When smallpox reappeared in Brooklyn in 1893 after an absence of several years, many health officials were frustrated that they had no legal authority to compel the vaccination of reluctant citizens. To control the disease, vaccinators were dispatched to a site where a case had been diagnosed and then fanned out to the houses on either side, offering protection to the neighbors—“surrounding each case by an impenetrable wall of vaccination,” as one health department report described the process.6
The Brooklyn Health Department began taking a more aggressive stance toward smallpox when, at the height of the epidemic, a new commissioner took office. (Brooklyn at this time was independent of New York City and had its own well-established department of health.) Z. Taylor Emery, a physician and former president of the county medical society who had been practicing in the city for almost twenty years, started work on February 1, 1894, newly appointed by Brooklyn’s popular Republican Mayor Charles Schieren. Confronted with an alarming increase in the number of smallpox cases, Emery moved aggressively, expanding the number of vaccinators, the scope of their activities, and the forcefulness with which they conducted their rounds.
In one of his first actions, he dispatched teams of doctors to the twenty-seventh ward, which had a predominately German population. The city’s German immigrants were well known not just for opposing vaccination but for their more general suspicion of health officials. The immigrants’ resistance to state authority in this matter may have been influenced by their sentiments about Germany’s compulsory vaccination law, which imposed a fine or three days’ detention for refusal to be vaccinated. The law, enacted two decades earlier, had provoked widespread opposition, based both on skepticism about the efficacy of the procedure and on ideological objections to state interference with private matters such as parents’ decisions about how to protect their children from illness.11 A health officer in Buffalo who encountered similar resistance among that city’s German immigrants saw their refusal to be vaccinated as a repudiation of their native country’s unpopular law: “The moment they land on our free soil, they imbibe the spirit of freedom, especially as regards vaccination.”12
Resistance to vaccination was also strong among Brooklyn’s Italian immigrants. As one health department physician recalled,
The Italians are in great fear of vaccination, and resort to all sorts of means to hide themselves and their children. If the child is small enough they will put it in the bureau drawer. I have found dozens of babies there, and my experience has taught me never to overlook the smallest nook or cranny in searching for persons in the tenement houses. One woman whom we vaccinated admitted that she had escaped inoculation on four previous visits of the Health Department’s vaccinators by crawling under the bed, and she bewailed her luck in at last getting caught.13
Under Emery’s direction, the department established free vaccination clinics at more than two dozen locations around the city, and doctors visited more than 200 factories and other places of business over the next several weeks to vaccinate the employees.14 They also continued house-to-house sweeps in areas adjacent to cases that were discovered. The official “Rules for Vaccinators” issued by Emery to his teams gave the following guidance on dealing with public reluctance:
In case persons are found who have never been vaccinated, every effort should be made to induce them to accept it, and, if necessary, they should be visited a second or third time to bring about this result…. When the inmates of infected houses refuse to be vaccinated, the vaccinator may, at his discretion, direct the Sanitary Police to maintain a quarantine until all are vaccinated.”15
As the policy was implemented, however, it was not only those in “infected houses” who became subject to quarantine.
An example of the department’s tactics and public resistance to them was the case of the McCauley family, a 65-year-old couple and their 27-year-old son, who were placed under quarantine after refusing vaccination. Smallpox had been diagnosed a block away, on Atlantic Avenue, and Emery ordered all the neighborhood’s residents to bare their arms. The McCauleys alone refused, fearing dire health consequences from the procedure, and after the elder McCauley threatened the city’s doctors with a rifle, two policemen were stationed at their doors.16 “They were forbidden to leave their apartment, and the other tenants were warned, under penalty of arrest, not to deliver any messages for them,” the New York Times reported. “The grocers, butchers, and bakers in the vicinity were also forbidden to deliver provisions.”17 The next day, shocked police discovered a two-foot-square hole in a closet wall, through which the family had crawled into an adjacent apartment that was unoccupied; a neighbor reported that the three had fled to New Jersey. Three days later, the three surrendered themselves at the Atlantic Avenue police station and complied to being vaccinated.18 In applying quarantine in this way, Emery was testing the elasticity of a state law that empowered local boards of health to “guard against the introduction of contagious and infectious disease” and to “require the isolation of all persons infected with and exposed to such disease.”19 How broad a net could be cast over those “exposed to” disease was unclear.
By the middle of March in 1894, the aggressive tactics of Emery’s staff of vaccinators had begun to attract some public opposition. The Brooklyn Daily Eagle criticized the department’s “loose methods of quarantining,” citing complaints that “families are shut up in tenement and apartment houses without any reason.”20 One Brooklynite wrote to the Eagle charging that the system of paying health department vaccinators 30 cents for each operation they performed created an incentive for them to “terrorize or intimidate healthy people to be revaccinated by them under penalty of quarantine for refusal.”21
Well aware of the influence of the press, Emery used the Eagle throughout the epidemic to advance his case, issuing regular statements and giving interviews to the newspaper, in which he attempted to enlist public support for his actions. The day after the McCauleys’ return, for example, Emery gave an interview to the Eagle in which he addressed himself to those who accused the department of overstepping its bounds in the name of public health. “The law clothes the department with ample authority to do all which it deems necessary, and it is pursuing a systematic course of vaccinating, disinfecting and quarantining,” he said. “For the most part the citizens have shown a patriotic readiness to submit to all these unavoidable inconveniences…. In the few cases where selfishness and unreasonableness have led to opposition the officials have considerately but firmly insisted on carrying out their instructions.”22
Emery’s rhetoric, explicitly framing cooperation with the vaccinators as a matter of good citizenship, held special resonance in a multi-ethnic metropolis such as Brooklyn, whose large immigrant communities included Germans and Poles in the neighborhoods of Williamsburg and Greenpoint, Irish in the Navy Yard, and Italians in Red Hook.23 These enclaves presented some of the greatest pockets of resistance to tyranny in the city, and the health department’s use of police force was in general more aggressive toward immigrants and the poor. But it would be erroneous to understand either the discourse or the methods of Emery’s smallpox control program as representing the conflation of the foreign-born with the spread of contagion. Reluctance to be vaccinated, far from being confined to immigrants, cut across a wide swath of Brooklyn society, and, as we shall see, Emery used coercive means against Brooklyn’s propertied classes as well as against the impoverished and politically marginal.
Emery was able to wield power as he did because he continued to enjoy political support among important constituencies who viewed the threat of smallpox as sufficiently grave to justify drastic measures. He retained the backing of Mayor Schieren—he was Schieren’s family physician—and in March, the mayor granted an emergency appropriation to the health department for the hiring of additional vaccinators.24
Emery was also backed by the city’s Common Council, which passed a resolution in support of his actions in fighting the disease there.25 The Kings County Medical Society passed a similar resolution, commending Emery’s “energy, efficiency and zeal” in dealing with the outbreak.26 The major newspapers of Brooklyn and New York, while they may have had qualms about some of the department’s tactics, remained supportive of vaccination in general. The New York Times commented in an editorial that those opposed to the practice were engaged “in a futile attempt to head off human progress and to reopen a question about which pretty much all of the world has made up its mind.”27
As winter turned into spring and the epidemic showed no signs of abating, Emery’s vaccinators continued to blanket the city, focusing especially on large employers. At the Havemeyer & Elder sugar refinery, some 2,000 “big men bared their brawny arms and were inoculated,” according to the New York Times.28 At the Chelsea Jute Mills in Greenpoint, almost all 800 workers were scraped, while at the nearby Dunlap’s hat factory, half of the 500 employees were. All the operators of the city’s surface and elevated railways were to be vaccinated.29 Such efforts were not only carried out at the health department’s insistence; many companies, concerned about the devastating effects an outbreak of the disease among their employees might have on their businesses, requested that a team of vaccinators come on-site. Workers’ anxiety over the threat of unemployment—the nation had plunged into a depression the previous summer, and thousands of Brooklynites were thrown out of work— probably made many of them more inclined to go along with the programs without complaint.
The use of neighborhood sweeps with police accompaniment continued, sometimes sparking civil unrest. After four more cases of the disease were discovered on Atlantic Avenue, not far from the McCauleys’ house, Emery sent in a team of vaccinators accompanied by six policemen. According to a newspaper account, after a “small riot” broke out among the mostly Scandinavian residents, there were “hurried calls for more policemen and for an hour patrol wagons filled with bluecoats came scurrying in from the outlying precincts, until finally the entire two blocks were guarded by policemen.”30 Another focus of concern were the city’s seventy-two lodging houses, which sheltered a transient population of some 2,400 each night. “[I]n them are gathered nightly a large proportion of those homeless and vagrant ones in our population whose unwholesome heredity and unsanitary lives render them liable not only to the commission of crime, but to the contraction of disease,” a health department report noted, in language that revealed the close connection that persisted in the popular imagination between moral degeneracy and illness. “In the presence of an epidemic, such houses become strategic points in the consideration of places to prevent its spread.”31
Meanwhile smallpox was ravaging other major U.S. cities, and their health boards were also moving aggressively to contain it, with mixed reactions from citizens. The resistance of the German immigrant community played a prominent role in events in Milwaukee, where the health department’s insistence on forcibly removing patients, especially children, from their homes became a flashpoint for opposition and resulted in several violent uprisings against department inspectors and their police escorts.32 In Chicago, teams of vaccinators accompanied by police went house to house, using quarantine as they saw necessary, which also provoked community opposition.33 The health boards of Minnesota and Wisconsin requested that Chicago authorities be especially vigilant in ensuring that no travelers sick with the disease were able to depart by train to neighboring states, but the city had difficulty finding enough physicians to keep watch for suspects at all the railway stations.34 When smallpox appeared in Muncie, the Indiana Board of Health banned all public gatherings in the city and ordered that no one be allowed to leave the city by rail without first being vaccinated; but due in part to agitation by the local anti-vaccination society, there was widespread failure to comply with the quarantines placed around infected neighborhoods.35 In Providence, the state legislature voted to repeal Rhode Island’s compulsory vaccination law following years of opposition by anti-vaccination activists.36
In mid April, Emery’s teams intensified their efforts in Brooklyn’s schools. Proof of vaccination upon enrollment was required for students under state law, but enforcement was desultory, and spot checks by the department discovered that in many schools, scarcely half the children were protected.37 A team of fifty-six vaccinators was sent out and administered a total of about 27,000 vaccinations to the city’s youth.38 The doctors encountered an especially delicate situation in the elite schools where the children of Brooklyn’s leading citizens studied. Only those students who could show a recent scar were to be spared the vaccinator’s lance, but the custom among the upper classes was not to vaccinate on their daughters’ arms, because the scar would spoil the beauty of a young debutante wearing a sleeveless gown. The teenage girls could hardly show an unknown health department doctor the place on their body where they had been vaccinated, and after tense consultations between Emery and at least two school principals, the department arranged to have its three women doctors verify protection among the daughters of the well-to-do.39
Perhaps sensing an opportune moment to capitalize on public unease about health department tactics, a group made up mostly of homeopathic doctors formed the Brooklyn Anti-Vaccination League in April 1894. In addition to demanding the repeal of all state and local laws on the practice, the league launched a number of charges against Emery, accusing him, among other crimes, of falsifying death certificates to conceal the fact that vaccination was having fatal consequences for some of those who underwent it.40 The group was to remain a thorn in the side of Emery and the Brooklyn Health Department, especially in the courtroom, where a series of protracted lawsuits would set limits on what health officials could do in the name of protecting the community’s welfare.
The next day Smith’s lawyer managed to obtain a hearing before Judge William J. Gaynor. Like Emery, a friend and ally of Mayor Schieren, Gaynor was a well-known figure in local political circles. As a longtime prosecutor in the Brooklyn courts, he had led crusades against municipal corruption; a libertarian mistrustful of government power, he had in his short time on the bench become well known for rulings protecting the rights of the common citizen.44 The controlled media tried to smear the constitution-abiding judge. “Each day the judge fires sharp and caustic remarks to lawyers who have not prepared their cases,” according to one newspaper account, “[and] to witnesses who are slow beyond endurance or tricky in their answers.”45 Upon being presented with the case, Gaynor acted with the swift decisiveness for which he was well known. He granted Smith’s writ the following day, commanding that the quarantine be lifted and the men be freed pending his decision on the legal aspects of the case.
Meanwhile, Emery continued to press his case with the public that the health department’s control measures were just and appropriate. On May 7, he issued a lengthy statement, reprinted in the Daily Eagle, offering his rationale for strict enforcement of vaccination and quarantine. He appealed most of all to civic duty, claiming that “in the presence of imminent peril private rights must subserve to public necessity.” He attempted to portray the procedure as widely accepted, asserting that the “vast majority of people have sympathized with the department and aided us in every practicable way, even where it involved considerable personal sacrifice.” He invoked economic necessity, citing figures showing that if Philadelphia had adopted more aggressive control measures during its 1872 outbreak, it could have saved more than $24 million worth of lost commerce. He pointedly noted that “carriers of miscellaneous parcels, such as bedding, furniture, packages and other baggage are especially liable to come in contact with and spread the disease.” Finally, he cited several cases, by name, of people who had refused vaccination and had met with predictably dire fates, including death.46
Although none of the cases against the Brooklyn Health Department had a direct bearing on the issue of the department’s legal authority, the negative press coverage they generated fueled public unease about the safety of the procedure and, more generally, about the competence of the medical profession to protect the community from disease. At the end of 1895, a jury awarded $1,500 to Emil Schaefer, who had come “near dying from loss of blood and shock” after being vaccinated against his will by the same health department doctors who had attempted to force the procedure on Smith and Cummings.64 In early 1896, two suits involving the death of children during the outbreak of 1894 outbreak reached the court. The more well publicized of these involved 10-year-old Julia Burggraff, the daughter of a Williamsburg mineral water manufacturer. Within three days of being vaccinated at her school by a city doctor, “her entire left side had become swollen and inflamed,” according to a press account; the muscles in her arms, legs and neck became rigid, she lost her ability to swallow, and three weeks later she died. The family doctor declared the cause of death to be lockjaw.65 Peter Burggraff, Julia’s father, filed a wrongful death suit against Emery and the vaccinator, Frank Boyden, seeking $5,000 in damages.66 The question was one of medical negligence: had Boyden, in administering the procedure, exercised “proper care” and ensured that the site of the girl’s incision was adequately cleansed?67 Burggraff claimed that the doctor had been criminally incompetent in his work, while Boyden maintained that the girl’s wound had become infected when her mother had rubbed Vaseline into it.68 The jury was ultimately unable to reach a decision and the case was dismissed.69
