Pox_ An American History - Michael Willrich [38]
So far the disease had proved exceptionally mild, but also exceptionally expensive. The city and county governments spent the huge sum of $30,000 fighting the epidemic. They set up quarantine camps, enforced vaccination, and furnished 75,000 tubes and points of free vaccine. City officials strictly enforced vaccination: at least seven people were arrested in the first weeks of the epidemic for refusing to be vaccinated. But outside Birmingham, enforcement was spottier, and by December 1897, more than twenty towns and camps reported smallpox. In January, the local authorities called on the Marine-Hospital Service for aid. Surgeon General Wyman extended to Birmingham and Jefferson County the same offer he would later make to Middlesboro: the U.S. government would take general control of the quarantine camps, provide free vaccine, and organize a corps of men to inspect and vaccinate the population. But the city and county must “bear all other expenses.” The local authorities readily accepted.63
From his headquarters in Birmingham, Magruder organized a corps of thirty inspectors, recruiting local physicians and medical students. He assigned each to a territory within the city, in which they inspected all homes and their occupants. Magruder advised the inspectors to extend courtesy to everyone—the “refined and rough, reasonable and unreasonable, crank and sage.” But under no circumstances would the Service honor certificates of vaccination. “In all large towns,” he explained, one could find “some physicians who will give false certificates for a small fee.” Magruder’s instructions show his awareness of the urban tradition of resistance to compulsory vaccination, abetted by local doctors who were supposed to be the front line of public health. He told his inspectors to check every person’s arm for a fresh vaccine scar—the only real proof of a successful recent vaccination. The inspectors were to make a thorough search of every room they visited, “especially in negro quarters,” looking for concealed people with smallpox. Ambulance wagons carried the sick to one of the quarantine camps. All suspects found living in a house with a smallpox sufferer were vaccinated at once and sent to the detention camp to be kept under watch for sixteen days. At the camps, Magruder introduced an innovation of which he was particularly proud. He surrounded each camp with a high fence of barbed wire. Thirty feet inside of this line he marked out a “dead line,” beyond which no “patient” was allowed to tread. At night the entire area was illuminated with gasoline torches, “enabling a small number of guards to effectually prevent the escape of convalescents.” Even with the doctors moving to and fro, to the detainees the federal quarantine facilities must have invited comparisons to Alabama’s notorious convict labor camps.64
The mining camps outside of the city posed a special problem. Magruder believed the disease was spread chiefly by itinerant African American coal miners, who avoided vaccination whenever they could. Since they lived in unincorporated camps, none of the local compulsory vaccination ordinances applied to them. When superintendents of mining companies tried to enforce vaccination, “the men would leave in such numbers as to cause serious embarrassment from lack of laborers.” The men just picked up and moved to another camp where vaccination was not enforced. As a consequence, those mining superintendents who had tried compulsory vaccination on their premises gave up the effort.65
Magruder had an idea. He called together the owners and superintendents of the mining