Pox_ An American History - Michael Willrich [3]
The vaccination corps had not been on the block long before the doctors realized the need for reinforcements, men armed with more than vaccine. As the physicians moved from door to door, rapping loudly and calling for the occupants to come out and be vaccinated, many residents refused to cooperate. The doctors tried to explain the danger, which could not have been easy given the many tongues spoken on the block. But many people would not submit to having their own or their children’s arms scraped by the vaccinators without, according to The New York Times, “loud wails and even positive resistance.” Receiving word of the worsening situation on All Nations Block, the commander of the West Sixty-eighth Street station dispatched a detail of six policemen to assist the doctors in “enforcing the vaccination.”10
Well into the cool autumn night, All Nations Block echoed with the rapping of nightsticks on doors, the shouting and pleas of the residents within, and, through it all, the rattle of the horse-drawn ambulance wagons as they moved to and from the infected district. By midnight, the vaccination corps had discovered another twenty-two cases on the block, many of them little children, all of them, in the health officers’ view, requiring immediate isolation. The ambulance wagons carried the patients five miles over rough city roads to the Willard Parker Hospital, the health department’s contagious diseases facility at the foot of East Sixteenth Street on the East River, where the doctors gave them a more full examination. From there they were ferried off Manhattan and many more miles upriver to the city smallpox hospital, the “pesthouse” on North Brother Island, a nineteenacre wooded island situated between Rikers Island and the Bronx mainland. Pesthouses, public hospitals used to isolate poor people suffering from infectious diseases, were the most dreaded of American institutions. The trip to North Brother Island was a grim journey into unknown territory. No known cure for smallpox existed. The pesthouse doctors could do little more than treat the patients’ symptoms. It was up to the virus, and to each patient’s own resources, to determine who among the infected would die in the seclusion of North Brother Island.
The germ theory taught that contagious diseases such as smallpox did not arise spontaneously; they did not spring to life in vaporous miasmas from stagnant water or decomposing filth, as physicians and sanitarians had previously assumed. Doctors now understood smallpox to be caused by invisible life forms—“germs”—that could only survive and proliferate by infecting human carriers. There seemed to be no animal or insect vector for smallpox: no species of mosquito, rodent, or bird that carried the disease from person to person, place to place. If smallpox suddenly appeared in a previously healthy community, there were only two possible explanations: either viral material from a recent case had survived for a time in clothing or bedding or, more likely, someone had brought the pox into the community. On this point medical science reinforced the common reflex of human communities everywhere to blame sudden misfortune on their most marginal inhabitants, outsiders and “others.”11
“What a potent factor in maintaining the prevalence of small-pox is that unemployed and largely unemployable degenerate, the habitual vagrant or tramp,” observed a writer in the London-based Lancet, the preeminent English-language medical journal. “The fact that this parasite upon