Table of Contents Title Page Copyright Page Dedication ONE - BEGINNINGS TWO - THE MILD TYPE THREE - WHEREVER WERTENBAKER WENT FOUR - WAR IS HEALTH FIVE - THE STABLE AND THE LABORATORY SIX - THE POLITICS OF TIGHT SPACES SEVEN - THE ANTIVACCINATIONISTS EIGHT - SPEAKING LAW TO POWER EPILOGUE Acknowledgements Notes Index Also by Michael Willrich City of Courts: Socializing Justice in Progressive Era Chicago THE PENGUIN PRESS Published by the Penguin Group Penguin Group (USA) Inc., 375 Hudson Street, New York, New York 10014, U.S.A • Penguin Group (Canada), 90 Eglinton Avenue East, Suite 700, Toronto, Ontario, Canada M4P 2Y3 • (a division of Pearson Penguin Canada Inc.) • Penguin Books Ltd, 80 Strand, London WC2R 0RL, England • Penguin Ireland, 25 St Stephen’s Green, Dublin 2, Ireland • (a division of Penguin Books Ltd) • Penguin Books Australia Ltd, 250 Camberwell Road, Camberwell, Victoria 3124, Australia • (a division of Pearson Australia Group Pty Ltd) • Penguin Books India Pvt Ltd, 11 Community Centre, Panchsheel Park, New Delhi–110 017, India • Penguin Group (NZ), 67 Apollo Drive, Rosedale, Auckland 0632, New Zealand (a division of Pearson New Zealand Ltd) • Penguin Books (South Africa) (Pty) Ltd, 24 Sturdee Avenue, Rosebank, Johannesburg 2196, South Africa Penguin Books Ltd, Registered Offices: 80 Strand, London WC2R 0RL, England First published in 2011 by The Penguin Press, a member of Penguin Group (USA) Inc Copyright © Michael Willrich, 2011 All rights reserved LIBRARY OF CONGRESS CATALOGING IN PUBLICATION DATA Willrich, Michael Pox : an American history / Michael Willrich p ; cm.—(Penguin history of American life) Includes bibliographical references and index eISBN : 978-1-101-47622-2 Smallpox—Epidemiology—United States Smallpox—History—United States Epidemics—United States—19th Century— History Epidemics—United States—20th Century—History I Title II Series: Penguin history of American life [DNLM: Smallpox—epidemiology—United States Smallpox—history—United States Disease Outbreaks—United States History, 19th Century—United States History, 20th Century—United States WC 590] RA644.S6W.5’210973—dc22 2010034544 Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of both the copyright owner and the above publisher of this book The scanning, uploading, and distribution of this book via the Internet or via any other means without the permission of the publisher is illegal and punishable by law Please purchase only authorized electronic editions and not participate in or encourage electronic piracy of copyrightable materials Your support of the author’s rights is appreciated http://us.penguingroup.com For Wendy PROLOGUE NEW YORK, 1900 Manhattan’s West Sixty-ninth Street no longer runs from West End Avenue to the old New York Central Railroad tracks at the Hudson River’s edge In the space now occupied by aging high-rise condominium towers and their long shadows, there once stood a low-slung street of tenements and houses At the turn of the twentieth century, it was said to be the most thickly populated block in the most thickly populated city in the United States of America Someone called it “All Nations Block,” and, being a pretty fair description of the place, for a while the name stuck A brisk walk from the fashionable hotels of Central Park West, All Nations Block was a rough world of day laborers, bricklayers, blacksmiths, stonemasons, elevator runners, waiters, janitors, domestic servants, bootblacks, tailors, seamstresses, the odd barber or grocer, and, far outnumbering them all, children Each morning, the children streamed east to Public School No 94 at Amsterdam Avenue or to the crowded kindergarten run by the Riverside Association at 259 West Sixty-ninth Street That same foot-worn building housed the charitable association’s public baths; in any given week, four hundred men or more paid a nickel for a towel, a piece of soap, and a shower that had to last The tenement dwellers of All Nations Block did not choose their neighbors It was the kind of place where an itinerant black minstrel actor, feeling feverish and far from his southern home, could find a bed for a few nights, in a great warren of rooms whose other occupants were Italian, Irish, Jewish, German, Swedish, Austrian, African American, or simply, so they said, “white.”1 The men of the West Sixty-eighth Street police station knew the block and its ways well The policemen came when the neighbors brawled, when jewelry went missing in an apartment by the park, or when the Irish boys of the All Nations Gang got too rough with the Chinese laundryman on West End Avenue The police came once again on the night of November 28 A forlorn and drunken stonemason named Michael Healy, imagining himself to be under attack in his room (“They’re after me,” he had shouted, “See those black men!”), had hurled himself through a fourth-floor window and fell, in a cascade of glass, to, or rather through, the ground below The Irishman made a two-by-twofoot hole in the surface, breaking through to some long-forgotten trench near the building’s cellar A neighborhood boy ran to the Church of the Blessed Sacrament on West Seventieth Street and summoned a priest When the priest arrived, he crawled right through the hole and into the trench, which was already crowded with police, an ambulance surgeon, and Healy’s broken but still breathing body Before this subterranean congregation, the priest administered last rites That was the way things went on All Nations Block It was the night before Thanksgiving, the first of the new century.2 New Yorkers of a certain age would remember that Thanksgiving as the day the smallpox struck the West Side The outbreak had in fact started quietly a few days earlier, on All Nations Block The city health officers found the children first: twelve-year-old Madeline Lyon, on Tuesday, and on Wednesday, a child just across the street, identified only as a “white boy four years old.” For the health officers to diagnose the cases with any confidence, the children must have been suffering for days, with raging fevers, headaches, severe back pain, and, likely, vomiting, followed by the distinctive eruption of pocks on their faces and bodies Once the rash appeared and the lesions began their two-week metamorphosis, from flat red spots to hard, shotlike bumps to fat pustules to scabs, the patients were highly contagious The health officers removed the children, stripped their rooms of bedding and clothing, and disinfected the premises.3 The health department followed the same procedure with the five other cases that were reported elsewhere in Manhattan within hours of the Lyon case One was a white domestic servant named Mary Holmes, who worked in an affluent apartment house on West Seventy-sixth Street The other four were black, evidently from the neighborhood of the West Forties They were Adeffa Warren, Lizzie Hooker, Susan Crowley, and Crowley’s newborn daughter—these last two had been removed in haste from the maternity ward at Bellevue Hospital Through interviews, health officers had established that the four black patients had come into contact with an unnamed infected “negress,” who remained at large How any of these patients might have been connected to the children on West Sixty-ninth Street, about a mile and a half uptown, remained uncertain But the authorities were working on the assumption that the outbreak started on All Nations Block.4 The officers of the internationally renowned New York City Health Department, medical men given broad powers to police and protect the public health in one of the world’s most powerful centers of capital, were not easily shaken by the odd case of smallpox among the wage earners Now and then an infected passenger got past the U.S government medical inspectors at Ellis Island or crossed into the city on one of its many railroad tracks, waterways, roads, footpaths, or bridges Most New Yorkers had undergone vaccination for smallpox at one time or another—on board a steamship crossing the Atlantic, in the public schools, in the workplaces, in the city jails and asylums, or, if they possessed the means, in their own homes under the steady hand of a trusted family physician When an isolated case of smallpox triggered a broader outbreak, the health officials took it as an unmistakable sign that the population’s level of immunity had begun to taper off, as it did every five to ten years The time had come to sound the call for a general vaccination “We are not afraid of smallpox,” said Dr F H Dillingham of the health department, when the news broke that smallpox had reappeared on Manhattan “With the present facilities of this department we can stamp out any disease.”5 On Thanksgiving Day, as the Columbia University football team took the field against the Carlisle Indian School and three thousand homeless people lined up for a hot dinner at the Five Points House of Industry, a vaccination squad from the health department’s Bureau of Contagious Diseases moved into West Sixty-ninth Street The four doctors began a quiet canvass of All Nations Block, starting with the immediate neighbors of the infected children Health department protocol called for a thorough investigation of each case, in order to trace its origin, followed by the immediate vaccination of all possible contacts In a place as densely inhabited as All Nations Block, everyone would have to bare their arms for the vaccine.6 With a willing patient, the vaccination “operation,” as doctors called it, lasted just a minute or two The doctor took hold of the patient’s arm, scoring the skin with a needle or lancet He then dabbed on the vaccine, either by taking a few droplets of liquid “lymph” from a glass tube or using a small ivory “point” coated with dry vaccine Either way, the vaccine contained live cowpox or vaccinia virus that not long before had oozed from a sore on the underside of an infected calf in a health department stable In the coming days, the virus would produce a blisterlike vesicle at the vaccination site In due course, the lesion would heal, leaving a permanent scar: the distinctive vaccination cicatrix If all went well, the patient would then enjoy immunity from smallpox for five to seven years, sometimes longer And, of course, as long as a person was immune, she could not pass along smallpox to others.7 Philippines and Puerto Rico and Spanish-American War assembly areas See camps death rate of wounded troops deaths from disease Dodge Commission report last battle of mustering of troops reasons for smallpox as endemic to theaters of smallpox threat and spatial strategySee also specific strategies Spencer, E Edwin Spencer, Herbert Spencer, William H Spooner, John Coit state(s) See also specific states medicine Middlesboro outbreak, role in police power and See police power State v Hay steamship travel captain’s power first and second class for Italian immigrants length of journey smallpox control for steerage See steerage travel/steerage passengers surgeons See ship surgeons steerage travel/steerage passengers coercion of compulsory vaccination of dangers of quarantine for Stephenson, William Sternberg, George Miller Stevens, Charles Stithton, Kentucky Stoner, George W Storey, Moorfield Sturdevant, Homer E Supreme Court, U.S Allgeyer v Louisiana Barron v Baltimore business-friendly rhetoric of criteria for hearing cases Doe v Bolton Jacobson v Massachusetts See Jacobson v Massachusetts Lochner v New York Plessy v Ferguson police power rulings Schenck v United States surgeon, as term Sweden Swedish Lutheranism Taft, William Howard Talladega, Alabama Tamany Democratic machine Tatham, D H Tavera, Trinidad H Pardo de Taylor, J N Teller Amendment Tennessee Tenth Amendment See police power tetanus incubation period postvaccination See postvaccination tetanus vaccination Thirteenth Amendment Tiedeman, Christopher G Tillman, Benjamin R Tolstoy, Leo “Tomb of His Ancestors, The” (Kipling) tort law Treaty of Paris tropical medicine Tuskegee Institute Twain, Mark Twentieth Kansas Volunteers Twenty-sixth U.S Volunteers typhoid typhus Union College United States antivaccinationism in arrival of vaccination in compulsory vaccination in death rate from smallpox decentralized political structure of eradication of smallpox in freedom in immigration to See immigrants/immigration imperialism of See imperialism, U.S last confirmed smallpox outbreak last variola major outbreaks as least vaccinated country smallpox inSee also epidemics of 1898–1903 smallpox vaccination in vaccination in vaccination rate vaccination’s arrival in universal vaccination See compulsory vaccination University of Pennsylvania U.S Public Health and Marine-Hospital Service authority enlarged epidemics of 1898–1903 and history of immigrants and legacy of trust for Medical Department of the U.S Army compared to National Hygienic Laboratory of See National Hygienic Laboratory role of segregated facilities of smallpox control and smallpox reporting southerners and structure of surgeons of uniform of work of UtahSee also specific places antivaccinationism in Board of Health smallpox outbreak in Utah Anti-Compulsory Vaccination League Utah Supreme Court vaccination compulsory See compulsory vaccination diphtheria invention of polio public distrust of in Puerto Rico smallpox See vaccination, smallpox as term Vaccination vaccination, smallpox African Americans’ rate of arm-to-arm arrival in the United States bovine See bovine vaccine compulsory See compulsory vaccination crisis of 1901–2 See vaccine crisis of 1901–2 in England in Europe history of humanized virus invention of Kentucky, rates in as lost art in the South Middlesboro, rates in in New York City in the Philippines phony certificates postvaccination tetanus procedure for public opinion on regulation of See vaccine regulation resistance to See antivaccinationism/ antivaccinationists risks of See also vaccine failure sources of in the South technological advances in temporary immunity of in the United States universal See compulsory vaccination Wertenbaker and Vaccination A Crime (Oswald) Vaccination a Curse (Amerige) Vaccination Brought Home to You (Clymer) vaccination lawsuits See also specific cases administrative power and complex precedents in due process and equal protection in in Georgia in North Carolina post-Jacobson school victories vaccination scar forgery of as passport as signifier of American rule vaccine, smallpox dry point glycerinated humanized virus introduction to New World as least safe vaccine manufacture of See vaccine manufacture/vaccine manufacturers preservation and transportation of principal viruses used in quality of See vaccine quality regulation of See vaccine regulation vaccine court vaccine crisis of 1901–2 in Atlantic City in Camden See Camden vaccine crisis in Cleveland lack of governmental liability for liability for in Philadelphia physicians and in St Louis vaccine failure in crisis of 1901–2 See vaccine crisis of 1901–2 government’s lack of liability for liability for vaccine laws vaccine manufacture/vaccine manufacturers See also specific manufacturers advertising by competition among compulsory vaccination as boon to cows used in See bovine vaccine emergence as commercial industry in Europe glycerin used in by government government production opposed by innovations in insulation from liability as interstate trade items necessary for lack of regulation of licensing of low barriers to entry marketing by by New York City Health Department in the Philippines production methods production standards profitability of in Puerto Rico regulation of See vaccine regulation regulation welcomed by as unregulated vaccine quality antivaccinationism and improvement in research on vaccine refusers vaccine regulation debate over in Europe federal government and first glimmerings of lack of at state level U.S legislation introduced U.S legislation passed vaccinia (cowpox) vaccinifier varicella Varieties of Religious Experience (James) variola, meaning of term variola major variola minorSee also mild type of smallpox variolation, smallpox variola vera variola virus See smallpox (variola virus) varioloid Virginia virion, definition of viruses Wadhams, S H Wai, Wong Wait, William Cushing Walk, H J Walker, A J Wallace, Alfred Russel Walsh, Ralph war, infectious disease and War of the Classes (London) Warren, Adeffa Warrington, Anna Wash & Company Washington, Booker T Washington, George Washington Post, The Waterhouse, Benjamin Weinberger, Harry Welch, William welfare state See social insurance/welfare state Wells, Heber M Wertenbaker, C C Wertenbaker, C P on African Americans ambitions of appearance of childhood of Confederate background of death of death of siblings, effect on early career of education of epidemics of 1898–1903 and final years of career grave of mobility of politics of politics of smallpox control and procedures of reforms advocated by on segregation as smallpox expert Sons of the American Revolution and theatrical quality of work of uniforms of U.S Public Health and Marine-Hospital Service career of vaccination and in Virginia Volunteers Wilmington outbreak and writings and speeches of Wyman and Wertenbaker, Mary Ella Wertenbaker, William Western New York Homeopathic Medical Society West Virginia Weyler, Valeriano “What Credence Should Be Given ” (Reed) Wheaton, Lloyd “White Man’s Burden, The” (Kipling) whites African Americans and See race/racism in epidemics of 1898–1903 epidemics of 1898–1903 and as exempt from smallpox in Middlesboro outbreak poor, lack of medical care for smallpox seen as black disease by vaccination of blacks, opposition to as vaccine refusers White Star Whitman, Walt Willard Parker Hospital William, R C Williams, George Fred Williams, John Joseph Willson, Robert Wilmington, North Carolina African Americans of Marine-Hospital Service station race riots smallpox outbreak See Wilmington outbreak Wilmington Messenger Wilmington outbreak African Americans and antivaccinationism in compulsory vaccination in first case pesthouse as public health battleground racial issues in Wertenbaker and Winslow, C E A Winters, Mamie Wisconsin Wisconsin Medical Journal Wisconsin Supreme Court women’s rights Wong Wai v Williamson Wood, Leonard Woodward, William C workers/working class antivaccinationism and compulsory vaccination and cotton mill government and, conflict between housing conditions for laws protecting miners mobility of workman’s compensation laws workplaces, compulsory vaccination in World Health Organization World’s Colombian Exposition World War I Worthington, Robert Wright, S P Wright Troupe Wyman, Walter management style of Wertenbaker and X rays Yellow Creek Valley yellow fever Young, LeGrande Also by Michael Willrich City of Courts: Socializing Justice in Progressive Era Chicago ... Copyright © Michael Willrich, 2011 All rights reserved LIBRARY OF CONGRESS CATALOGING IN PUBLICATION DATA Willrich, Michael Pox : an American history / Michael Willrich p ; cm.—(Penguin history of American. .. Manhattan and many more miles upriver to the city smallpox hospital, the “pesthouse” on North Brother Island, a nineteenacre wooded island situated between Rikers Island and the Bronx mainland... agents—the orthopoxviruses—that infect diverse members of the animal world There is cowpox, monkeypox, raccoonpox, camelpox, and so on Many of those poxviruses infect multiple species Cowpox, for example,