Pox_ An American History - Michael Willrich [65]
Wertenbaker’s plan was a model of “military authority”: house-to-house inspections by physicians and police, compulsory vaccination of everyone who could not show a recent vaccination scar, the relocation of all suspected disease carriers into detention camps, and treatment of all small-pox patients in an isolation hospital. Wertenbaker leavened this litany of logistics with aphorisms drawn from his experience in the field. “A policeman is of great assistance to an inspector.” “Measures, good or bad, half done are worse than useless, as they give a fancied security.” “Smallpox cannot be suppressed without the expenditure of money. The more promptly you act the less it will cost.” Middlesboro could not have been far from his mind as he wrote those last lines.82
Like all measures of health policing since the invention of the quarantine in fourteenth-century Venice, Wertenbaker’s “Plan” had a draconian streak. But for all of Wertenbaker’s frustration with southern political institutions and officials—who, in his view, had let an eminently manageable pestilence run wild—his smallpox work instilled in him a certain optimism that those officials often lacked about the potential of the people. The people might be ignorant. They might spread false rumors. But in his travels through the southern states, Wertenbaker had learned from them. Above all, he had come to appreciate the ethical and political value of candor. Public health work required a big stick, to be sure, but it achieved little in the long run if the public remained unconvinced. Wertenbaker advised local health authorities to leaven force and discipline with education and persuasion. “If these facts are explained to the people by someone in whom they have confidence,” he promised in the “Plan,” “much of the opposition to vaccination will disappear.”83
As Wertenbaker’s faith in the southern people grew, his opinion of their local institutions continued to diminish. In February 1900, after more than two years of smallpox work, Wertenbaker sent Surgeon General Wyman a memorandum. Not only did epidemic smallpox continue to plague many of the southern states, but now reports of new outbreaks of mild type smallpox (and, occasionally, its more terrifying ancestor) were reaching Washington from locales in the Middle West, the urban North, and the far West. The epidemics had become a national problem, making a coordinated federal response imperative.
“As matters now stand,” Wertenbaker wrote, “the suppression of the disease is left to individual communities, where action is but rarely taken until after smallpox has made its appearance.” Not only were the present methods expensive, but they allowed smallpox to spread endlessly from one community to another. “It is only by a general concerted action, embracing all the infected territory that we can hope to arrest the spread of the disease, and [guarantee] its ultimate suppression,” Wertenbaker told Wyman. “The Marine-Hospital Service, being the guardian of the Public Health, seems to be the proper source for the inauguration of such measures.” Wertenbaker had always believed that a successful smallpox eradication effort on any scale necessitated having a single “officer in charge.” And he let Wyman know that if his proposal for nationalizing smallpox control met with the surgeon general’s approval, he, C. P. Wertenbaker, would be willing to be that man.84
Wertenbaker surely knew better than to expect any such sudden sweeping change in existing institutions. If the smallpox epidemics of the end of the century had shown anything, it was that democratic institutions and the political communities they governed often moved slowly, especially when official claims to expertise and visions of social control