia.

Meghan Crnic: They had noticed that, when they brought their children there, their children just seemed particularly healthy and happy and robust.

Ed Ayers: This is historian Meghan Crnic.

Meghan Crnic: They began to sort of think about how they could provide those same benefits to the many, many children who were sort of stuck in the city during the summer months.

Ed Ayers: As in the city’s poor and working class children who couldn’t afford a trip to the beach. One of these socially-conscious tourists came across a book by a French physician named Andre Brochard.

Speaker 19: Sea-Air and Sea-Bathing for Children and Invalids.

Ed Ayers: Brochard advocated for the healthful effects of ocean-side retreats for children.

Speaker 19: Seeing every day the little ones bathing, walking on the sands, fishing, or otherwise disporting themselves, breathing with delight the salt breezes which gave them strength and health, one thought more than once struck me vividly: there are physicians who have never seen the sea, living at the great distance from its shores. These are consequently ignorant of the resources which marine medication offers to the practitioner in the disorders of children.

Brian Balogh: Inspired by Dr. Brochard, philanthropists decided to build a hospital to serve the city’s poor and ailing children. The Children’s Seashore House opened in Atlantic City in 1872. Mothers often accompanied their children to the sea, where they could receive treatment at a low cost.

Meghan Crnic: If they were in the main hospital building, a lot of times, those children would have more chronic conditions such as what would be referred to as non-pulmonary tuberculosis or surgical tuberculosis. One of the peculiarities about children, when they contract tuberculosis, is that it doesn’t, generally speaking, manifest itself in the lungs, but rather in the bones and in the joints, in which case the children who would have tuberculosis would oftentimes have what they would refer to as sort of bone deformities. Children could be bent over, it could exist in their spines and in their hips.
Rickets was another one which, at the time, wasn’t fully understood in the same ways we understand it today, which would be a lack of vitamin D. They were oftentimes coming with what was politely called summer complaint, which is also known as diarrhea, and so it was children who had really bad gastrointestinal disorders. Those were really the children who were most vulnerable of dying during the summer months, when infant mortality in Philadelphia could reach upwards of about 25%.

Brian Balogh: Well, I’d love for you to pick a specific child and describe him or her to us and take us through his or her day.

Meghan Crnic: Sure. One of the few sources that I have that actually came directly from a parent was a woman who had written a thank you letter to this Philadelphia Inquirer for publishing an article about the Children’s Seashore House. She wrote about how she had been desperately seeking treatment for her daughter because her daughter had rickets and, despite being three years old, she said that she was no larger than a six-month-old at the time and was unable to walk because of the disease. Despite her best efforts, no physician had been able to really help her, and so she wrote to the Children’s Seashore House and asked for admission for her and her daughter, Amy. The physicians at the Seashore House told her to come down and she took the train from the Wilkes-Barre/Scranton area.
During the day, for the most part, what would happen is they would wake up in the morning, there would be medical rounds where the physician would go around and visit the children and see how they were doing, after which they would then go out in the ocean and they would play. Depending upon the time period, there were more or less strict regiments about how frequently and how often children could sea-bathe. At least in the 1870s, they were very strict. They believed that being in the ocean for more than four minutes could result in horrible things happening to you. You could get headaches, you could faint, you could become profoundly dizzy, you could even die if you stayed in the ocean too long.

Brian Balogh: This is even if you’re healthy?

Meghan Crnic: Yes, even if you’re healthy. They had … Actually, in the book written by Brochard, he details it very specifically that there are three phases that swimmers and bathers go through, and you wanted to sort of remove yourself before that third phase, where you were sort of losing all the benefits. You wanted to remove yourself before that. At least at one point in time, they had some very strict regiments.
Those were eventually kind of loosened up, but it was almost always done … The sea-bathing was almost always done under the supervision of nurses to make sure the children were bathing properly. For children who weren’t able to walk themselves out into the ocean, they would actually have bathers who could carry the … They would be adult men who would carry the children out into the ocean, sometimes just in their arms, sometimes they would have specially-devised baskets or slings for children.

Brian Balogh: What were the specific benefits for children of these brief stints in the ocean?

Meghan Crnic: One of the things that they found was that open wounds that were associated with tuberculosis that they referred to as sinuses, those sinuses would actually close. This was a problem that physicians in urban hospitals were really trying to solve. They were coming up with all sorts of technological interventions and they just had a really hard time figuring out how to successfully treat those wounds. The conclusion ended up being that the benefits of sort of washing out those wounds with the saline water, the ocean water, really did help those wounds heal successfully.
The ocean also had the benefits of having children move more, so getting them physically active, getting them moving, which would in turn increase their metabolism, which was one of the sort of holistic benefits, really, of the time at the shore that people attributed not only to the sea-bathing but also to just the benefits of being in the ocean breezes.
Really, for the most part, they would be doing a lot of the things that would have looked familiar to tourists while they were there. They were flying kites, they were building sandcastles. There’s lots of images of just children playing on the beach that looked very, very similar to other activities that children would have been partaking in on either side of the institution.

Brian Balogh: As you’ve described it, certainly the Atlantic City hospital was funded by people who were tourists themselves, so obviously a large wave of tourism had already begun. Did this tourism, which only increased in volume, did it vie or did it sit in tension with the healthful purposes of these hospitals? Did they become competitors, if you will?

Meghan Crnic: There was some tension that existed. As more tourists came, the original hospital building in Atlantic City was very near the center of town and so buildings were being constructed around the hospital that were obstructing its breezes. The physician, just in a single sort of note, said that the tourists did not always appreciate having to view patients and sick patients on the beach while they were there on their vacations, and so they actually moved the hospital pretty far down the beach.
I actually think that the hospitals served an important role within these communities to help maintain those longer standing associations within leisure and health when there was very much this notion that maybe leisure wasn’t totally acceptable yet but health-seeking was. Physicians published a lot of medical journal articles, published from one another. They also published popular books that really detailed just how healthy the seascape was for people, which all stood very much in stark contrast to the urban environment from which most people were coming.

Brian Balogh: Yes.

Meghan Crnic: I think, within these places certainly like Atlantic City, which very much promoted itself as a family-friendly environment, that having something like a Seashore House where tourists could go and visit and remind themselves of those health practices that really underpinned their leisure practices was a beneficial reminder, in some ways.

Brian Balogh: Right. It was almost an excuse for relaxing, but one that was acceptable to society. Getting healthy would make you more productive in the long run.

Meghan Crnic: Absolutely. That’s exactly what this was about. Even for children, the idea was sort of to be able to build up these children’s bodies and strengths to be able to withstand the kind of forces of living in an urban city, with the idea that they were going to be the future workers of America.

Brian Balogh: There does seem to be a strong assumption that beaches are a healthy or healthful place, well into the 20th and 21st century. Would you agree with that? Do you think that has … If you do, you think that has anything to do with the seaside hospitals that you work on?

Meghan Crnic: I do. I think that a lot of these practices that really began in the 19th century remain with us as our sort of cultural traditions. Certainly, my family likes to tease me every time we go to the beach about how healthy they feel when they’re down there. I fully embrace that. I think that it’s one of those really fascinating things where I think people still feel it and people still sense it, but we’ve lost a medical language in which we can really describe the impacts that we’re feeling.
One of the things that I love and am intrigued by is that there is today, within medical practice and especially pediatrics, a re-emergence of attention to the myriad benefits that nature can provide. There are a lot of really great scientific studies that are coming out now about the benefits of being out in both green space and what some medical geographers refer to as blue space, which is being near an ocean. I think it’s coming back, in some ways.

Brian Balogh: Meghan Crnic is a historian at the University of Pennsylvania.