According to reports at the time, nationwide there were only 34 hospitals, homes, or camps for the care and treatment of tuberculosis patients, and these facilities had long waiting lists for their services.5 So feared was the disease that no hospital in Baltimore would assume care of a tubercular patient for any time longer than it took to establish the diagnosis. The Baltimore Sun reported that fewer than 100 people in Baltimore could be afforded institutional care. The Hebrew Hospital could take 6; the Hospital for Consumptives near Towson could accommodate 30; and the consumptive ward at Bayview, 50. At the facility near Towson, 49 people were admitted in 1901 and of that number, only 14 people showed “marked improvement.”6 This record indicates that care was limited and protracted, and the outcome for the patient not very optimistic. Mortality statistics reported in the larger cities in the United States and elsewhere in 1900 bore this out.
Like mortality statistics in other cities of the United States, deaths in Baltimore attributed to pneumonia were not included in the figures of death from TB. Deaths by pneumonia in 1900 were equal to, if not slightly more than, those of consumption, indicating that confusion between the two diseases may explain the lower total numbers of TB.
A sign in the window of the historic Goldfield telegraph office reminded citizens and visitors not to spit on the sidewalks. Goldfield, the largest city in Nevada by 1906, attempted to stem the spread of disease, fearful as the people were of germs without the benefit of modern antibiotics. Famed Goldfield resident and deputy sheriff of Esmeralda County Virgil Earp died while in office of “pneumonia” in October 1905 (courtesy David W. Wallace, 2008).
Fear of the disease spread as no solutions were found. In March 1903, the Maryland Commission set out to identify the residence and the place of employment of all consumptives. Dr. John S. Fulton, secretary to the State Board of Health, cited his experience that consumption typically followed families that resided in crowded, unsanitary conditions. Dr. Fulton told his colleagues the story of a young man and woman who married and moved into a house formerly occupied by someone who had died of the disease. Within 18 months, “the perfectly healthy” wife expired from the white death.7 The woman may have contracted the disease anywhere, at any time, but Dr. Fulton did not have this understanding of the disease at the turn of the century and instead blamed her new house.
For the remainder of 1903, the commission prepared elaborate maps of the state, dividing them into segments where volunteer agents could go out, visit, and report households infected with the disease. Meanwhile, 1903 was a banner year for Joe Gans, who successfully defended his title four times. During the year he was also invited to Europe, but no reports have surfaced that he actually left the United States.
By January 14, 1904, Gans, who seemed at the pinnacle of his career, was sharing headlines in the Baltimore Sun with the alarming subject of tuberculosis. The Tuberculosis Commission reported that the death rates for the disease per 10,000 for 1902 were “20 for whites and 40 for the colored race in Baltimore city, and in the rest of the State were 12 for whites and 29 for colored.”8 It was also noted that births for whites in Baltimore were three times that of blacks.
Expositions such as Chicago’s Columbian Exposition in 1893 were popular events, highlighting the country’s innovative scientific and cultural achievements. Because of its prestigious medical community, Baltimore hosted the first Tuberculosis Exposition, in 1904 at Johns Hopkins University. During the week of January 25, stellar figures in the field of tuberculosis appeared in Maryland to share their expertise.9 Dr. Lawrence Flick, director of the Henry Phipps Institute of Philadelphia, spoke on the “House Infection of TB,” Dr. Nazyck P. Raenel of the University of Pennsylvania and Dr. D. E. Salmon, chief of the Bureau of Animal Husbandry, spoke on tuberculosis in animals; Dr. S.A. Knopf of New York discussed the possibilities of eradicating pulmonary consumption. Representing Canada and also speaking was Dr. George Adami of Montreal, the Canadian authority on tuberculosis. Perhaps the most publicly well-known authority was Dr. Edward Livingston Trudeau of New York, the pioneering founder of the sanitarium movement in America. Himself a sufferer of tuberculosis, Trudeau founded in 1885 and directed the first sanitarium in the United States, the Adirondack Cottage Sanitarium in New York. The exposition brought much needed attention to the subject of tuberculosis. Shortly after the great health exposition, the National Association for the Study and Prevention of Tuberculosis was formed in the United States.
The exhaustive statistics and exhibits by the State Tuberculosis Commission and the City Health Department, with all of their maps and charts made public, also made public what had heretofore been kept private. Widespread attention to the subject had an effect just the opposite of enlightening the public, forcing mention of the disease underground. Public notices of disease and quarantine, such as the smallpox case January 9, 1904, at Mount Pleasant, Frederick County, tended to strike fear. The William Rippeon home was quarantined by the health officer for smallpox.10 It appeared that 30 year old Rippeon, with a wife and 5 children, had contracted the disease by simply talking for half an hour on Christmas Eve with a fellow who died from the disease on Dec. 31. Rippeon, his family, and his neighbor, who made an unfortunate holiday visit to his home, were all quarantined at the Rippeon home and all their names made public. In the newspaper immediately below this public announcement appeared an article on Dr. Charles A. Grise, pastor of Ebenezer Methodist Episcopal Church in Easton, Maryland, “who sleeps outside in a tent to take in the fresh air.”11 This had caused him to regain the strength he had lost from “catarrh.” The temperature was said to have been at zero degrees. Outdoor “sleeping porches” became popular home additions. People could have their own sanitarium-like accommodation at home, where their bodies could rest appropriately to prevent or fight the disease.
Even before antibiotics, not everyone diagnosed with the White Plague died from it. With rest and fresh air, some seemed to recover, which gave those health-seekers with more active stages of the disease at least some hope for recovery if they had the resources to travel to one of the new “health spas” or to a more healthful climate. This form of treatment seemed recreational, and sanitariums, catering to those who could afford the luxury, took on a resort-like flair. It meant fresh air, sunshine, good food, rest, non-strenuous exercise (such as horseback riding or golf), and positive thinking.
Some sufferers chose to visit the sea where they believed the salty air and warm breezes would speed recovery. The seacoast wasn’t just for those already in ill health, it was considered a healthy location for summer vacations away from the congestion of the packed cities. Between his boxing bouts, Gans rented a cottage at Atlantic City during the summer of 1900. One might speculate that Gans suspected he had the disease by 1900. But the more likely reason for his summer retreat was that he was newly married and he certainly had the financial means to escape to the seacoast.
With the awareness that fresh air and sunshine were needed for healthy living, city officials at the turn of the century began to allocate land and funds for public parks where people of all walks of life could take in healthy outdoor activity away from the dark, polluted confines of cramped city dwellings. Gans, and other athletes who came to Baltimore to train, frequently did road work around the lake at Druid Park in Baltimore. During this time schools acquired land for playgrounds and students were encouraged to spend time outside, partaking in physical education. Rules that we take for granted today as standards of etiquette were preventive health measures for a people terrified of spreading and receiving germs. Public anti-spitting ordinances were adopted in cities. Mothers taught their children to turn their heads or to cover their mouths when sneezing. But Gans couldn’t avoid close contact in dark training gyms and tough contests. Even the best-conditioned fighters, their muscles starving for oxygen, will gasp and spit on each other inadvertently over the course of a long fight.
From 1904 to 1906 the papers noted that Gans, on occasion, was not the Gans of old. His stren
gth had noticeably diminished in several bouts even though he was fighting men at welterweight. Gans had only two fights in 1905: a no-decision with Rufe Turner earlier in the year and a disappointing draw with Mike “Twin” Sullivan in the fall. In the Turner fight it was reported that by the sixth round “Gans himself was dead tired, and the two swings that he landed ... had no steam behind them.”12 Again, the papers noted that Gans’ blows in the Sullivan fight lacked steam. It was said that if Gans had landed the same blows on Sullivan that he was capable of a few years earlier, his man would have been floored. Regardless, Sullivan’s left shoulder was beaten raw by Gans’ many right overhand swings that failed to reach Sullivan’s jaw. Gans was seen panting, and it was unusual to see the champion falling into clinches. After the fifteen-round fight, Gans immediately left the Lyric Theater in Baltimore, speaking to no one. Later it was learned that Gans had been terribly ill.13
The year 1905 had not been good for Gans personally. With a lack of fights and a lack of money, his wife, Madge, had left. Gans filed for divorce in July on the basis that she had been unfaithful. Gans would appear back in the Baltimore court on February 6. Sitting next to Gans was his principal witness, Al Herford. Many of the local sporting men showed up for the trial. The defendant failed to appear in court, but her correspondent, Jeremiah Hill, gave a “sweeping denial of the charges.”14 The judge ruled against Gans and denied him the divorce.
By 1906 Gans clearly needed money, and recognition in the ring would help to bring him that. In January he took on Twin Sullivan again, for the welterweight title. The title weight was set at 142 pounds, although Gans was clearly only 135 pounds. W. W. Naughton, who was now in Gans’ camp, wrote (over seven months before the Gans-Nelson battle in Goldfield), “If he loses at that weight he will not forfeit the lightweight championship which has never been taken from him, and he will have a pretty strong claim to the welterweight championship if he wins. This because Sullivan defeated Jimmy Gardner who was regarded as the world’s welterweight champion.”15 The match was in Gans’ control from the outset, and it was all over by the fifteenth, with Sullivan lying on the floor and his head propped up against the bottom rope of the ring.
In 1906 Gans had to convince the public that he was still the rightful owner of the lightweight title, not to mention the welterweight title. He petitioned repeatedly to get a fight with Nelson in order to reclaim the lightweight title that had never been rightfully taken from him. When he would get the fight, he would have to reduce to 133 pounds, a weight that the Nelson camp thought he could never achieve. But Gans would do whatever it took to be successful in the ring, even if it meant hours of roadwork, poor nourishment, and numerous Turkish baths to sweat off the pounds, dehydrating himself to a dangerous degree. Undoubtedly, his body would be weakened by the strain of this conditioning, and Gans’ draconian measures to make weight only made him more susceptible to the death germs coursing through his body.
Today, we know that TB can be transmitted through blood or wounds, and that it is most often transmitted through the air from coughs, sneezes, or sputum which can send moisture into the air containing germs that can be inhaled by others. Once in the lungs bacteria can pass through the bloodstream to various parts of the body, infecting bones or other organs. After infection from bacteria inhaled into the air sacs of the lungs, the bacteria may remain active inside the body but cause no symptoms. Whenever the body’s immune system is weakened by age, disease, or some other condition, the bacteria may attack the body and move into an active stage. Medical author Diane Yancey says that about half of all active cases come from previously dormant or latent cases, the other half result from infections within the past two years, causing active disease. Scientists do not understand what causes the bacteria to reactivate.
Once active, the bacteria reproduce and spill into the bloodstream. A nodule may appear in the lungs within a week and a hole in the lungs within a month. When patients have active TB, they must be isolated to prevent the spread of the bacteria to others. Symptoms of the disease include a persistent cough, blood in the sputum, chest pain, fatigue, weight loss, fever, chills, and night sweats. Without treatment 40 to 60 percent of victims will die a slow, agonizing death. At first the lungs will produce thick mucus secretions in an attempt to purge the infection. From the lung damage, a patient may spit up blood and experience chest pain. Eventually in severe cases the lungs become so damaged and blood filled that breathing is extremely difficult and painful and the victim eventually dies from strangulation. Tuberculosis can also exist outside of the lungs. It can lodge in the intestines, in bones or joints, even infecting the spinal cord. Drug resistant TB has been found widely throughout the United States. According to Yancey, 50 million people are infected with drug resistant strains of tuberculosis. She states that in countries with high rates of resistant tuberculosis about one third of all TB cases are incurable. Ninety percent of people without a drug resistant strain of the bacteria can be treated effectively.16
No Cure for the White Death in 1900
In 1906 medicine was decades away from any cure for TB. American physicians, usually sufferers themselves, operated the sanitariums as quasi-medical facilities. German doctors were the first to establish the health retreats. The American West and Southwest, with its wide open spaces, low humidity and relatively pollen-free environments, offered exotic, tourist-like destinations for the extended trips necessary to effect a cure. Prescott, Arizona, was one such place. Located south of the mountains of Flagstaff and north of the desert area of Phoenix, Prescott, with its dry, cool air at the mile-high altitude, became a health resort after the state’s capital moved to Phoenix.
By the summer of 1910 Gans was fortunate that he had the means to travel to the West, where many believed that consumption could be cured in the dryer climate. One can be assured that he had probably exhausted whatever remedies he could get his hands on in the East. Testimonial evidence of a cure with potions were advertised throughout the United States. One company advertised: “To neglect a cold, bronchitis, lung trouble or Consumption is dangerous. We all know how prone people are to deny they have Consumption.... Call consumption by its own dread name—and then—take Echman’s Alternative.... Write for Evidence to the Echman Laboratory, Sixth and Market Streets, Philadelphia.”17
When the mining industry declined, many areas of the Southwest began to realize the potential income of the lengthy stays of the “lungers.” By 1910 sanitariums had been established across the Southwest advertising various treatments for the diseases of the throat and lungs where physicians and graduate nurses were in constant attendance. Residents could choose from tent houses, mission-styled bungalows, cabins, or hospitals. Many had their own clubhouses.18 And because they catered to the middle and upper classes, the resorts did not mix races. African Americans had to find private homes or lodges built specifically for them. For many health-seekers, the American Southwest was their last hope.
At the sanitarium, daily regimens were highly orchestrated by the doctor. Up at a designated hour, conversation, fresh air, lunch, bedtime at same time every night. Positive thinking was mandatory, even though many of the treatments were excruciatingly painful. When breathing became difficult and labored, some physicians attempted to collapse the lung by repeatedly poking the patient with hypodermics, injecting solutions or drawing them out. The mention of death was strictly verboten. Nurses and attendants told everyone they were going to get better, and they could point to patients who improved and were sent home even though patients who were not expected to live were put on the train to avoid having them expire at the sanitarium. The initial deposit for treatment included the cost of a train ticket home. Because the trains couldn’t accommodate dead bodies for longer than 30 hours, conditions were scrutinized to make sure the patient could survive the time on board.
The grim reality of society stricken by plague, as described so well by Albert Camus in La Pest, was played out also in response to the White Death. When it became obvious
that Gans would expire from his disease, he hired a doctor to travel with him from Prescott, reassuring train officials that they wouldn’t have to deal with his condition. Time was critical in Gans’ final days when he was attempting to return to Baltimore before he died, and this explains why he exited the train temporarily in Chicago. It was believed that he would expire on the day he arrived there and officials were reluctant to put him on a train bound for Baltimore.
Euphemisms for death became popular expressions among patients at the sanitarium when they noticed that someone was “going out soon,” or “would not be here much longer,” or even “passed in the night.” Cemeteries as we know them today became popular during this period. The church yard fell out of favor, replaced by the more appealing spot outside of town, among rolling hills where people could find eternal “rest” in the beauty of pastoral, open spaces.
As much of life in America was segregated, so was death. The first and only cemetery for a number of years for African Americans in Baltimore was Mt. Auburn, originally named “The City of the Dead for Colored People.” At the time of Gans’ death in 1910, the location was known as the Sharp Street Cemetery, even though it was miles south of Sharp Street in an area called Westport. The deed to the property had been granted to the Sharp Street Methodist Episcopal Church in 1872.
By the end of 1907 Gans had opened the Goldfield Hotel and finally established himself as one of the immortals of the prize ring. And he would keep fighting with the death germs of TB in his body, well into 1909. As he engaged in the final fights of his career, did he consider his TB an inevitable death sentence, or did he think boxing would offer him a reprieve? What is clear is that he fought on, leaving his family secure and leaving rich legacies to the boxing world, and even to the worlds of ragtime and jazz music.
Joe Gans Page 25
