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By Root 320 0

that had been hastily built were just as swiftly torched or torn asunder by crowds of people, white and black, who refused to let their neighborhoods be turned into smallpox dumping grounds. “We were totally unprepared to take care of a contagious disease,” recalled Dr. J. M. Manning, superintendent of health of Durham, North Carolina. Dr. Manning rode with the mayor across Durham, looking for a suitable place to pitch an isolation tent, but they were “met with shot-guns” wherever they stopped. Where officials did manage to establish pesthouses, they had to find a way to keep people in them. Even with armed guards and gasoline torches, most pesthouses and detention camps could not hold people who had the will and energy (as patients with mild smallpox often did) to escape. Local newspapers that a generation earlier had published notices of runaway slaves now ran stories about African American pesthouse fugitives who had broken loose from their confinement and fled into the night.34

No public health measure inspired more ill will than compulsory vaccination. Some of the opposition came from the top of the political order—from state lawmakers, who almost everywhere maintained that if compulsory vaccination were to exist at all it must be by local mandate. Even in the midst of the regional epidemic, efforts to enact uniform statewide vaccination legislation failed in several states, including Alabama (despite strong support from the medical profession), Florida (where rural representatives killed a bill favored by their urban colleagues), and North Carolina (where a bill drafted by the state board of health was “treated with absolute contempt”). Even in those few states that did enact new vaccination laws—such as Mississippi, a yellow fever state with an exceptionally well-funded board of health—lawmakers merely authorized local governments to compel vaccination and impose penalties. Compulsory vaccination of public schoolchildren could be attempted under state legislation or local authority, but in a region with almost no compulsory school attendance laws, such measures had limited reach. As Secretary Richard H. Lewis of the North Carolina Board of Health commented, “One practical difficulty on educational lines now is to get the children to go to school at all.”35

In the absence of state statutes, during smallpox epidemics local governments often ordered vaccination under their own general police powers, performing their legal duty to protect their populations from immediate danger. The orders usually resembled the one issued by the Wilmington aldermen: they required everyone in the community to show proof of a recent successful vaccination. The penalties ranged dramatically—with fines from $5 to $100, jail terms from ten to forty days. Some judges ordered violators to work on the public roads. In one North Carolina town, a man who refused to be vaccinated and threatened to spread smallpox among his “political enemies” had “three buggy whips worn out on him.” By contrast, some state and local measures created exemptions for specific classes of people. The city of Nashville made exceptions for people aged seventy or over, for women more than five months pregnant, and for individuals who, “in the opinion of the vaccinating physicians, are too ill to submit to the procedure.” Wertenbaker took a dim view of such exemptions. Only two classes of people should be allowed to neglect this duty, he wrote in his “Plan”: those who have had smallpox already and “those who are dead.”36

Local or not, compulsory vaccination orders engendered strife. Much the same drama played out across the South, from High Point, North Carolina—where Wertenbaker arrived to find that the furniture factory employees had “closed their houses, and gone into the country to avoid being vaccinated”—to Sherman Heights, Tennessee, where a crowd of citizens drove off county vaccinators with stones, curtain poles, and guns. Some people loudly protested the measures as violations of their personal liberty. Others tried to shrug off the health officers’ authority.