Tag: quarantine

MUNCIE, IN — In 1893, an outbreak of smallpox caused public health officials to take drastic, draconian measures to prevent the spread of disease.  The unpopular, violent quarantine that followed provides a memorable case study of the failings of forcible mandatory quarantine of a city.

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The incident began when Muncie’s Health Officer, 34-year-old Dr. Frank G. Jackson, was informed of a serious illness that required his investigation. On Thursday, August 17, 1893, the young doctor trekked across town to discover a patient with a high fever and skin eruptions, described as “black chicken pox.”

Early on, there was disagreement among doctors about whether the first patient — and subsequent patients — actually had chicken pox or the more severe smallpox virus.  By the time there were 14 suspected cases, Dr. Jackson convinced the city council to take action and institute a domiciliary quarantine of the infected families. The city health officer was granted arrest powers, and the newly-formed Committee on Public Safety was clothed (in the words of the resolution) “with full power to take whatever measures are in their judgement necessary to prevent further spread of the disease, and support the quarantine declared by the health officer.”

By August 22, a quarantine was in full effect, complete with armed guards with the authority to arrest anyone who disobeyed quarantine restrictions. Initially, the quarantine was restricted to containing the infected houses, which were marked with yellow cardboard signs reading “Smallpox.” Red flags were posted to segregate the boundaries of the quarantine zone — an area eight blocks wide and sixteen blocks long.  The guards were posted outside the infected houses to prevent unauthorized entry or escape.  They were told to kill all stray cats and dogs as a precaution against the spread of the disease.

The City Council invoked a mandatory vaccination effort on August 22, and sent government agents “house-to-house in the infected district to vaccinate and inspect for unsanitary conditions.”

A week after the first public declaration, on August 25th, there were 11 cases under treatment; one woman had died.

But many citizens were skeptical and defiant of the dramatic measures being used against them.  Residents frequently sneaked out of the backs of their homes to visit neighbors and friends, while armed patrols marched in the front.

The public saw reasons to doubt the city’s doctors, who bickered over the best way to treat smallpox.  Many people viewed vaccines as dangerous and ineffectual; some patients got smallpox in spite of their inoculation. People were also disgusted by the vaccines, derived from “aseptic bovine lymph” — the pus of blisters found on infected cows housed in “vaccine stables.”

There was a mass exodus from Muncie during the early stages of the quarantine, in which an estimated fifteen hundred people hurriedly fled to live with friends and relatives elsewhere throughout the country.

Mayor Arthur W. Brady assured Muncie residents and the surrounding towns that authorities had the situation “thoroughly under control,” despite numerous failings of the guard staff. The following day, on August 29th, twenty out of twenty-two guards resigned their posts, citing undesirable risks and low pay.

By September 7th, there were dozens of cases of smallpox in Muncie.  The Indiana State Board of Health stepped in and took the situation to an extraordinary level, curtailing civil rights in the name of public health.  The following proclamation was issued:

1. No public meeting of any sort should be held. No exercises should be held at any church, lodge, opera house, ball ground, or any place (including school when it was to open) of like character.
2. The people generally should remain at their homes as much as possible. Congregations of persons on the streets should be avoided. The police were directed to see that no crowds collected on the street. Loitering or loafing would subject parties to arrest.
3. Special care should be taken to keep at a good distance from the infected houses. No communication should be had with persons infected or in danger of infection.
4. Everybody should be vaccinated, whether vaccinated in the past few years or not.

Muncie officials were so fearful that they suspended library services, burned a number of books, and fumigated every piece of mail and luggage leaving the city.

Aside from bans on public assembly and compulsory vaccination, the quarantine prevented the freedom of travel for Muncie residents.  People wishing to leave the city were required to carry certificates from the public health officials declaring that they had been vaccinated and were free of infection.

Trains, being the dominant mode of inter-city travel, were restricted to passengers who could present certificates of vaccination from public health officials. Ticket agents were forbidden by the State Board of Health to sell tickets to anyone without the proper government paperwork, and a special police task force set up checkpoints at the train station to ensure compliance.

The neighboring towns became increasingly paranoid of Muncie residents.  Special policemen patrolled the roads to check travelers for their government-issued health certificates.  Traveling salesmen had a particularly difficult time during the quarantine, and were frequently subject to arrest.

When patients succumbed to the virus or the complications that followed, they were buried in the middle of the night on the first night after their death. No public funerals were permitted.

Eventually the domiciliary (at home) quarantine tactic was scrapped, and sick people were forcibly removed from their homes and taken to the city’s two newly-designated “Smallpox Hospitals,” where patients were corralled and languished for weeks on cots.  The average quarantine time was 40 days.

The favorite disinfectant and treatment of the day was a “bi-chloride of mercury,” a substance (later found to be toxic) that was rubbed topically on sores, and used to bathe smallpox patients. It was liberally applied to contaminated surfaces, and even rubbed onto to the screens of doors and atomized into the air at hospitals and schools.

The city council even passed an ordinance authorizing health officials to “use all necessary means, including force and the breaking of doors if required, to compel the removal of all persons having smallpox.”

The warrantless detainment order was met with a torrent of criticism. Although prominent city attorneys touted it as “constitutional,” others strongly disagreed. Even the police refused to enter homes without a warrant.

It turned out to be the health officials who payed the least regard to the rights of the afflicted.  When a known smallpox sufferer refused to go to the hospital, sometimes even the doctors themselves would force their way into the homes to drag them into quarantine.

This thuggish behavior was met by resistance from some residents.   There were reported instances of homeowners repelling the authorities with firearms.  At least one pesky health official was wounded from a gunshot blast to the arm when an “irate father” refused to relinquish his child into government custody.  When residents were very resistant to being taken to the hospital, there are even reports of authorities “starving out” the families until compliance was gained.

Resenting their foul treatment, some indignant residents even purposely spread the disease by throwing infected rags out of their homes into surrounding spaces.

Dr. Jackson, as Muncie Health Officer, criticized the reluctance of local judges in accepting affidavits against families who were suspected of concealing an infected family member. He lamented that “there was found to be no authority by which we could compel persons to submit to an inspection of their premises, although we were certain that cases of small-pox were being concealed.” He added that “in all of such cases, we made and enforced our own laws, as in times of martial law.”

While Dr. Jackson approved of forcible home entry, he later observed that the compulsory hospitalization ordinance he oversaw “was found impossible to enforce without absolute loss of life by violence.”

As many as 150 guards were employed at the height of the Muncie quarantine.

The state quarantine order was finally lifted on November 4th, and one of the two Muncie smallpox hospitals was closed. For the first time in 9 weeks, churches were allowed to hold services and schools reopened their doors.

As of December 1893, there had been 150 cases of smallpox reported in Muncie, and 22 deaths, according to Dr. Jackson’s report. The compulsory vaccination order affected 10,00-13,000 people.

Both Dr. Jackson and County Health Officer Dr. Hugh Cowing concluded that “house quarantine was an utter failure.”

The Muncie quarantine provides a valuable historical lesson in the lengths governments will go to during the hysterical times of public health crisis. Compulsory vaccination was later challenged in the U.S. Supreme Court in Jacobson v. Massachusetts (1905). The court, of course, sided with the government and decreed that individual rights may be subordinated to the “common good” and individuals may therefore be subjected to the compulsory police powers of the state.

 

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REFERENCES:

1. Twelfth Annual Report of the Indiana State Board of Health (1893): 103-186.

2. Eidson, William G., “Confusion, Controversy, and Quarantine: the Muncie Smallpox Epidemic of 1893,” Indiana Magazine of History 86 (1990): 374-398.