55. In the Matter of . . . Mary Mallon (1909), Return to Writ.
56. In the Matter of . . . Mary Mallon (1909), Proposed Order and Notice of Settlement. It is probable that the judge did not understand the difficulty of quantifying bacterial counts in this era, nor their unreliability, and he might also have been baffled by the different reports of the two laboratories. The important point, no doubt, is that health department officials who testified to Mallon’s dangers convinced the judge and he merely accepted the laboratory results at face value. I am grateful to bacteriologist Thomas Brock at the University of Wisconsin for his discussion of the quality of the procedures to measure bacilli in stools in this period.
57. In the Matter of . . . Mary Mallon (1909), Return to Writ.
58. Mary Mallon’s undated letter is filed with ibid. Westmoreland and Mary Mallon refer to the same drug: hexamethylenamin is methenamine, a condensation product of ammonia and formaldehyde, (CH2)6N4, a urinary antiseptic. Urotropin is a proprietary brand of methenamine.
59. Mary Mallon’s letter describing the times physicians offered her surgery is discussed further in chap. 6. The letter can be found in In the Matter of . . . Mary Mallon (1909). On the surgical cure for typhoid fever, see Thomas J. Leary, “Surgical Method of Clearing Up Chronic Typhoid Carriers,” JAMA 60 (1913): 1293–94; H.J. Nichols et al., “The Surgical Treatment of Typhoid Carriers,” JAMA 73 (1919): 680–84; Edwin Henes, “Surgical Treatment of Typhoid Carriers,” JAMA 75 (1920): 1771–74; Walter H. Vosburgy and Anna E. Perkins, “The Surgical Treatment of Typhoid Carriers in the Gowanda State Hospital,” Surgery, Gynecology & Obstetrics 40 (1925): 404–6; George H. Bigelow and Gaylord W. Anderson, “Cure of Typhoid Carriers,” JAMA 101 (1933): 348–52; and Herman F. Senftner and Frank E. Coughlin, “Typhoid Carriers in New York State with Special Reference to Gall Bladder Operations,” American Journal of Hygiene 17 (1933): 711–23.
60. William Hallock Park and Anna Williams, Pathogenic Microorganisms: A Practical Manual for Students, Physicians, and Health Officers (New York: Lea & Febiger, 1914), p. 361. The health officials could not force Mary Mallon to undergo the surgical procedure. See, for example, Charles E. Simon, Human Infection Carriers: Their Significance, Recognition and Management (Philadelphia: Lea & Febiger, 1919), p. 101.
61. See the NYCDH, AR, 1921, p. 53. See also, for example, Eilif C. Hanssen, “The Present Status of the Typhoid Carrier Problem,” New York State Journal of Medicine 39 (July 15, 1939): 1347–52.
62. In the Matter of . . . Mary Mallon (1909), Writ.
63. Note recorded on Mary Mallon Carrier Card #36, one of several different carrier cards, copies of which are in the Hoffman/Marr Collection. I am grateful to Ida Peters Hoffman and John S. Marr for their permission for me to visit their homes and to use the information collected in their own research.
64. The 1907–1909 numbers are computed from the laboratory reports filed with In the Matter of . . . Mary Mallon (1909), and the figures for 1915 through 1936 are computed from the various carrier cards in the Hoffman/Marr Collection.
65. See Cassedy, Charles V. Chapin, pp. 54–56, and Frederic P. Gorham, “The History of Bacteriology and Its Contribution to Public Health Work,” in A Half Century of Public Health, ed. Mazyck Porcher Ravenel (New York: Arno Press Reprint ed., 1970), pp. 66–93. Originally published in 1921 by the American Public Health Association. Chapin’s use of the new methods to trace typhoid fever carriers is illustrated in the case of Margaret Hurley, a Brown University fraternity house cook who infected at least four students with typhoid fever, one of whom died. See the Charles Value Chapin Scrapbooks, Collections of the Rhode Island Historical Society, February-March, 1929. My thanks to Sarah A. Leavitt for calling my attention to this case.
66. Winslow, Evolution and Significance, p. 36. Winslow identified the two decades from 1890 to 1910 as the “period of scientific control of communicable disease by the applications of bacteriology,” a period he and others referred to as ushering in the “new public health” (p. 49). See also, for example, Philip D. Jordan, The People’s Health: A History of Public Health in Minnesota to 1948 (St. Paul: Minnesota Historical Society, 1953).
CHAPTER TWO: “Extraordinary and Even Arbitrary Powers”
1. For a general overview of public health departments and their work in this period consult John Duffy, The Sanitarians: A History of American Public Health (Urbana: University of Illinois Press, 1990).
2. For a full history of the New York City Health Department, see John Duffy, A History of Public Health in New York City, 1625–1866 (New York: Russell Sage Foundation, 1968) and John Duffy, A History of Public Health in New York City 1866–1966 (New York: Russell Sage Foundation, 1974). To understand how New York events influenced the hinterland, see, for example, Judith Walzer Leavitt, The Healthiest City: Milwaukee and the Politics of Health Reform (Princeton: Princeton University Press, 1982).
3. On this latter point, see Daniel M. Fox, “Social Policy and City Politics: Tuberculosis Reporting in New York, 1889–1900,” Bulletin of the History of Medicine 49 (1975): 169–95.
4. On Hermann Biggs, see C.-E. A. Winslow, The Life of Hermann M. Biggs, M.D., D.Sc, LL.D.: Physician and Statesman of the Public Health (Philadelphia: Lea & Febiger, 1929).
5. Hermann Biggs’s editorial from the Monthly Bulletin, March, 1911, quoted in Winslow, Life of Hermann M. Biggs, pp. 230–31.
6. A. W. Freeman, “Typhoid Fever and Municipal Administration,” U.S. Public Health Reports 32 (1917): 642–55, quotation from p. 642.
7. Hermann M. Biggs, “The Preventive and Administrative Measures for the Control of Tuberculosis in New York City,” The Lancet 2 (August 6, 1910): 371. See also John S. Billings, “Principles of Adminstrative (sic) Control of Communicable Diseases in Large Cities,” American Journal of Public Health 5 (1915): 1204–8.
8. William H. Welch, “Foreword” to Winslow, Life of Hermann Biggs, pp. xi—xii.
9. George Soper, “Curious Career of Typhoid Mary,” Bulletin of the New York Academy of Medicine 15 (October, 1939): 704.
10. Hoobler later became head of Children’s Hospital, Detroit.
11. George Soper, “Typhoid Mary,” The Military Surgeon 45 (July, 1919): 8.
12. Soper, “Curious Career,” p. 705.
13. In Baker’s account, she was not requesting fecal specimens at this time.
14. On the history of women in medicine, see Regina Morantz-Sanchez, Sympathy and Science: Women Physicians in American Medicine (New York: Oxford University Press, 1985).
15. S. Josephine Baker’s autobiography Fighting for Life (New York: Macmillan Co., 1939) remains the best source for Baker’s life story. See also the short biography written by Leona Baumgartner in Notable American Women vol. 1, ed. Edward T. James (Cambridge: Belknap Press of Harvard University Press, 1971), pp. 85–86. In her efforts to differentiate herself from the jazz singer with the same name, Baker adopted the use of the initial of her first name, Sara.
16. Isabelle Keating, “Dr. Baker Tells How She Got Her Woman,” Brooklyn Daily Eagle, May 8, 1932, p. A17. I am grateful to Ida Hoffman for leading me to this reference.
17. Baker, Fighting for Life, p. 74.
18. Ibid., p. 74.
19. Ibid., p. 75.
20. Mary Mallon to George Francis O’Neill (editor of the American crossed out and O’Neill’s name added), 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. This letter is fully discussed in chap. 6.
21. William H. Park, “Typhoid Bacilli Carriers,” JAMA 51 (September 19, 1908): 982.
22. See, for example, ibid., pp. 981–82, and William Hallock Park and Anna Williams, Pathogenic Microorganisms: A Practical Manual for Students, Physicians, and Health Officers (New York: Lea & Febiger, 1914), pp. 355–73.
23. Charles V. Chapin, The Sources and Modes of Infection (New York: John Wiley & Sons, 1910), p. 110.
24. Milton J. Rosenau, Preventive Medicine and Hygiene (New York: D. Appleton-Century Co., 1935), pp. 137–38. See also William Saphir, Walter H. Baer, and Frederic Plotke, “The Typhoid Carrier Problem,” JAMA 118 (1942): 964–67. According to one observer, there were over 35,000 deaths each year from typhoid fever in the United States. C. L. Overlander, “The Transmission of Typhoid Fever,” Interstate Medical Journal 21 (1914): 133–44.
25. Cecil K. Blanchard, “Typhoid Carriers: Their Detection and Control,” Public Health News (New Jersey State Department of Health) 9 (1924): 250–58.
26. M. Dorthy Beck and Arthur C. Hollister, Typhoid Fever Cases and Carriers: An Analysis of Records of the California State Department of Public Health from 1910 through 1959 (Berkeley: State of California Department of Public Health, 1962), pp. 14, 18.
27. James G. Cumming, “Should the Barriers Against Typhoid be Continued?” JAMA 98 (1932): 94; and Saphir, Baer, and Plotke, “Typhoid Carrier Problem,” p. 964. By 1930, Washington officials estimated only 671 carriers per 100,000 population.
28. Editorial, “A Pressing Problem,” American Journal of Public Health (1915): 313.
29. Numbers of cases as reported in the New York City Health Department Annual Reports. See, for example, the table in the 1959 Report summarizing department data for the years 1898–1939.
30. A. L. Garbat, “Typhoid Carriers and Typhoid Immunity,” Monograph 16, Rockefeller Institute for Medical Research, New York, 1922. See also, Eilif C. Hanssen, “The Present Status of the Typhoid Carrier Problem,” New York State Journal of Medicine 39 (July 15, 1939): 1347–52.
31. Hanssen, “Present Status of the Typhoid Carrier Problem,” p. 1347. Likewise, in Connecticut, new typhoid cases could not be traced to water or milk supplies but were blamed on healthy carriers. M. Knowlton, “The Typhoid Carrier Problem in Connecticut” (1936), as cited in Saphir, Baer, and Plotke, “Typhoid Carrier Problem,” p. 964.
32. James G. Cumming, “Should the Barriers Against Typhoid be Continued?” JAMA 98 (January, 1932): 94.
33. Beck and Hollister, Typhoid Fever: California, pp. 12–16; Herman F. Senftner and Frank E. Coughlin, “Typhoid Carriers in New York State with Special Reference to Gall Bladder Operations,” American Journal of Public Hygiene 17 (1933): 711. According to William Best, deputy health commissioner of New York City, city officials showed 727 carriers by 1937, of which 270 “were listed as the result of persistence of positive stools after recovery from typhoid.” I cannot verify these numbers from other sources. See William H. Best, “Is Routine Examination and Certification of Food Handlers Worth While?” American Journal of Public Health 27 (1937): 1005. See also Stephen M. Friedman, “Chronic Fecal Typhoid Fever Carriers in New York City,” unpublished M.P.H. thesis, Columbia University School of Public Health, 1978. I am grateful to Dr. Friedman for permission to use his paper in my research.
34. California located 94 percent of its registered carriers between 1910 and 1919 this way. See Beck and Hollister, Typhoid Fever: California, and Senftner and Coughlin, “Typhoid Carriers in New York State.” See also, “Typhoid in the Large Cities of the United States in 1922,” JAMA 80 (1923): 691–94. The latter article was part of an ongoing series in JAMA on typhoid in large cities. The editors concluded that tracing group outbreaks was virtually the only way to detect carriers, otherwise finding “an almost impossible epidemiologic tangle” (p. 692).
35. Charles Bolduan and W. Carey Noble, “A Typhoid Bacillus-Carrier of Forty-Six Years’ Standing, and a Large Outbreak of Milk-Borne Typhoid Fever Traced to This Source,” JAMA 58 (1912): 7–9. Carriers in dairies were particularly dangerous, leading one public health official to write that Mary Mallon “constituted a decided menace to the community, but it is safe to say that the morbidity produced by her was numerically insignificant compared with what it would undoubtedly have been had she been employed as a milker on a farm, or in handling milk at a large municipal dairy.” J. W. Trask to Charles V. Chapin, December 15, 1908, in response to Chapin questionnaire. See also same to same, January 5, 1909, and E. C. Levy to Charles V. Chapin, December 7, 1908, “I would certainly take extreme measures if a carrier were found on any of our milk producing farms.” Letters found in the Chapin Papers, Rhode Island Historical Society, Box 1, Folder “Management of Milk Outbreak of Typhoid Fever, 1908–1909.”
36. Friedman, “Chronic Fecal Typhoid Fever Carriers,” p. 24. See also John C. Welton, John S. Marr, and Stephen M. Friedman, “Association Between Hepatobiliary Cancer and Typhoid Carrier State,” The Lancet 1, no. 8120 (1979): 791–94.
37. Best, “Routine Examination,” pp. 1003–6. See also Louis I. Harris and Louis I. Dublin, “The Health of Food Handlers: Results of 1,980 Physical Examinations in the New York City Department of Health,” Department of Health Monograph no. 17, a Cooperative Study by the Department of Health, Metropolitan Life Insurance Company, and the American Museum of Safety, (New York, 1917).
38. See Beck and Hollister, Typhoid Fever: California, p. 41; and Senftner and Coughlin, “Typhoid Carriers in New York State,” p. 712.
39. Best, “Routine Examination,” p. 1004. For a more optimistic view of the examination of food handlers and a brief discussion of other detection methods, see Charles F. Bolduan and Samuel Frant’s review, “The Typhoid Carrier Situation in New York City,” Medical Officer, February 13, 1937, pp. 66–67.
40. Best, “Routine Examination,” p. 1006. A fourth way of identifying healthy carriers involved discovery of the carrier state during surgery or medical treatment undergone for other reasons. This was haphazard and could not be relied upon for locating substantial numbers of carriers. See, for example, Beck and Hollister, Typhoid Fever: California, pp. 37, 40.
41. New York State Department of Health, Annual Report, 1920, p. 66. Two excellent articles addressing this question are: L. L. Lumsden, “What the Local Health Officer Can Do in the Prevention of Typhoid Fever,” Public Health Reports 25 (1910): 111–20; and C. L. Overlander, “The Typhoid Carrier Problem,” Boston Medical and Surgical Journal 169 (1913): 37–40.
42. NYCDH, AR, 1913, p. 84. Family members of such people were provided with free immunizations. In 1913, 1,710 such immunizations were provided.
43. NYCDH, AR, 1915, p. 51.
44. NYCDH, AR, 1916, p. 56. See also, reports for 1918–1922. The New York rules followed national guidelines closely. Milton J. Rosenau advised in his textbook: “The proper place to care for typhoid fever is in a suitable hospital. A private home is a poor makeshift for a hospital, and it is unreasonable to turn a household into a hospital for four to eight weeks or longer.” He further advised that convalescents should be kept until “the danger of bacillus carrying has passed.” Rosenau, Preventive Medicine and Hygiene, pp. 156–57, 158. See also, for example, Transactions of the Tenth Annual Conference of State and Territorial Health Officers with the United States Public Health and Marine-Hospital Service, Washington, D.C., June 1, 1912, Public Health Bulletin no. 59 (Washington, D.C.: Government Printing Office, 1912), p. 65. Chicago used regulations similar to New York’s, also requiring, “The family must be sufficiently intelligent and willing to carry out the rules.” See Heman Spalding and Herman N. Bundesen, “Control of Typhoid Fever in Chicago,” American Journal of Public Health 8 (1918): 358–62, quotation from p. 361. The New York rules appear in “Typhoid Carriers and Their Control in New York City,” Weekly Bulletin of the Department of Health, City of New York 11 (1922): 289–90, which also lists (without names) the 107 chronic carriers then under department observation. The Minutes of the Board of Health provide the names and addresses of 106 healthy carriers of typhoid fever then on department rolls. Minutes, Board of Health of the City of New York, New York Municipal Archives, Box 3948, vol. 43, May 24, 1923, pp. 19–22. Names are added to the list, passim, through the 1920s and 1930s. See also May 3, 1922, Minutes, Box 3947, vol. 40, for the 1922 alterations to the Sanitary Code; and June 30, 1915, Minutes, Box 3939, vol. 2 in the box for the initial alteration to address
the carrier state (as it applied to various diseases, including cholera, dysentery, polio, diphtheria, and typhoid fever).
45. These carrier cards can be found at the National Archives, Washington, D.C. Unfortunately, it seems that the city did not continue to send its carrier records to the national office. I am grateful to John Parascondola and Aloha Smith for their help in locating these records, and to Lian Partlow who, during a research trip of her own to Washington, brought me copies.
46. NYCDH, AR, 1918, p. 56. One of the three was Mary Mallon; the other two cannot be named by current available sources but it is clear from the subsequent records that these individuals were not hospitalized on an indefinite basis.
47. See, for example, NYCDH, AR, 1918, p. 53. In 1919, officials declared, “Unfortunately with the facilities at our disposal, we have not been able to do more than merely scrape the surface in the examination of approximately three-quarter million of food handlers in this city” (NYCDH, AR, 1919, p. 82).
48. F. M. Meader, “The Detection and Control of Typhoid Carriers of Disease,” Medical Times, September, 1916, p. 278. For New York state rules about typhoid carriers, see Charles E. Simon, Human Infection Carriers: Their Significance, Recognition and Management (Philadelphia: Lea & Febiger, 1919), pp. 230–32. See also John W. Brannan, “Hospitals and Typhoid Carriers,” American Journal of Medical Sciences 144 (1912): 347–50.
49. Friedman, “Chronic Fecal Typhoid Fever Carriers,” p. 30. Bolduan and Frant concluded similarly: “In an overwhelming proportion, the carriers having once been told of their carrier state are very eager to co-operate and are willing to do everything within their power to prevent the spread of the disease to anybody else. With the exception of the well-known Typhoid Mary and two others, we have had but 24 cases of the disease that could be traced to typhoid carriers already known to be such.” Bolduan and Frant, “Typhoid Carrier Situation,” p. 67.
Typhoid Mary Page 28