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Authors: Michael Willrich

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That sense of danger made a pesthouse, in one medical writer's estimation, “the most unpopular neighbor that a man could have.” Health officers seeking sites for a new pesthouse were turned back by shotgun-wielding farmers in Durham, North Carolina; writ-bearing “taxpayers” in Omaha, Nebraska; petition-signing citizens in Houston; and blaze-setting residents in Union County, Kentucky. In Bradford, Pennsylvania, three hundred men and women burned down a vacant schoolhouse that local officials had turned into a pesthouse. In Turtle Creek, eight miles outside of Pittsburgh, a “Quaker mob,” two thousand in number, rioted to prevent the board of health from trying the same thing. Firemen turned their hoses on the unruly Friends.
76
Whether the agitators were immigrant laborers or white “taxpayers,” whether they favored the axe or the writ, collective action to keep out the kept-outs had an inherently conservative aspect. These turf defenders did not necessarily object to the pesthouse as a political response to contagious disease. In most cases, their quarrel would evaporate if the government chose another site—somebody else's backyard. Grievances and interests varied. Property owners feared that a pesthouse in the neighborhood would diminish real estate values. Poor residents protested the endangerment to their health as well as the constant reminder that they lived in their town's dumping ground.
In March 1901, two cases of smallpox were discovered in Orange, New Jersey, a city of 24,000 known for its hat-making industry. The board of health hired a builder to construct a pesthouse at the city dump. But the site was surrounded by tenements filled with Italian workers and their families. As the carpenters set to work, a crowd gathered. By evening, 300 angry residents and just two policemen had gathered at the site. The crowd rushed the pesthouse. Someone lit a pile of wood shavings, and within minutes a blaze was making its way toward the structure. Firemen arrived, but a group of the residents stood on their hose, while one tried to cut it with a knife. Clubs flying, the police arrested three men. More police arrived, the crowd was driven back, and the fire was extinguished. The next night, a single pistol shot rang out at the dump. Men carrying axes and crowbars poured out from the surrounding tenements. In a few minutes they reduced the building to splinters. For good measure, a crowd returned later and set fire to the pile of broken wood.
77
In the wake of the incident, the Orange Common Council refused to authorize construction of another pesthouse.
The New York Times
lamented that the revolt illustrated “the readiness with which well-ordered and generally law-abiding communities revert to barbarism when their fears or evil passions are aroused.” But one letter writer from Orange, a self-described “Sympathizer with the People,” saw justice in the crowd's actions. “Simply because the residents in the vicinity of the ‘dump ground' are working people they are to be made uncomfortable and their health and that of their children endangered because the Board of Health—so-called—chose to put a pesthouse up in the midst of their dwellings,” the sympathizer wrote. “Legally, I suppose, the people were in the wrong, but morally they had every right to act as they did.”
78
 
 
T
he altogether ordinary Americans who defied public health measures during the nation's turn-of-the-century war on smallpox left a deep mark upon the historical record. In their actions rather than their words—which, unlike those of the well-organized, predominantly middle-class antivaccinationists, were rarely recorded—they created a public transcript of opposition to the growth of institutional power in everyday life during the Progressive Era.
That record of dissent had political consequences. It forced compulsion to show its true self. It emboldened the antivaccination movement. It raised doubts in the heads of some lawmakers and a governor or two. And it even made an impression upon the institutions most removed from the common people, the courts. “It is a matter of common knowledge that the number of those who seriously object to vaccination is by no means small,” observed Justice Orrin Carter of the Illinois Supreme Court, “and they cannot, except when necessary for the public health and in conformity to law, be deprived of their right to protect themselves and those under their control from an invasion of their liberties by a practically compulsory inoculation of their bodies with a virus of any description, however meritorious it might be.”
79
Compulsion engendered resistance even in those tightest of spaces whose inhabitants had no legal claim to liberty at all: prisons and jails. Vaccination was a routine part of penal discipline in the United States, as the young Jack London discovered when he was arrested for vagrancy during his long tramp across North America in the 1890s. London recounted the experience in a chapter of his book
War of the Classes
(1905), entitled “How I Became a Socialist.” While traveling near Niagara Falls, he was “nabbed by a fee-hunting constable, denied the right to plead guilty or not guilty, sentenced out of hand to thirty days' imprisonment for having no fixed abode and no visible means of support, handcuffed and chained to a bunch of men similarly circumstanced, carted down country to Buffalo, registered at the Erie County Penitentiary, had my head clipped and my budding mustache shaved, was dressed in convict stripes, compulsorily vaccinated by a medical student who practiced on such as we, made to march the lock-step, and put to work under the eyes of guards armed with Winchester rifles.”
80
For London, living the hobo's life as a member of America's “submerged tenth,” the underclass of his day, compulsory vaccination was but one in a litany of injustices that prompted his conversion from a working-class individualist into a socialist and a citizen of the world. During the experience, he said, some of his “plethoric national patriotism simmered down and leaked out of the bottom of his soul somewhere.” In another telling, London recalled with warm solidarity how another inmate, a veteran of the penal system with whom London had shared some tobacco, advised London to “suck it out”—literally to suck the vaccine from his arm. The writer was glad that he did. For afterward he saw “men who had not sucked and who had horrible holes in their arms into which I could have thrust my fist.” London could muster no sympathy for his fellows in prison stripes who had done nothing to stop the state of New York from making its mark on their bodies.
81
“It was their own fault,” he said. “They could have sucked.”
82
SEVEN
THE ANTIVACCINATIONISTS
The
Medical News
gave it a billing worthy of P. T. Barnum: “a smallpox case destined to be famous in the history of the progressive victory of therapeutic science over the ranks of ignorance, prejudice, quackery, and sentimentalism.” A more neutral observer (if one could be found) might have described the entire affair as a case of medical brinksmanship gone wrong.
1
It had all started with a dare. On November 25, 1901, Dr. Samuel H. Durgin, lecturer in the Harvard Medical Department and chairman of the Boston Board of Health, made a statement to
The Boston Globe
. “If there are among the adult and leading members of the antivaccinationists,” he said, “any who would like an opportunity to show the people their sincerity in what they profess, I will make arrangements by which that belief may be tested and the effect of such exhibition of faith, by exposure to smallpox without vaccination, be made clear.” Chairman Durgin said he doubted there was “a man or woman among them”—Boston's small but fervent antivaccination movement—who would accept his challenge.
2
Boston was battling its most serious smallpox epidemic in a generation. The epidemic of 1872–73, Durgin's first trial as a member of the board, had killed over a thousand people. There was no telling how many would die this time. The first cases, discovered in May 1901 in a Roxbury factory, had killed no one. It seemed that the new “mild type” smallpox, which had been troubling the southern and midwestern states for the past few years, had finally reached Boston. With summer came one small outbreak after another. September brought thirty new cases, October forty-nine, November nearly two hundred. By then, several people had died. With the smallpox hospital on Southampton Street filled to capacity, the board outfitted additional wards at the quarantine hospital on Gallop's Island, in Boston harbor. According to city physicians, nine out of ten patients turning up at the pesthouses had never been vaccinated. The board opened free vaccine stations around the city. Durgin reached out to Archbishop John Joseph Williams, and his appeal for universal vaccination was read aloud at Sunday services across Catholic Boston. And though the board had yet to issue a vaccination order, hoping to preserve the image of voluntarism for as long as possible, the board's “virus squad” began its bruising nighttime raids of the city's lodging houses.
3
In the midst of this public health emergency, an anonymous circular appeared on the streets of Boston. Addressed to parents, guardians, and the people, it warned that vaccination caused “disease, constitutional debility, death.” The circular advised that the state law requiring vaccination for all public school pupils—now being strictly enforced in the city—made an exception for any child who presented a certificate, signed by a physician, stating that the child was an “unfit subject for vaccination.” Having won this concession from the legislature in 1894, the antivaccinationists were now making the most of it. “There are hundreds of physicians in Massachusetts who are well aware of the uselessness and evil effects of vaccination,” the circular instructed. To them,
no
child was a fit subject for vaccination. “Apply to any one of them for a certificate of exemption for your child.” The leaflet provided an address—an office at No. 1 Beacon Street, just steps from the gold-domed State House—to which parents could write for names of such doctors. Asked by the
Globe
for a comment, Durgin issued his challenge.
4
It must have seemed to Durgin's peers that the stress of the job had finally gotten to him. Had the respected chief of one of the nation's leading public health departments really just dared unvaccinated citizens to expose themselves to smallpox? In all likelihood, Durgin expected no one to take the bait. A man of his experience knew the antivaccinationists were nothing if not sincere. But their beliefs did not constitute a suicide pact. While antivaccinationists considered vaccination a medical fraud and
compulsory
vaccination an “atrocious crime,” few imagined themselves invulnerable to smallpox.
5
One of the few was Dr. Immanuel Pfeiffer of Boston. A Danish immigrant and former dealer in real estate, the sixtyish physician was a handsome man with an erect bearing, a thick head of hair, and a well-groomed beard. He was a public figure of well-known enthusiasms: spiritualism, physical culture, free speech, and, uniting them all, antivaccinationism. An apostle of the idea that the mind possessed almost limitless power over the material world, Pfeiffer offered his own body as the proof of his beliefs, winning a Houdini-like reputation for his vigorous constitution and capacity to withstand physical hardship. In 1900, he garnered national press attention by fasting for twenty-one days. A year later, he fasted for a month. “He has been considered a crank by many people,” the
Globe
observed; and yet those who knew the man acknowledged that he had “a brain of unusual power and activity, a fitting concomitant of his stalwart figure and imposing carriage.” In his heterodox medical journal,
Our Home Rights
, Pfeiffer taught readers that the best way to ward off disease was through sanitation, proper diet, and impeccable hygiene. He advertised his services as a “renowned natural healer” who “successfully treats all kinds of chronic diseases by the simple laying on of hands, after having been pronounced incurable by regular physicians.”
Regular physicians
: to Pfeiffer, that phrase signified unthinking medical orthodoxy and creeping state regulation of the healing arts, a trend he fought as president of the Massachusetts Medical Rights League.
6
Pfeiffer's views on vaccination were a matter of public record. In December 1901, one month after Durgin issued his challenge, Pfeiffer attended a lecture at a meeting of the Ladies' Psychological Institute of Boston. The speaker was Dr. John H. McCollom of Boston City Hospital, an instructor in contagious diseases at Harvard and a prominent member of the Massachusetts Medical Society—a “regular,” through and through. McCollom presented a by-the-book argument for vaccination. As gruesome images of smallpox patients beamed onto a screen from his stereopticon, McCollom narrated humankind's long struggle with smallpox, culminating in the scientific triumph of Jennerian vaccination. He traced the development of vaccine, touting the virtues of modern glycerinated lymph. He marshaled statistics from historical epidemics to demonstrate that well-vaccinated people rarely contracted smallpox and, when they did, suffered far less than their unvaccinated neighbors. The same argument could be found in countless medical journals, government reports, and newspapers. But with smallpox spreading in the city—perhaps in that very room—the audience hung on McCollom's every word. Coming to the end of his lecture, he opened the floor to questions .
7
Pfeiffer rose. “Is it not true, doctor,” he began, “that men of science and immense learning have effectually claimed that persons whose bodies are cleanly, sound and generally healthy are protected from smallpox?”
McCollom responded, “No, it is not true, and I do not recollect of hearing any learned or scientific men making any such claim.”

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