Plague and Fire

by James C. Mohr

  Chinatown residents considered the regime of daily inspections to be the most intrusive and personally objectionable of the Board's antiplague initiatives. Intimate bodily inspection by strangers seemed insulting, unnecessary, and ineffectual. Partly to end the need for the regular inspections, some Chinatown residents heeded the pleas of their business leaders and actively cooperated with the Board's efforts to clean and disinfect the district. Volunteer crews from inside the area worked with authorized crews from outside to remove garbage and to empty privies, even though the outside crews were being paid by the Board of Health and the crews from inside Chinatown were not being paid at all-yet another way in which Chinatown's residents felt discriminated against. Even so, white inspectors optimistically reported that many district residents were helping with the cleanup "willingly, as they [were] anxious to break the quarantine and be at liberty once more."Z5

  Not everyone pitched in. Handbills posted in the quarantined area openly attacked the Chinese consul and vice-consul as "worse than useless" when it came to looking out for the welfare of ordinary residents. Other posters made overt death threats against the Qing representatives, who were accused of caring more about trade goods than people. For his cooperation with Emerson, Day, and Wood, and for his outspoken support of the Board's policies, Li Khai Fai was assaulted by a hostile crowd inside the quarantined zone and barely escaped by dashing off on his bicycle. Protesters also castigated Tong San Kai, the hospital director who had assisted the Board's physicians in their investigations of the first five deaths.''

  The confinement of so many Asian workers in Chinatown, in the words of a white paper, also had "a somewhat depressing effect on the commercial affairs of their Caucasian neighbors." Though the Chinese consul and vice-consul protested the closing of Chinatown's businesses when white businesses were allowed to remain open in the rest of the city, the quarantine resulted in a citywide slowdown. The Chamber of Commerce asked the Board of Health to consider establishing smaller quarantine zones outside Chinatown, where workers could be housed under observation for a safe period of time and then return to their jobs, but the physicians refused. Elsewhere in the city, the Board members suspended school indefinitely, and most restaurants closed, many from lack of workers. The quarantine's terms severely curtailed all forms of public transportation. Shipping came almost to a halt, as incoming goods had to be isolated and fumigated, and most of the men who usually worked on the wharves were confined in Chinatown, just across the street from where they would ordinarily be loading and unloading ships.21

  Hawaiians visiting in Honolulu from other islands found themselves forbidden to return home without special passes from the Board. The Hawaiian-language press condemned the Board not for its "efforts to [defeat] the black fever-if it is, in fact, the black fever," but for its "crookedness" in the enforcement of its own rules, since whites found the travel passes easier to obtain than Hawaiians did. Ke Aloha Aina also called for legal action to be taken against Board of Health agents alleged to be selling inter-island travel passes under false pretenses, and the Hawaiians protested against the liberties allowed to those whose "money makes them immune from the grip of bubonic plague." Hawaiians also suspected that "the doctors of the Board of Health" had caught the "bubonic-plaguelike disease of greed" from their friends in the Dole administration, accusing them of erecting the quarantine barriers "so that white [businesses] can profit."'"

  To support their accusations of racial bias, the Chinese pointed out that the quarantine line had been drawn to include Chung Kun Ai's brandnew City Mill, which fronted on the harbor, but excluded the white-owned Honolulu Iron Works-Honolulu's largest industry-whose grounds were immediately contiguous to City Mill. The protesters certainly had a point: on the quarantine maps, the Honolulu Iron Works property appeared as a small peninsula extending from the white commercial district along the waterfront into lower Chinatown. Moreover, rumors circulated that employees of the Iron Works who lived inside Chinatown were being allowed to cross the quarantine line and continue working regular shifts as long as they did not venture beyond the foundry's grounds. Consul Yang also identified a Chinese store on the other side of the Iron Works that appeared to be as arbitrarily inside the line as the Iron Works were artificially outside it and a Chinese-occupied block along Nuuanu Street that might logically have been excluded from the quarantine zone.29

  Some Japanese businessmen believed that the abruptly declared quarantine was actually directed at them, not the Chinese. They suspected that the emergency policy was just another thinly disguised effort by white businessmen in the annexationist camp to find ways of curtailing the rapidly escalating economic power of their Japanese competitors. To minimize the impact of the quarantine on their businesses, Japanese merchants actively smuggled goods in and out of the quarantined zone. Whenever detected, Wood reported, the Japanese merchants "simply laughed and treated the [Board's regulations] as a joke."30

  Under their emergency edicts, Emerson, Day, and Wood also assumed complete authority over the disposal of the dead. Bodies from anywhere in the city had to be inspected personally by Hoffman, who would take tissue samples for microscopic examination. If he found evidence of the pestis bacillus, the remains would be cremated as quickly as possible. Behind this policy lay a fear that plague bacteria might somehow escape from a buried corpse and survive in soil or in groundwater to attack again. Such fears were widely held by public health officials around the world and probably originated with Yersin and Kitasato themselves, both of whom had previously studied agronomy and therefore knew that soils harbored many different sorts of bacteria. Yersin claimed to find pestis as deep as eighteen inches below the surface of the ground during the outbreak in Hong Kong. Kitasato, who was conducting Japan's battle against the world epidemic, insisted that plague sites remain under quarantine for a full year, in order to make certain that the ground was completely decontaminated."

  Though Emerson, Day, and Wood regarded the cremation of plague victims as scientifically logical, their order alienated many Chinese. In an effort to sustain the tradition of burying the dead in their ancestral lands, many overseas Chinese practiced a system whereby they interred the dead for some years wherever they died, then had their bones disinterred and sent back to China. Cremation not only rendered that impossible, but also raised the specter of spiritual oblivion. British orders to cremate plague victims in Hong Kong had provoked rioting in 1894. The government plague fighters failed to explain the rationale behind their cremation edict to the Chinese, and the white press fanned already tense race relations by applauding the procedures not only as a prudent health measure but also as a demonstration "to a number of the prejudiced nationalities" that cremation was "an excellent manner in which to dispose of the dead ."322

  Following "the fashion set in the cholera epidemic" five years before, as well as the international protocols agreed upon in Europe, the three physicians launched another immediate and massive cleanup campaign throughout Honolulu, but especially within Chinatown. Most physicians in Honolulu assumed that plague, whatever its source, had probably found shelter in local refuse. Consequently, the triumvirate ordered all accumulations of garbage to be burned and all sewers to be cleaned and repaired. To signal its support of the sanitation efforts, the Honolulu Chamber of Commerce offered a modest contribution of private money to help with the cleanup. Much more was needed, however, so Emerson, Day, and Wood promptly invoked their authority to draw additional funds from the Hawaiian treasury, initially to construct a new city crematorium and a new city garbage incinerator. Before the crisis was over, the amounts drawn would soar into the millions of dollars.33

  o the great relief of everyone in Honolulu, no additional plague deaths occurred in the days following the initial outbreak. The dying stopped so abruptly, in fact, that people began to doubt whether plague had really been in the city at all. Would a real epidemic of bubonic plague kill just five people in a little more than twenty-four hours, then disappear? Doubts increas
ed when Hoffman released the result of a postmortem he performed on the body of a Hawaiian woman who expired inside Chinatown three days after the quarantine went into effect. This time he found no pestis bacilli and attributed the woman's death to unknown causes. Also puzzling was the behavior of a guinea pig Hoffman had injected with bacteria taken from one of the first five victims. The guinea pig continued to plod stoically around its cage, apparently unaffected by what was supposed to be a deadly dose. Though Hoffman vigorously defended his positive findings of plague in the first five victims, other European and American physicians began to question that diagnosis.'

  "I think this [plague business] is all foolery," proclaimed the unofficial leader of these skeptical doctors in a newspaper interview. The source of that opinion, John S. McGrew, was not just another physician in town. Now seventy-four years old, he had graduated from Ohio Medical College in Cincinnati in 1847 and served as a surgeon in the Union army during the Civil War. After the war he had taken his second wife on a world tour, but when they reached Honolulu in 1867, they decided to go no farther and settled there permanently. McGrew had been a leader among the city's Western physicians since then. In 1892 he founded the Hawaiian Medical Society, and he served as its president for the next five years.2

  McGrew commanded a great deal of influence among Honolulu's oldest generation of American business and political elites. Passionately involved in pro-American politics, McGrew had played a role in securing the U.S.-Hawaiian reciprocity treaty of 1875, which opened the American market to Hawaiian sugar planters. He also helped the U.S. Navy obtain lease rights to Pearl Harbor in the i88os. King Kalakaua himself called the doctor "Annexation McGrew." When the McKinley administration finally maneuvered its formal takeover of the Hawaiian Islands in 1898, the pro-American press hailed McGrew as "the Father of Annexation." Above all else, McGrew did not want the presence of plague to cast a shadow over the already contentious debate underway in Washington, D.C., about whether to grant full territorial status to Hawaii. Territorial status would consummate his political ambitions as triumphantly as the honorary vice presidency of an International Medical Congress had consummated his professional ambitions. He did not want a tiny handful of newcomers to torpedo the process-especially if they were wrong.'

  Other less-outspoken physicians in the city joined the crusty McGrew in suggesting more discreetly that their colleagues on the Board of Health might have overreacted. Unless the presence of plague was proven beyond a doubt, the critics argued, the Board's physicians had a duty to refrain from making Hawaii look like a medically dangerous place and a responsibility to avoid crippling their city's trade by adding Honolulu to the international list of plague ports. Emerson, Day, and Wood had moved too precipitously on too little evidence, the critics argued, and they had abused their emergency powers.4

  Old grudges and professional antipathies also surfaced. Several European physicians, who disliked the upstart Dole administration to begin with, resented the completely arbitrary delegation of absolute authority to just three doctors-all of whom were shamelessly pro-American and all of whom had gained appointment through political loyalties and personal networks. The medical outsiders saw the whole business as an abdication of civil responsibility on the part of the government and "a very dangerous experiment" undertaken with insufficient cause. Though McGrew was more likely to accuse Emerson, Day, and Wood of the opposite-being insufficiently attuned to pro-American political interests-he also resented the Board's power for personal reasons. Years earlier he had secured a government medical post for his adopted son Henri, only to have the Board publicly humiliate the family by removing Henri for incompetence.'

  Disagreements among the city's white physicians came to a head when the Hawaiian Medical Society, which was still dominated by McGrew's allies, met in the main dining room of the prestigious Pacific Club on the evening of December 16 to discuss Honolulu's medical situation. Several doctors grumbled about the unreliability of the Board's evidence; others suggested that the cases they had seen could be explained without a diagnosis of plague. James H. Raymond spoke for several physicians when he professed no overt hostility toward bacteriology per se, but said he did not believe that standard "bacteriological methods" themselves had yet definitively proved the presence of plague-especially since Hoffman's "valiant little guinea pig" had so impolitely refused to die. The way Raymond and others like him saw the situation, Emerson, Day, and Wood were relying on nothing more than the unsubstantiated opinion of a relatively unknown young German who thought he saw through his one good eye some bacteria that looked like pestis.b

  What began as a professional debate soon descended to acrimonious exchanges of personal opinion and rank speculation. Those who sided with the three doctors on the Board of Health found themselves increasingly on the defensive. At the end of the evening, the medical assembly publicly embarrassed Emerson, Day, and Wood, first by refusing to endorse Hoffman's bacteriological report on the original five plague cases, and then by voting to table a conciliatory motion that would have affirmed the temporary presence of plague at the time the quarantine was declared, even if the disease might no longer be present in the city.'

  When the Star criticized the Medical Society the following day for its divisive stance and lack of support in the face of such a crucial question, Luis F. Alvarez, one of those who voted against the Board the night before, wrote a public letter to all of the city's newspapers defending his fellow skeptics. Most of the papers printed it. Unlike the other critics, Alvarez actually knew something about bacteriology, having traveled to the Johns Hopkins Medical School in 1895 to take an introductory course in the new techniques. Yet he used his experience not to defend Hoffman's findings but to suggest-with some justice-that all such examinations were necessarily judgmental, imprecise, and open to doubt. Alvarez, who also doubled as Spanish consul to the Dole government, had a large practice among Portuguese and Hawaiians employed in the sugar trade and hence a strong incentive to keep that trade vigorous. Like the editor of the Independent, he shuddered at the possibility of headlines in the United States proclaiming "Hawaiian Sugar Tainted with Bubonic Plague," and he argued that "the Board of Health be very sure of your bacteriological tests before you insist upon a fiat that may absolutely ruin the prospects of this country just when they should be the brightest.""

  The Medical Society meeting and the Alvarez letter revealed a division among Honolulu's white physicians that closely paralleled the division among the city's Chinese healers. On the one hand, many, but not all, of the older practitioners in both the white and the Chinese medical communities generally continued to place their faith in practical experience and personal observation, which they trusted more than microscopic examinations they did not fully understand. With no new cases breaking out, both white and Chinese traditionalists suggested that the Board of Health had erred in its diagnosis and urged Emerson, Day, and Wood to rescind their declaration of plague. The whites wanted to restore their city's healthful reputation; the Chinese wanted to liberate Chinatown.

  On the other hand, many, but not all, of the younger physicians in both the white and the Chinese medical communities accepted Hoffman's bacteriological proof, and agreed with the Board of Health that the world pandemic of plague had indeed come ashore in Honolulu, at least briefly. In contrast to the traditionalists, they praised the Board for recognizing that fact and for promptly implementing the tight quarantine and aggressive cleanup campaigns that had apparently throttled the epidemic before it could do widespread damage. Tong San Kai, the physician in charge of the new Chinese hospital and Consul Yang's official medical advisor, came forward in the midst of this controversy to publicly defend the Board's actions. Like Li and Kong, Tong had been in China when plague struck there five years before, and Tong had seen the body of You Chong, the man who died at the Wing Wo Tai store. Tong was convinced that You Chong and the others had indeed died of plague. "The Health Department took hold of the situation in a manner which I feel will
prevent its spreading much," opined Tong through a translator, "and it is possible they may be able to check it."9

  Even as Honolulu's traditional physicians questioned the Board's science and sagacity, politicians and the press attacked the government's doctors for having allowed Chinatown to become so unsanitary in the first place. Even in newspapers closely allied with the Dole administration, strong editorials castigated Emerson, Day, and Wood for paying too much attention in recent years to import inspections and not nearly enough attention to enforcing the city's health and housing codes. Others placed "the final responsibility" for failing to enforce sanitary standards in Chinatown on the doorstep of "Dole and his Cabinet," since they had not provided the Board with enough resources. The Board's physicians were accused of being "too busy in the practice of their profession and the collection of fees, private and public," to pay attention to "the unsavory section" of "the city under their care." Still others accused the Board of tacitly exempting Chinatown's powerful American landlords from compliance with city hygiene requirements. Many voices blamed a faulty reporting structure for the mess in Chinatown and called for a Board of Health that would be independent of the attorney general's office. The Board even found itself embroiled in disputes over the efficacy of purported antiplague remedies being sold unscrupulously by city pharmacies to frightened citizens."'