ON JULY 9, 1832, THE STEAMSHIP HENRY CLAY SAILED THROUGH THE WATERS OF LAKE ERIE and made its way to the foot of Superior Street in Cleveland. The arrival of ships thrilled the locals, and a crowd gathered to hear news bulletins and see who would come ashore. As the 125-foot, 500-passenger steamer neared the wharf, the captain stepped onto the deck and yelled out to those who had gathered.

“The cholera has broken out amongst my passengers and crew . . . for God’s sake, send a Doctor aboard!”1

The ship had sailed from Detroit where its soldiers had gone ashore for a Fourth of July barbecue. That evening, an Army doctor diagnosed two of the men from the Clay with Asiatic cholera, reported his discovery to his officers, and fled on horseback as panic spread through the city. Soon afterward, the Clay headed east to Cleveland where the captain called ashore for help. Knowing those infected could die within hours, the crowd scattered. But one took the captain’s plea to heart and fetched Dr. Edwin Cowles, who had recently settled in Cleveland with his family and joined the village board of health.

Records tell us Dr. Cowles was known for his unwavering belief in justice for all—the high, the low, the rich, and the poor.2 While village residents had recently voted to prevent any boat with cholera cases to land its passengers in Cleveland, only Dr. Cowles and village trustee Thomas P. May voted to allow those passengers onshore. The Clay’s arrival tested the mettle of Cowles and the members of the newly formed Cleveland Board of Health. They redirected the Clay to Whiskey Island, where residents built a makeshift cholera hospital to isolate the infected. This “Pesthouse” represented the first response of the village of Cleveland to a public health crisis. In a matter of days, Dr. Cowles boarded the Clay, joining the soldiers—most fit, some ill—as it sailed on to Buffalo. He was committed to helping the sick even though his colleagues were certain he was sailing to his death.

A rare rendering of the city of Cleveland, 1853. Cleveland Public Library, Map Collection.

Dr. Cowles’s selflessness reflected a new sympathy taking hold among Clevelanders.

The doctor’s selflessness reflected a new sympathy taking hold among Clevelanders. In the early 1800s, that sympathy was in short supply. In the fall of 1819, the overseers of Cleveland’s poor sent notice to township constables that Mrs. Betsy Wood and her four children were penniless. It was up to the constables, the notice said, to instruct Mrs. Wood and her children “to depart from the township of Cleveland.”3 Whether widowed or jilted, Mrs. Wood and her children were cast into the wilderness, two months shy of Christmas, to survive or perish on whatever food and shelter they could scrounge. Cleveland had banished others in the same way, 150 of them between 1817 and 1830. Even so, it was a practice that didn’t sit well with many of the 4,000 people who had settled in Cleveland by 1835. Two years later, in 1837, as Cleveland was incorporated, the village transferred its poorhouse to the new city and the “Hospital for the City Poor” or “City Hospital” was born. That transfer of the poorhouse from village to city represented the first public health initiative by the City of Cleveland, an initiative that lives on in MetroHealth to this day. It is an initiative MetroHealth traces back to Dr. Edwin Cowles.

City Hospital, known as City Infirmary, opened on Scranton Road in 1855.

Not long after his safe passage back from Buffalo, Dr. Cowles lived out most of his remaining days in Cleveland with his wife and children. In 1841, he joined the Liberty Party, the predecessor to the Republican Party of Abraham Lincoln. His love for justice reflected his adamant hatred for slavery: “[It] violated every commandment,” he said, “. . . every principle of justice, all laws of human nature, and destroyed the foundation of a common humanity.”4 An early abolitionist, Dr. Cowles helped many people fleeing slavery escape to freedom. His work was made easier as Clevelanders established Station Hope, a key stop on the Underground Railroad, and helped Black Americans make their way to Canada.

Dr. Cowles died in June 1861. But his selfless care for those in need and his work toward social justice live on nearly 200 years later. Today, MetroHealth, the descendant of City Hospital, holds steadfastly to its founding principles, remaining forever devoted to hope, health, and humanity.

Today, MetroHealth, the descendant of City Hospital, holds steadfastly to its founding principles, remaining forever devoted to hope, health, and humanity.


“No such hifalutin’ notions of City authorities as calling their old Poorhouse a ‘hospital’ were accepted by the hard-headed old settlers,” quipped the authors of The History of City Hospital. “Poorhouse it had always been, therefore Poorhouse it should always be.”5

From its beginnings in 1837, the official name of Cleveland’s public hospital was “City Hospital.” The nicknames “Poorhouse” and “Infirmary” lasted until World War I. With good reason. The original Poorhouse, which stood at the corner of Sumner Avenue and East 14th Street, on the grounds of the Erie Street Cemetery, cared for the poor and delivered what was called outdoor relief: firewood, food, rent, and clothing. There was some medical care as well. From May 1837 to February 1838, for example, City Hospital administered 200 smallpox vaccines to those who could not afford them.6

In 1855, the Infirmary opened on Scranton Road and became the new home for City Hospital. It provided accommodations for “the insane of the city,” as well as “the poor who were sick and infirm,” 7 along with facilities for physicians who trained medical students.

In 1889, a general hospital opened on the City Hospital campus to accommodate the City’s ballooning population. In the late 1800s, Cleveland grew to six times its size, from 43,000 residents in 1860 to 261,000 in 1890. Then, in 1899, in response to rising mortality rates of children—more than a third of children died by the age of 5—City Hospital added Children’s Hospital along Valentine Street. By 1900, the population of Cleveland doubled yet again, which made the 1901 smallpox epidemic ever more terrifying. At Scranton Road, building crews quickly assembled Detention Hospital to isolate the infected. After the epidemic passed, Detention Hospital was converted into a tuberculosis sanatorium. That same year, Cleveland’s director of charities and correction, who oversaw City Hospital, suggested to the mayor that they create a colony of four farms on 2,000 acres southeast of the City. The driving force was to provide care for the elderly. “There is a feeling that many of the aged, bowed down by the cares and toil of years,” Director Reverend Harris Reid Cooley said, “deserve something better in their declining days.”8

From its beginnings in 1837, the official name of Cleveland’s public hospital was “City Hospital.”
In 1933, the tuberculosis sanatorium was replaced by a 435-bed facility called Sunny Acres.
Children’s Hospital at City Hospital, c. 1900.
The Glick Center
In 2022, MetroHealth celebrated the opening of the ten-story, 435-bed MetroHealth Glick Center.
Garden and building
MetroHealth Medical Center.

Cooley Farms initially hosted another poorhouse, which included dormitories and small cottages for elderly couples. The Correction Farm included a corrections facility, which provided work for the incarcerated among its crops and in its orchards and gardens, as well as a dairy that sent much of its milk to City Hospital.9 Prisoners also operated a blacksmith shop, a piggery, and a sawmill. In return they received educational, religious, and vocational guidance. The section known as Overlook Farms included the Municipal Sanatorium for Tuberculosis of the City of Cleveland. It opened in 1906 with 100 beds and was replaced by another facility in 1913. Highland Park Farm, the cemetery at Cooley Farms, served as a final resting place for the indicted and un-indicted alike. In 1920, Modern Hospital magazine regarded Cooley Farms as “the most ambitious welfare project that an American city has ever undertaken.” 10

On the Scranton Road campus of City Hospital, another sanatorium was added in 1904. Likewise, the hospital of City Hospital was renovated again in 1921, and construction on a new hospital began in 1922. The East 35th Street Dispensary, a forerunner of today’s community health centers, opened in the 1920s.

In 1932, on Cooley Farms, a 169-bed hospital, christened “the City Infirmary and Chronic Hospital,” opened its doors. And in 1933, the tuberculosis sanatorium was replaced by a 435-bed facility called Sunny Acres.

In 1957, the City of Cleveland sold City Hospital to Cuyahoga County for one dollar. The county was better equipped to use levies to raise the funds needed to attract and retain one of the most decorated groups of research clinicians in the country.11

After the sale, the main campus became Cleveland Metropolitan General Hospital, and its network of public healthcare facilities became known as the Cuyahoga County Health System, the first health system in the United States.12 For a brief spell, the main campus took the cumbersome name Cleveland Metropolitan General/Highland View Hospital.

In 1989, the system became known as MetroHealth, and the Scranton Road facility became known as the MetroHealth Medical Center, Main Campus.

Today, the MetroHealth System serves Northeast Ohio at its four hospitals, four emergency departments, and more than 20 other health centers across Cuyahoga County. In 2022, MetroHealth celebrated its 185th year of community service with the opening of the ten-story, 435-bed MetroHealth Glick Center. The new hospital is the centerpiece of a $1 billion campus transformation that will create the country’s first hospital in a public park.

Despite all the labels over the years, one thing refused to change. From its founding day, City Hospital has remained steadfastly loyal to its mission of caring for everyone who comes through its doors—no matter what name hangs on those doors.


Meeting Health Crises
with a Missionary Zeal