Pox_ An American History - Michael Willrich [137]
One American city tried a very different spatial approach to the fight against smallpox. Like most public health authorities of his day, Cleveland health officer Martin Friedrich believed in compulsory vaccination; it was, after all, national policy in his native Germany. With his gold spectacles and close-trimmed beard, the thirty-six-year-old physician might have been mistaken for Sigmund Freud as he entered cheap lodging houses in the middle of the night and urged free vaccination upon the rowdy bachelors he encountered.65
In the spring of 1901, mild type smallpox struck the cities along Lake Erie. (More than 1,200 cases would be reported by year’s end, but only 20 deaths.) Friedrich launched a wholesale vaccination campaign concentrated in the city’s immigrant working-class neighborhoods. But four people died of tetanus following vaccination, and many more took ill. With a candor all too rare for a health official of the day, Friedrich announced that the available vaccines were unreliable at best, toxic at worst. “A man would have to have a heart of stone if he would not melt at the sight of the misery it produces,” he said.66
Backed by the progressive mayor Tom Johnson, Friedrich ceased vaccination and embarked on a different sort of campaign to fight smallpox. He ordered all smallpox patients isolated from the general population. Then he hired a corps of medical students to go house-to-house with formaldehyde generators and fumigate every home in the city. The disinfection campaign took months to complete, but by the end of 1901 it seemed to bring smallpox under control, making the Cleveland experiment national news and Friedrich a reluctant hero of the antivaccination movement. When a physician named J. H. Belt accused Friedrich of “furnishing aid and comfort to the enemy,” the health officer responded that his campaign had won hearts and minds where compulsory vaccination had won only enemies. “A sigh of relief went over the city when I stopped vaccination,” he wrote. “The people began to work in harmony with us, opened their houses for us to disinfect them, gave us all the information we wanted, and helped us in every way conceivable.”67
For the many contemporaries who applauded Dr. Friedrich’s Cleveland experiment as a more palatable alternative to coercion, time delivered an unsettling rejoinder. Friedrich’s candor about vaccine safety was laudable. His formaldehyde clouds appeared to stamp out the disease, enabling him to duck the most controversial public health issue of his generation—compulsory vaccination. But this dispensation was only temporary. Friedrich’s policy left people unprotected.
A homeless man from Hoboken, New Jersey, entered the city in May 1902, carrying in his feverish body smallpox of the severest type. As Friedrich said, it was “the smallpox ‘we read about.’” The city launched a sweeping campaign in which more than half the city’s residents were vaccinated through an extraordinary public effort involving civic groups, religious leaders, and the local Academy of Medicine. Chastened but still cautious, Friedrich used the city’s new bacteriological laboratory to test the vaccines on the market for one that was safe and reliable. The vaccination campaign finally stamped out the epidemic by early 1903. But by that time, 246 people lay dead from smallpox.68
On January 25, 1902, the Philadelphia Medical