Pox (37 page)

Even without smallpox aboard, travel in steerage was hazardous to the health. Late nineteenth-century American reformers and port officials protested the “heartless treatment” of steerage passengers on journeys that some compared to the “Middle Passage” of the bygone slave trade. Federal law levied a $10 penalty on ship companies for every passenger over eight years of age who died en route to the United States. But as two New York State commissioners of immigration lamented in 1868, the law was little enforced and did nothing for the hundreds of steerage passengers who died each year. The “interest of humanity” and “political economy,” these officials declared, required the reform of a system where “emigrants are treated more like beasts of burden than human beings.” The New York officers urged Congress to require all immigrant ships bound for America to carry a medical officer.
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By the time Congress finally enacted such a law, in 1882, the germ theory was on the rise. “Reasons of hygiene” joined the old “sentiments of charity, morality, and humanity” in congressional deliberations. Consequently, ship surgeons would do much more than care for sick passengers. They would become on-board agents of American quarantine regulations. That same year, 1882, the short-lived National Board of Health called for a new federal law to mandate “the vaccination of all immigrants not previously protected”—a policy that at that time applied only to passengers from foreign ports known to be infected with smallpox. But the board's argument that compulsory vaccination served the national interest—by preventing the constant importation of smallpox and stopping the amassing of “large numbers of susceptibles in circumscribed localities” (cities)—failed to move Congress to adopt a uniform national policy until another decade had passed.
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Faster ships, more than sharper laws, made the Atlantic crossing safer. In 1867, the journey took fourteen days or more; by 1900, some steamships could make the trip in under six. But the passenger's relief was the quarantine officer's headache. Speed altered the nature of the threat from smallpox. The average incubation period for the disease was about twelve days; in the age of sail, if anyone on board was infected that fact was likely to become known well before the vessel reached port. With each new increment of speed, the likelihood increased that infected travelers would reach port without presenting symptoms. As Dr. William M. Smith, health officer of the port of New York, reported in 1888, smallpox was the most difficult “latent contagion” to check by maritime quarantines. In that year alone, Dr. Smith's medical officers inspected some 383,000 steerage passengers. Given the rising boat speeds, any number of them might have contracted smallpox in a European village, traveled more than three thousand miles to New York, shown no symptoms at quarantine, boarded a train, and not felt the first fever until reaching the American heartland. Outbreaks in Illinois, Indiana, and Missouri were traced to recently arrived immigrants from Europe. According to Smith, this problem of latent contagion had caused “more anxious reflection” among American port health officers “than any other subject during the past nine years.” He called for a strict policy that all passengers not vaccinated within the previous eight years submit to the procedure within two days of boarding a U.S.-bound ship.
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Increasingly, immigrant-receiving ports enforced just such a rule. One English opponent of vaccination, arriving in New York aboard a White Star steamship, wrote home that “America was closed against the unvaccinated anti-vaccinator, [who] was fast falling into the condition of the American negro-slave who was hunted down everywhere by everybody.” Like New York, the port of Boston required all arriving steerage passengers to present a certificate, signed by the ship's medical officer, stating that they were protected from smallpox due to having survived the disease or by recent vaccination. Anyone failing to meet this requirement would be vaccinated by a port physician on arrival or be detained for fourteen days on Gallop's Island. Steamship companies posted the port's vaccination requirements, translated in several languages, on their Boston-bound ships. For many immigrants, seeing this notice was their first encounter with American law.
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For some steerage passengers, vaccination aboard a ship at sea was just one inconvenience among many. For others, the experience was overwhelming. Steamship companies insisted they were merely providing a service, one required of them in order to do business in American ports. Passengers, they said, were at liberty to refuse the service and face the consequences. But the true test of liberty lies in its exercise. Liberal political theorists since John Locke had suggested that real human freedom and consent required physical space—“room enough”—for their exercise. Liberty needs an exit.
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M
ary O'Brien was just seventeen when she boarded the Cunard Steamship Company's
Catalonia
in Queenstown, Ireland. The
Catalonia
set sail for Boston on the Fourth of July, 1889. Mary had never been away from home, and her mother had recently died. She made the journey with her father and brother, traveling in a steerage compartment with three or four hundred strangers.
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When the
Catalonia
was about three days out from Boston, Mary sat with other female passengers on deck. A ship steward approached and told them to go below. Not knowing the purpose, Mary descended the staircase into steerage. At the landing, halfway down, she passed the ship's surgeon, I. T. M. Griffin, who stood with two stewards. She continued to the bottom of the stairs. All of the ship's female steerage passengers had been lined up at the foot of the stairs and were making their way slowly up. The male passengers were nowhere to be seen. (Mary later learned that her father and brother, along with all the rest, had been taken to another part of the ship.) As the line moved forward, Griffin inspected each woman's arm and “proceeded to vaccinate those that had no mark.” As they passed inspection, each woman received a card from a steward—a vaccination certificate to be presented to the port physicians. Mary held back until she was the last woman on the stairs. She later recalled that she saw “no means of exit except where the surgeon stood.” She told Griffin that she knew from her mother that she had been vaccinated as a baby. He said there was no mark, and she “must be vaccinated.”
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It seemed to Mary that no time at all had passed between that utterance and the sensation of Griffin's penknife scraping her left arm and the dabbing on of some stuff from a glass tube. By her own admission, she had not spoken out; she had not struggled. But she would later testify before a Boston jury that she had been vaccinated against her will and that the vaccine had made her sick. The judge instructed the jury that there was no evidence to support O'Brien's claim of assault. Hearing the case on appeal in 1891, the Supreme Judicial Court of Massachusetts agreed. To reasonable men of privilege and power—on a bench that included the future Supreme Court justice Oliver Wendell Holmes, Jr.—the young Irishwoman's legal claim may have seemed absurd. But, O'Brien's lawyers argued, “a distinction must be drawn between mere submission and positive consent.” In the closed space below the waterline, separated from home and family, the immigrant girl had, by all appearances, passively submitted. Seeing no other exit, she held up her arm to be vaccinated. How many others felt as she did, we will never know.
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In 1891, the U.S. government took control of immigration administration. As it did, the poorer immigrants passed through an increasingly elaborate gauntlet of medical inspection at the nation's borders. At many American ports, state quarantine officers continued to inspect immigrants, but they did so in compliance with a burgeoning national regime for the processing of aliens. Mass immigration continued unabated, but immigration policy grew increasingly fraught, a battleground for business interests and organized labor, nativists and humanitarians. Global outbreaks of cholera, small-pox, and other diseases kept hygiene central to the administrative process. In laws of 1891 and 1893, Congress assigned the U.S. Marine-Hospital Service responsibility for keeping migrants with contagious diseases from entering the country. Service officers inspected immigrants at port stations from New York Harbor to San Francisco Bay, as well as at designated crossings along the Canadian and Mexican “frontiers.” At a growing number of foreign ports, Service men attached to U.S. consulates inspected immigrant ships
before
departure, advising steamship companies to refuse passage to those passengers who appeared likely to be turned back for medical reasons upon reaching America.
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U.S. quarantine regulations in force by 1894 made vaccination a prerequisite to entry. Like the older state rules, the federal requirement treated steerage passengers as a class: “All passengers occupying apartments other than first or second cabin shall be vaccinated prior to entry, unless they can show that they have had smallpox, or have been recently successfully vaccinated.” Every steerage passenger bound for America received an inspection card that detailed an elaborate transatlantic process of medical inspection. Boxes on the front of the card recorded the migrant's passage through inspection by a U.S. consular agent or Marine-Hospital Service officer at the port of departure; through quarantine at the port of entry; and by the U.S. Immigration Bureau. Another box, completed by the ship's medical officer, called for the passenger's number on the ship's manifest list, where U.S. inspectors could find the detailed information on each passenger (including a medical history) required by U.S. law. The back of the card called for an official stamp or signature certifying vaccination. In seven languages, the card warned its holder, “Keep this card to avoid detention at quarantine and on railroads in the United States.”
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A ship entering New York harbor after 1891 first passed quarantine, which remained the province of New York port authorities. The port health officer and his assistants boarded, examining the ship's manifest and its bill of health—a statement from the U.S. consulate detailing the sanitary condition of the ship and the port of embarkation. The inspectors then searched for passengers infected with any of five quarantinable diseases: smallpox, cholera, plague, typhus, or yellow fever. Smallpox was a constant concern. Unlike the mild form of the virus spreading across much of the country after 1898, the disease making the Atlantic passage was still classic deadly smallpox.
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New York quarantine officials viewed Italian immigrants as a special threat, despite the fact that Italian state medicine had long been in the vanguard of European smallpox control. The Italians had introduced bovine vaccine, and Italian law required all children to be vaccinated within six months of birth and required revaccination for entry into the schools and factory jobs. But none of the nation's fourteen vaccine-manufacturing establishments could be found south of Rome. And in southern Italy, where most immigrants to the United States originated, vaccination was far from universal. For Dr. Alvah H. Doty, health officer of the port of New York, smallpox arriving on steamships from Naples was a “constantly recurring” problem. Without the quarantine precautions, “a horde of people would be landed on our shores to scatter smallpox broadcast over our land.” It became routine: a huge ship would steam into the harbor, quarantine inspectors would find smallpox aboard, and all of the steerage passengers would be subject to vaccination and detention on Hoffman Island.
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If the New York inspectors found no quarantinable diseases aboard, they left the ship. At that point, physicians of the Marine-Hospital Service's Boarding Division took over. They gave passengers in the first- and second-class cabins a perfunctory inspection. Rarely was a first-class passenger singled out for closer inspection; and when this did occur, it usually happened not because the passenger looked especially unhealthy, but because some unspecified social marker made him appear out of place. As one officer of the Service explained, “If a passenger is seen in the first cabin, but his appearance stamps him as belonging in the steerage or second cabin, his examination usually follows.”
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When the steamship at last arrived at its destination, a wharf or dock in New York City, only passengers traveling in third-class or steerage were ferried to the federal government's immigration depot at Ellis Island to run the gauntlet of medical inspectors known, in Service parlance, as “the line.” The inspection at Ellis Island began as soon as the immigrants stepped off the barge. They lined up under the watchful eyes of the medical inspectors, who scanned the crowd for any individual possessing a mental or physical defect. Carrying their baggage, the immigrants climbed the steep stairs to the Registry Room, also known as the Great Hall. Watching from the top of the stairs, Service physicians looked for signs of weakness or heavy breathing that might indicate heart trouble. As the immigrants made their way through the congested gates and cordoned-off areas of the facility, officers examined eyes and scalps, hands and throats, all the while looking for signs that the passenger was unfit to enter the American nation.
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The power to exclude migrants from the political space of the nation—ordering their return to their port of origin, at the expense of the steamship company—was the ultimate power entrusted to U.S. officials at points of entry. The exercise of this authority rested upon the medical expertise of the Marine-Hospital Service officers, who by 1903 inspected nearly 900,000 immigrants each year at thirty-two American ports and several overseas. The power to exclude was not exercised often. In an average year, U.S. officials turned back fewer than 1 percent of all arriving immigrants. But medical criteria, rather than political radicalism or poverty, became an increasingly important reason for exclusion, until it was the principal one. No wonder many recalled those hours at Ellis Island as the longest of their entire journey.
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