Pox_ An American History - Michael Willrich [23]
The variola virus itself played no small role in the vaccination controversies that embroiled communities across the United States. As reports of outbreaks reached Washington from communities across the South during 1898 and 1899, many local physicians, public health officers, and political leaders commented that smallpox did not seem its old self. And the more people smallpox struck, the bigger the “kick” the public put up against vaccination. 62
Dr. Henry F. Long was one of the first southern medical men to report on this unprecedented new situation. Harvey Perkins had died as expected. But something peculiar happened to the sixty-two others who landed in Dr. Long’s pesthouse during the months after Perkins made his long walk through the woods of Iredell County: every last one of them survived.
TWO
THE MILD TYPE
A peculiar new form of smallpox invaded communities across the American South during the last three years of the nineteenth century. The mysterious disease brought little of the horror people expected from smallpox. For every hundred people infected, only one or two died. Physicians and lay-people often mistook the symptoms for chicken pox, measles, or some other eruptive disease. The eruption passed through the normal stages, but the pustules typically remained superficial and discrete. Miraculously, most people recovered without pockmarks. At first the new pox reportedly spread almost exclusively among African Americans. Because of its unprecedented mildness and its reputation for infecting “none but negroes,” the new smallpox was allowed to gain a beachhead in the southeastern United States. Local governments were slow to respond until someone died or the disease crossed the color line. In this way, isolated cases became outbreaks, outbreaks became full-scale epidemics, and a disease whose ultimate capacity for destruction no one could foretell made its way from place to place.1
As the disease spread back and forth along the rivers, roads, and rails of the southern states, a growing inventory of popular sobriquets traveled with it. “Cuban itch,” some called it, or “Porto Rico scratch,” “Manila scab,” “Filipino itch,” “Mexican bump,” “Nigger itch,” “Italian itch,” “Hungarian itch,” “Camp itch,” “Army itch,” “Elephant itch,” “Kangaroo itch,” “Cedar itch,” “Bean pox,” or simply “Bumps.” These invented diagnostic names, which some physicians adopted, expressed the lack of alarm with which ordinary people greeted this highly contagious, obviously itchy, and occasionally fatal eruptive disease. They’d seen worse.2
Like the rumors that everywhere circulated about the new disease, the made-up names traced its origins, in a matter-of-fact way, to particularly salient features of the social and political landscape of end-of-the-century America. Americans continued the practice, already old when smallpox first exploded across Europe, of ascribing the foul scourge to rival powers, the wandering poor, and other scapegoats. Surely, the Americans said, the “itch” came from the exotic colonial frontiers opened by the war with Spain. Or from the rowdy work camps that had sprung up across the southern countryside, wherever logs needed cutting, tracks laying, or coal hauling. Or from the bodies of a formerly enslaved people, now moving about the region in search of work and a greater measure of freedom. Or from the new immigrants who steamed across the Atlantic from unfamiliar parts of southern and eastern Europe. But behind all of these names, and the tales of origin they told, lay an old foe. “In nine out of ten cases,” said Passed Assistant Surgeon C. P. Wertenbaker of the U.S. Marine-Hospital Service, “these prove to be smallpox.”3
The full scope of these southern outbreaks may never be known. Many localities—and even some state governments, such as Arkansas’s and Georgia’s—had no public health board, much less any system for tracking the incidence of infectious diseases. Even where active health boards existed, the diagnostic confusion caused by the new “mild type