In both settlements, the Italians often welcomed health officials’ efforts to improve their environment. In the summer of 1900, Blauvelt met little opposition when he rolled onto Mott Street at the head of a “disinfecting party,” equipped with two wagons carrying one hundred gallons of disinfectant. Sanitary inspectors, backed by eighty policemen, moved through hallways, rooms, and cellars, pumping spray into every nook and across every surface they suspected of harboring germs. But when health department tactics collided with cherished cultural practices or the sanctity of the family, the officers encountered strong opposition. No action occasioned greater resistance than when authorities tried to remove an Italian child infected with tuberculosis or smallpox from her mother. Such experiences had convinced charity officials and health officers that Italian tenement mothers—knowing little English and seemingly indifferent to modern hygiene—posed a special threat to their own children and to the public health. “With ignorance of that stamp,” said the crusading reformer Jacob Riis, “there is no other argument than force.”6
With the return of smallpox to New York in late 1900, the eyes of the department were trained once again on the city’s “Little Italies.” In mid-January 1901, officials discovered a case of smallpox in a Mott Street tenement. In the last few days of the month, a department raiding party removed thirty people with smallpox from Italian Harlem. Inspectors found children tucked away in cupboards. “No one knows the damage that has been done by these Italians,” said Dr. Frederick Dillingham, assistant sanitary superintendent for Manhattan. “They have gone from infected homes to work everywhere in this city; they have ridden in street cars, mingled with people, and may have spread broadcast the contagion. The most stringent measures should be taken to stamp out the spread of the disease.” Now, on the night of February 1, as Blauvelt’s men looked around at all those tenements, they had a good idea what they would find behind their brick and wooden walls.7
At Blauvelt’s command, the men moved. They followed the same method on each block. With policemen stationed on the roofs, at the front doors, and in the backyards, doctors and police entered the tenements and rapped on doors, rousing men, women, and children. Frightened and furious, the residents moved into the lighted areas, where doctors inspected their faces for pocks and their arms for the mark of vaccination. Some understood the officials’ English. They translated for the many who did not. Everyone lacking a good mark had to submit to vaccination. According to the Times, which had a reporter on the scene, many residents were “forcibly vaccinated.”8
While some fought, others fled. Quick-footed men slipped past police at stairwells, doorways, and coal scuttles, bolting into the night. Doctors and police chased a man wearing nightclothes as he leaped over back fences. Catching him, they discovered he had recently been vaccinated—he had the ripe sore on his arm to prove it. He fled because, speaking no English, he did not understand the raid’s purpose. He ran as if his life depended on it.9
The Times reporter recorded the “many dreadful scenes” that marked the progress of the vaccination corps through “the infected district.” Italian Harlem was a predominantly male world—a complex and conflicted community forged in the common experiences of separation and alienation. Separation from loved ones back in southern Italy. Alienation from New York’s Irish-dominated Catholic Church and Tammany Democratic machine. Only on these blocks did the authority of the Italian workingmen normally prevail. On a typical day, the streets were a male domain of bocce games, card playing, and conversation. Even so, mothers had a special moral authority in the tenements. In rooms where precious space was set aside for shrines to the Madonna, the bond of mother and child received the utmost respect. Now, as doctors and policemen “tore suffering little children from the arms of shrieking mothers,” the reporter watched in amazement as “embryo riots” erupted in the rooms, yards, and streets.10
Chief Inspector Blauvelt and a group of his men arrived at the three-story wood-framed building on First Avenue that housed Caballo’s saloon. They climbed the steps to the second floor. In the rear of the building, they came upon the door with the brass padlock. Tenants insisted those rooms were vacant. But Blauvelt and his men paused at the threshold. According to the Times reporter, “after a time they heard someone move within and the faint moan of a child in pain.” The men kicked down the door. Inside, they found a second locked door. They forced it open. They came upon the pile of boxes. Pulling them away, they found the children under the bed. All three, the doctors quickly determined, were sick with smallpox “in the most dangerous stage.”11
The mother of the Caballo children—who must have been in that room all along, the “someone” who moved within—struggled with the men as they carried her children and little Antoinette down the stairs to the street. The doctors tried to calm her, assuring her she could accompany her children to the isolation hospital on North Brother Island. Well-behaved mothers were sometimes allowed that privilege, especially if they were nursing infants. But when she continued her protest on the street, the physicians barred her from the ambulance wagon. Mrs. Caballo, the Times reporter wrote, “fought like a tigress on the sidewalk, and her screams aroused the neighborhood for blocks around.” At last, she was driven indoors. The ambulance rolled away.12
By the end of that long night, Blauvelt’s corps had scraped vaccine into the arms of many tenement dwellers, put watches on suspicious people, and removed nine infected children from their homes. Three-year-old Marion Scarroni was already dead when the doctors found her. None of the infected children had ever been vaccinated. In defiance of the law, their families and neighbors had secreted them away for days. Perhaps the parents believed they could best take care of their own children themselves; with smallpox, attentive care could mean the difference between survival and death. Or perhaps the parents feared, as the Times reporter supposed they must, that their little ones would “be taken away from them forever.”13
In the early hours of the morning, the men of the vaccination corps made their way through the still sleeping city to their own homes to get some rest. They would need it. The Department of Health had another raid planned for Italian Harlem the following night.
None of the children had ever been vaccinated. The scarless arms of those nine children of the Italian diaspora tell us something about their political status. Each was, in the words of the Constitution, a “natural born Citizen” of the United States. How could a child’s skin say so much? In the final years of the nineteenth century, in the midst of the greatest sustained wave of human migration the world had ever seen, a vaccination scar had become something more than a sign of immunity from smallpox. The scar had become a sort of passport—a stamp-sized tattoo of political immunity, required by U.S. law and the quarantine regulations of the nation’s major ports for entry into the American body politic. This legal requirement did not apply with equal force to all. The class-based spatial arrangements of the ocean voyage governed migrants’ treatment upon arrival; steerage passengers underwent a far more exhaustive medical inspection than did their shipmates traveling in first- and second-class cabins. This much is reasonably certain: at the turn of the century, no child en route from Italy to a place like East Harlem would have made it through the Port of New York without well-defined pockmarks (proving a previous case of smallpox) or a discernible mark of recent vaccination.14
Twenty-four million people migrated to the United States between 1880 and 1924, two thirds of them entering the country through the Port of New York. The world over, people were on the move. Within Europe, some two million people picked up and moved each year in the late nineteenth century. Others reached ports like Bremen, Naples, or Liverpool and kept going. The promise of decent jobs and a greater measure of political and religious liberty helped make the United States the foremost destination of the global transoceanic migrations of the era. Until the 1920s, U.S. immigration law—shaped by interests of humanity and political economy—left the borders open to most of the world
’s peoples. Still, slowly accumulating categories of exclusion tightened the nation’s points of entry, revealing the particular contours of the immigrant nation’s rising anxiety about newcomers. Congress welcomed all but prostitutes (excluded in 1875); Chinese people, convicts, lunatics, idiots, and paupers (1882); unskilled contract laborers (1885); polygamists and “persons suffering from a loathsome or a dangerous contagious disease” (1891); and epileptics and anarchists (1903).15
Immigrants to the United States traveled alone, in families, or even as transplanted communities. Some came only as sojourners, others as the first pioneers in chains of family members intent on permanent settlement. Increasingly, they came from regions of southern and eastern Europe that prior to the 1880s had been insignificant players in the peopling of America. Italy alone contributed tens of thousands of migrants each year during the 1890s, hundreds of thousands annually after 1900. Four fifths of the Italians came from the southern peninsula and Sicily (the mezzogiorno). Compared to the familiar English, Scottish, Irish, and Germans, the “new” immigrants from Russia, the Austro-Hungarian Empire, and Italy seemed utterly foreign to many native-born Americans, who associated them with urban squalor, criminality, and, above all, disease. American state and federal governments shared that assessment, and beginning in the 1880s they built an increasingly elaborate system for the control of immigrant ships and the diseases they carried.16
Whether they began their journey by foot, wagon, or rail, immigrants from Europe or Asia got their first glimpse of America from a crowded, clamoring steamship. By 1870, steam had replaced wind as the force that powered the Atlantic crossing. During the next three decades, as the immigrant trade exploded, steamships grew larger and faster. Dozens of companies competed for immigrant fares, including Britain’s White Star and Cunard lines, France’s Companie Générale Transatlantique, Germany’s Hamburg-Amerika line, and New York–based Pacific Mail Steamship Company. Steel hulls, better boilers, and stronger engines enabled the construction of great ships weighing five thousand tons or more. Each might carry as many as three hundred passengers in their first- or second-class cabins and a thousand or more belowdecks in the steerage compartments—so named because of their location near the ships’ steering machinery.17
Companies packed steerage passengers onto tiers of narrow metal bunks that rose from dirty floors to low, sweaty ceilings. Toilet facilities were inadequate, portholes few. The lines running from southern Italy were notorious. One journalist, traveling as an immigrant from Naples in 1906, wondered how a steerage passenger was supposed to “remember that he is a human being when he must first pick the worms from his food . . . and eat in his stuffy, stinking bunk, or in the hot and fetid atmosphere of a compartment where 150 men sleep.” The introduction of third-class cabins on some lines around the turn of the century offered passengers a bit more space. But accommodations remained exceedingly tight for the vast majority making the ocean voyage to America.18
The discovery of smallpox aboard a crowded ship at sea, a common occurrence in the nineteenth century, was a harrowing event that called forth the full power of the captain. As “master of the vessel,” the captain’s legal authority over his crew and passengers was, in the words of one law scholar, “necessarily summary and virtually absolute.” The captain’s men pulled infected passengers from their bunks and isolated them in the ship’s infirmary. They fumigated compartments and personal effects. They vaccinated all aboard. Stoner’s Handbook for the Ship’s Medicine Chest instructed that the scabs from the sick passengers had to be carefully gathered up and burned, lest the infectious stuff be “conveyed not only to other parts of the ship, but to any part of the world to which the ship is bound.” U.S. quarantine regulations required that the dead be wrapped in a sheet saturated with carbolic acid or bichloride of mercury and then placed in a hermetically sealed coffin or buried at sea. Nineteenth-century practice was to throw the bodies overboard “the instant that life had ceased.” When the ship reached its destination, crew and passengers could expect to spend fourteen days in quarantine while medical officers waited to see how widely smallpox had spread among them. Exceptions were often made for travelers in first and second class.19
Even without smallpox aboard, travel in steerage was hazardous to the health. Late nineteenth-century American reformers and port officials protested the “heartless treatment” of steerage passengers on journeys that some compared to the “Middle Passage” of the bygone slave trade. Federal law levied a $10 penalty on ship companies for every passenger over eight years of age who died en route to the United States. But as two New York State commissioners of immigration lamented in 1868, the law was little enforced and did nothing for the hundreds of steerage passengers who died each year. The “interest of humanity” and “political economy,” these officials declared, required the reform of a system where “emigrants are treated more like beasts of burden than human beings.” The New York officers urged Congress to require all immigrant ships bound for America to carry a medical officer.20
By the time Congress finally enacted such a law, in 1882, the germ theory was on the rise. “Reasons of hygiene” joined the old “sentiments of charity, morality, and humanity” in congressional deliberations. Consequently, ship surgeons would do much more than care for sick passengers. They would become on-board agents of American quarantine regulations. That same year, 1882, the short-lived National Board of Health called for a new federal law to mandate “the vaccination of all immigrants not previously protected”—a policy that at that time applied only to passengers from foreign ports known to be infected with smallpox. But the board’s argument that compulsory vaccination served the national interest—by preventing the constant importation of smallpox and stopping the amassing of “large numbers of susceptibles in circumscribed localities” (cities)—failed to move Congress to adopt a uniform national policy until another decade had passed.21
Faster ships, more than sharper laws, made the Atlantic crossing safer. In 1867, the journey took fourteen days or more; by 1900, some steamships could make the trip in under six. But the passenger’s relief was the quarantine officer’s headache. Speed altered the nature of the threat from smallpox. The average incubation period for the disease was about twelve days; in the age of sail, if anyone on board was infected that fact was likely to become known well before the vessel reached port. With each new increment of speed, the likelihood increased that infected travelers would reach port without presenting symptoms. As Dr. William M. Smith, health officer of the port of New York, reported in 1888, smallpox was the most difficult “latent contagion” to check by maritime quarantines. In that year alone, Dr. Smith’s medical officers inspected some 383,000 steerage passengers. Given the rising boat speeds, any number of them might have contracted smallpox in a European village, traveled more than three thousand miles to New York, shown no symptoms at quarantine, boarded a train, and not felt the first fever until reaching the American heartland. Outbreaks in Illinois, Indiana, and Missouri were traced to recently arrived immigrants from Europe. According to Smith, this problem of latent contagion had caused “more anxious reflection” among American port health officers “than any other subject during the past nine years.” He called for a strict policy that all passengers not vaccinated within the previous eight years submit to the procedure within two days of boarding a U.S.-bound ship.22
Increasingly, immigrant-receiving ports enforced just such a rule. One English opponent of vaccination, arriving in New York aboard a White Star steamship, wrote home that “America was closed against the unvaccinated anti-vaccinator, [who] was fast falling into the condition of the American negro-slave who was hunted down everywhere by everybody.” Like New York, the port of Boston required all arriving steerage passengers to present a certificate, signed by the ship’s medical officer, stating that they were protected from smallpox due to having survived the disease or by recent vaccination. Anyone failing to meet this requirement would be vaccinated by a port physician
on arrival or be detained for fourteen days on Gallop’s Island. Steamship companies posted the port’s vaccination requirements, translated in several languages, on their Boston-bound ships. For many immigrants, seeing this notice was their first encounter with American law.23
For some steerage passengers, vaccination aboard a ship at sea was just one inconvenience among many. For others, the experience was overwhelming. Steamship companies insisted they were merely providing a service, one required of them in order to do business in American ports. Passengers, they said, were at liberty to refuse the service and face the consequences. But the true test of liberty lies in its exercise. Liberal political theorists since John Locke had suggested that real human freedom and consent required physical space—“room enough”—for their exercise. Liberty needs an exit.24
Mary O’Brien was just seventeen when she boarded the Cunard Steamship Company’s Catalonia in Queenstown, Ireland. The Catalonia set sail for Boston on the Fourth of July, 1889. Mary had never been away from home, and her mother had recently died. She made the journey with her father and brother, traveling in a steerage compartment with three or four hundred strangers.25
When the Catalonia was about three days out from Boston, Mary sat with other female passengers on deck. A ship steward approached and told them to go below. Not knowing the purpose, Mary descended the staircase into steerage. At the landing, halfway down, she passed the ship’s surgeon, I. T. M. Griffin, who stood with two stewards. She continued to the bottom of the stairs. All of the ship’s female steerage passengers had been lined up at the foot of the stairs and were making their way slowly up. The male passengers were nowhere to be seen. (Mary later learned that her father and brother, along with all the rest, had been taken to another part of the ship.) As the line moved forward, Griffin inspected each woman’s arm and “proceeded to vaccinate those that had no mark.” As they passed inspection, each woman received a card from a steward—a vaccination certificate to be presented to the port physicians. Mary held back until she was the last woman on the stairs. She later recalled that she saw “no means of exit except where the surgeon stood.” She told Griffin that she knew from her mother that she had been vaccinated as a baby. He said there was no mark, and she “must be vaccinated.”26
Pox Page 27