What The LA Smallpox Epidemics Of The 1800s Can Teach Us About Covid Today
As the bleak winter of 1862 dragged on into 1863, the isolated, ramshackle town of Los Angeles was visited by a terrifying scourge -- smallpox.
With its telltale fever and disfiguring skin rash, the highly infectious disease jumped from adobe to adobe, killing more than 100 people and sickening hundreds of others. If those numbers don't sound like much, remember L.A. had only 4,000 or so souls at the time and the outbreak wiped out half of its indigenous residents.
"The city's smallpox wagon, dubbed the 'black Maria,' was a frequent and disheartening sight as it rolled through the streets carrying victims to the city hospital, or 'pesthouse,'" writes John W. Robinson in Los Angeles in Civil War Days 1860-1865.
This smallpox outbreak would be the deadliest in American Los Angeles but it wasn't the only one. Historian Kristine Gunnell says L.A. would go on to weather several more smallpox epidemics during the 19th century -- including 1868 to 1869, 1877, 1884 and 1887. While that first outbreak was devastating, the last one was seen as more of an annoyance, a PR headache for the booming City of Angels, which was trying to brand itself as a land of sunshine and health.
How Los Angeles and its denizens coped with these epidemics may seem hauntingly familiar to Angelenos today -- a case study in fear, misinformation, denial, rumors and rivalry.
The Pest Of Pestilence
Southern California was already reeling in the winter of 1862. A drought had decimated the cattle business, plunging the region into economic distress. When the first cases of smallpox cropped up in late 1862, they were concentrated in California's Native community. By mid-January of 1863, the disease had spread across racial and socio-economic barriers, killing 14 Angelenos in a single day. Undertakers were overwhelmed and local government, underfunded.
Fortunately, doctors had a powerful tool in their arsenal since English doctor Edward James had developed the first smallpox vaccine in 1796. The vaccine was available to all residents, regardless of race or socio-economic class, although it often had to be administered more than once to be effective.
"While technology has improved, the methods for containing infectious disease have changed remarkably little in the last 150 years," says Gunnell, author of Daughters of Charity: Women, Religious Mission, and Hospital Care in Los Angeles, 1856-1927.
"In 1863, the city hired health inspectors to identify cases and impose quarantine. In effect, they were 19th Century contact tracers. The city also offered a free vaccination program. Yet the availability of medical treatment, nursing care and even the enforcement of quarantine regulations depended on one's class status... Those who had family members to care for them and could afford to pay private physician's fees, were treated at home. Those who did not, went to the quarantine hospital, or 'pest house.'"
Dr. Russel T. Hays, the city surgeon, was tasked with vaccinating everyone in Los Angeles. Anyone who refused to be vaccinated could be arrested. Many Native Californians were wary of receiving any medical treatment from the American government. Instead, according to historian Leonard Pitt in The Decline of the Californios, many marginalized Angelenos, including those in the indigenous and Mexican communities, relied on folk remedies, often with disastrous results.
According to KCET's D.J. Waldie, the common advice was that those with smallpox should "refrain from eating peppers and spices, wash salted meats, bathe at least once every eight days, and burn sulfur on a hot iron to fumigate sickrooms." Native Californians used sweating ceremonies followed by icy plunges as a treatment. For many people who were infected with smallpox, historian Robinson notes, this hastened death.
Other Angelenos turned to quacks like William Money, who is also notable, according to the Cecilia Rasmussen of the Los Angeles Times, for being L.A.'s first documented cult leader. As Rasmussen explains, Money claimed to be an expert in "astrology, natural history, medicine, meteorology, theology, history and cartography" and he once attempted to raise himself from the dead (it didn't work out). Rasmussen writes;
"When Money boasted that he could imitate Christ and rise from the grave on the third day, Angelenos dared him to prove it. Money climbed into a pine box. Its top was nailed shut and the box was lowered into the ground. However, before the last shovel of dirt was tossed atop the coffin, he lost his nerve. 'For the love of God, let me out!' he screamed."
"We doctors never bothered about trying to run old 'Doc' Money out of town. We knew that if we did try to do so, the chances were that the public would have loved Money more," wrote L.A. doctor John W. Shuman, according to Rasmussen.
For everyone else, there was little to do but quarantine and wait out the virus, which still has no cure.
"Infected premises were affixed with a yellow flag and quarantined. During the height of the epidemic, nearly every house in Sonora-town [L.A.'s poorest Mexican American neighborhood] flew the dreaded flag. By early February, there were 278 cases in town, and more than a hundred lay in their graves," Robinson writes in Los Angeles in Civil War Days 1860-1865.
Disadvantaged communities also feared being forcibly removed to the "pest house," four miles outside the city. They had good reason to be scared.
"When Catholic sisters known as the Daughters of Charity came to inspect the house, one remembered finding patients 'lying pell-mell on the floor, suffering in every way.' They had no beds, little food and dirty linens. The smell must have been horrible. With the temporary nature of the epidemic, the city council wanted to do things as cheaply as possible, and rank prejudice against people of color, especially those who were poor, didn't help matters," Gunnell says.
Mercifully, the city asked the Daughters of Charity, renowned nurses who already ran the county hospital, to step in. They transformed the small pest house, cleaning it and treating its patients with compassion and dignity. But it was too little too late. According to historian Leonard Pitt, "Almost the entire settlement of Mexicans and Indians from the plaza north to the mill died."
Robinson believes that the 1863 epidemic probably killed half of L.A.'s indigenous residents. The disregard for L.A.'s Native people is evident in the Los Angeles Star's reporting on the death of famed Cahuilla chief Juan Antonio. On February 29, 1863, the paper wrote:
"Old Juan Antonio and four other Indian chiefs have died of smallpox and I have been informed that the bodies have not been buried and that they are being mutilated by hogs and dogs. Of course, it is a matter of much annoyance to the whites in the neighborhood."
Quarrels Over Quarantine
By March of 1863, L.A.'s smallpox plague had subsided. Residents hoped the disease was a thing of the city's rough and tumble past but this was not to be. Smallpox would periodically rear its head over the next 20 years although none of those outbreaks would be as deadly as the one in the winter of 1863.
When smallpox reappeared in early 1887, it found a city that had transformed from backwater to boomtown. Los Angeles was now being sold in a sophisticated campaign as the health capital of the world. Business was strong and the population, exploding -- from 11,395 people in 1880 to 50,396 in 1890. Railways connected L.A. with the rest of the world and the harbor bustled with vessels carrying goods in and out.
There were rumblings of trouble in early January 1887, when the Los Angeles Times reported that smallpox had made its way by rail from Guaymas, Mexico to Nogales, Arizona. According to Los Angeles Harbor historian Dennis Piotrowski, the first smallpox case in Los Angeles County was reported on February 16, 1887.
Government leaders attempted to staunch the spread of smallpox through the city. They placed a yellow flag in front of every quarantined home and often had a police officer stand guard to make sure no one went in or out. They published the addresses of quarantined buildings in local papers so Angelenos could avoid them. They fumigated infected buildings. The city also began constructing a small, temporary tent hospital in Chavez Ravine, far from the city's busy center and near the old Jewish cemetery.
It seems the city had learned very little about how to manage a safe and comfortable smallpox hospital so they, once again, turned to the Sisters of Charity. Gunnell writes in Sisters and Smallpox: The Daughters of Charity as Advocates For the Sick Poor in Nineteenth-Century Los Angeles:
"Upon her arrival at the Los Angeles pest house in 1887, Sister Veronica Klimkiewicz, D.C., noted that the building was in such a state of disrepair that it was 'hardly fit for domestic animals.' The city had hired incompetent and unreliable caretakers, for whom 'the large pecuniary consideration offered was the principal, if not the only inducement to enter so repulsive a service.' Because of the filthy conditions and a reputation for indifferent care, Sister Veronica explained, 'As a consequence, none, or very few, who were in circumstances to resist the public pressure that sought to.'"
"This fear will now be entirely removed when it is known that, with their wonted heroism, the Sisters of Charity have come to the front and will have entire charge of the smallpox hospital. Everyone knows that that means the very best and tenderest of care," the Los Angeles Times reported.
These efforts couldn't hold back the tide of gossip. On March 8, false rumors that Dr. H.S. Orme, an L.A. resident and director of the California Board of Health, had called for the entire city to be locked down caused Angelenos to panic. The next day, a furious Los Angeles Times (owned by one of L.A.'s main boosters, Harrison Gray Otis) opined:
"In pursuance of the brilliant policy of trying to scare one's self to death for nothing, the wire was full yesterday of crazy reports that at 6pm Los Angeles was to be shut out from the rest of the world by a burglar-proof quarantine. No more trains were to be run into the city, nor out of it, and it was even doubtful if telegrams could be sent, lest one should infect the operator in New York. Without even stopping to think that there is no law on earth by which such a thing could be done, unless, perhaps in Russia, several hundred remarkable idiots flew to the railroad offices to see when 'the last train' would go and to get tickets to San Francisco, where there is smallpox all the year round - as there is in every great city."
At Turnverein Hall, a small theater in downtown L.A. (where the L.A. Civic center is now), a group of young men met to form a protective association that would financially support sick members. When the Board of Health met on Spring Street, Dr. M. Hagan was made Health Officer for the city and charged with issuing a daily bulletin. Free vaccines were also offered in tents in downtown, and 125 railway workers were given emergency vaccines.
On March 10, 1887, the L.A. Times claimed there were 14 smallpox cases at the hospital, while another 10 people were quarantined at home.
Fear of the pest house, no matter the sisters' loving care, meant a percentage of infected residents attempted to cure themselves. Others were suspicious of vaccines, which often didn't work and had to be administered more than once. Some Angelenos may have tried a home remedy published in the Los Angeles Star and said to be a favorite of British soldiers in China:
"When the preceding fever is at its height, and just before the eruption appears, the chest is rubbed with croton oil and tartaric ointment. This causes the whole of the eruption to appear on that part of the body to the relief of the rest. It also secures a full and complete eruption, and thus prevents the disease from attacking the internal organs."
An L.A. policeman with the last name of Harthorn who was living in a large mixed-use block at Fifth and Spring Streets also refused to go to the smallpox hospital, much to Dr. Hagan's fury. The doctor told the Times:
"I went up there at once and promised him that a tent should be erected near the hospital; that it would have a floor, a stove and beds for himself and his wife; that we would not try to force him to go out, but wanted him to go, that the moral effect would be bad if he refused to go; that he should have far more luxuries than I should have for myself in case I should be taken down."
"Mrs. E.C. Freeman, a poor widow, who opened a bakery and restaurant... last June... has been completely ruined. All her help left, and all her customers, and now it is hard to find anyone who even passes her door... A poor woman who roomed upstairs, and worked at a dressmakers, has lost her position... McInerney Brothers, who have a grocery and notion store at 411, were doing a living business, and now are absolutely deserted... Copes Shoe Store at 412 has been closed because business has left it entirely... Harthorn's windows open on another building full of lodgers and only a few feet away. These are a few of the troubles caused by a paid city officer's refusal to comply with the city's health rules."
On Saturday, March 12, the San Francisco Examiner printed a sensational article that blared:
"For some time past, there have been rumors going about that the booming city of Los Angeles was in a bad way in a sanitary point of view. It was stated that the dread scourge smallpox was playing sad havoc with her citizens and visitors, and that not one-half of the cases were reported to the authorities. Be this as it may, the people who dwell in the city of the angels were modestly silent on the matter, and their real-estate boom and the smallpox strode onward together."
L.A. leaders were incensed. Mayor William Workman responded that the account was "grossly incorrect," and that there were only 41 cases and 4 deaths in the entire county. The Los Angeles Times was more explicit, threatening their rivals at the Examiner:
"The Examiner is guilty of a crime when it ignores the correct statements, so readily available, and gives currency to a sensational report gathered from a scared and irresponsible traveler and dressed up in gaudy colors by a cheap reporter. The Examiner has, for some time, enjoyed a considerable clientage in Southern California, but if this is the way it proposes to stab our section in the back, it will soon begin to pay dearly for its malevolence. The smallpox scare, we are glad to say, is about over... The streets are thronged with people every day and business goes on as though nothing unusual had transpired. The real estate transactions last week footed up nearly $1,200,00."
On March 17, Simpson reported to the Associated Press that the situation was not as desperate as had been reported. But he also said that the smallpox hospital at Chavez Ravine was too small and that the disease had spread across all socio-economic lines, from the stately homes on Hill Street to the poorest sections of "Spanish-town."
"We found that the people of Los Angeles are inclined to extreme secrecy concerning the smallpox, and the press there is as silent as possible. They seemed to consider that the visit of the State Board of Health was impertinent, and they say that they are able to take care of the disease themselves," Simpson told colleagues back in San Francisco.
On March 21, 1887, the Los Angeles Times reported that a "malevolent thrust at the business interests of Los Angeles" had been aimed at the city by the "mean and cowardly act of a rival." These hysterics came because of a resolution passed the day before by the San Francisco Board of Health. It read:
"Resolved, that the city of Los Angeles be declared infected with smallpox, and as the port of San Pedro is the port of departure from that city, it be declared infected, and that all vessels arriving from there shall be placed in quarantine until thoroughly inspected by the quarantine officer."
According to Piotrowski, 15 people died of the 1887 smallpox outbreak, although with L.A.'s secrecy and shoddy records, the true number may be higher. As was typical, the smallpox outbreak faded away in the spring. Although Los Angeles faced several small outbreaks in the early 20th century, by the mid-1900s, the scourge of smallpox never again haunted the city, according to Gunnell. Los Angeles continued its ascendancy as a bustling, modern metropolis where the sun never stopped shining and the land always increased in value.
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