Pox_ An American History - Michael Willrich [122]
The response of American public health departments to epidemic smallpox at the turn of the century revealed progressive social governance at its most powerful and problematic. New York City’s methods were exceptional only in their bureaucratic sophistication and scale. The same working principles, tactics, and values drove campaigns against smallpox in urban communities from San Francisco to Boston. The known behavior of smallpox—its tendency to spread like wildfire in crowded places—dictated a spatial response. In fact, smallpox would one day be eradicated across the world using a strategy of isolation, surveillance, and targeted vaccination not so different from that used by New York City to fight this, its last major epidemic of the disease, in 1901 and 1902. But the spatial strategy of disease control generated its own political theater of government coercion and working-class resistance.
Space, a necessary condition for the exercise of human freedom, came at a premium in the modern, urban-industrial society that the United States was so rapidly becoming. No one knew the price of space better than “the masses”: the sort who journeyed to America below the water line, in the teeming steerage compartments of steamships, and who sought work in factories and mines, shelter in tenements and lodging houses, leisure in saloons and dance halls, and an education for their children in the public schools. Fighting contagion in the name of the public health meant wielding extraordinary authority in those tight spaces. Public health was, without question, a cutting-edge, progressive enterprise—the marshaling of modern science for the betterment of society. Few stood more to gain than tenement dwellers from successful campaigns against smallpox and other plagues. But as the price for the space they occupied in the nation, such people were expected to bear a level of intrusion and coercion that American governments did not dare ask of their better-off citizens. As a consequence, smallpox control triggered some of the Progressive Era’s most dramatic conflicts between working-class people and the government. That is why Blauvelt’s medical men traveled with a police escort.
New York’s two major Italian “colonies” on the East Side—home to tens of thousands of America’s newest immigrants—were closely watched by health officials even when smallpox did not threaten. As workingmen and families from southern Italy poured through New York harbor during the 1880s and 1890s—forming one distinct enclave on the Lower East Side around Mulberry, Elizabeth, and Mott streets, and another up here along the southern edge of East Harlem—their communities had become known to health officers as danger zones. The Italians understood all too well that disease flourished in those crowded, airless, double-decker tenements. Many who had made the move north from Mulberry Bend to East Harlem had done so not just to be closer to the construction and transit companies that were building northern Manhattan but also to live in this relatively cleaner and more open section by the East River. But East Harlem, too, grew thick with people and sickness.5
In both settlements, the Italians often welcomed health officials’ efforts to improve their environment. In the summer of 1900, Blauvelt met little opposition when he rolled onto Mott Street at the head of a “disinfecting party,” equipped with two wagons carrying one hundred gallons of disinfectant. Sanitary inspectors, backed by eighty policemen, moved through hallways, rooms, and cellars, pumping