By Kate Womersley
In June of 1901, The Commoner, an American weekly journal, advertised a new medical treatise for the general reader:
Although Newyorkitis has been largely forgotten today, it caused a stir on publication. “Rarely has a book fresh from the press attracted so much attention,” touted The New York Press. “[I]n all sections of the country has appeared column after column – and even whole pages – concerning Dr John H. Girdner’s Great Book,” The Commoner wrote later that year.
Promoting Newyorkitis outside of Manhattan strikes me as strange, given the audience for which Girdner’s book seems to be intended. A critique-cum-self-help guide, Newyorkitis hoped to save the “chronic New Yorker”, an individual who had lived in the metropolis for too long, and had been both hardened and weakened by it. Peculiar to 38 square miles of island, a sickly tribe of Newyorkitics were thought at risk from physical, psychological and moral degeneration. The suffix –itis denotes an inflammation, as for appendicitis, but in this case it was the patient’s very character, fed by the city’s “artificial” lifestyle, which had swollen: “he has got his New York inflamed.” “Newyorkitis is a communicable disease,” Girdner continues, which “seems to spread by mental and moral contact of the healthy with the afflicted,” leading to more and more people becoming dangerously self-absorbed:
“There is a nervous affection known as chorea, in which the patient sometimes turns round in a small circle when he attempts to walk. The egotism of Newyorkitis seems to be a metaphysical variety of this disease.” 
A Newyorkitic’s daily footprint “extends only from the East River to the Hudson, and from the Battery to the Harlem River and Spuyten Duyvil.” His attention is pathologically consumed because he “imagines that the whole of his country, or all of it worth his consideration, is included in this area.” His concerns are lavish, caring too much for clothes, “highly spiced” gossip of the newspapers, and “the price per front foot of the street he lives in.” The situation at the opening of the twentieth century had, Girdner warned, become “endemic and epidemic.”
This tone of crisis crescendos over 200 pages. Girdner lists the symptoms and signs of Newyorkitis, which include dull aches as well as “general paresis”, “lack of deliberation in all muscular movements”, digestive complaints, near-sightedness (because skyscrapers “effectually limit the field of vision. The only opportunity for using the eyes for distant vision is to look up at the sky”), flat-footedness (from walking on tarmac), and a perverted appetite (as the stomach “has to be aroused and the gastric juices started flowing by a cocktail, or some other irritating drink, before each meal”). The moral symptoms are worst of all: to care nothing for others, and to summon all effort for personal hedonism.
Girdner illustrates his theory with (supposedly) real-life case studies. One man is said to have died of Newyorkitis – “a pronounced disbeliever in the power of everything except dollars” – while another was finally cured, but only when he left Manhattan altogether. This sufferer threw out his monocle, lost his phony English accent (both deeply Newyorkitic affectations), and “traveled over his own country, studied its needs, resources, and institutions, and began to develop. His Newyorkitis gradually disappeared, and at the present writing he occupies an important public position, and has become an honored and useful citizen.” 
I have quoted Newyorkitis at length to show that an animating question when reading the text is whether or not Dr. Girdner is presenting a ‘real’ psychological and somatic illness. In search of an answer, the book’s 1901 reception is usefully misleading. Many of the book’s first readers seem to have been confident in Girdner’s sincerity. A reviewer in 1901’s November issue of The Sacred Heart takes Newyorkitis entirely seriously, and concludes by saying that
“If Dr. Girdner studied other parts of his country as he had studied New York, he should discover that the disease, some of whose symptoms are as described, is not found only in New York, despite the name he gives it. If we are to believe the statements of sociological conditions in this country, this phase of ‘Newyorkitis’ is widespread.”
The Evening Post in Chicago agreed that Girdner “discusses his theme with perfect good nature and a trim restraint throughout, and his pages are well worth study, even outside of New York.” Manhattan’s The World, proud of having its own city pathology, sums up the general tone in its claim that Newyorkitis is an “Important contribution to medical and social science.”
This straight reading continues right up to the present in historical and analytical commentary. The few mentions of Neyorkitis in academic volumes, such as Howard Mansfield’s Turn and Jump: How Time and Place Fell Apart (2010) and Stephen Kern’s The Culture of Time and Space: 1880-1918 (1983), tend to refer to Girdner’s treatise as another contribution to the Western medico-commentary on anxiety and nervousness at the turn of the twentieth century.
Indeed, Newyorkitis should be read in the context of its time and an intense concern about city living. In 1881, Dr. George Beard was the first to suggest that the USA was suffering from a national strain of neurasthenia, ‘American Nervousness’. A bombardment of incessant sounds, sights, technology and the sheer volume of other people had reached fever pitch. Life was faster; humans were not. Beard popularized the theme and genre, warning against the harmful impact of urban environments which could bring on physical symptoms, ennui and loneliness. Diagnoses for new psychopathologies emerged around this anxiety, and by 1900 every neighborhood seemed to be furnished with its own nerve doctor. Against this backdrop, Girdner’s Newyorkitis almost makes sense as a sincere psychological treatise.
However, we must take note of the few critics in 1901 who sensed that Girdner was writing with a wry smile. The Republican in Denver reported with tongue-in-cheek that
“New York is writhing under the keen thrusts which have been given it by Dr. John H. Girdner. That is, New Yorkers are imagining that every other fellow is referred to when the doctor caustically described the average Newyorkitic.”
The reviewer’s hyperbole here and sensitivity to Girdner’s wit suggests he thought the book’s more fantastical sections are parodic. Perhaps the most nuanced appraisal of Newyorktitis can be found in The Outlook from November 1901, a news and opinion weekly magazine published in Manhattan. In the ‘Books of the Week’ column, Newyorkitis is summed up as “a sort of lay sermon built on a scientific basis” but goes on to say that the book is
“well worth reading by any one who cares to see marked local limitations treated in serio-humorous style. The author pays his respects to vice-hunting clergymen, millionaire philanthropists and several other notabilities just now very much in the public eye.”
The columnist believes, I think correctly, that Girdner’s writing is at once serious and scurrilous, a critique which opens up possibilities for reading Newyorkitis as a satire as well as a deeply concerned political argument. In a Swiftian vein, Girdner’s flights of imagination, wicked turn of phrase and sense of humor go far beyond a mere joke.
This way of reading Newyorkitis finds support in Girdner’s career, which brought together high and low culture; expertise and mass appeal. Son of Dr. William Girdner, a surgeon for the Union Army, John Harvey Girdner was brought up in Edgar Creek, Tennessee. Country life didn’t promise professional opportunities, and he moved to Manhattan to take his MD at the University Medical College of New York University. Graduating in 1879, he took up his internship at Bellevue Hospital and enjoyed a swift progression to the position of surgical lecturer at New York Medical School. His niece back in Tennessee wrote touchingly in a family memoir that she would “never see that Uncle again as he has become too busy and will never have time to come to this part of the country.”
It was not psychiatry, but surgery in which Girdner excelled. His most significant contribution to surgery was his 1889 invention of an electric instrument to detect the presence of bullets in body tissue. Before x-rays, this telephonic bullet probe was a profound enhancement to operative practice. Girdner also improved the design of the phimosis forceps (an instrument for easing foreskin tightness), by introducing a specialised spring for greater precision. As well as practical tools, Girdner brought new techniques to the operating room, being the first surgeon to graft skin from a dead body onto a living patient. These advances won him plaudits both within and beyond the profession, and he often found himself at the White House during the Grover-Cleveland Administration where he became a close friend of the politician William Jennings Bryan.
Girdner had a medical identity outside of the OR too. Not quite in keeping with his lofty reputation, he wrote a light column in Munsey’s Weekly, a “magazine of the people and for the people, with pictures and art and good cheer and human interest throughout.” His articles had a serious purpose though, and intend to convince Americans that a healthy life should be viewed holistically. He believed that patients were not merely a sum of removable body parts, but were conditioned by diet, hygiene and mental wellbeing. His Munsey titles include ‘Man and his Clothes’ (with sections headed ‘The Crime of High Heels’, ‘The Tyranny of Trousers’, ‘The Origin of Baldness’), ‘Medical Science and Its Enemies’, ‘The Food We Eat’ and ‘Disease Germs, and How to Avoid Some of Them,’ all carried off in a jaunty and forthright prose style. His descriptions of how the human body works bring a bit of color to physiology for the non-specialist:
“An innocent looking beefsteak lying on a butcher’s block, when passed through the chemical laboratory of the human body, may furnish forth the vital energy necessary to carry a hod, to write an immortal poem, or to commit a hideous murder.) [From ‘The Food We Eat’]
Moreover, Girdner felt duty-bound to fight against quackery. He wanted to expose the “charlatans who deceive and rob the public by promises to cure disease with one electric device or another.” But he also emphasized each individual’s own responsibility to himself:
“Let a man once get this idea of classing his body along with the rest of his possessions, and it is only reasonable to expect that he will at least take as good care of it as he does of his coat, his hat, his horse, or his dog.” [From ‘Healing By Electricity‘]
Girdner’s prescriptions make use of humorous faux-sincerity to get their point across. Irritated by New York’s hustle and bustle, for example, he suggests that a “Society for the Prevention of Noise” be set up to secure “that inward peace which passeth understanding” to be “modeled somewhat after the pattern of the Society for the Prevention of Cruelty to Animals”.
When read alongside Newyorkitis, the archive of Girdner’s journalism shows how effective medical satire can be. Today, newspapers and magazines are full of mocking commentaries about medicalization and the ‘worried well’, but rarely do they come from the pens of physicians, and rarely are they tempered with fondness and understanding. Girdner understood that his advice would be best received if he didn’t hector, but rather amuse and cajole through vivid storytelling.
In the twenty-first century, when many of the gravest health risks are posed by lifestyle choices, we need another John Girdner to entertain us into action. Such a writer might raise our awareness to the absurdity of our current situation, and prove once again that humor can be a powerful public health intervention.
Kate Womersley is an editor at REMEDIA. She has a master’s in History of Medicine from Harvard University where she was a Frank Knox Fellow, and is currently a graduate medical student at Cambridge University.