An Inflammation of Place

On the symptoms and spread of Newyorkitis.

By Charlee Dyroff

Monday, February 10, 2020

The “El” at Bowery and Division Street, Manhattan, 1936. Photograph by Berenice Abbott. The New York Public Library, The Miriam and Ira D. Wallach Division of Art, Prints and Photographs.

At the turn of the twentieth century, the surgeon Dr. John H. Girdner started to notice something peculiar about his Manhattan patients. Girdner had left his home state of Tennessee to study at New York University and worked his way up the medical ranks, even attending to President James A. Garfield when he was shot. After twenty-five years of treating patients in the big city, Girdner decided to write his findings in a book. “A very large percentage [of people] lead an artificial life here,” he warned. “This manner of life has brought about a condition of mind, body, and soul, which I have endeavored to describe under the title of Newyorkitis.”

In what a Nashville American review described as a “merciless diagnosis,” Girdner’s 1901 book Newyorkitis dedicated over two hundred pages to breaking down the effects that living in Manhattan has on a person’s health. The suffix -itis generally denotes an inflammation, and Girdner explained how those who inhabit the city and are exposed to incessant noise, tall buildings blocking the horizon, and a culture obsessed with money could get “their New York inflamed.”

The media saw evidence of Girdner’s syndrome everywhere. In 1905 the New York Tribune published a report about the disease claiming that “there were three thousand cases of men falling dead or dying suddenly, an increase of five hundred over any previous year.” “The pace of the average New Yorker,” the article concluded, “is not only too fast, it is deadly.” The newspaper quoted Girdner at length to emphasize the severity of the epidemic that had struck the city:

New York at the present time is not reproducing itself. We are all living swiftly, dying swiftly. Were it not for the influx from out of town the decrease in population would soon be noted. But as it is, for one New Yorker that dies two strangers take up their abode in the city, and thus the loss is not noticed. New Yorkers are driving themselves and are being driven like beasts of burden. They are working like dynamos all day, playing like idiots at night.

A year later the New York Times ran a feature about a hotel in New Jersey where “physicians are sending patients [to] take a course of hydrotherapy baths as a cure for a nervous malady which they have diagnosed as ‘New Yorkitis.’ ” And as late as 1934 the New York Herald reported that the Hunter College health services department was being reorganized to fight “the chaos caused by a continuous combination of physical and mental shocks” seen in students as a result of Newyorkitis.

From The Commoner, July 12, 1901. Library of Congress, Chronicling America.

New York was a place of substantial flux and chaos when Newyorkitis was first published. Between 1870 and 1900 over twelve million immigrants arrived in the United States, and more than 70 percent of them entered the country through Manhattan, which became known as “the Golden Door.” This continuous stream of people meant more noise, more traffic jams, more pollution, and more sanitation problems. At the same time innovations and expansions in steamship and railroad infrastructure increased trade in the region; almost 70 percent of all U.S. imports entered via Manhattan by 1884. Technological inventions such as electric lights and wireless radio changed the pace of society and the length of time people could spend working. New York became known as the capital of commerce, opportunity, modernity—but also the epitome of the fast life in a way that both excited and frightened people, whether they lived in the city or watched it from afar. And it was this buzz, this extreme growth and new style of living, that invited questioning and analysis; it provided an opportunity for ideas like those in Girdner’s Newyorkitis to catch on and spread like a disease.


What does it mean to be diagnosed with an inflammation of place? In the book Girdner listed physical symptoms such as nearsightedness caused by looming buildings limiting vision in every direction, irritated ears from the constant noise in the streets, and a “rapidity and nervousness and lack of deliberation in all muscular movements.”

City Hall Station, Manhattan, 1904. The New York Public Library, The Miriam and Ira D. Wallach Division of Art, Prints and Photographs.

While Girdner was concerned with the physical manifestations of Newyorkitis, he was more interested in the moral and mental states of the city’s denizens. The egotism of New Yorkers and the pompousness with which they lived was the focus of the longest section of his book. He argued that these symptoms—self-centeredness, lack of faith, and greed—“are found in all classes of society,” although they were especially prominent in “better classes.”

“One of the most pronounced symptoms of Newyorkitis,” he wrote, “is a circumscribed mental horizon. The patient thinks in a circle bounded by the confines of Manhattan Island.” By these measurements no one was immune from the disease or could “resist some degree of inoculation” after living on the island for a few years. He worried women were particularly susceptible, becoming “paralyzed to such an extent that [their philoprogenitiveness, or love of offspring] takes on an entirely abnormal character.” In their delusion, they may place “natural maternal love and devotion on a dog, a cat, a bird, or some other of the lower animals.”

And in one brief paragraph, Girdner explained how “Newyorkitics,” or those affected by the disease, will brush those aside who try and engage in a conversation about the mistreatment of people of color. They are too busy being blinded by material desires to care about civil rights, politics, or anyone outside themselves. These moral cases of Newyorkitis will call “you a ‘traitor’ when you tell him that this nation is again engaged in wronging a colored people.”

According to Girdner, most people who had a case of Newyorkitis didn’t have the slightest clue they were sick. They were too submerged in city life to understand what was happening to them. It wasn’t until after Newyorkitis was published that medical professionals, the media, and stricken individuals finally had a name under which to file all sorts of so-called symptoms of living a fast-paced city life, whether physical, mental, or moral. Suffering from burnout? You’ve got Newyorkitis. Apathetic? You’ve come down with Newyorkitis. Live in New York? You probably can’t escape a case of Newyorkitis.


Even though Newyorkitis was used to diagnose a variety of medical issues, it was most commonly associated with neurasthenia, overworking, and burnout. Girdner’s knowledge of these symptoms came not just from working as a doctor but also from personal experience. A 1901 Nashville American profile by Henry Francis Beaumont revealed that Girdner had overworked himself and gone into a period of mental decline after moving to New York City in the 1880s. “It is a fact known to but few people, and by them carefully guarded,” Beaumont wrote, “but for eighteen months the young surgeon’s mind was deranged, it was at first thought forever.” His father and a “skilled professional associate” spent nearly two years in England reviving Girdner’s health and sanity.

Upon returning to New York, Girdner built himself a reputation as a skillful doctor. He was known as one of the first surgeons to successfully perform a skin graft, operating on a young girl who was injured in a cable-car collision on Brooklyn Bridge in 1888. A year later he invented a probe that allowed medics to detect bullets in body tissue before X-rays were invented. (Some say he appropriated this instrument after seeing Alexander Graham Bell use it first.)

The Curb Market, New York, by Joseph Petrocelli, 1921. Brooklyn Museum, Gift of Mrs. Joseph Petrocelli.

Girdner was not just a popular surgeon but one with a knack for influential and relatively accessible writing. He contributed to monthly magazines, such as the North American Review, Munsey’s, Cosmopolitan, and Harper’s Magazine. His writing centered around medical issues but often served to critique some aspect of society. In one 1886 article titled “The Plague of City Noises,” Girdner argues that living in a loud urban area takes a toll on a person’s nerves and health. Similar research and ideas on the connection between noise and neurosis from this article were included in Newyorkitis, which then spurred New Yorker Julia Barnett Rice to found the Society for the Suppression of Unnecessary Noise in 1906. A year later Rice’s efforts led the U.S. Congress to pass a law silencing tugboat whistles. Her society also helped establish quiet zones around schools and hospitals.

Girdner took a more ironic approach to some of his other magazine articles, and a few reviewers of Newyorkitis wondered if his book was also meant to be a playful call to action. Beaumont wrote, “A perusal of it will find gentle humor and pungent wit,” and in The Medical Mirror, a monthly magazine for doctors, Isaac Newton Love called it “a satirical analysis of the village and some of its people.”

While many of his readers, including those working in mainstream media, took Girdner at his word, I can’t help but think that Beaumont and Love were on to something. That through hyperbole and irony, Girdner wanted people to pause and see the ways that society was deteriorating. In his preface, Girdner writes a letter to the reader: “This book is intended as a plea for a wider thought horizon, a more genuine and comprehensive brotherly charity, less materialism, and more cultivation and development of those qualities which distinguish man from the lower animals.”

It’s possible Girdner’s true motive in writing the book was to use a purported medical diagnosis as a way to force city dwellers, especially the wealthy, to examine what living in a place like New York was doing to their character and temperament. But his attempt to call attention to the provincialism of the city was taken all too seriously, creating a diagnosis that was used in earnest.


Newyorkitis, whether satire or symptom, was not the first diagnosis connected to a place. In the late 1890s, about a decade before Girdner’s book was published, philosopher William James popularized a very similar term: Americanitis. This illness was known as a certain kind of neurasthenia derived from living in the United States. It was described by writer Elbert Hubbard as “an intense desire to ‘git thar’ and an awful feeling that you cannot.” The American Israelite, a Jewish newspaper in Ohio, summarized Americanitis as “a nerve jangle” that was “the result of the strenuous life” and “the product of the convulsive spasm notion of doing things.” Both illnesses reflect the idea that the pace of modern life in cities was wearing people out.

Tenements, New York, by Consuelo Kanaga, c. 1930. Brooklyn Museum, Gift of Wallace B. Putnam from the Estate of Consuelo Kanaga.

Americanitis and Newyorkitis surfaced during a time when popular medical theory compared the body to a machine. As a result, many doctors thought a person’s health was connected to how much energy they used and whether or not their internal nervous system was depleted. This theory allowed physicians to point toward external factors, like a person’s surroundings, to diagnose internal ailments such as anxiety, depression, and muscle pain. The St. Louis Post described this scenario succinctly in 1914: “Naturally the most delicate machinery gives way first before the strain, and so the nerves sound the first warnings of the coming crash.” In 1925 a physician named William S. Sadler wrote a New York Times article about Americanitis. “One reason we are unequal to the modern urge for speed is that the mind has outrun the evolution of the physical nervous system,” he wrote, adding that Americans “are nervous bankrupts.”

Because Newyorkitis could manifest as burnout, there was a sort of cachet in having such a malady, as if acquiring an “itis” was simply an unavoidable symptom of success. To be diagnosed with either illness was, in a sense, a privilege. Historian David Schuster wrote in his 2011 book Neurasthenic Nation that neurasthesia “indicated the presence of an active mind, a competitive character, a lover of liberty—in short, the quintessential American.” Newyorkitis denoted health problems that resulted from working too hard, doing too much, being too busy—problems that many Americans, especially New Yorkers, wanted to have. If you aren’t burned out and underslept, if inflammation had not yet been achieved, are you even a real New Yorker?

The New York Tribune acknowledged this strange pride in being diagnosed in 1905. “New Yorkers themselves not only admit it, but too generally take pride in the swiftness of the currents of life here,” it reported. In that telling, people who live in the city would rather be a part of the chaos, thrive for a moment, and die out than not to have been a part of it at all.


At the time the medical field was evolving and generally unregulated, leaving drug companies free to capitalize—in true American form—on Newyorkitis and Americanitis by creating and selling potions and treatments to help assuage symptoms resulting from these strange modern diseases. Rexall’s Americanitis Elixir, packaged in rectangular bottles made of golden brown glass, with long necks capped with a cork, promised to “strengthen and tone…the nerves to meet this unnatural demand upon them.”

Some cures were based on gender: men were sent into the wild and away from the city to refresh, while women were generally prescribed rest and locked in their bedrooms with little to no responsibility for weeks.

Herald Square, 34th and Broadway, Manhattan, 1936. Photograph by Berenice Abbott. The New York Public Library, The Miriam and Ira D. Wallach Division of Art, Prints and Photographs.

It would seem like the most obvious cure for a disease of place would be to leave it. But, according to Girdner, it wasn’t that simple. Instead, he wrote, “The treatment of Newyorkitis may be summed up in one word: culture.” He encouraged those reading the book to shake themselves of their current state by going to church or participating in community acts.

In one of Girdner’s case studies, a man—“aged forty-six, married, born in New York City”—had begun to develop symptoms in college due to his fraternity lifestyle. After graduating, he became a full-force Newyorkitic. He went to clubs, drank, gambled, spent weekends in the country “wearing a red coat and other ridiculous clothes.” One day, pretending to be a prince, he put on armor used to decorate his country house and fell down the stairs. The helmet dented his head, and the fall jolted him from his delusions of grandeur, curing him almost instantly of the disease.

It’s as if Girdner were telling readers that it was not about taking medicine, seeing fancy surgeons, escaping to the country, or subscribing to bed rest, but rather a matter of having an awareness of self. A cure for the disease was within people’s grasp if only they could be knocked out of their small ways of thinking and back into the present moment. If only they could let go of the fast-paced life and stop struggling to “have something” and instead put their energy into trying to “be something.”