Dr. Tara C. Smith, who blogs at Aetiology, has a wonderful post today: Plague in Victorian San Francisco–lessons for public health communication. It's a kind of extended footnote to an article she published as a guest blogger on Scientific American today; both are worth reading. Excerpt:
Like many scientific issues today, it wasn’t the facts that ended Kinyoun’s career in San Francisco, but his messaging. Admittedly, he was acting without all the knowledge of plague transmission that we have today–it wasn’t confirmed in 1900 that rat fleas were the main vector of the disease from rodents to person, and so Kinyoun couldn’t have been sure his attempts to quarantine Chinatown would be ineffective.
Furthermore, in some cases, he was merely obeying orders from his superiors. His boss, Surgeon General Walter Wyman, had recently published a monograph on plague, endorsing the idea that plague selectively targeted Asians due to their particular diets and their poverty.
Still, the way Kinyoun went about attacking those most affected in the initial outbreak–the Chinese immigrants–only served to terrify them and drive plague cases underground.
Indeed, when public health officers went door-to-door searching for plague cases, one anecdote notes that a game of dominoes was set up in a home, and all the men stayed perfectly still with dominoes in their hands while officers searched the home for anyone with plague symptoms. Little did they know that a plague corpse was sitting at the card table, “Weekend at Bernie’s” style. Other Chinese fled Chinatown, bunking with friends and relatives elsewhere when possible.
Threats were made to burn Chinatown (as had recently happened in Honolulu); Kinyoun tried to bar travel by any “Asiatics” on trains or boats leaving the city, clearly a race-based order.
Furthermore, even when cases of plague were identified in Chinatown, the very practice of carrying out autopsies was offensive to the Chinese, giving them even more reason to hide their sick and dead rather than cooperate with Kinyoun and other public health authorities.Dr. Smith's articles on based in part on a book by Marilyn Chase, The Barbary Plague: The Black Death in Victorian San Francisco, which I reviewed for The Tyee in 2006. It's more than just a chronicle of America's plague years; it's also the story of Dr. Rupert Blue and the founding of the US Public Health Service.
