Pox_ An American History - Michael Willrich [41]
From the date the Service took over, only seven new cases developed in Middlesboro. Each day the Smallpox Hospital released more recovered patients. First they underwent a regimen of baths, while hospital staff washed their clothes in bichloride of mercury. The last smallpox case surfaced on April 6. Wertenbaker had returned to Wilmington the previous day, leaving the cleanup operation in Middlesboro in the hands of a Service officer named Hill Hastings. By April 14, only two cases of smallpox remained in Middlesboro. Hastings had them transferred to the Bell County pesthouse. (It was the very least Bell County could do.) On April 15, on Surgeon General Wyman’s orders, Hastings and his men broke up the Marine-Hospital Service’s camp at Middlesboro. Five months after it began, the Middlesboro epidemic finally came to an end.73
For J. N. and A. T. McCormack of the Kentucky Board of Health, the Middlesboro epidemic had been a disaster—a disaster that threatened to overtake the entire state, one ill-governed community at a time. Political fecklessness and pound-foolishness had allowed Kentucky’s first encounter with mild type smallpox to spiral out of control. On March 25, Secretary McCormack issued a state bulletin, warning that the Middlesboro epidemic would be repeated everywhere if local authorities did not take its two main lessons to heart.
The first lesson was legal: under Kentucky laws, the expense of smallpox control had to be quickly met by the affected counties and cities. The price of inaction in Middlesboro amounted to thousands of dollars in government funds, “very many thousands in loss of business,” and the sheer “mortification of clamoring for outside aid.” In the future, McCormack said, the state board would not hesitate to order a quarantine against cities and counties that failed to do their duties.74
The second lesson was racial: Kentucky communities could no longer ignore the spread of smallpox among African Americans. “The exemption of the white race” from the new smallpox was coming to an end. In a chilling statement, McCormack advised that “visiting and strange negroes be hunted, vaccinated, and kept under observation.” As the Kentucky epidemic spread, McCormack redoubled his efforts to control the movement of African Americans. At the October 1898 meeting of the board, he warned that the unrestricted travel of unvaccinated colored persons constituted “a menace to the health and lives of the people of this state.” The secretary proposed a resolution, which the board swiftly adopted. The new regulation made it unlawful for any person exposed to smallpox—and any African American, period—“to leave Cincinnati, Louisville, Memphis, Evansville, or any other point or place where small-pox now or may hereafter prevail,” for any point in Kentucky by train, steamboat, or other conveyance without a certificate of vaccination issued by a public health officer. A vaccination certificate had become a kind of internal passport, required of all blacks, as well as those whites who had actually been exposed to smallpox, for travel into, or within, the state of Kentucky. The most basic freedom of all—freedom to move—which African Americans had exercised in extraordinary numbers in the late nineteenth-century South, redefining the national map in the process, was now made dependent upon their vaccination status.75
In the aftermath of the local outbreak that launched a four-year-long epidemic in the state of Kentucky, costing county and municipal governments more than $300,000, the officials of Middlesboro and Bell County seemed no more inclined than before to assume the legal