Through the afternoon of December 27, the Board physicians were "kept busy" with an abrupt surge of new cases, mostly in Chinatown. By the end of the day, they were convinced of the need for quick and decisive action. Shortly after midnight, in the early hours of December 28, they formally re-mobilized the Hawaiian national guard and formally reinstated a complete quarantine of the Chinatown district. This time the triumvirate vowed a regimen "far more strict than the last quarantine" and ordered the national guard to patrol the periphery of the quarantined zone with bayonets fixed. By 3:0o A.M. the cordon was in place."'
The midnight quarantine drew angry protests and ugly threats the next morning. The English-language press suspected a young Chinese lawyer of actively organizing protests among his countrymen both inside and outside Chinatown, though the press did not know for sure who the young radical was. Three different groups of Japanese men disregarded the admonitions of the Japanese consul and attempted "to run the guard," only to be captured by mounted police and returned to the quarantine district. The staff of Ke Aloha Aina sympathized with their Hawaiian friends caught inside the zone. "While people ... were sleeping in their homes, they suddenly became surrounded by government troops who were sent to guard the area with their rifles projecting everywhere. Residents were panicstricken, but helpless to defend themselves from the will of the government." Like the Board of Health itself, KeAlohaAina blamed the reimposed quarantine at least in part upon the Chinese practice of sending plague victims out of Chinatown to die elsewhere.31
Following initial resistance, order was restored inside the quarantined zone over the course of the day. The United Chinese Society organized a committee of twelve under the direction of Lin Shen Chow to emulate the voluntary inspections being undertaken by the Japanese. The society doubtless hoped that such actions might forestall the reimposition of outside inspectors, whose activities had caused so much tension during the earlier quarantine. Learning from recent experience, the triumvirate immediately ordered the delivery of fresh meat, fresh produce, and poi to residents inside the quarantined zone, at government expense.32
Emerson, Day, and Wood were convinced they had acted none too soon. Even as guards were being posted, they apprehended a gravely ill Chinese laborer attempting to slip out of the quarantined zone. He was forcibly removed to the plague hospital at Kakaako, where he quickly succumbed. An autopsy, performed by Kobayashi Sanzaburo and Mori Iga, the two principal directors of Honolulu's Japanese hospital, confirmed bubonic plague as the cause of death. On the same day, Hoffman's slides also confirmed the death of a young Hawaiian boy named Maunakina as plague. Skeptics could grumble all they wanted, businessmen could wish things were otherwise, politicians could worry about Hawaii's image, and the residents of Chinatown could protest their quarantine; but the three physicians on the Board of Health were now fully convinced they had the world epidemic of bubonic plague on their hands-and the brief quarantine in the middle of December had not snuffed it out.33
he grim "Christmas present" of 1899 put tremendous pressure on Emerson, Day, and Wood. With the reconfirmation of their absolute emergency powers came an expectation that they would not only stop the epidemic from decimating the city in the short run, but also extinguish the plague so completely that it would be unable to establish a permanent Hawaiian presence. Exactly how to achieve either of those goals, however, was far from obvious. Every day that passed brought additional deaths, and people throughout the city were beginning to realize that they were all trapped together in the middle of the ocean with no place to run.
By reinstating the Chinatown quarantine, the three physicians hoped to confine the disease to a manageable area, as they thought they had done two weeks earlier. But confinement without some program of eradication was pointless, even dangerous, since everyone confined inside the zone with the pestis bacteria remained at risk. So Emerson, Day, and Wood turned to the ad hoc sanitary committee they had appointed before the plague reappeared, hoping those men had some ideas about eliminating the conditions that pestis seemed to require.
On the afternoon of December 29, the three members of the ad hoc committee met with the three physicians at the Board of Health office. Emerson, Day, and Wood were encouraged to learn that the committee members had already developed a detailed list of ten proposals for sanitizing the Chinatown slum. The proposals ranged from "the immediate building of a garbage crematory," through extensive site grading and sewage treatment, to revised zoning laws with sharp teeth. The committee recognized that many of their proposals were potentially expensive for both Chinatown property owners and the public treasury, but they assured the physicians that they had given their assignment a great deal of thought and tried to consider both the present crisis and Honolulu's future. "With our large ocean trade we shall always be exposed to contagion," they argued, so in the long run the city would be ahead to spend whatever it took to make sure Chinatown was "in a condition to repel disease, and to prevent [diseases from] securing a foothold rather than undergo the loss caused by quarantine regulations, the interruption of trade, and the prevention of the free flow of commodities, which is essential to the life of commerce as well as the very existence of [our] community."'
Fully persuaded-and glad to have a coherent plan of action-Emerson, Day, and Wood approved the ad hoc committee's proposals and began to allot funds to implement them. The amounts they authorized were substantial, far in excess of their initial estimate of $ioo,ooo. Even though the earlier figure had triggered taxpayer protests and editorial debates, the three physicians now unflinchingly approved "$120,000 for water filtration plants, $25,000 for a garbage crematory, $8o,ooo for opening new streets and alleys, and $300,000 for extending the sewer system." In a single afternoon, the "mission boy" public health officer and the two medical partners from Ohio launched the most massive public works projects in Hawaiian history. The sums they drew from the republic's treasury in half an hour would never have been authorized by the civilian legislature under normal circumstances. But these were hardly normal circumstances. Indeed, the three physicians wondered whether the sanitation program by itself-even on this unprecedented scale-was enough. Was there anything else they could, or should, consider?'
To address that question, Emerson, Day, and Wood called a special session of the Board of Health for the following evening, December 30. Around the table with them sat titular Board president Henry Cooper, the republic's attorney general who seldom attended the Board's regular meetings, and George W. Smith, a civilian member of the Board. C. B. Reynolds, who had overseen preparation of the sanitary proposals accepted the day before, attended as an invited guest. Cooper called the group to order at 7 P.M., and introduced another invited guest, Lorrin Thurston, the man who had masterminded the Hawaiian annexation movement and who still served as the republic's principal political strategist.
Everyone around the table knew Thurston well and had worked with him in many capacities before; and the broad-gauged Thurston, in turn, had plenty of prior experience in matters of medical policy and public health. Emerson remembered serving with Thurston on the old Board of Health under Kalakaua; Day had been part of Thurston's inner circle since Day's admission to the secret Annexationist Club that toppled Liliuokalani; Wood knew Thurston not only as a close personal friend but also as the mastermind of Hawaii's American takeover. No doubt concerned about what the on-again-off-again plague reports from Honolulu might be doing to Hawaii's chances for full territorial status, Thurston had decided to get involved. In the words of the Friend, a paper that greatly admired him and agreed with his agenda for the future of Hawaii, Thurston wanted to put his "great organizing and directing ability" at the disposal of his friends on the Board and to offer some suggestions for "efficient dealing with the enemy."'
Thurston began by summarizing the fears and criticisms then circulating among the dominant Americans in Honolulu. Most of the latter seemed afraid that the Board was acting too deliberately and too cautiously in the face of a grave thre
at, not only to the immediate health of the population but also to the long-term future of Hawaiian development. Everyone knew that the pandemic had been lingering in Hong Kong for five years. Should the same thing happen in Honolulu, the result would be nothing less than "a ruinous catastrophe." Everything the annexationists had worked for would be put at risk if bubonic plague were allowed to become endemic. The maritime economy of the archipelago might be crippled for years. Consequently, Thurston had come to urge "stronger measures" than any taken so far.4
Thurston had recently read in the journal Nineteenth Century an analysis of the way the current plague epidemic was affecting a city in Portugal. The essay confirmed his view that conventional quarantines by themselves had done little to quell the disease elsewhere; in fact, they probably increased the likelihood of additional cases among the already vulnerable people confined to infected areas. Logically then, Thurston believed, the Honolulu Board should not confine people inside plague zones, but should remove them and quarantine them elsewhere long enough to know they were not plague carriers themselves, while trying to destroy-by whatever means necessary-the sources of plague left behind.'
During informal discussions with Wood prior to the Board's formal session, Thurston and the doctor had both agreed that fire was the one and only sure method of eradicating the otherwise apparently tenacious plague bacilli. Drawing the obvious conclusion, Thurston now suggested to his longtime associates around the table that they begin removing people from known plague sites for their own good, placing the evacuees in safe quarantine zones, and then burning the vacated sites, along with any contents that might harbor bacteria, in order to destroy the pestis known to be lurking there. Thurston left in abeyance the difficult question of trying to define the appropriate dimensions of a plague site: a room, a single building, the surrounding block, a whole neighborhood, or perhaps an entire district?'
To advance the discussion, Cooper offered a test case. Along with two physicians and two city surveyors, he had inspected a set of interconnected buildings where a Chinese man known simply as Ahi had died of plague. The entire inspection party had concluded that most of the buildings at the site were incapable of being effectively cleaned or disinfected in the manner authorized the previous day. Nor could fresh water or sewers be run to them. Since there was every reason to believe that "the whole block is infected around Ahi's place," Cooper proposed relocating the other residents of that block to a special quarantine camp elsewhere in the city and burning all but four or five salvageable structures. Cooper recognized the gravity of his proposal. Even "to discuss this matter," he observed, raised a "question of policy."
When civilian George Smith expressed qualms about the legality of Cooper's proposal, the attorney general countered with a remarkably frank statement. According to the minutes of the meeting, he claimed that there were "two ways of going about [the task of sanitizing the block in question]. The legal one was to serve notice on the owners and occupants for abatement of nuisances[,] giving them time to [make improvements]; the other way was to go in and destroy the unsanitary structures[,] leaving the matter of damages to be settled later." Cooper strongly advocated the more draconian course of action. "The Board had been charged with being negligent for not adopting drastic measures. These criticisms may be misunderstood abroad and cause far reaching consequences endangering the commerce of the country." With the stakes so high, the government's chief legal officer was announcing to the Board that he had no intention of abiding by legal technicalities. Extraordinary crises justified extraordinary actions.'
A defender of traditional property rights, Smith again demurred. "Follow the course of the law and give [property owners] notice," he urged his colleagues on the Board. "I think it is ridiculous," he asserted, "to burn all these people out. Condemn these buildings according to law." Smith was confident that ordinary condemnation proceedings would force property owners, some of whom were his friends, to make necessary improvements. He was also concerned about how the Board was going to provide for a potentially large number of displaced persons with little or no lead time to prepare either temporary or permanent housing arrangements."
The three physicians felt frustrated by a lack of alternative approaches. Bacteriological laboratories around the world were continuing to work on various antiplague serums, but none had yet produced anything of proven frontline value in the struggle against the pestis bacterium. A number of prophylactic preparations were in production, but their effectiveness was hotly debated, not only by those who had tested them in the field but also by rival producers and nonbelievers. British experiments in India with the best known of those prophylactic preparations, the so-called Haffkine's serum, had been inconclusive. Kitasato himself claimed no more than a 5o-percent success rate with a preventive serum he had developed and tried in Japan. Moreover, no one in the world was claiming to have found a therapeutic antidote to give people who already had the disease. And even if promising products were about to appear somewhere in the world, they could not possibly reach Honolulu by ship for another four to six weeks. Death tolls could soar in that length of time, and the disease might become so thoroughly entrenched that outside help would be of little value.'
The Board's physicians were further handicapped in December 1899 by the fact that none of the world's bacteriologists, and certainly no one in Honolulu, really knew much about the behavior of the pestis bacteria they had identified five years earlier. They had an exact portrait of what the enemy looked like, so they knew when it was present; but they still had remarkably little information about the enemy's essential qualities, much less how it was getting from person to person. How long could the bacteria survive in food, or in merchandise, or in water? How much heat and cold could the bacteria tolerate? Were other animals besides rats susceptible to plague? Could the bacteria live in the ground, and if so, for how long? The answers to such questions were just not available to the doctors sitting around the table that late December evening, or to their colleagues elsewhere in the world.10
As with the case of serums, Emerson, Day, and Wood knew that earlier efforts to kill plague bacteria in noninvasive ways, including some they had tried themselves, had gone quite badly. They were also familiar with British efforts in India to deploy a host of different gaseous disinfectants and acid washes against pestis. In addition to being quite costly, those materials had proved awkwardly inefficient to apply. But worst of all, according to reports in the international public health journals, money and manpower aside, none of them had proved capable of thoroughly eradicating ambient bacilli under real-life conditions. Thus in the opinion of most experts, including the authoritative Kitasato, the sole weapon absolutely certain to destroy pestis was fire, which is why the Board had ordered the cremation of plague victims from the outset and why Thurston and Cooper, with Wood's tacit support, were now proposing the use of fire in Honolulu."
Given the seriousness of the situation and the lack of alternatives, Emerson declared himself ready to accept the new policy implied in Cooper's proposal. The veteran public health officer had trusted Thurston's judgment at the time of the kahuna crisis, and he was prepared to trust him again. "I am willing to go right ahead and take all the responsibility and burn anything and do anything that is necessary," opined the senior physician at the table. "I think that is the proper policy of the Board." Day quickly concurred. To stop the epidemic, he said, the three of them had a responsibility "to remove the people from the infected houses," even if that meant destroying "many of the houses in Chinatown."
Wood, who had already conferred with Thurston unofficially, put his support into the form of a motion. Henceforth, "all wooden buildings in which a case of plague occurs, and all wooden buildings in immediate communication therewith" would be "burned as soon as possible, precautions being taken to prevent the fire spreading," and people living in such buildings would "be immediately removed ... to quarantine quarters." Special provisions were made for brick and stone buildings, which might
be saved and disinfected in other ways; for various sorts of furnishings inside condemned buildings, depending upon whether or not the physicians thought they were likely to harbor bacteria; for the disposal of personal items, some of which could be fumigated and returned to their owners; for damage appraisals, which would be necessary at some future point when residents would be compensated for their losses; and for many other matters, including recompense for personal items like family photographs and treasured heirlooms that might have to be incinerated lest they harbor bacteria.'2
With all of the others determined to adopt the new policy, Smith acquiesced. Signaling support, he moved that the block inspected by Cooper's team be declared "an infected district and a source of filth and a cause of sickness; and that all dwellings, building, stores, structures or other enclosures situated thereon, be destroyed by fire; saving and excepting such buildings as may be reserved therefrom which are shown on a map of such district by red lines." The voting members of the Board unanimously adopted Smith's motion, the first of what would become many similar condemnations. The order could not be executed until assessors had gone through the block and alternative housing had been found. Nonetheless, invoking their emergency powers, the Honolulu Board of Health had decided to begin the twentieth century by removing residents from their homes and incarcerating them in quarantine camps and by burning private property in defense of the public's health."
For the record, Wood made clear that the Board itself would control all aspects of the new policy and maintain direct oversight of all relocation camps. Emerson urged his colleagues to begin requisitioning various public sites and official buildings for use "as quarantine quarters for people from infected houses." Probably in direct response to editorials in the press that accused the quarantine of rapidly descending to the level of "opera bouffe," Day moved to strengthen the city's guard stations and maintain public order. The group dispersed at 9:45 P.M., having agreed in less than three hours on a dramatic escalation in their war against bubonic plague. Day broke the tension by remarking to his colleagues that "the community would have said the Board `had gone crazy"' if they had adopted these policies six months earlier.14
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