Most epidemic diseases that had attacked Hawaii in the past, like cholera in 1895, had typically done most of their killing in early waves that peaked quickly. Had that been the case with this pandemic, the fact that January's initial increases were relatively small might have been grounds for optimism. But public health officials all around the world had noted that the bubonic plague of the late i 89os typically killed relatively few people when it first appeared in a given area, then continued to kill in steadily accelerating numbers for the next several months, peaking long after its first appearance. The deaths of early January thus appeared ominous, the beginning of a relentlessly upward trend. Unless the plague could be stopped, the worst almost certainly lay ahead. Though modest by themselves, the rates of increase experienced in the first week of January would produce horrific totals if projected out several months. Western physicians, who read about these patterns in their medical journals, were especially frightened about the small but steady increases of early January.
All of the cases were occurring inside the quarantined district of Chinatown, and with each confirmed death came additional property condemnations, followed by additional burning orders and the need to house still more refugees in the city's quarantine camps. By the end of the first week of January, the men of the Honolulu fire department found themselves working from dawn to dusk, usually burning small or isolated structures in the morning and larger clusters of buildings in the afternoon. Emerson, Day, and Wood wondered privately in their daily meetings whether their fire policy might eventually result in the destruction of virtually everything inside the quarantined area if the epidemic continued to spread.
While the three physicians running Hawaii agonized about what might become of the quarantined district in the long run, others preferred not to wait and see. Rather than letting the epidemic become more virulent, they urged the medical triumvirate to strike first by preemptively torching the entire area in which the plague would almost certainly do its greatest damage-Chinatown. If the practical effect of burning confirmed plague sites seemed likely to result in a drawn-out, piecemeal destruction of the old slum anyway, why not get it over with quickly and stop the epidemic in its tracks?
To discuss that question, Emerson, Day, and Wood held a special meeting after dark on the evening of January 3. Dole himself came over to Board headquarters to take part in the discussion, accompanied by several of his closest advisors. Most of the latter leaned toward burning Chinatown in its entirety as quickly as possible, though they recognized the immense problems of dealing with the economic losses that would occur and the great difficulty of providing for the thousands of people who now lived in the buildings that would be destroyed. Still, the position of Judge George R. Carter was typical. Though Carter had been one of the three special agents who drafted the proposals for sanitizing Chinatown-the expensive proposals adopted only a few days earlier-Carter now privately urged his medical friends to accelerate the process by burning the entire area first. If you do so, he assured them, you will have "the support of the people." Lorrin Thurston, who had been overseeing the construction of new detention camps, told the three physicians that at least two thousand people could already be accommodated, and it would not take long to build more barracks.
Dole expressed reservations about the legality of wholesale preemptive burning. He had no difficulty with the policy of summary action where deaths had already occurred, but his legal background now made him think that formal notices for the abatement of nuisances should be served before torching properties not directly implicated in plague deaths. Attorney General Henry Cooper-the constitutional officer who presided over the Board of Health-conceded that the preemptive burning of Chinatown would be "a tremendous question to face," but he assured Dole and everyone else present that he could overcome any legal hurdles. In his view, Emerson, Day, and Wood should move aggressively to destroy the slum in the quickest and most expeditious manner they could.
Francis M. Hatch, a longtime government insider who had held several cabinet posts and who claimed to speak authoritatively for the city's leading American merchants, brought still more pressure when he told the three physicians that Honolulu's businessmen were increasingly concerned about the mounting "loss to the community from the suspension of trade"-and their own plummeting incomes. In Hatch's view, the white business community would support drastic measures of any sort, however costly and however arbitrary, as long as the measures promised a speedy end to the epidemic and an early restoration of international commerce, which they regarded as the lifeblood of the Hawaiian Republic. Backing that opinion, the Commercial Advertiser, the principal public voice of the merchant community, had already begun a steady drumbeat of editorial exhortations directed at the triumvirate, all of which argued that the preemptive destruction of the Chinatown slum was the step most likely to halt the expanding plague in the shortest possible time.'
Emerson, Day, and Wood felt squeezed. On the one hand, their New Year's policy had evoked threats of legal action from landlords and stirred the potential for civil unrest inside Chinatown; on the other hand, influential government insiders, powerful merchants, and increasingly strident editors were trying to bully them into even more radical action. It did not help that Emerson had been battling illness himself since before the New Year announcements. Writing to his sister the day after the special session with Dole and his advisors, he told her, "the war is still waging in and about China-town. I am not enough of a prophet to foresee when the end will be." Although he assured her that he was determined to fight on, he admitted that sometimes "I get very weary, and do not care whether `school keeps or not.""
Assailed from all directions, the three physicians decided to stay the course they had set in the final days of 1899. At the conclusion of the special evening session, they formally resolved to continue burning buildings where cases of plague had been reliably confirmed, but they refused to order the preemptive destruction of Chinatown as a whole. The evening's discussion forced them, however, to recognize more clearly than ever both the probable need and the medical desirability of moving as many Chinatown residents as they could out of harm's way. With that in mind, the physicians drew an additional $250,000 from the Hawaiian treasury "for the expenses of the epidemic" and voted to begin construction of "barracks and accomodations [sic] for 5000 people." They also began to search for additional warehouses to store the growing piles of clothing, furniture, and household goods being removed from condemned buildings in Chinatown for fumigation and quarantine.4
Hawaii's attorney general was clearly irked at this outcome. The morning after Emerson, Day, and Wood rejected the hard line he advocated, Cooper officially resigned as president of the Board of Health, notwithstanding the constitutional provision that placed him in that position in the first place. He was spending so much time presiding as a figurehead over medical matters during the present crisis, he declared, that he was unable to function effectively as attorney general. As far as he was concerned, the doctors were henceforth completely on their own.
Undeterred, the three physicians themselves promptly elevated Clifford Wood to the presidency. Well organized, persuasive, and not easily pushed around, Wood was the obvious choice among the three and likely to be far more effective under the circumstances than either the ailing Emerson or the genial Day. No longer reporting even symbolically to the republic's attorney general, the triumvirate was now more independent than everparticularly after Dole issued a personal statement of support for their current policies and his council of state not only acknowledged the election of Wood but reaffirmed the absolute authority of the Board of Health for the duration of the plague emergency.'
After electing Wood president, the doctors also accepted the resignation of L. D. Keliipio, who had been a civilian member of the Board for several years but had not attended a meeting since the fire policy was announced. Though little is known about Keliipio or why he resigned in the midst of the Board's reorganization, his withdrawal hin
ted at some disagreement, or at least nervousness, about being associated with the fire policy as it unfolded. Francis M. Hatch, who clearly had few qualms about burning anything and everything in Chinatown, accepted a presidential commission to take Keliipio's seat.6
From his first day on the job, Wood was an active president. To deal with the rising number of cases and to take some of the heaviest burdens off himself and his two colleagues, Wood ruled that any physician working under the direct authority of the Board, not just the Board physicians themselves, could officially pronounce a case to be plague. This greatly augmented the power and responsibility of the private physicians who were working on the front lines of the battle in such capacities as health inspectors and hospital attendants. Wood then formally extended the state of medical emergency and tightened the city's travel restrictions. The three physicians also imposed a ban on construction throughout the city, because they wanted to develop stronger sanitary codes for all new buildings and they needed all of the city's construction workers to help build quarantine camps. In yet another effort to explore alternatives or supplements to burning, Wood appointed Board member Smith a committee of one to consider the pluses and minuses of "disinfecting the ground in the infected district with sulphuric acid."'
To formally announce the new regime, Wood summoned the Chinese and Japanese consuls to a meeting at the Board of Health office. He told the consuls about the administrative changes and gave them a chance to voice any concerns they had about the fire policy so far. After Yang and Saito left, the three physicians went into executive session to discuss the continuing problem of concealed deaths, particularly among the Chinese. Another lengthy discussion ensued about whether or not to take some kind of action against those Chinese physicians who appeared to be complicit in that practice, but as before, the three Board doctors decided to avoid a direct confrontation with the Chinese traditionalists."
Of more immediate interest to Emerson, Day, and Wood were prospects for improved relations between themselves and the Western traditionalists who belonged to the Hawaiian Medical Society. The December meeting of that society had publicly disavowed the Board's early quarantine actions and belittled the bacteriological evidence of plague. In the wake of that session, many Medical Society members had declined to serve as health inspectors, "stating they did not believe so far that the situation was so alarming as to call for extraordinary precautions." The incident strained longtime professional friendships and created a rift within the Western medical community of Honolulu. But the resurgence of plague since Christmas had validated both the triumvirate's early actions and the accuracy of Hoffman's initial conclusions, and as a result, some members of the Medical Society now seemed slightly embarrassed, anxious to abandon the skeptical stance they had assumed three weeks earlier.'
On Saturday, January 6, the Medical Society invited its members to another special meeting to reconsider the present situation. Current president of the Medical Society Charles B. Cooper (no relation to Attorney General Henry Cooper) quickly signaled the dramatic about-face of those who attended. In the evening's principal speech, Cooper declared that the Board's actions since Christmas had demonstrated that Emerson, Day, and Wood were now fully "deserving of the confidence of the people." Their willingness to use fire against the plague was singled out for special praise: "By no other act," Cooper asserted, "could the Board of Health have so completely" regained widespread support. Cooper's public endorsement carried added weight with the physicians assembled that night, since everyone present knew that Cooper was married to the daughter of John McGrew, the society's cantankerous founder, who had dominated the meeting three weeks earlier and openly attacked the Board's professional credibility."
Other former critics pushed even further in defense of the triumvirate's right to act boldly. James H. Raymond, for example, who had belittled Hoffman's bacteriological conclusions and urged censure of the Board's actions at the Medical Society meeting three weeks before, now blithely asserted that "the question of the medical profession being the representative body of the people is a well-established fact," and it therefore followed that medical officers had a duty to force the city to do whatever was necessary for its own good. "The law of self-preservation" superceded any lawyerlike quibbling over formal lines of authority. Raymond personally favored the complete destruction of Chinatown, after which, following Kitasato, he thought the district should lie fallow for a year before being rebuilt to sanitary standards. In what the press reported to be "strong speeches," many other physicians, most of whom had previously refused to support the Board, spoke in a similar vein."
Day-the ideal conciliator-replied on behalf of his Board colleagues. He began by acknowledging forthrightly that attendance was noticeably smaller at this meeting than it had been at the special session three weeks earlier. He and everyone else in the Western medical community knew that plenty of traditionalists had boycotted this meeting and still wished to remain at arms' length from the policies being pursued by the Board of Health. The Western physicians of Honolulu were far from unanimous in their approach to public health policy. Lest anyone miss that conclu sion, the anti-Dole press went out of its way the next morning to undercut the Medical Society's about-face by observing pointedly that "most of the physicians in whom the people have confidence were conspicuous by their absence from the meeting.""
Even so, Day was delighted that the physicians who came to the meeting had decided to bury the hatchet. He reminded them that almost everyone present had been calling for many years for more extensive city sewers, better garbage incinerators, filtered water, burial reforms, and the "reconstruction" of slums like Chinatown. The plague crisis now offered an opportunity to achieve those goals as "emergency measures." "If we attempt to combat the plague by any other means," Day believed, "we shall have the same trouble as is experienced in Hongkong [sic], where the plague breaks out from year to year and is never entirely eradicated. Nothing but the most modern system of sanitation will do for us now." Hoffman then seconded the call for "radical measures" in Chinatown, which he described as "the dirtiest and most foul district I have ever seen.""
By stressing sanitation as a common ground for cooperation, Day's speech again revealed the ambiguous relationship between the new science of bacteriology and the long-standing traditions of earlier nineteenth-century public health. Bacteriologists believed that illnesses like plague arose neither from dangerous environmental conditions (as sanitationists had argued for more than a century) nor from problems within the body of its victims (as millennia of traditional physicians had assumed), but from specific microscopic agents that inflicted the disease. Even Cooper had conceded "the impartiality of the pestilence in smiting different races." Yet Day still placed his emerging ideas about bacteriology into a conceptual framework that regarded cleanliness as a cardinal element of public health.'''
Physicians like Day and Hoffman no longer thought that filth produced diseases in and of itself, but suspected that foul conditions almost certainly harbored and sustained the disease-causing microbial agents that did produce diseases. International authorities supported that view, citing the fact that the vast majority of plague outbreaks in cities worldwide over the last five years had occurred in their least sanitary districts. Bacteriologists could thus comfortably continue to endorse traditional sanitation as a weapon in their fight against plague. And physicians like Cooper and Raymond, once convinced that plague was really present, found common ground with the Board in the form of familiar sanitary goals. Raymond made the point explicitly: "I think the question of unity in the medical profession on the subject of sanitation is one of the essentials of this meeting."-'
At the end of the evening, the assembled physicians voted on a series of specific endorsements. Though a minority hoped that fumigation and disinfection might save parts of Chinatown, a majority of the physicians present joined the city's white editors and white merchants in urging that "all structures in the infected districts" be burned. The
ground "where such buildings stood" should be cleared, disinfected, and left vacant for ayear. Residents rendered homeless in this process should be furnished "sanitary habitations" at public expense. The physicians also strongly approved the Board's already-announced sanitary goals. Filtration systems sufficient to cleanse the entire Honolulu water supply should be installed. The city's small sewer system should be extended into all areas of the city not already served. And finally, the Board should force the city to launch a program of ongoing garbage destruction to prevent future accumulations of filth.'
What the pro-government press hailed as "The Great Doctors' Meeting" thus produced a paradoxical victory for Emerson, Day, and Wood. On the one hand, they regained the official support of the Medical Society, whose members had humiliated them just three weeks earlier. On the other hand, the same Western physicians who had previously told them they were going too far were now telling them they were not going far enough, and the resolutions passed by the Medical Society provided a professional imprimatur and medical rationalization for those already calling for the summary torching of Chinatown.
The Commercial Advertiser lost no time in hailing the Medical Society resolutions as confirmation of its earlier editorial admonitions regarding Chinatown and the plague. In bold capitals, it printed the Medical Society resolutions, and in strong editorials, that voice of the white commercial elite endorsed them in glowing terms. Reciting a litany of previous epidemics, all associated with Chinatown, the paper argued that Honolulu had "tolerated epidemics [there] too long." The time had come to do something about the conditions that had allowed those epidemics to gain their footholds and terrorize the city. Without forceful actions now, plague would hold on and recur into the future. "What of our tourists and our sugar cargoes then? 1117
Plague and Fire Page 13
