Pox

by Michael Willrich

  In the midst of this public health emergency, an anonymous circular appeared on the streets of Boston. Addressed to parents, guardians, and the people, it warned that vaccination caused “disease, constitutional debility, death.” The circular advised that the state law requiring vaccination for all public school pupils—now being strictly enforced in the city—made an exception for any child who presented a certificate, signed by a physician, stating that the child was an “unfit subject for vaccination.” Having won this concession from the legislature in 1894, the antivaccinationists were now making the most of it. “There are hundreds of physicians in Massachusetts who are well aware of the uselessness and evil effects of vaccination,” the circular instructed. To them, no child was a fit subject for vaccination. “Apply to any one of them for a certificate of exemption for your child.” The leaflet provided an address—an office at No. 1 Beacon Street, just steps from the gold-domed State House—to which parents could write for names of such doctors. Asked by the Globe for a comment, Durgin issued his challenge.4

  It must have seemed to Durgin’s peers that the stress of the job had finally gotten to him. Had the respected chief of one of the nation’s leading public health departments really just dared unvaccinated citizens to expose themselves to smallpox? In all likelihood, Durgin expected no one to take the bait. A man of his experience knew the antivaccinationists were nothing if not sincere. But their beliefs did not constitute a suicide pact. While antivaccinationists considered vaccination a medical fraud and compulsory vaccination an “atrocious crime,” few imagined themselves invulnerable to smallpox.5

  One of the few was Dr. Immanuel Pfeiffer of Boston. A Danish immigrant and former dealer in real estate, the sixtyish physician was a handsome man with an erect bearing, a thick head of hair, and a well-groomed beard. He was a public figure of well-known enthusiasms: spiritualism, physical culture, free speech, and, uniting them all, antivaccinationism. An apostle of the idea that the mind possessed almost limitless power over the material world, Pfeiffer offered his own body as the proof of his beliefs, winning a Houdini-like reputation for his vigorous constitution and capacity to withstand physical hardship. In 1900, he garnered national press attention by fasting for twenty-one days. A year later, he fasted for a month. “He has been considered a crank by many people,” the Globe observed; and yet those who knew the man acknowledged that he had “a brain of unusual power and activity, a fitting concomitant of his stalwart figure and imposing carriage.” In his heterodox medical journal, Our Home Rights, Pfeiffer taught readers that the best way to ward off disease was through sanitation, proper diet, and impeccable hygiene. He advertised his services as a “renowned natural healer” who “successfully treats all kinds of chronic diseases by the simple laying on of hands, after having been pronounced incurable by regular physicians.” Regular physicians: to Pfeiffer, that phrase signified unthinking medical orthodoxy and creeping state regulation of the healing arts, a trend he fought as president of the Massachusetts Medical Rights League.6

  Pfeiffer’s views on vaccination were a matter of public record. In December 1901, one month after Durgin issued his challenge, Pfeiffer attended a lecture at a meeting of the Ladies’ Psychological Institute of Boston. The speaker was Dr. John H. McCollom of Boston City Hospital, an instructor in contagious diseases at Harvard and a prominent member of the Massachusetts Medical Society—a “regular,” through and through. McCollom presented a by-the-book argument for vaccination. As gruesome images of smallpox patients beamed onto a screen from his stereopticon, McCollom narrated humankind’s long struggle with smallpox, culminating in the scientific triumph of Jennerian vaccination. He traced the development of vaccine, touting the virtues of modern glycerinated lymph. He marshaled statistics from historical epidemics to demonstrate that well-vaccinated people rarely contracted smallpox and, when they did, suffered far less than their unvaccinated neighbors. The same argument could be found in countless medical journals, government reports, and newspapers. But with smallpox spreading in the city—perhaps in that very room—the audience hung on McCollom’s every word. Coming to the end of his lecture, he opened the floor to questions .7

  Pfeiffer rose. “Is it not true, doctor,” he began, “that men of science and immense learning have effectually claimed that persons whose bodies are cleanly, sound and generally healthy are protected from smallpox?”

  McCollom responded, “No, it is not true, and I do not recollect of hearing any learned or scientific men making any such claim.”

  Pfeiffer: “Is it not admitted by eminent physicians and learned men that there are more ills resulting from vaccination than from the disease of smallpox?”

  McCollom said he had “never heard a scientific man” say any such thing.

  Pfeiffer: “And did not the people of Ohio rise up against vaccination to such an extent that it has been abolished there?” (He was referring to Cleveland health officer Martin Friedrich’s recent decision to suspend wholesale vaccination in favor of disinfection.) Before McCollom could answer, Pfeiffer launched into another question. Then another. The cross-examination went on like this for some time, as Pfeiffer exhibited his famous endurance and McCollom—and the audience—approached the limits of theirs.8

  A month later, on January 18, 1902, Pfeiffer wrote to Durgin, seeking permission to visit the smallpox wards at Gallop’s Island “for the purpose of scientifically looking into the disease in all its various forms.” The letter indicated that the two men had already spoken; Durgin had asked Pfeiffer to put his request in writing. To this, the chairman readily assented, waiving the hospital’s strict requirement that all visitors show evidence of recent vaccination. Pfeiffer had not been vaccinated since infancy. Durgin’s dare had a taker after all.9

  Many would later question the chairman’s decision. By January 1, city physicians had already vaccinated 185,000 residents; family doctors and other agencies had vaccinated roughly 300,000, for a total of 485,000 in a city of 586,000. That was an exceptionally high vaccination rate (83 percent) for a U.S. city. But Durgin seemed determined to reach that final 17 percent and to strip Boston of its national reputation as “a hot-bed of the anti-vaccine heresy.” That January, under authority of a vaccination order issued by Durgin’s board, city doctors and police canvassed East Boston, South Boston, Charlestown, the North End, and the West End. The antivaccinationists stepped up their efforts, petitioning the Massachusetts General Court with bills to abolish compulsion. Nineteen citizens of Boston were prosecuted for resisting vaccination (including one East Boston father, John H. Mugford, who would fight his case all the way to the state’s Supreme Judicial Court). Meanwhile, the epidemic continued. By late January, nearly 700 Bostonians had been stricken with smallpox; 108 had died. Durgin held the antivaccinationists responsible, and Pfeiffer was their most visible leader.10

  On January 23, Pfeiffer toured Gallop’s Island in the company of Dr. Paul Carson, the port physician. Carson, a former Dartmouth football star, instructed Pfeiffer in hospital protocol, helping him don the requisite white gown and cap. The two men walked the wards that housed more than one hundred smallpox-stricken patients, stopping at their grim bedsides so Pfeiffer could examine the disease in its various stages. Pfeiffer complimented his host on the cleanliness of the facility. He remarked that the air lacked the infamous smell of smallpox—an odor one country doctor of the era likened to “a hen-house on a warm April morn.” Carson suggested that Pfeiffer smell a patient’s breath. Pfeiffer leaned in, inhaling deeply. Durgin was not present. But he later told a reporter that he was “glad the suggestion of the breath was made, so that Dr Pfeiffer might be gratified in every conceivable way in his expressed desire.” Arriving at the end of the tour, Pfeiffer returned the robe and cap and, on Carson’s instructions, washed his hands, face, hair, and beard in disinfectant before boarding the boat back to Boston.11

  In the days that followed, agents for the board of health kept Pfeiffer under close surveillance. They stood sentry outside
his Washington Street office. They shadowed him on his rounds. They trailed him to the State House, where he testified in crowded public hearings on the antivaccination bills. Pfeiffer had drafted one of the bills himself. It called for “obtaining the consent to inject any poisonous substance into the body of any person.”12

  The surveillance went on for a week, eight days, nine, ten.... Then, on February 3, the eleventh day after his exposure to smallpox—right about the time when a person infected with the virus would be expected to fall ill and become contagious—Durgin’s agents lost Pfeiffer.

  Iconoclasts! Charlatans!! Cranks!!! Of “the little coterie of obstructionists who call themselves antivaccinationists,” the leaders of scientific medical opinion in turn-of-the-century America had little good to say. “To call him an ass,” the New York country doctor–cum–memoirist William Macartney said of the antivaccinationist, “is to disparage donkeys in general.” With the same stubborn sort in mind, health officials from Kentucky to California called a tough case of smallpox “the fool-killer.” Dr. James Hyde, the small-pox expert at Rush Medical School, offered a more searching psychological profile of vaccination’s discontents. “A class of men,” he imagined them, “whose minds are so curiously constituted that they will select for study the nether side of the social fabric, the weakness of the best of governments, and the minor defects in the character of the world’s heroes.” For years to come, few medical historians or science writers would feel any professional obligation to soft-pedal their contempt when writing about the “antivaccine, anti-government, and anti-science crowd.”13

  To be sure, the turn-of-the-century antivaccination movement attracted more than its share of odd characters and showboating extremists. As Boston’s Dr. Charles F. Nichols (the author of Vaccination: A Blunder in Poisons) observed, “The subject evokes strong language—explosives, not apologetics.” The aptly named Dr. Robert A. Gunn told an audience at the Manhattan Liberal Club in 1902 that he would “shoot down as he would a burglar” any health officer who attempted to vaccinate his family, confident “no jury of American freemen” would find him guilty of murder.14

  With the passage of time, the ideas of the early twentieth-century antivaccinationists may seem quaint, or worse. But those ideas, so markedly wrong by modern scientific standards, still offer critical insights into the tumultuous transformation of American society, culture, and government in the Progressive Era. Dr. Hyde’s unflattering psychological profile of the antivaccinationists hints at their deeper historical significance. These men and women, for whom opposition to compulsory vaccination had become a political cause, were profoundly disaffected by the growing administrative power and social reach of the American government in their time. For many of them, active opposition to “state medicine”—a term embraced by the state itself—was part of a larger social and cultural struggle against the dramatic extension of governmental power into the realms of education, family life, personal belief, bodily autonomy, and speech.15

  The antivaccinationists’ sense of themselves as members of a political movement distinguished them from the far greater numbers of Americans who resisted compulsory vaccination during the smallpox epidemics of 1898–1903. For the African American coal miners of Birmingham, the tenement mothers of Italian Harlem, or the barrio dwellers of Laredo, resisting compulsory vaccination was indisputably a political act. By rioting, forging vaccination scars, scrubbing vaccine from their children’s arms, or driving vaccinators from their neighborhoods, thousands of ordinary Americans rebelled against government authority. Their actions emboldened antivaccinationists, but that did not make every “vaccine refuser” an antivaccinationist. For most refusers, resistance was an act in and of the moment; it lasted only so long as did the threat of compulsion itself. Antivaccinationists were different. They were activists—people with a cause. They aimed to win converts, move public opinion, change laws. As John Pitcairn, the wealthy Pittsburgh plate glass manufacturer and president of the Anti-Vaccination League of America, told a committee of the Pennsylvania General Assembly, “There is no money in the cause we represent; it is the cause of truth, the cause of freedom, the cause of humanity.” For some, that cause became a lifelong crusade.16

  Many antivaccinationists had close intellectual and personal ties to a largely forgotten American tradition and subculture of libertarian radicalism. That tradition took on a feverish new life as industrial capitalism, progressive reform, and the professionalization of knowledge fostered the rise of a distinctly modern interventionist state during the Progressive Era. The same men and women who joined antivaccination leagues tended to throw themselves into other maligned causes of their era, including anti-imperialism, women’s rights, antivivisection, vegetarianism, Henry George’s single tax, the fight against government censorship of “obscene” materials (under the late nineteenth-century “Comstock laws”), and opposition to state eugenics. Seventy-year-old Dr. Montague R. Leverson—an English immigrant, onetime California state assemblyman, and perennial leader of the Brooklyn Anti-Compulsory Vaccination League—was denounced, accurately, by The New York Times as “an extreme advocate of personal liberty,” an “untiring writer of letters and pamphlets” on “all sorts of impracticable theories” from the injustice of the obscenity laws to the lawlessness of the U.S. war in the Philippines. It was the antivaccinationists’ uncompromising defense of personal liberty, as they understood it—and not merely their unorthodox medical beliefs—that placed them, in the eyes of so many of their contemporaries, on the wrong side of history. That same “crankiness” makes their words and works an unusually revealing porthole to their times.17

  Antivaccinationism was a worldwide phenomenon in the late nineteenth and early twentieth centuries. The American activists were well aware of the vaccination riots that rocked Montreal in 1885 and Rio de Janeiro in 1904. They knew (if only through Kipling’s stories) of the grassroots resistance that Britain’s vaccination campaigns had aroused across India. But given their common language and the legal and political traditions that they shared, American antivaccinationists always felt an especially close connection to their English counterparts. And together the English and American antivaccinationists proudly claimed the mantle of another unpopular movement: the transatlantic nineteenth-century antislavery movement.18

  A natural affinity linked abolitionism and antivaccinationism. Both upheld bodily self-possession as the sine qua non of human freedom; both distrusted institutions; and each evoked public scorn in its time as the dangerous cause of a lunatic fringe. Frederick Douglass told an English correspondent in 1882 that compulsory vaccination had long offended his “logical faculty” as a man “opposed to every species of arbitrary power.” Some antivaccinationists, including the English leader William Tebb ( 1830–1917) and the California spiritualist Dr. James Martin Peebles (1822–1922), lived long enough to participate in both movements. For others, antislavery provided a rich source of moral inspiration and political rhetoric. Beginning in 1902, Lora C. Little of Minneapolis edited The Liberator, a smartly written antivaccination journal named after William Lloyd Garrison’s abolitionist newspaper from antebellum Boston. Little’s Liberator was well known to Garrison’s son, William Lloyd Garrison, Jr. (1838–1909), a businessman reformer whose causes included anti-imperialism, free trade, women’s rights, repeal of the Chinese Exclusion Act, and antivaccinationism. During the 1840s the elder Garrison renounced the U.S. Constitution as a pro-slavery compact, a “covenant with death,” and “an agreement with hell”; in his son’s time, Immanuel Pfeiffer denounced health boards as “covenanters with death and leaguers with hell.” Addressing the Western New York Homeopathic Medical Society in 1902, Dr. J. W. Hodge of Niagara Falls thundered, “Compulsory vaccination ranks with human slavery and religious persecution as one of the most flagrant outrages upon the rights of the human race.” It may have been the single most quoted line in the American antivaccinationist literature. It is still quoted by antivaccinationists today.19

>   For men and women who espoused a form of radical individualism, critics of vaccination were quick to recognize the power of association. “From all parts of the state, and indeed from all parts of the country,” declared the Minneapolis-based Northwestern Lancet in February 1901, “come reports of the organization of small anti-vaccination societies, whose first work is to embarrass health and school officials in their efforts to prevent the spread of small-pox.” As vaccination enforcement surged, organizations long moribund sprang back to life and new leagues appeared on the scene. The longest-running groups had formed in response to the first major wave of compulsory vaccination laws during the 1870s and 1880s. The granddaddy of them all, the Anti-Vaccination Society of America, was established in New York in 1879, during a visit from England’s William Tebb.

  Between 1879 and 1900, other organizations formed, including the New England Anti-Compulsory Vaccination League (1882, Hartford), the American Anti-Vaccination Society (1885, New York), the American AntiVaccination League (1889, New York, claiming 380 members by 1901), and an Indiana-based organization called the Anti-Vaccination Society of America (1895, claiming 200 members by 1901). Around the turn of the century, state leagues were up and running in California, Colorado, Connecticut, Massachusetts, Minnesota, Missouri, Pennsylvania, Utah, and other states, in addition to the welter of local societies in communities such as Berkeley, Boston, Brooklyn, Cleveland, Milwaukee, and St. Paul. The existence of two distinct organizations, each calling itself “the” AntiVaccination Society of America, attests to a lack of coordination in the movement. The antivaccinationists had little of the organizational discipline (or membership base) of a national interest group such as the General Federation of Women’s Clubs, whose success in winning protective legislation for female factory workers rested on its ability to mobilize affiliated organizations at every level of the polity. By comparison to the GFWC, the antivaccination movement was an unmade bed.20