Smallpox Patients at Middlesboro, Ky., Without Food Since Saturday. Federal Authorities May Act.
NY Times, March 14, 1898.
MIDDLESBORO, Ky., March 14—Surgeon Wertenbaker of the United States Marine Hospital Service investigated the situation here to-day, and in a report to Washington states that there are forty cases of variola, twenty-nine suspects in the pesthouse, and four hundred suspects quarantined at home. Wertenbaker is anxious and willing to render Federal assistance, but can only do so on invitation of the State Board of Health. Dr. McCormack, Chief Inspector of the State Board, says he can cope with the epidemic, but that the State has no available funds. The county refuses to make appropriations, and the city is bankrupt.
Dr. McCormack vigorously opposes Federal intervention, and proclaims that if the county does not render necessary aid he will withdraw at once and release the patients from the pesthouse. The unfortunate patients have been without food since Saturday morning and hunger is driving them to desperation. They have informed the guards that if food is not forthcoming they will take French leave.”
On March 17, Congress overruled Dr. Arthur T. McCormack, and gave Charles P. Wertenbaker the go-ahead “to confer and cooperate with the State authorities by furnishing inspection, vaccination, and disinfection service.”
On March 24, Wertenbaker filed his evaluation of the situation:
“SIR: I have the honor to make the following report on the operations of the Service at this place:
“Upon receipt of your telegram on the afternoon of March 17, 1898, directing me to assume control of the operations of the Service at this point, I held a consultation with the representative here of the State board of health (Dr. Robertson) and outlined a plan of action for the suppression of the epidemic of smallpox here. I employed 5 inspectors and started them at work making a thorough inspection of the city, vaccinating all persons that had not been successfully vaccinated.
“I also employed 25 guards. Not being able to secure the camp train, it became necessary to look around for some house capable of being used as a hospital. I was fortunate in securing one that was originally built as a boarding house, containing ten rooms upstairs and five large rooms on the first floor. It was occupied at the time as a boarding place, and I had to pay the proprietor $50 to move out, but as it was the only available place to be found it was considered best to do this.
“The house is located in the outskirts of the city, about a mile from the center, is isolated and well adapted for the purpose. It had to be completely fitted out, as it contained, after the boarding-house keeper moved out, only a cooking stove and twelve chairs, which I bought of the keeper.
By hard labor we got the house fitted up and moved into it 91 persons from the former pesthouse, which was located in a thickly settled part of the city and adjoined the detention camp, and there were no adequate means of keeping the patients and suspects apart. The Service was then organized under six divisions as follows: Headquarters, inspectors, guards, disinfecting division, suspect camp, smallpox hospital.
“The smallpox hospital corps consists of Dr. W. C. Duke in charge, nurses, cooks, attendants, etc. An ambulance has been secured, and is kept near the hospital, and is sent in whenever needed for a patient.
The suspect camp consists of a row of wooden houses, 12 in number, adjoining a row of 4 houses that were formerly used as a smallpox hospital. This camp is in charge of Dr. W. N. Shoemaker, and has the usual corps of attendants. At both the smallpox hospital and suspect camp the physicians in charge remain in each, respectively, and the physician of the smallpox hospital is quarantined and not allowed to leave the place.
“Both the camp and hospital are supplied with tents furnished by the State board of health, and are used as bathing and disinfecting tents. Patients discharged from the hospital are given a bath, followed by a bichloride of mercury bath (1-2000) and then a bath in fresh water. The clothes are washed in a solution of bichloride of mercury (1-800) and dried. The same precautions are taken with suspects admitted and discharged from the suspect camp.
“All suspects are vaccinated on admission. Suspects are detained sixteen days.
“Under the direction of Chief Inspector Dr. Samuel Blair, the city has been divided into 5 districts, and an inspector assigned to each. They report at headquarters at 9 a. m. and between 5 and 6 p. m. They make a house-to-house inspection, examining all persons, vaccinating all who have not been protected, and in the event of the refusal of anyone to be vaccinated, the name of each person so refusing is sent in to headquarters, where they are turned over to the city authorities, where the option is given them of being vaccinated or being sent to jail, and in the latter event they are vaccinated as soon as they enter, under a law requiring all inmates of jails to be vaccinated.
“Any case of smallpox, or suspicious case of disease, is at once reported by telephone to headquarters, and the chief inspector is directed to visit and report on the case.
“Should the case prove to be smallpox, the ambulance is sent at once to remove it to the hospital. Another ambulance, connected with the suspect camp, is kept to bring suspects and their bedclothing to the camp, this clothing being disinfected before being used.
“The guard consists of a chief and assistant chief and 25 privates, guarding the smallpox hospital, the suspect camp, the depot, and the four principal roads leading into the city, for at the present time the city is in quarantine, and no one is allowed to go in or out except upon a permit signed by myself and Dr. Robertson.
“The chiefs of guard are on duty for twelve hours each daily; the guards at the camp and hospital are relieved every eight hours, while those at the depot have a twelve-hour tour of duty. Those guarding the roads are on from 6 a. m. to 10 p. m.
“The chiefs are required to accompany each relief and put the men on duty, and also to inspect the post of each guard at least once during his tour of duty. As the guards are much scattered, the chief is furnished a horse. The guards are armed with Springfield rifles borrowed from the local military company, and the presence of a guard with a rifle on his shoulder is very effective in keeping order.
“This division is under the charge of Acting Assistant Surgeon Porter. Two autoclaves, with carboy of formalin, have been received from New Orleans for use in this division. Sulphur disinfecting outfit, consisting of pots, tubs, etc., have been purchased. Bichloride solution in barrels, with force pump and hose, has also been secured, and this division is at work.
“Two wagons are required to transport the outfits from house to house, and the work will be pressed as rapidly as possible. A map of the city, with each infected house marked on it with red ink, has been made, and as each new case appears the house is marked on the map, and is disinfected as soon a possible.
“There is much work for this division to do, as there are many infected houses. Those houses that can not be disinfected will be reported to the local authorities with the request that they be burned.
“I have secured comfortable offices, centrally located, for administrative work. I have had a telephone put in, which enables us to communicate with the smallpox hospital, the inspectors, and other parts of the city. The work now being systematized, and the raw material being gradually worked into shape, we are moving along easily and effectively.
“The disease has been so widespread, and the methods used so ineffectual, that it is hard to predict when the epidemic will be under control.
“Confidence has been restored among the people, who are now looking forward hopefully to an early termination of their trouble.”
C. P. WERTENBAKER,
Passed Assistant Surgeon, U. S. M. H. S., Commanding.
Sources: ‘Starving in a pesthouse,’ New York Times, March 15, 1898
Public Health Reports, Vol XIII, No. 13, April 1, 1898, published by US Treasury Department, United States Marine-Hospital Service
online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1998914/pdf/pubhealthreporig04185-0001.pdf