Typhoid Mary

by Judith Walzer Leavitt

  How can we address the problem that is now, still, again, before us? Shall we insist on locking up the people who are sick or who are at risk of becoming sick because they threaten the health of those around them? The representations of Mary Mallon and of Typhoid Mary reviewed in this book and the range of meanings that continue to resonate from the beginning of the century to its close indicate that our own situation in large part determines how we think about these questions and informs our various responses to this public health dilemma. We can view people who carry disease as if they consciously bring sickness and death to others—like the demon breaking skulls into the skillet. We can view such people as inadvertent carriers of disease, as innocent victims of something uncontrollable in their own bodies. We can see disease carriers as instruments of others’ evil, as victims of society’s or science’s perversity.

  Wherever we position ourselves, as individuals and as a society, we must come to terms with the fundamental issue that whether we think of them as guilty or innocent, people who seem healthy can indeed carry disease and under some conditions may menace the health of those around them. We can blame, fear, reject, sympathize, and understand: withal, we must decide what to do. Optimally, we search for responses that are humane to the sufferers and at the same time protect those who are still healthy.

  Mary Mallon’s captivity and the stories of other individual sufferers and carriers demonstrate the need for policies that, when health needs and personal rights conflict, put the least restriction on individual lives compatible with protecting the public’s health. Programs that seek to stem preventable diseases at the price of stigmatizing or impoverishing people, or that employ Cuban-style coercive mass isolation, are unjust, undemocratic, and ultimately not effective. The conflict between competing priorities of civil liberties and public health will not disappear, but we can work toward developing public health guidelines that recognize and respect the situation and point of view of individual sufferers. People who can endanger the health of others would be more likely to cooperate with officials trying to stem the spread of disease if their economic security were maintained and if they could be convinced that health policies would treat them fairly. Equitable policies applied with the knowledge of history should produce very few captives to the public’s health.

  Events in Mary Mallon’s Life

  September 23, 1869 Born in Cookstown, County Tyrone, Ireland

  1883 Immigrated to America

  March 19, 1907 Apprehended by health department; isolated at Willard Parker Hospital; thereafter sent to North Brother Island

  June-July, 1909 Habeas corpus hearing, New York Supreme Court

  July 16, 1909 Remanded back to North Brother Island

  February 19, 1910 Signed affidavit and released from North Brother Island

  December, 1911 Tried to sue city for damages

  October, 1914 Hired as cook at Sloane Maternity Hospital

  March 26, 1915 Apprehended for second time by health department and sent back to North Brother Island

  March 1, 1918 Employed by city as Riverside Hospital helper

  June 11, 1918 Granted off-island privileges

  1925–1932 Worked in Riverside Hospital laboratory

  December 4, 1932 Suffered a stroke, becoming bedridden

  November 11, 1938 Died at Riverside Hospital

  November 13, 1938 Buried from St. Luke’s Church; interred in St. Raymond’s Cemetery, Bronx, N.Y.

  Notes

  INTRODUCTION: “A Special Guest of the City of New York”

  1. The term “Typhoid Mary” should always appear in quotation marks because it is a phrase applied to Mary Mallon and not her real name and in acknowledgment of its negative connotation. However, because the consistent use of quotation marks becomes too cumbersome and because the phrase appears without them so frequently in common parlance, I will use the term alone throughout the book. I urge readers to remember that the term is a creation of circumstances and not a given name.

  2. The most recent, although brief, historical look at her is Alan M. Kraut, Silent Travelers: Germs, Genes, and the “Immigrant Menace” (New York: Basic Books, 1994), pp. 98–103.

  3. Milwaukee Journal, January 25, 1994, p. 1.

  4. Wisconsin State Journal, December 22, 1993. I use these local examples knowing that similar stories are published throughout the country.

  5. The phrase is Wade Oliver’s, from his biography of William H. Park. See Wade W. Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D. (New York: E. P. Dutton & Co., 1941), p. 266. See pp. 262–66 for his full section on Mary Mallon.

  6. In the Matter of the Application for a Writ of Habeas Corpus for the Production of Mary Mallon, New York Supreme Court (June 28—July 22, 1909), Return to Writ. Available at the New York County Courthouse.

  7. New Yorker, January 26, 1935, p. 21.

  8. New York American, April 2, 1907, p. 2.

  9. New York American, June 30, 1909, p. 18.

  10. The phrase “microbes into infinity” is from Nicholas Wade, “Ebola’s Vengeance: Microbes into Infinity,” New York Times, May 15, 1995.

  CHAPTER ONE: “The Rigorous Spirit of Science”

  1. Parts of this and the next chapter are derived from Judith Walzer Leavitt, “ ‘Typhoid Mary’ Strikes Back: Bacteriological Theory and Practice in Early Twentieth-Century Public Health,” Isis 83 (1992): 608–29, and are reprinted here with permission.

  My conclusion that Mary Mallon was the first healthy carrier to be identified and followed in North America rests on Soper’s work (see n. 3) and on the subsequent renditions of her story. See, for example, Milton J. Rosenau, Preventive Medicine and Hygiene, 6th ed. (New York: D. Appleton-Century Co., 1935), p. 141. I looked for identification or charting of specific healthy carriers in the United States before Mary Mallon because the knowledge of such people had existed and been in use for about ten years previous, but I could not find other individuals so identified. See, for example, Walter Reed, Victor C. Vaughn, and Edward O. Shakespeare, Abstract of Report on the Origin and Spread of Typhoid Fever in U.S. Military Camps During the Spanish War of 1898 (Washington, D.C.: Government Printing Office, 1900), pp. 178–79. My thanks to Robert J. T. Joy for reminding me of this source. Gordon Jones posited that a carrier was responsible for a seventeenth-century outbreak in Virginia, but even the identification of illness as typhoid fever is problematic in that period, retrospectively without bacteriological confirmation. See Gordon W. Jones, “The Scourge of Typhoid,” American History Illustrated 1 (1967): 222–28.

  2. The social connection between the Thompsons and the Sopers was suggested to me by Tom Wenzell, the Thompsons’ grandson, in a telephone interview from his home in New York City, October 27, 1994. I am grateful to Gerard Fergerson for putting me in touch with Mr. Wenzell, and to Mr. Wenzell for his help.

  3. See George Soper, “[The Epidemic at Butler, Pa.]” Engineering News 50 (1903): 542; “Filtration and Typhoid,” Engineering Magazine 26 (1904): 754–55; “The Epidemic of Typhoid Fever at Ithaca, N.Y.,” Journal of the New England Water Works Association 18 (1905): 431–61; and “The Management of the Typhoid Fever Epidemic at Watertown, N.Y., in 1904,” ibid. 21 (1908): 87–163. The last was published after Soper’s initial work on Mary Mallon, but the work reported in it was carried out and known earlier. On the Ithaca investigation see Heather Munro Prescott, “ ‘How Long Must We Send Our Sons Into Such Danger?’ Cornell University and the Ithaca Typhoid Epidemic of 1903,” Paper presented at the Conference on New York State History, June 11, 1988. I am grateful to Professor Prescott for sending me a typescript of this paper. Soper’s biography in brief is available in Who’s Who in America 24 (1946–47): 2215. Soper later went on to work on sewerage problems, on air and ventilation in subways, and on street cleaning methods.

  Soper’s investigations of Mary Mallon were published in three main articles. The first, “The Work of a Chronic Typhoid Germ Distributor,” Journal of the American
Medical Association (hereafter JAMA) 48 (1907): 2019–22, was the first published account tracing Mary Mallon. See also his “Typhoid Mary,” The Military Surgeon 45 (July, 1919): 1–15; and “The Curious Career of Typhoid Mary,” Bulletin of the New York Academy of Medicine 15 (October, 1939): 698–712. In his 1939 article, Soper identified the renters as the family of General William Henry Warren, instead of Charles Henry Warren as he had done elsewhere (p. 699). He identified the investigators that the Thompsons first hired as “experts.” His only specific naming of them occurred in the 1907 article, when he wrote the water samples were analyzed by E. E. Smith and D. D. Jackson (p. 2020). In one case Soper identified the person who hired him as Mrs. Thompson (“Curious Career,” p. 699). Mrs. Thompson’s role was confirmed by Tom Wenzell (see n. 2).

  It is not entirely clear when Soper began his investigation of the Oyster Bay outbreak. In a few accounts, he wrote it was during the “winter” and also claims it was four months after the August outbreak, which would place his start sometime in December, 1906. When he wrote he worked on the investigation “for some months” before locating Mary Mallon in March, 1907, it suggests that he began his investigations in November, 1906. In yet another rendition, he claims he was “not called for more than six months after the outbreak,” which would date the beginning of his investigation in February, 1907, only one month before her apprehension. (“Winter” is stated in “Chronic Typhoid Germ Distributor,” p. 2019 and in “Typhoid Mary,” p. 2; the four-month interval is given in “Curious Career,” p. 704; the more than six months claim is in a letter to the British Medical Journal, January 7, 1939, p. 38.) See chap. 4 for more on Soper’s involvement.

  4. Soper had not sought healthy carriers in his earlier typhoid fever work in Ithaca, Butler, or Watertown, but in his first published article on Mary Mallon he did refer to the German word for chronic carriers, “typhusbazillentragerin,” indicating his familiarity with the literature. See “Chronic Typhoid Germ Distributor,” p. 2022. When he first presented his work on the Mallon case to the Biological Society of Washington, D.C., on April 6, 1907, he called attention to the work of pioneer bacteriologist Robert Koch. See the discussion of the meeting in “Chronic Typhoid Fever Producer,” Science n.s. 25 (1907): 863. I am grateful to John Q. Barrett for helping me locate the minutes of this meeting in the Smithsonian Archives, Record Unit 7815. In his 1919 recounting of Mary Mallon’s discovery, Soper wrote: “Somewhat similar investigations had been made in Germany, and I make no claim of originality or for any other credit in her discovery. My interest and experience in the epidemiology of typhoid had been of long standing. I had read the address which Koch had delivered before the Kaiser Wilhelm’s Akademic, November 28, 1902, and his investigation into the prevalence of typhoid at Trier, and thought it was one of the most illuminating of documents. In fact it had been the basis of much of the epidemic work with which I had been connected.” See Soper, “Typhoid Mary,” p. 14. The peaches are mentioned in “Curious Career,” p. 702.

  5. An excellent study tracing epidemiology to its prebacteriology roots is William Coleman, Yellow Fever in the North (Madison: University of Wisconsin Press, 1987).

  6. The seven outbreaks that Soper attributed to Mary Mallon are listed at the end of the laboratory reports submitted by the New York City Health Department to the New York Supreme Court at Mallon’s habeas corpus hearing in July, 1909. See In the Matter of the Application for a Writ of Habeas Corpus for the Production of Mary Mallon, New York Supreme Court (June 28—July 22, 1909). Available at the New York County Courthouse. Soper details the cases in “Chronic Typhoid Germ Distributor,” p. 2020; “Typhoid Mary,” pp. 5–7; and “Curious Career,” pp. 702–4. The following discussion is garnered from all of the above. The employment agency from which Soper received most of his information was called Mrs. Strickers’, although it was run by a man (unnamed in the extant records).

  7. “Typhoid Mary,” p. 6. Soper introduces an error, no doubt typographical, in this account of the Mamaroneck outbreak, giving the date here as 1904, when he means 1900. He also misspells Hermann M. Biggs’s name (as “Herman M. Briggs,” p. 9). See also “Curious Career,” p. 702.

  8. The court records give nine as the number infected in the Drayton group, but cite the source as Soper, who indicates seven sufferers in the family and the addition (which he does not always note) of a day nurse and household worker.

  9. In one account of this outbreak, Soper added two other individuals, a nurse and a “woman who came to work by the day,” as also afflicted with typhoid fever; in another account he added just one. “Curious Career,” p. 703, adds the two; “Typhoid Mary,” p. 6, adds one.

  10. R. J. Wilson later was one of the physicians who helped supervise Mallon’s stay on North Brother Island. Soper refers to him as R. L. Wilson in “Curious Career,” p. 703, and in “Chronic Typhoid Germ Distributor,” p. 2021, but gets his name right in “Typhoid Mary,” p. 9.

  11. Quoted in Soper, “Chronic Typhoid Germ Distributor,” p. 2019–20.

  12. The list of cases that Soper traced to Mary Mallon is presented in “ ‘Carriers’ of Infectious Disease,” School Health News 4 (February, 1918), p. 1, but it wrongly attributes seven cases to the Oyster Bay outbreak. It goes on to list the other outbreaks that Soper thought could be traced to Mallon in 1913–1915.

  13. Soper, “Chronic Typhoid Germ Distributor,” p. 2022.

  14. Soper presents the seven outbreaks and the numbers as provided above, and concludes: “In all there have been twenty-six cases and one death,” in “Chronic Typhoid Germ Distributor,” p. 2021; he repeats the information in “Typhoid Mary,” p. 9. William Park repeats it in his 1908 article, “Typhoid Bacilli Carriers,” JAMA 51 (1908): 981, and in the 1914 textbook he wrote with Anna Williams, Pathogenic Microorganisms: A Practical Manual for Students, Physicians, and Health Officers (New York: Lea & Febiger, 1914), pp. 560–61. The New York City Health Department gives the same count in its 1907 Annual Report (p. 321); and I am guilty of repeating the same mistake in “ ‘Typhoid Mary’ Strikes Back.” There is a hint that two more people might have been infected at the Drayton home (see nn. 8 and 9), but I will use twenty-two as the number of cases, since that is the figure for which Soper actually provides evidence.

  Typhoid inoculations, which were developed based on Almroth Wright’s work in 1896 and work by R. Pfeiffer and Wilhelm Kolle in the same year, were first recommended for use in the United States army in 1909 and made compulsory for troops in 1911. Immunity achieved through inoculation is not lifelong. Such vaccinations became common during a threat of an epidemic, but during the years before Mary Mallon was incarcerated in 1907, we can safely assume that none of the members of the families for whom she worked had been inoculated. Many might have achieved permanent immunity from having recovered from a case of typhoid fever.

  15. Minutes of the Biological Society were printed in Science n.s. 25 (1907): 863–65. See also the Minutes of the 429th meeting of the Biological Society of Washington, April 6, 1907, Record Unit 7185, Smithsonian Archives. I am grateful to John Q. Barrett for helping me locate the archival minutes.

  16. See, for example, Alan M. Kraut, Silent Travelers: Germs, Genes, and the “Immigrant Menace“ (New York: Basic Books, 1994), p. 98; and Mary C. McLaughlin, “Mary Mallon: Alias Typhoid Mary,” The Recorder (American Irish Historical Society) 40 (1979): 44–57. On pages 47–48, Dr. McLaughlin writes: “Most of the cases of typhoid were in the servants. It is postulated that the food prepared by Mary for members of the various families was mostly cooked and thus the typhoid bacillus killed. The uncooked desserts were probably prepared and served by the butlers or maids. The chances of Mary handling desserts of the servants was greater.”

  17. For example, the Daniels and Starr investigation of the Dark Harbor, Maine, outbreak concluded that either the footman alone or the first three (of seven) cases simultaneously had been infected outside the home and brought the infection into the house. Soper, when reviewing the evi
dence, concluded, “On checking over [Daniel’s] report I could not agree with him. I found that the three had not eaten the same food or drunk the same water.” See “Curious Career,” p. 703.

  18. Soper relates this story in “Typhoid Mary,” pp. 7–8; and in “Curious Career,” pp. 704–5. I analyze it more closely in later chapters.

  19. The early years of Mallon’s incarceration can be found in the Soper articles listed in n. 3 and in Park, “Typhoid Bacilli Carriers,” p. 981. The published health department reports for the year 1907 note merely that “special studies were made during the year on the so-called typhoid carriers. . . . A woman who had served as cook in various families during the past five years is known to have infected at least twenty-six people and has caused at least two deaths. This patient was examined from week to week.” Annual Report of the Board of Health of the Department of Health of the City of New York for the Year Ending December 31, 1907 (New York: Martin E. Brown Co., 1908), p. 321. (Hereafter Board of Health Annual Reports are cited NYCDH, AR, followed by the year. The actual titles of reports varied from year to year.) Any unpublished health department material for this period, with the exception of some Minutes which are here used, is either destroyed or not available at the present time.