Pox_ An American History - Michael Willrich [47]
According to the conventional understanding of the Constitution’s Tenth Amendment, police power—the right to interfere with individual liberty and property rights in order to serve the public welfare—was reserved chiefly to the states. During the constitutional firestorm of Reconstruction, the U.S. Supreme Court had breathed new life into that old understanding, almost as if the Civil War and the Fourteenth Amendment had left the federal system unaltered. The immediate losers in the Court’s jurisprudence were African Americans, whose civil rights Congress proved increasingly powerless (and unwilling) to protect. But the decisions reverberated in other areas as well. In the Slaughter-House Cases (1873), the Court’s majority reinvigorated the long-standing constitutional position that gave the state and local governments primary and, as far as the federal courts were concerned, well-nigh unlimited authority to restrain liberty and property in the name of the public health.16
In practice, the boundaries of local, state, and federal power frequently blurred. From time to time Wertenbaker did encounter smallpox in his work for the Service. On assignment in Chicago, he served as the federal sanitary inspector at the World’s Columbian Exposition of 1893. With Asiatic cholera spreading across Europe and visitors and performers arriving in Chicago from all corners of the globe, American officials braced themselves for an outbreak at the Exposition. Instead, smallpox struck the White City that summer and spread across the real-life Second City during the fall and winter, taking hold in the West Side tenement sweatshops and killing more than a thousand people. Wertenbaker assisted overwhelmed city health officials by searching for concealed cases on the hundreds of boats that had taken up winter quarters along the icy Chicago River. He surely heard about, if he did not witness for himself, the small riots that broke out as city vaccinators worked their way through the tenements. State Factory Inspector Florence Kelley, a Hull House social settlement veteran who knew the West Side well, would never forget “the feeling against vaccination in the tenements.” One young surgeon on the vaccination squad had been “disabled for life” when an agitated tailor shattered his elbow with a bullet.17
If Wertenbaker ever doubted the effectiveness of vaccination, as some physicians did, his work in Chicago and elsewhere gave him reason to believe. Vaccination as practiced in much of the United States during the 1890s was an unpleasant and risky medical procedure. Even under the best of circumstances newly vaccinated people often felt ill and achy for days. But in the vast majority of people, vaccination worked. As chief of the Service’s Delaware Breakwater Station in August 1896, Wertenbaker inspected the steamship Earnwell, just in from Colón, Panama. Three men on board had broken out with pox. Two of them had undergone vaccination before their voyage; they experienced mild attacks. The first mate had evidently escaped vaccination, and he suffered terribly from a severe confluent case. Wertenbaker could do little more than watch the seaman die from a preventable disease.18
In January 1898, Wertenbaker took command of the Marine-Hospital Service station at Wilmington, North Carolina, his first southern assignment in seven years. A bustling port located thirty miles up the Cape Fear River from the Atlantic Ocean, Wilmington was the state’s largest city. Roughly half of the city’s 21,000 inhabitants were African American. Most black residents worked in manual and domestic labor, but Wilmington had a sizable African American middle class of skilled tradesmen, physicians, lawyers, and