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for their own national context, citing the hundreds of smallpox deaths among U.S. soldiers in the Philippines, despite the boast of one Army surgeon that vaccination and revaccination “went on as regularly as the drills at any army post.” American antivaccinationists also Americanized the Leicester argument. Wallace (among other English polemicists) had made much of the fact that in the antivaccination stronghold of Leicester, where health officials emphasized sanitation, the citizens suffered far less smallpox per capita than in “well-vaccinated Birmingham.” The American Leicester was Cleveland, where Friedrich’s wholesale disinfection campaign in 1901 had apparently wiped out a smallpox epidemic. The antivaccinationists tended to leave out the inconvenient fact that smallpox soon returned to Cleveland, killing hundreds of unvaccinated citizens.41

Antivaccinationists everywhere had the greatest impact when their arguments resonated with pressing public concerns. In turn-of-the-century America, the “noisy storm” ultimately had less to do with vital statistics than vital issues. The antivaccinationists spoke to three of the Progressive Era’s core public concerns: antimonopoly, child protection, and the uncertain meaning of liberty in a modern, urban-industrial society.

The turn of the century was the heyday of federal trust-busting prosecutions and muckraking exposés of the corporate “octopuses” that dominated vital industries such as the railroads, steel, oil, and sugar refining. Antimonopoly and an acute awareness of the role of business interests in corrupting politics at every level were among the most widely resonant reform issues of the era. The antivaccinationists tapped into the pervasive antimonopoly resentments of their day.42

Beneath the aura of public service surrounding vaccination policy, charged the antivaccinationists, lay an unholy conspiracy of self-dealing health officials, profit-seeking vaccine makers, and regular physicians bent on monopoly: the “cowpox syndicate.” “Vaccination yields fees to lymph-peddlers and baby-slashers,” declared the Belgian-born American physician Felix Oswald in his 1901 book, Vaccination A Crime. Who could deny the interest of vaccine makers in a policy that generated artificial demand for their product? The interests of private physicians were not much more subtle. During epidemics, many local governments still contracted with private physicians to vaccinate the public. Porter F. Cope of Philadelphia, a banker’s son and champion of “medical freedom,” estimated the total salaries paid to American public health officials at $14 million. Throw in the $20 million invested in vaccine farms (again, according to antivaccinationists), and compulsory vaccination constituted a substantial interest. “As long as the golden eggs of that goose can be squeezed out by proper manipulation,” wrote Oswald, “Dr. Edward Jenner will continue to be classed with the chief benefactors of the human race.”43

The profit-seeking of the “vaccine trust,” antivaccinationists argued, was a natural result of the regular physicians’ place-seeking campaign for a “medical monopoly.” The prospect of fees was probably far less important to the regulars than the government imprimatur conferred by legislatures and health boards upon vaccination—a measure closely identified with the mainstream physicians’ struggle for authority. The return of medical licensing troubled Americans who had nothing personally at stake in the matter. “I don’t know that I cared much about these osteopaths,” Mark Twain testified before the New York legislature, “until I heard you were going to drive them out of the State; but since I heard this I haven’t been able to sleep.” For William James, the licensure problem ran deeper still. The power to license doctors was the power to grant a monopoly over belief itself.44

The distinguished Harvard psychologist (and older brother of Henry James) testified in March 1898 before a “tremendous throng of men and women” at the Massachusetts State House. The legislature’s committee on public health