Pox_ An American History - Michael Willrich [51]
Wertenbaker’s experiences in the field would make him into an advocate for reform in the field of public health administration. He pushed for better, safer vaccines. He promoted official candor and public education as the best remedies for the pervasive “prejudice” against vaccination. And though Wertenbaker never discarded the racial beliefs of his time and place, he would, in an era of overwhelming white indifference to African American health, call for the government to mobilize rural blacks to organize their own fight against infectious disease. Ultimately, Wertenbaker’s smallpox sorties led him to conclude that there was only one way to stamp out infectious disease in the South—by increasing the scale and scope of federal police power.31
If late nineteenth-century American jurists were certain about anything it was this: the states could take any action necessary to protect their citizens from the “present danger” of a deadly infectious disease. Since the dawn of the republic, state and local governments had wielded powers both plenary and plentiful to defend the people from outbreaks of smallpox, yellow fever, cholera, and other pestilences. Individual liberty and property rights melted away before the state’s power—indeed its inherent legal duty—to defend the population from peril. Under the broad authority of the police power, state and local governments confined suspected disease carriers against their will, established armed quarantines on land and at sea, seized private homes for smallpox pesthouses, removed infected persons by force from their homes, and enacted, in the approving words of the U.S. Supreme Court, “health laws of every description.” Considering the case of a merchant from Burlington, North Carolina, who had refused to submit to his town’s vaccination during the epidemic winter of 1899, Justice Walter McKenzie Clark of the state supreme court drew a ready analogy between public health and the sovereign’s power of self-defense. “[I]t is every day common sense,” he said, “that if a people can draft or conscript its citizens to defend its borders from invasion, it can protect itself from the deadly pestilence that walketh by noonday, by such measures as medical science has found most efficacious for that purpose.” Like war, it seemed, epidemic disease was the health of the state.32
But in the cities, towns, and rural hamlets that C. P. Wertenbaker visited across the South, convalescent people with infectious smallpox scabs on their faces and limbs moved freely about the streets, ran country stores, and went to work in the fields and mills. Meanwhile, local physicians engaged each other in front porch debates about the nature and provenance of this mysterious eruptive disease. When alarmed public health officials called for strong measures, local government agents often hesitated to act, not wanting to interfere with business or upset the electorate. When officials finally did act, as Wertenbaker wrote in a report to Surgeon General Wyman, time and again the people “revolted.”33
Health officials met with resistance to every form of action they took. African Americans were said to be particularly quick to hide sick relatives and friends from health inspectors and the police, but whites did it, too. Shotgun quarantines on the public roads proved to be a weak defense against rural folk who knew their way through the woods. “We had just as well undertake to quarantine against red foxes and jack rabbits,” said one Kentucky health official. Pesthouses