Pox_ An American History - Michael Willrich [40]
Wertenbaker’s inspectors, under the charge of Dr. Blair, set out immediately into the streets and neighborhoods of Middlesboro. Wertenbaker divided the city into five districts, assigning one inspector to each to make a house-to-house canvass. A local newspaper boasted awkwardly that the Service’s inspection showed that “outside of small-pox this is the healthiest town on the globe.” They examined everyone, vaccinating the few unscarred people they found. Anyone who refused the vaccination order was promptly turned over to the city authorities, who gave the violator the option of being vaccinated or taken to jail. As Wertenbaker reported to Wyman, it was something of a moot question, because if the uncooperative person chose jail, “they are vaccinated as soon as they enter, under a law requiring all inmates of jails to be vaccinated.” The violence of compulsory vaccination at gunpoint in the Over the Rhine district had given way to something different, more orderly but still highly coercive.70
Wertenbaker took steps to separate the smallpox patients from the smallpox suspects. He turned a row of twelve houses near the old Brown’s Row pesthouse, where patients and suspects had been confined, into a detention camp for suspects. He placed the camp under the charge of Dr. W. N. Shoemaker of Birmingham, who had become acquainted with Service methods from the epidemic there, and a staff of attendants and guards. For a smallpox hospital, Wertenbaker rented the old Biggerstaff boardinghouse, a two-story building on the city’s western outskirts, and fitted it out with beds and supplies. Someone christened it the South Boston Hospital, after the nearby South Boston Iron Works, once a major supplier of cannons and armaments to the U.S. government. Wertenbaker’s men moved the ninetyone people who had been languishing in the Brown’s Row pesthouse into the hospital and placed them under the charge of Dr. W. C. Duke, a physician from Memphis who had been trained in Service work. It was a simple facility, but Duke had the assistance of nurses and attendants, and no patient would go hungry for lack of provisions.
In all smallpox epidemics, good nursing care—including the provision of such basic human needs as warmth, proper food, water, and clean sheets—had a major influence on mortality rates. A poorly run or ill-provisioned pesthouse (and many turn-of-the-century pesthouses were both) could be far worse for a patient’s chances of recovery than care at home with family, which is one reason why so many families hid their sick from the health authorities. During the Service’s operation at Middlesboro, the hospital treated 103 patients. About three quarters of them were African American, and the males outnumbered the females 64 to 39. The patients’ ages provided a very rough measure of the vaccination status of the general population before the epidemic. All but six of them were under forty. Dr. Duke’s staff treated twenty-two children under ten years old, including seven younger than a year. All of the patients in the hospital, including the infants, survived. Even in an epidemic of mild smallpox, that was no small achievement.71
Given the strong contemporary belief that smallpox could be spread by contaminated objects, or fomites, a critical component of any state-of-the-art smallpox eradication effort was