by Black Death at the Golden Gate- The Race to Save America from the Bubonic Plague (retail) (epub)
While Kinyoun paced his island laboratory, the Sanitation Department continued its inspection of Chinatown, an exercise largely aimed at smothering rumors spreading across the country that San Francisco was teeming with plague. Twenty-five volunteer physicians accompanied by a squad of policemen went door to door, ostensibly on the lookout for cases of serious illness or unsanitary conditions. The men took special care to avoid finding anything incriminating, even in places famous for their filth. The hotel where Wong Chut King died, which was known for the putrid smell resulting from open sewer lines spilling into its subterranean rooms, was found to be “not so inviting as it might be, but the same could be said of basements in all buildings,” said Dr. Chalmers, the chief sanitary inspector, after completing his rounds.
Nearly a week had passed since Wong Chut King’s death and no further victims were found. The press in San Francisco declared the city safe once more. “The bubonic scare has collapsed,” the Chronicle proclaimed. Then, as if on cue, the bloated body of Chu Gam, a twenty-two-year-old laborer, was discovered at 723 Sacramento Street, two short blocks from Portsmouth Square.
Chu’s remains had evidently sat undisturbed for several days, sending the body into an advanced stage of decomposition. Neighbors did not complain as the smell of death overwhelmed the three-story flophouse where the man had lived, nor did the health inspectors pick up on the stench that was noticeable on the street outside. Only when a local undertaker intervened and attempted to obtain a burial permit did the Health Board become aware of Chu’s death. An autopsy was ordered, but the procedure was nearly made impossible by the pungent mix of gas and bloody foam emanating from the corpse, evidence that the internal organs had begun to rupture and decay. Rotting flesh obscured the search for buboes. Nevertheless, a doctor from the Board of Health removed a tissue sample and sent it to Kinyoun, who soon identified the presence of plague bacilli. It was the second death attributed to the disease within a span of eight days.
Others soon followed. The decomposing body of Ng Ach Ging, a thirty-five-year-old Chinese cook, was deposited outside an undertaker’s office at 905 Dupont Street two days later. The following afternoon, the body of Lee Sung Kong, aged forty-seven, was found abandoned in a Chinatown alleyway. Kinyoun took part in the autopsies of both men and found clear samples of plague bacilli, a discovery that both confirmed his worst fears and escalated them further. Plague was not only spreading, he realized, but Chinese residents—possibly with the assistance of Western-trained doctors familiar with the methods of bacteriology—appeared to be hiding victim’s bodies in hopes that the decomposition process would obscure the true cause of death, turning the survival of the city into a cat-and-mouse game.
Kinyoun still clung to the hope that the rising death toll would shake the city out of its denial, yet he grew more incredulous as the press refused to admit the danger that San Francisco was in. “We do not believe that a single person has ever died of bubonic plague in this city,” the Chronicle wrote in an editorial after the body of the fourth plague victim was found. “It is useless to say that the bodies have been spirited away. They must be buried and before they can be buried there must be a permit.”
It took one of the most powerful men in the country to push the city into action. On Sunday, March 18, twelve days after the discovery of Wong Chut King’s body, the New York Journal, owned by William Randolph Hearst, published a special national edition that declared “The Black Plague Creeps into America.” Oversized drawings of cemeteries and emaciated plague victims shared the front page with articles detailing what the paper described as a growing panic on San Francisco’s streets. Hearst, himself born and raised in the city as the only child of a millionaire mining executive, followed up on the publication by personally sending telegrams to the health officers of every major city in the country, warning them to take precautions against the spread of plague from San Francisco.
Almost immediately, ships hailing from the city were quarantined in ports along the Pacific coast. In Victoria, British Columbia, quarantine officers demanded that luggage and clothing belonging to passengers from the city be fumigated and then destroyed; in the tourist destination of Mazatlán, Mexico, passengers on a Pacific Coast Steamship Company ship that had left San Francisco the week before were forced to spend three days in quarantine before landing. Merchants in Alaska, then at the tail end of what was known as the Klondike Gold Rush, began refusing shipments of goods that originated in the San Francisco Bay. Hotels in Denver quickly began to fill, as travelers from cities along the East Coast who had intended to go to San Francisco turned back upon reading the Hearst report and began to mix with those escaping California.
“On the train from ’Frisco I was surprised at the large number with whom I conversed who frankly admitted that they were simply fleeing from the Asiatic plague, which, without any doubt at all, is now found to be in San Francisco,” a man from Albany, New York, told a reporter. “It is true there may be only a few cases of the plague, but if there is even one case it is enough to frighten away many tourists who, all their lives, have heard of how deadly this plague is and how rapidly it spreads when introduced into any country . . . On the very train which I came eastward there was represented almost every state east of the Missouri.”
As it felt its prospects dim, San Francisco looked for someone to blame, and soon found it in the out-of-town newspapers that were so willing to report the truth of Kinyoun’s findings. “There appears to be no motive at all in reading this report other than one of pure deviltry,” one merchant told the local press after noticing yet another story detailing the spread of the disease in San Francisco, urging his fellow residents to stop subscribing to any publication that printed stories confirming the presence of plague in the city. The Manufacturers and Producers Association, a trade group representing some of the city’s largest employers, called a special meeting at which it adopted a resolution praising the hometown newspapers which “defensed the city against the hurtful story that bubonic plague existed here” and imploring them to continue to “have a care for the general interests of the city” with their coverage. An editorial in the Call, meanwhile, opined that the Hearst report was the worst example of the cruel sensationalism of yellow journalism. “The whole business is a piece of idiocy, but, unfortunately for California, as harmful as if there was really occasion for it,” the paper wrote. “The man who walks the streets of San Francisco today is as safe from plague as he is in New York or Boston, but after the Journal’s scare edition it will take several months to convince people that this is the truth.”
With no other recourse, San Francisco turned to the Board of Health, which its newspapers had long derided, for redemption. Health authorities ordered a more extensive cleanup and inspection of Chinatown—and with it came the chance to discover the full extent of the threat the city now faced. “There is no use evading the issue. The Chinese quarter of this city is infected with plague. The Chinese are concealing the cases, and for this reason the board has increased the corps of inspectors . . . San Francisco is fronted with a serious condition, and the citizens must prepare to meet it,” the president of the Board of Health said in an article that ran in the Scripps–McRae chain of newspapers in the Midwest, but his admission received no mention in San Francisco papers.
Sanitation remained a relatively new concept in the United States, where as recently as 1850 Frederick Law Olmsted—now known chiefly as the co-designer of New York’s Central Park—had toured the country to highlight everyday acts of filthiness for which he deemed “barbarous too mild a term.” In Virginia hotels, he wrote, “every clean towel I got during my stay was a matter of special negotiation”; in Mississippi, the hotel bed he was offered was “furnished with soiled sheets and greasy pillows” used by previous guests. A request for drinking water in Texas resulted in a field hand smashing ice hanging from the side of a building with his hand and pouring the mixture of dirt, water and grime into a mud-streaked glass.
Cities
offered filth on a grander scale. New York’s first sanitary survey, conducted in 1864, noted overflowing toilets, manure-infested streets, and a persistent stream of blood leaking out of a Midtown slaughterhouse and flowing for two blocks along 39th Street to the river. Pedestrians would pay a nickel to young boys who stood at intersections along Broadway with brooms, ready to sweep a clear path through the slime.
Medicine at the time did not yet fully accept the germ theory of disease—the understanding that microscopic organisms invade and reproduce within host bodies, causing illness. Even sanitary reformers such as Edwin Chadwick remained convinced that filth itself spread disease, despite mounting evidence to the contrary. In 1854, John Snow, physician to Queen Victoria, traced an outbreak of cholera in London to a single contaminated well. Though Snow would later isolate the bacterium that transmitted the disease, Chadwick continued to believe that it was the putrid smell of the water, and not an unseen organism living within it, that spread infection.
Where early sanitarians did agree was on the need to change human behavior. Some of the first public health officers began focusing not only on structural improvements—maintaining clean sources of water and calling for the installation of private toilets in all buildings among them—but on private habits as well, emphasizing the need for daily bathing and teeth cleaning at a time when neither was common. Within a generation, good personal hygiene was considered a mark of Americanness, with newly arrived immigrants of all ethnicities often derided first for their filthy bodies, and later for foreign behaviors that they did not shed.
San Francisco had never organized a sanitation campaign of any significance, leaving Kinyoun skeptical that it could. His misgivings grew as he watched a platoon of seventy-five health inspectors and thirty physicians, each one accompanied by armed policemen, swarm through Chinatown’s narrow alleyways as if they were an invading army. Officials pounded on residents’ doors and, when refused admission, broke them down with axes and sledgehammers before ransacking apartments. More often than not, the inspection ended with health officials and policemen walking away with any valuables they could find.
Rumors of beatings and rape at the hands of health inspectors spread through Chinatown, cementing fears that the plague cleanup was merely an excuse for violence. Some Chinese women, fearful that the Western physicians conducting the raids were intent on poisoning them, hid their babies during the day and nursed them only in the darkest hours of the night. Unable to live with the embarrassment of a group of armed white men bursting into their homes and ordering them to present their naked groins for inspection, men throughout the district vowed to get even with what the Chinese began calling the “wolf doctors” who preyed upon them. One particularly loathsome official was singled out in an article in the Chinese Western Daily, which said that residents of Chinatown would be “glad to bathe in his blood.”
Fearing that any violent resistance would give the city a reason to burn down Chinatown and repopulate the district with white residents, the Chinese resorted to deception. One professor at the University of California, Berkeley who volunteered on the cleanup described coming upon a bustling house on Waverly Place in which five Chinese men were seated at a table, apparently playing a game of dominoes. A cursory inspection revealed no obvious cases of infection and the team of doctors continued their rounds. Two hours later, the police received a call from neighbors reporting a death in the same house. The professor returned to the now deserted building to find the dead body of one of the men he had seen just hours before, sitting in the same position. Only then did he realize that the man’s roommates had propped the corpse up against the table and pretended to converse with it while the inspectors were there.
The district’s open spaces offered little safety. Authorities slathered suspect buildings and streets with toxic chemicals, leaving residents struggling to breathe. Merchants complained that sulfur sprayed indiscriminately by health inspectors ruined their merchandise and made even the healthy feel sick. To protect themselves from the contaminants of a place they neither trusted nor understood, health authorities installed fumigation stations in Portsmouth Square, through which every inspector and policeman was required to pass on their way in and out of the district. Policemen on horseback stood sentry along the borders of Chinatown, scanning the streets for anyone who seemed obviously ill, while inspectors posted at railway stations and along the docks kept watch for Chinese trying to leave the city.
After two weeks of cleanup with no new cases identified, Phelan sent a telegram addressed to the mayors of the fifty largest cities in the Eastern half of the country, promising that Chinatown was now cleaner than at any other time in its history and that all signs of plague were gone. As March turned to April, health inspectors began pulling back from the district, confident that the danger had passed.
The calm would not last the month. On April 24, the body of Law Ann, a thirty-eight-year-old Chinese man who had come to California as a child, was found lying at the end of St. Louis Alley, a dead-end path just off Jackson Street. A dark bubo bulged from his left groin. Kinyoun took a sample of tissue from the body and soon confirmed that the man had died of plague.
Other deaths soon followed. Lim Fa Muey, a sixteen-year-old girl, suddenly collapsed and died on May 11 while working on the floor of a cigar factory, making her the first female victim of the disease. An inspection of her body revealed a walnut-sized bubo on her right thigh that had been covered up with a sticky black plaster, a sign that she had sought treatment from a Chinese healer. The same day, the decomposed body of Chu Sam, a thirty-eight-year-old merchant, was found at 717 Jackson Street. Its degraded condition rendered a formal autopsy impossible, yet tissue samples revealed plague bacilli. Chin Moon, a sixteen-year-old girl working as a servant for a Chinese family residing at 730 Commercial Street, died in the Pacific Hospital on May 15 after complaining of headaches, high fever and pain in the right thigh. Western physicians practicing in Chinatown initially diagnosed typhoid fever, before Kinyoun’s examination of tissue samples from the body uncovered plague. On May 17, Herr Woon Jock, a fifty-three-year-old Chinese laborer who had recently arrived in the city from Stockton, died at 740 Pacific Street, and an autopsy showed a swelling bubo on his left thigh.
Within the span of one week, the death toll from the disease had jumped to eight confirmed victims. Kinyoun suspected that dozens more had simply vanished, never to become a part of the official record nor give him any clue of where the disease was heading next. “How many Chinamen have died from plague and how many corpses of victims from this disease awaited shipment to China no white man will ever know,” he wrote in a letter to a friend in Washington.
Kinyoun spent frantic hours retracing the last days of each victim’s life, trying to find any shared connections that would have allowed plague to spread from one host to another. Yet he found nothing. The nearest victims had lived two blocks away from each other, but did not frequent the same stores or restaurants, while the furthest apart appeared never to have come within eight blocks of one another. With no linked source of infection, there could only be one conclusion: an epidemic was at hand.
Kinyoun rushed off a telegram directly to Wyman in Washington, not bothering to go through the usual middlemen who served as a buffer between them: “Examination plague suspect completed. Diagnosis confirmed by bacteriological examination. No connection traced to first at present. Don’t give this information to public. Will write reasons for secrecy.” The next day, he followed with a longer telegram which revealed his increasing desperation. “As requested, secrecy required first case on account of vicious attacks [by] local press,” he wrote. “Regard situation very serious; will require almost superhuman efforts to control now, so much time has been lost. Over 35,000 people must be controlled.”
He saw but one solution: the widespread administration of a still-experimental vaccine among the Chinese in the city, even if the procedure had to be done by force. Developed by Waldemar Mordecai Haffkine,
a Ukrainian scientist who, like Kinyoun, had once studied with Louis Pasteur, the so-called Haffkine serum had been developed by growing plague cells taken from cadavers and subjecting them to high heat in order to kill their ability to multiply. After potential patients in several villages refused to receive any serum that included plague germs, the first tests had been conducted on a group of prisoners in Bombay three years before. The serum was shown to reduce the risk of infection by half.
Yet its side effects—high fever, violent vomiting, and a deep but temporary reddening of the skin—would leave its recipients incapacitated for two days at least, and required additional injections every six months to remain effective. “Inoculation, although its results are extremely important and promising, is a prophylactic rather than a treatment, a wall against the enemy rather than a weapon with which to meet it,” noted an early report on the serum’s effectiveness which ran in the well-read journal Public Health Reports. Kinyoun estimated that it would cost at least $100,000—a sum equivalent to $2.7 million today—to buy and administer enough doses of the serum to cover everyone living in Chinatown. The high cost was warranted, he urged Wyman. “If depopulation should be necessary, ten times this amount will be required,” he warned.
Wyman agreed and immediately shipped twenty thousand doses of the Haffkine serum to San Francisco, with the promise of additional supplies once they became available. Despite the turbulent history between the men, Wyman now found himself forced to rely on and trust Kinyoun as his surrogate in a moment of crisis. He attempted to flatter Kinyoun with responsibility, sending him a personal telegram in which he admitted that in the fight ahead he would have to function as the “one man in supreme charge” of all efforts to stop the disease from destroying San Francisco. Successfully breaking the epidemic would require cordoning off Chinatown and instituting house-to-house inspections, all while preventing any Chinese from leaving the city on its ferries or rails—a job that only a man with Kinyoun’s experience could handle, Wyman suggested.