by David DeKok
Then, of course, there was Ithaca Water Works. It had miles of water mains in the city that had carried typhoid-infected water and might still harbor the germs. Soper’s plan was to force a device called a “wire devil” through the mains under pressure, then flush the entire system with potassium permanganate to kill any remaining typhoid germs. An estimated one thousand to fifteen hundred pounds of the chemical would be dumped in the existing reservoirs and be drawn through the system by opening many taps at once. The chemical would give the water a pinkish to red tinge but would not be harmful to humans, only to the typhoid germs. Because of the large amount of the chemical needed, plans were made to contact dealers in Germany as well as in New York City to determine how much could be quickly obtained.23
Soper worried about physicians and how they might react to his take-charge style and especially his stern directives to report every case under penalty of being fined by the Board of Health. He met with them on March 8 and received their promises of cooperation. When he asked how prevalent typhoid had been in Ithaca, he was told the last big outbreak had been in 1882 and prior to that in 1864.24 Three days later, any negative thoughts the Ithaca physicians might have harbored toward Soper were swept away when James C. Bayles, the New York Times editorial writer turned reporter, came out with the first of his reports from Ithaca. Bayles slammed the physicians, accusing them of refusing to report typhoid cases to the Board of Health. Some, he said, had even refrained from putting the real cause of death on death certificates if the patient had typhoid. As many as 250 typhoid cases might have gone unreported, Bayles speculated.25
He exonerated Ithaca Water Works and Morris from any responsibility for the typhoid epidemic, largely because, like so many in his day, he did not yet know about typhoid carriers. We can forgive him for that, but it is foolish to accord his beliefs and opinions on the causes of the Ithaca epidemic much credibility today. To Bayles, it made no sense to blame the water company. No physician had reported treating any typhoid case on Six Mile Creek, he reported, and none of the Italian workers at the dam site had missed even a single day due to illness of any kind. Voila! “Not one fact has been produced which contains the assumption that this colony brought typhoid fever into the Six Mile Valley or left it there,” he concluded with satisfaction.26 Again, and we cannot say this enough, Bayles had no idea that a seemingly healthy worker could be releasing millions of typhoid bacilli into the environment every time he defecated along the banks of Six Mile Creek.
Bayles seems to have been largely responsible for the start of the “blame Ithaca” movement, accusing the citizens of knowing they had a typhoid problem and doing nothing about it. “Typhoid has been more or less prevalent here for many years, and at no time has Ithaca long been free from it. For at least ten years the cautionary signals have been obvious to anyone who might have chosen to look for them,” he wrote. But Bayles, who was not a physician, was confusing intestinal disorders that were not typhoid, the so-called Ithaca Fever, with the disease that was ravaging the community and had come from one or more of the Italian workers.
Dr. H. Burr Besemer told the Ithaca Daily News that Bayles was simply wrong, that Ithaca Fever was not typhoid. He and other physicians believed Ithaca Fever was caused by other colonic bacteria in Six Mile Creek that had “grown fat on the sewage of the creek . . . and caused a continued fever of toxaemic, but not typhoid type.” Besemer said that in the past true cases of typhoid had been “few and far between” and had all been traced to their true source, and that there was no red flag the local doctors had been ignoring. He said that “any physician,” a dig at Bayles, “will by most careful study arrive at the same conclusion. To arrive at any other conclusion is doubly deplorable, both for the intelligence of the physician and the good of Godforsaken Ithaca.”27 Besemer did not know about typhoid carriers, either, but he was only comfortable with facts, not old and pernicious myths.
The Ithaca Daily News responded with blazing cannons, accusing Bayles of giving a copy of his article to Ithaca Water Works and thence to the Ithaca Daily Journal before it appeared in the Times. The Daily News wrote:
The article is apparently written with the purpose of relieving the water company of the blame which has been heaped upon it by indignant citizens. To accomplish this purpose, the author attempts to show that Ithaca has always had typhoid fever; that the city is a pest hole, and the advent of the present epidemic was discernible a year ago. To be brief, Mr. Bayles knows little about the matter. He is not, we understand, a physician. . . . His opinion on the point as to whether the disease here is typhoid fever or the measles is not then so very important.28
Bayles’s articles were very different from his editorials for the Times, to the point where we must wonder if he felt intimidated by the agreement worked out between Ochs, Ickelheimer, and Schurman to send him to Ithaca, whether or not there was any substance to his fears. Sometimes reporters will write the story they assume their bosses want rather than the one they believe ought to be written.
Although Soper himself did not yet know what Dr. Robert Koch had discovered about typhoid carriers, namely that they could be healthy yet harbor millions of the bacilli in their gallbladders, releasing fresh batches to the environment with every defecation, he did seem to understand that not all recent typhoid patients were fully disease free. But he thought the risk was from their urine. Soper wrote:
One of the most important measures adopted, and, it is thought, an innovation in the management of typhoid epidemics, was the use [in Ithaca] of urinary germicides to eliminate bacterial infection from the bladders of convalescents. . . . In the event of the discovery of this germ the patient was held under observation and given urotropin until the bacillus disappeared.29
Urotropin, made by combining ammonia and formaldehyde, was recommended by physicians in the early twentieth century as a means of ridding urine of typhoid germs after a patient had recovered from the disease. It did nothing, however, for the typhoid germs hiding out in the gallbladder. Urotropin, better known today as hexamine, is still used as a urinary antiseptic.30
Acting on his fears about contaminated urine, Soper summoned students who had recovered from typhoid to be examined by a physician on the Cornell University Medical School faculty. One such letter, which was actually signed by President Schurman, was received by Walter Stevenson Finlay Jr., a mechanical engineering student, and went like this: “As a means of assisting the Board of Health in its endeavor to stamp out all traces of the recent epidemic, Dr. Soper desires that you, as a former typhoid patient, present yourself for examination at Dr. [Abram T.] Kerr’s office, Stimson Hall, as soon as possible. I gladly second this request.” Chances are Finlay received the Diazo urine test for typhoid. Soper himself sent the follow-up letter, which informed the student “that there is no longer danger you may convey typhoid fever to others.”31 Soper believed that a disproportionately large number of Cornell students had contracted typhoid and so focused special attention on them.32
Besides the follow-up medical examinations, he arranged for systematic inspections of the many boarding and rooming houses occupied by students. Some students normally spent the summer in Ithaca, so it was necessary to do this now, in the spring, rather than put it off until later in the summer. The new rule in Ithaca was that no lodger or table boarder was permitted in a house in which there was a typhoid patient. The owner either had to evict the sick student and give the house a thorough cleaning and disinfecting or shut down the house until the patient had recovered. It appears from a letter in the files of Cornell University that not all owners complied voluntarily, resulting in the university sending letters to students living in such a house telling them to move out within twenty-four hours.33
One of Soper’s next projects was to increase garbage pickup in Ithaca from one to three times per week. But what to do with the trash? Ithaca typically dumped its garbage in low-lying areas along the lake, accessible to flies that
could light upon typhoid-contaminated materials and spread the disease. Soper’s solution was to build an incinerator. His first thought was to build it at the end of Renwick Pier along Cayuga Lake, but then he discovered an abandoned tannery that had two fire chambers connected to a seventy-five-foot smokestack. The incinerator stayed in operation for eight months and usually handled about fourteen wagonloads of garbage per day running twenty-four hours a day.34
A final, dangerous, and distasteful task was to muck out the city’s many private outhouses and carry away the filth to a safe location outside of town. Nearly a thousand typhoid cases (some patients, especially Cornell students, convalesced outside of Ithaca) had left untold millions of typhoid fever germs in the environment. Ithaca had upward of thirteen hundred outhouses, and Soper intended to clean them out and close them down. The city had begun building more sewer lines to eliminate the need for outhouses or direct discharges into Six Mile Creek, so few homeowners could any longer claim a need for alternative solutions. Many of the outhouses contained typhoid germs, and some had mounds of contaminated excrement piled against their exterior walls. “With infected privies close to your kitchens you can have no protection whatsoever; you cannot stop the flies from circulating between the excrement and your food,” Soper said in an interview with the Ithaca Daily Journal. The work began on April 11, involved fifteen men and eight horses, and continued through the summer. Ever the record-keeper, Soper reported that 418,193 gallons of excrement were removed from the outhouses, piled in horse-drawn wagons, and driven to a farm in the country, where the excrement was plowed into the soil to decompose. “It is a satisfaction to be able to say that in this extensive and dangerous piece of scavenging work there was no sickness nor accident,” he wrote. Most outhouses were shut down after being mucked out, the homeowners directed to connect to the city sewer system.35
And so it was through hard work like this that the epidemic in Ithaca was conquered. All the projects carried out by Soper did their part, eventually killing off the typhoid bacilli either with strong disinfectants or by denying them new hosts to infect, causing them to expire of their own accord. He considered Ithaca to be one of America’s worst typhoid epidemics in percentage terms.
There had been 965 cases of typhoid in Ithaca, he said, not including students who contracted the disease at Cornell but went home to convalesce—or die. By the time he delivered an address on the Ithaca epidemic to the New England Water Works Association more than a year later, on September 15, 1904, Soper had raised the total to an “estimated” 1,350 cases, which is more likely too low rather than too high. A minimum of 522 homes in Ithaca were touched by typhoid, including more than 150 in which more than two people contracted the disease. Probably the worst of those was the George house at 308 Lake Ave., where six members of one family lay prostrate with the illness.
Soper’s estimate of 1,350 cases would have included the original 965 plus about 151 Cornell students who became ill away from Ithaca.36 The remainder was truly an educated guess: cases never reported to the Board of Health, the ones Bayles of the New York Times had mentioned in his inflammatory article of March 11, and adults who were exposed in Ithaca but got sick somewhere else. This latter number included the Broadway musical comedy actress Nellie Follis, who contracted typhoid during an engagement at the Lyceum Theatre in Ithaca that winter and developed symptoms further down the road in Chicago. We know of her case only because she had a degree of celebrity in her day and the New York Evening World ran a story.37
The grave diggers were busy. Typhoid killed eighty-two Ithaca residents, of whom twenty-nine were Cornell University students. The twenty-ninth and last known student death, that of Leslie S. Atwater, an Ithaca native, occurred on May 6. The total does not include the collateral deaths of James Pray, Edwin H. Nourse, or Albert Mudge Sr., who contracted typhoid while nursing their sons. There were almost certainly more of these that did not come to wide public attention.
Even as students returned to Cornell, especially after Easter Sunday on April 12, members of the university faculty struggled to recover from their own bouts of typhoid.38 Earl Blough, an assistant in the Chemistry Department, was admitted to the Cornell Infirmary on January 23, making him one of the first fever patients in the facility, and was not discharged until April 1. The next day, he requested a leave of absence from his duties to recover fully from typhoid, which was granted. It appears he returned to his job in the fall.39 Another chemistry assistant, Walter S. Lenk, spent eight weeks in City Hospital and requested a leave of absence for the remainder of the academic year. “Having had severe complications during my illness, I find myself still weak and unable to take up my work for a number of months,” he wrote in a letter to Schurman on March 25. Lenk recovered and spent two more years at Cornell.40
John C. Gifford, an assistant professor of forestry, was one of three people living in a rooming house at 109 Summit Ave. to become ill with typhoid, another being Mark V. Slingerland, an entomology professor. Gifford saw the epidemic kill several of his friends and severely damage his own health, so much so that his doctors warned him that another northern winter might kill him. Both ill and out of a job—the New York State Legislature zeroed out the budget for the forestry program at Cornell that year, but that is another controversy—he moved to Coconut Grove in Florida and became an expert on the South Florida natural world.41 Slingerland stayed at Cornell for many years.
There was still the occasional cockeyed optimist. Professor George Lincoln Burr, a librarian who also taught medieval history, wrote to Andrew Dickson White on March 30 that “our typhoid epidemic seems almost a thing of the past” and that “all those still sick are on the high road to recovery.” President Schurman, in an odd comment that seemed almost like boasting, told the Board of Trustees that the 9.3 percent mortality rate among Cornell students with typhoid was better than the 13.3 percent mortality rate among Yale students with typhoid in the 1901 epidemic in New Haven, Connecticut, a much less severe epidemic in real terms.
New Haven in 1900 had 108,027 people, more than eight times the population of Ithaca. The epidemic toll was 465 cases and seventy-three deaths overall, not just at Yale, or about 68 per 100,000. Ithaca, by contrast, had a typhoid death rate of about 525 per 100,000 if Cornell’s approximately three thousand students are added to the city population of a little over thirteen thousand. Around the same time, Chicago had a ratio of 45 typhoid deaths per 100,000, Cincinnati was about the same, Cleveland was 110, Philadelphia was 72, and Detroit was 17.42
One of the last victims of the Ithaca epidemic, and perhaps the most tragic of all, was Dr. Alice Potter, a pioneering female physician in Ithaca who passed away on May 2 after a three-week battle with typhoid. Like every other physician in Ithaca, she had worked long days and nights ministering to dozens of typhoid sufferers, but unlike any of her colleagues, she came down with typhoid herself, almost certainly from a secondary infection originating with one of her patients.
Potter was operated on by Dr. Matthew Mann of Buffalo, who may have believed her intestinal pain was related to appendicitis. Mann was a gynecologist who had performed emergency surgery on President McKinley at the Pan-American Exposition after the president was shot there in 1901. His decision to perform the surgery in the park, rather than removing McKinley to Buffalo General Hospital, was widely criticized after McKinley’s death from infection. Dr. Potter was an 1897 graduate of the University of Buffalo Medical School and probably knew Dr. Mann. The story in the Ithaca Daily News about her death is somewhat confusing but clearly states that she was suffering from typhoid.
She was unmarried and lived simply. In her will, which she filed in Tompkins County Surrogate Court in 1901, Dr. Potter specified that she did not want more than $75 spent on her funeral, a modest amount even for 1903. A resolution passed at a meeting of Ithaca physicians on the day of her death paid tribute to her “cheerful presence, large hearted helpfulness, her untiring zeal in her wor
k, and her never failing kindness and love for humanity.” It lamented that her “short life had been sacrificed in her untiring efforts to relieve suffering and to save life.”43
Eight days after Potter’s death, the final typhoid patient was discharged from the Cornell Infirmary, where so many had suffered and died.44 President Schurman wrote an epitaph for his dead students that appeared in the 1902–1903 Cornellian, the university yearbook:
Toll for the fallen! Some of our best are no more. In the prime of manhood, like flowers of the field, they have been cut off and withered. The hearts of fathers and mothers, of brothers and sisters, of friends and some dearer than friends, have been wrung with anguish. Their sorrow is our sorrow. Our friends are no more. Never again shall we grasp the warm hand or hear the voice of these comrades we knew and loved. Alas! Alas! To all those whom the ties of kinship and affection united to our lost friends, this brotherhood of scholars, mourning a common loss, tender deep and sincere sympathy, though, indeed, tears are nearer than words.45
And from the Cornell University Class of 1903, a possibly cynical drinking song:
Here’s to 1903
Drink her down, drink her down
Here’s to 1903
Drink her down, drink her down
Here’s to 1903
She will win the victory
Drink her down, drink her down
Drink her down, down, down