posted 07-04-2008 11:18 PM            

What followed was ten years of a mix of heroic public health work and venal politics. Although author Marilyn Chase never calls attention to it, the situation was not all that dissimilar from what happened 80 or so years later with a different disease. Initially the plague was confined to San Francisco’s Chinatown, and the rest of the city responded by quarantining the entire area (with the barricade conveniently jogging and twisting to bypass white-owned businesses). The first response from higher up was by the local officer of the Federal Marine Hospital Service (predecessor of the Public Health Service), Joseph Kinyoun. Kinyoun confirmed the plague diagnosis and immediately set to work attacking the disease and alienating everyone he came in contact with. He offended the Chinese by insisting that all suspect plague fatalities be autopsied and cremated, both of which were religiously offensive. Chinese organizations responded by proclaiming that the supposed plague was Qi imbalance, and by hiding or smuggling their dead out of the city to keep them from being discovered. Kinyoun’s manner also put off city and State politicians, who felt (and probably rightly) that publicity about the plague would hurt business. The city promptly fired its entire Health Department and replaced the with doctors who would diagnose typhus or pneumonia or typhoid or anything but plague. The state hired private detectives to follow Kinyoun around, attempted to pass a law prohibiting the culture of plague germs, preparing a microscope slide of plague germs, or infecting an animal with plague germs (which would have made diagnosis impossible). The sponsor of the bill suggested that Kinyoun be lynched. Various doctors were trotted out to deny that there was any plague (some even denying the germ theory of disease). Kinyou was eventually recalled by Washington and sent to Detroit.

People (still mostly Chinese; it was argued they were especially susceptible because of their vegetarian diet) continued to die with all the symptoms of something that was resolutely denied to be the plague, generally during the summer months; however, the disease never became the wildfire killer that it had been in Europe and Asia. If San Franciscans thought about it at all, it was to proclaim that the whole its-anything-but-plague epidemic could be eliminated by burning down Chinatown; the San Andreas fault obliged on April 16, 1906. Despite poor sanitation and broken sewer mains, there was no outbreak of disease in the immediate post-seismic aftermath; however, by the summer of 1907 plague cases began to appear again. This time the disease (perhaps a slightly mutated strain?) was politically correct and hit Chinese and Caucasian alike, in widely scattered areas of the city. Washington dispatched Rupert Blue, who had worked in the city during the smoldering plague incidence years after 1900. Blue was a much better PR man than Kinyoun, and also had the advantage that the link between rodents and plague (although not with fleas, although it was widely suspected) had been confirmed in the interim after a plague outbreak in Sydney. Blue therefore took after the cities rat population like the Pied Piper, hiring a whole corps of ratcatchers, placing traps and baits all over the city, and outfitting a rented room as a rat mortuary, where thousands of rats per day were dissected and examined for plague. Although it seemed like a lost cause – the city’s rat population was estimated to be five times the human population – the final plague rat was killed in 1908 and the city was declared plague-free after there had been no cases for a year. (There’s an unfortunate aftermath; at least some of the rats made it into the countryside, where they infected wild rodents. Rodent plague swept eastward in rock squirrels, prairie dogs, marmots and ground squirrels, and is still enzooic in the American west, killing a few people every decade. It’s speculated that the main reason no serious outbreaks have occurred is the main North American arthropod vector, Ceratophyllus fasciatus, regurgitates much less blood than the European and Asiatic flea vector, Pulex cheopis, and is therefore much less likely to deliver an infectious bite).

The book is written well enough, although obviously by a journalist rather than a historian. Author Marilyn Chase telegraphs too many of her punches by following brief newspaper-style paragraphs that give the relevant facts by longer passages that repeat the same thing in a little more flowery language. It would also help – me, at least – if she would use modern terms for various disinfectant measures (such as “chloride of lime” and “bichloride of mercury”). However, her handling of the medical aspects are quite solid (her biographical note mentions she’s a medical reporter for the WSJ and is married to a doctor). This has been one of the more useful books in my desultory plague research, since it goes into considerable detail on how politicians and ordinary citizens respond to things like this. It’s sobering to reflect on what might happen if there was a similar response to a modern outbreak of a nasty infectious disease.

The Barbary Plague