3 Long, “Smallpox in Iredell County,” 214. My account of Harvey Perkins’s case also draws upon “From Bulletin, February 1898,” in NCBOH 1897–98, 82–85; C. P. Wertenbaker, “Smallpox at Statesville, N.C.,” PHR, 13 (Jun. 24, 1898), 634–35; and “Harvey Perkins Dead,” CO, Feb. 22, 1898, 6.
4 Long, “Smallpox in Iredell County,” 208.
5 USSGPHMHS 1898, 627, 598–99. “Warning Against Smallpox,” Mar. 25, 1898, in KBOH 1898–99, 23. C.P. Wertenbaker, “Investigation of Smallpox at Columbia and Sumter, S.C.,” PHR, 13 (May 13, 1898), 470. See “From Bulletin, February 1898,” in NCBOH 1897–98, 82; “Smallpox in the United States as Reported to the Supervising Surgeon-General United States Marine-Hospital Service, December 29, 1896, to December 31, 1897,” PHR, 12 (Dec. 31, 1897), 1421–22; C.P. Wertenbaker, “Smallpox at Middleborough, Ky.,” PHR, 13 (Mar. 25, 1898), 273–74. See also W. Michael Byrd and Linda A. Clayton, An American Health Dilemma, Vol. 1: A Medical History of African Americans and the Problem of Race: Beginnings to 1900 (New York: Routledge, 2000), 322–414.
6 “From Bulletin, January 1898,” NCBOH 1897–98, 80. “From Bulletin, February 1898,” ibid., 84. C.P. Wertenbaker, “One Case of Smallpox in Wilmington, N.C.,” PHR, 13 (Jan. 14, 1898), 25. C.P. Wertenbaker, “Investigation of Smallpox at Charlotte, N.C.,” PHR, 13 (Feb. 18, 1898), 140–41.
7 C.P. Wertenbaker’s transmission to Mayor E. B. Springs is published in “From Bulletin, February 1898,” 84.
8 Ibid., 84. “Harvey Perkins Dead.”
9 “From Bulletin, February 1898,” 85.
10 Long, “Smallpox in Iredell County,” 210. Lewis, “Annual Report of the Secretary,” 28. C.P. Wertenbaker, “Smallpox at Statesville, N.C.,” 634–35.
11 Long, “Smallpox in Iredell County,” 216.
12 Dr. H. Y. Webb, “Smallpox in Greene County,” ABOH 1883–84, 129.
13 At the turn of the century, public health reports in many places had yet to adopt a standardized, bureaucratic format. The biennial reports issued by the Kentucky and North Carolina boards of health, for example, as well as the weekly Public Health Reports published by the U.S. Marine-Hospital Service, consisted chiefly of letters and telegraphic transmissions from local health authorities, who leavened their smallpox dispatches with a wealth of local social and political detail. On the dramaturgic character of epidemics as social events, see Charles E. Rosenberg, “What Is an Epidemic? AIDS in Historical Perspective,” in Explaining Epidemics and Other Studies in the History of Medicine (New York: Cambridge University Press, 1992), 278–92.
14 KBOH 1898–99, 61, 81, 133, 92. PHR, 14 (Mar. 3, 1899), 278. PHR, 13 (Jul. 29, 1898), 781. “Vigorous Measures Have Been Adopted,” The State (Columbia, SC), Apr. 5, 1898, 2.
15 James Nevins Hyde, “The Late Epidemic of Smallpox in the United States,” PSM, 59 (Oct. 1901), 557–67, esp. 557.
16 H. F. Long, “Report of the State Small-Pox Inspector,” NCBOH 1899–1900, 29.
17 “Thou shalt not be afraid for the terror by night; nor for the arrow that flieth by day; Nor for the pestilence that walketh in darkness; nor for the destruction that wasteth at noonday.”—King James Bible, Psalm 91:5–6. This psalm was quoted, albeit inaccurately, in the most important vaccination decision handed down by the North Carolina Supreme Court. In the majority opinion, Justice Clark insisted upon the right of the community to protect itself against “the deadly pestilence that walketh by noonday.” State v. W. E. Hay, 126 N.C. 999, 1001 (1900).
18 KBOH 1896–97, 46–47. KBOH 1898–99, 30.
19 Col. A. W. Shaffer, “Small-pox and Vaccination for Plain People. By One of Them,” NCBOH 1897–98, 173.
20 F. Fenner et al., Smallpox and Its Eradication, (Geneva, 1988), 217–44, esp. 210, 217. Sergei N. Shchelkunov, “How Long Ago Did Smallpox Virus Emerge?” Archives of Virology, 154 (2009): 1865–71. See also Ian Glynn and Jenifer Glynn, The Life and Death of Smallpox, 6–54, esp. 4; and Donald R. Hopkins, Princes and Peasants: Smallpox in History (Chicago: University of Chicago Press, 1983).
21 By “natural” host range, I mean outside the laboratory. See S. S. Kalter et al., “Experimental Smallpox in Chimpanzees,” Bulletin of the World Health Organization, 57 (1979): 637–41. For a useful overview of the virology of variola and the other orthopoxviruses, see Fenner et al., Small-pox and Its Eradication, 69–119.
22 See C.-E. A. Winslow, “Communicable Diseases, Control Of,” in Encyclopaedia of the Social Sciences , ed. Edwin R. Seligman (New York: MacMillan, 1937), vol. 3: 66–78. The death toll figure is from Richard Preston, “The Demon in the Freezer,” New Yorker, July 12, 1999, 47. See also Preston’s Foreword to D. A. Henderson, Smallpox: The Death of a Disease (Amherst, NY: Prometheus Books, 2009), 12.
23 U.S. Treasury Department, Public Health and Marine-Hospital Service, Handbook for the Ship’s Medicine Chest, by George W. Stoner, M.D., 2d ed., 21. See also Fenner et al., Smallpox and Its Eradication, 117.
24 Macaulay quoted in Hopkins, Princes and Peasants, 38. Glynn and Glynn, Life and Death of Small-pox , 1, 4. Fenner et al., Smallpox and Its Eradication, 169–208.
25 Jennifer Lee Carrell, The Speckled Monster: A Historical Tale of Battling Smallpox (New York: Dutton, 2003). Fenner et al., Smallpox and Its Eradication, 224, 229. Henderson, Smallpox, 40–43. Mary Beth Norton et al., A People and a Nation: A History of the United States, 6th ed. (Boston: Houghton Mifflin, 2001), 26. See Alfred W. Crosby, The Columbian Exchange: Biological and Cultural Consequences of 1492 (Westport, CT: Greenwood, 1972). For a compelling reconsideration of the “virgin soil” theory, see David S. Jones, “Virgin Soils Revisited,” William and Mary Quarterly, 60 (2003): 703–42.
26 Fenner et al., Smallpox and Its Eradication, 224.
27 “Précis upon the Diagnosis and Treatment of Smallpox,” PHR, 14 (Jan. 6, 1899), 37–49. Hopkins, Princes and Peasants, 13. Preston, “Demon in the Freezer,” 48.
28 Fenner et al., Smallpox and Its Eradication, 71.
29 “Smallpox in the United States as Reported to the Supervising Surgeon-General United States Marine-Hospital Service, January 1 to December 30, 1898,” PHR (Dec. 30, 1898), 1559–62.
30 “Précis.” The following description of the clinical course of smallpox relies heavily on the exhaustive research compiled by a team of World Health Organization scientists in Fenner et al., Small-pox and Its Eradication, esp. chs. 1 and 3. Running more than 1,400 pages, the tome is often referred to as “The Big Red Book of Smallpox.” It is by far the single most comprehensive source on the science of smallpox and vaccination. For a more concise medical discussion of the pathology of smallpox, see Hopkins, Princes and Peasants, 3–9. Like Frank Fenner and his coauthors, Dr. Hopkins, a physician and epidemiologist, worked in the WHO smallpox eradication program.
31 “Précis,” 38.
32 “Smallpox Rumor,” CO, Feb. 26, 1898, 6. Fenner et al., Smallpox and Its Eradication, 266, 45. Hopkins, Princes and Peasants, 3.
33 “Précis,” 38. Fenner et al., Smallpox and Its Eradication, 5, 44, 167. See also Michael R. Albert et al., “Smallpox Manifestations and Survival during the Boston Epidemic of 1901 to 1903,” AIM, 137 (Dec. 17, 2002): 993–1000, esp. 993.
34 “Précis,” 38. See also Fenner et al., Smallpox and Its Eradication, 6; Michael Kelly, “Small-Pox: Its Medical Treatment,” MC, Jan. 1, 1902, 171.
35 Long, “Smallpox in Iredell County,” 214. Hopkins, Princes and Peasants, 277–81, esp. 277.
36 J. C. Wilson, Fever-Nursing, 2d ed. (Philadelphia: J. B. Lippincott Company, 1895), 165. Fenner et al., Smallpox and Its Eradication, 19, 189.
37 On the names of smallpox, see Fenner et al., Smallpox and Its Eradication, 229; Preston, “Demon in the Freezer,” 44.
38 “Précis,” 38–39. Preston, “Demon in the Freezer,” 47. Fenner et al., Smallpox and Its Eradication, 19, 21, 56, 130. See also Stoner, Handbook for the Ship’s Medicine Chest, 21.
39 “Précis,” 37, 38.
40 Long, “Smallpox in Iredell County,” 216
.
41 Stoner, Handbook for the Ship’s Medicine Chest, 21, 22. “Précis,” 39. Long, “Smallpox in Iredell County,” 215–16. Fenner et al., Smallpox and Its Eradication, 19, 22.
42 Long, “Smallpox in Iredell County,” 217. “Report of Dr. Llewellyn Eliot, M.D.,” July 1, 1895, in Annual Report of the Commissioners of the District of Columbia For the Year Ended June 30, 1895, Serial Set Vol. No. 3391, Session Vol. No. 24, 54th U.S. Congress, H.R. Doc. 7, p. 1296. Fenner et al., Smallpox and Its Eradication, 68.
43 Fenner et al., Smallpox and Its Eradication, 50–54.
44 “Supply of Coffins Is Short,” AC, Mar. 8, 1900, 8. See “Guarding Public Health,” ibid., Mar. 23, 1901, 3; “Will Not Ask for Increase,” ibid., Dec. 11, 1901, 4.
45 “Précis,” 39. Fenner et al., Smallpox and Its Eradication, 22, 139, 167.
46 “Précis,” 38–39. Fenner et al., Smallpox and Its Eradication, 32, 4, 167. Preston, “Demon in the Freezer,” 50. See also Stoner, Handbook for the Ship’s Medicine Chest, 22.
47 WTC. The image of the scarred man is #1500, titled “Small Pox (after recovery).”
48 See, for example, the display advertisement for the John H. Woodbury Dermatological Institute in New York City, NYT, Jan. 26, 1908, 6; and “Woman Choked to Death,” ibid., Jul. 15, 1910, 7. See also “Sheriff’s Department,” Houston Post, Feb. 15, 1897, 6; “Priest’s Murder Was Incited by a Rare Jewel,” NYEW, May 27, 1907, 2.
49 See generally John Duffy, The Sanitarians: A History of American Public Health (Urbana and Chicago: University of Illinois Press, 1990); idem, From Humors to Medical Science: A History of American Medicine, 2d ed. (Urbana and Chicago: University of Illinois Press, 1993); Gerald Grob, The Deadly Truth: A History of Disease in America (Cambridge, MA: Harvard University Press, 2002). Nancy Tomes, The Gospel of Germs: Men, Women, and the Microbe in American Life (Cambridge, MA: Harvard University Press, 1998). For a concise overview, see C.-E. A. Winslow, “Public Health,” in Encyclopaedia of the Social Sciences, ed. Edwin R. A. Seligman, vol. 11, 646–57. The best introduction to the legal aspects of public health administration in the early twentieth century is James A. Tobey, Public Health Law: A Manual of Law for Sanitarians (Baltimore: The Williams & Wilkins Co., 1926).
50 Fenner et al., Smallpox and Its Eradication, 146.
51 Elizabeth A. Fenn, Pox Americana: The Great Smallpox Epidemic of 1775–82 (New York: Hill and Wang, 2001). Fenner et al., Smallpox and Its Eradication, 217, 245–58. Hopkins, Princes and Peasants , 249–53.
52 Fenner et al., Smallpox and Its Eradication, 258–73.
53 James Gillray, “The Cow Pock—or—the Wonderful Effects of the New Inoculation!” The cartoon appeared in Vide—The Publications of the Anti-Vaccine Society, June 12, 1802. It is now held in the National Library of Medicine Collection, and may be viewed in vivid color at http://www.nlm.nih.gov/hmd/frankenstein/frank_promise.html, accessed November 9, 2006. For a fascinating discussion of the cultural context, see Tim Fulford and Debbie Lee, “The Jenneration of Disease: Vaccination, Romanticism, and Revolution,” Studies in Romanticism, 39 (2000): 139–64.
54 “Précis,” 42.
55 “Précis,” 39–40, esp. 40. Fenner et al., Smallpox and Its Eradication, 27, 65.
56 Peter Baldwin, Contagion and the State in Europe, 1830–1930 (Cambridge: Cambridge University Press, 1999), 244–354. See also Fenner et al., Smallpox and Its Eradication, 258–76.
57 See generally Tobey, Public Health Law.
58 According to the “Précis,” “The French army numbered 23,000 deaths by it [smallpox], while the German army had only 278.” “Précis,” 43. I am using the numbers here from Fenner et al., Small-pox and Its Eradication, 232, assuming them to be more accurate.
59 “Précis,” 43. USSGPHMHS 1898, 630.
60 For phony certificates, see “Vaccination Certificate Frauds,” NYT, May 9, 1904, 8. For evidence of families taking care of their own (and then being discovered by the authorities), see “Smallpox Nest in Brooklyn,” ibid., Mar. 20, 1901, 2; “Defies the Health Board” (Harrison, NJ), ibid., Jul. 27, 1901, 2; “Fight for a Sick Child” (Newark, NJ), ibid., Nov. 12, 1901, 3. For escapes from quarantines or pesthouses, see “‘Mother’ Jones Arrested” (in a Utah mining camp), ibid., Apr. 27, 1904, 3. For resistance to vaccination in other U.S. settings, see “Miners Resist Vaccination” (Lead, SD), ibid., Apr. 25, 1902, 1; “Object to Vaccination” (African American railway workers on the Western Maryland Improvement), WP, May 3, 1901, 9. For Filipino resistance to U.S. compulsory vaccination in the Philippines, see “Manila Is Healthful,” NYT, Aug. 19, 1903, 8. Note these are just a few examples, and they are taken only from the first few years of the twentieth century. I also have collected many examples from the 1890s and further into the decades of the 1900s and 1910s.
61 “Smallpox and Vaccination,” BMJ, 40 (Feb. 1901), 525.
62 See for example C. P. Wertenbaker, “Investigation of Smallpox at Columbia and Sumter, S.C.,” PHR, 13 (May 13, 1898), 468–70.
TWO: THE MILD TYPE
1 G. M. Magruder, “Passed Assistant Surgeon Magruder’s Report on Smallpox at Little Rock, Ark.,” PHR, 13 (May 6, 1898), 437. See Louis Leroy, Smallpox: Its Diagnosis, Treatment, Restriction and Prevention, with a Few Remarks upon the Present Epidemic, issued by the Tennessee State Board of Health (Nashville: Tennessee State Board of Health, 1900).
2 See Charles V. Chapin, “Variation in Type of Infectious Disease as Shown by the History of Small-pox in the United States 1895–1912,” Journal of Infectious Diseases, 13 (1913), 171–96, esp. 173; Charles V. Chapin and Joseph Smith, “Permanency of the Mild Type of Smallpox,” Journal of Preventive Medicine, 6 (1932): 273–320.
3 C. P. Wertenbaker, “Plan of Organization for the Suppression of Smallpox,” p. 62, typescript in CPWL, vol. 6.
4 On public health administration in the southern United States, see Francis R. Allen, “Development of the Public Health Movement in the Southeast,” Social Forces, 22 (1943): 67–75. On the lack of administrative systems for tracking disease and vital statistics in the states, especially in the South, see USSGPHMHS 1910, 189; USSGPHMHS 1911, 241; U.S. Census Bureau, A Discussion of the Vital Statistics of the Twelfth Census, by Dr. John Shaw Billings (Washington, 1904), esp. 7–8; and Chapin, “Variation in Type,” 171–72.
5 “Warning Against Small-Pox,” Feb. 15, 1898, KBOH 1898–99, 22. See Chapin, “Variation in Type,” 173, 174; G. M. Magruder, “Work of the Service in Suppressing Smallpox in Alabama,” PHR, 13 (Mar. 18, 1898), 246–51; KBOH 1900–01, 17; NCBOH 1903–04, 13; USSGPHMHS 1898, 598–99.
6 Richard H. Lewis, “Annual Report of the Secretary of the North Carolina Board of Health, 1898–99,” in NCBOH 1899–1900, 23. See, e.g., C.P. Wertenbaker, “The Smallpox Outbreak in Bristol, Va.-Tenn.,” PHR, 14 (Nov.3, 1899), 1890; “Value of Vaccination,” PHR, 14 (Feb. 10, 1899), 180.
7 LBOH 1898–99, 55, 129. NOBOH 1900–01, 23–24. “Guarding Public Health,” AC, Mar. 23, 1901, 3. As late as 1909, Surgeon General Wyman said no one could predict “whether” the mild type of smallpox would “change to the more usual fatal form.” USSGPHMHS 1909, 201.
8 Chapin, “Variation in Type,” 196. In 1932, Chapin and his coauthor Joseph Smith published another major scientific article on the subject; Chapin and Smith, “Permanency of the Mild Type,” esp. 319, emphasis added. The authors observed: “The statement should rather be, that it [mild type smallpox] has for the most part bred true, for it is not intended to prejudge the question whether it ever reverts to the classical type. That it does not revert is the belief of practically all American epidemiologists who have had experience with this disease.” Ibid., 276. See Fenner et al., Smallpox and Its Eradication, 96.
9 Fenner et al., Smallpox and Its Eradication, 3, 96–103, 329–32. K. R. Dumbell and Farida Huq, “The Virology of Variola Minor Correlation of Laboratory Tests with the Geographic Distribution and Human Virulence of Variola Isolates,” American Journal of Epidemiology, 123 (1986): 403–15.
10 Fenner et al., Smallpox and Its Eradication, 3.
11 Chapin, “Variation in Type.” 171–96. Charles and Smith, “Permanency of the Mild Type.” Fenner et al., Smallpox and Its Eradication, 3, 96–103, 329–32. J. Pickford Marsden, “Variola Minor: A Personal Analysis of 13,686 Cases,” Bulletin of Hygiene, 23 (1948): 735–46.
12 The phrase “creative destruction” comes, of course, from Joseph A. Schumpeter, Capitalism, Socialism and Democracy (New York: Harper and Brothers, 1942).
13 On the fascinating history of Middlesboro, see Harry M. Caudill, Theirs Be the Power: The Moguls of Eastern Kentucky (Urbana: University of Illinois Press, 1983), 16–35; John Gaventa, Power and Powerlessness: Quiescence and Rebellion in an Appalachian Valley (Urbana: University of Illinois Press, 1980); Kenneth W. Kuehn et al., eds. Geologic Impacts on the History and Development of Middlesboro, Kentucky (Lexington: Kentucky Society of Professional Geologists, 2003); Ann Dudley Matheny, The Magic City: Footnotes to the History of Middlesborough, Kentucky, and the Yellow Creek Valley (Middlesboro, KY: Bell County Historical Society, 2003).
14 Quoted in Gaventa, Power and Powerlessness, 47. See ibid., 47–83. On British investment in the United States, see Eric Rauchway, Blessed Among Nations: How the World Made America (New York: Hill and Wang, 2006), 42–52, esp. 48.
15 Katie Algeo, “Historical Overview: Settlement History of the Cumberland Gap Region,” in Kuehn et al., eds., Geologic Impacts, 3–8.
16 55th U.S. Congress, 2d Session, H.R. Doc. 10, Annual Report of the Comptroller of the Currency (Washington, 1897), vol. I: 496–97. “Encouraging. Middlesborough Town and Lands Company Has a Meeting in London,” MWH, Dec. 3, 1897, 4. See Algeo, “Historical Overview,” 7–8; Gaventa, Power and Powerlessness, 76–78; Matheny, Magic City, xxii–xxiv, 102–21.
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