Seek and Hide: Public Health Departments and Persons with Tuberculosis,1890–1940

Koch Robert , “The Aetiology of Tuberculosis,” The American Review of Tuberculosis (25) March, 1932, pp. 299, 306, 311. This is a translation of the paper that Koch read at the Berlin Physiological Society on March 24, 1882.

Physicians themselves often noted these facts. “Fully one-half the deaths from consumption,” wrote James Clark, “occur between the twentieth and fortieth years…. Mortality is about its maximum at thirty.” (Quoted in Sweetser William , Treatise on Consumption (Boston: T. H. Carter, 1836), p. 45. Sweetser also noted that females were more prone to consumption than males, (Ibid, p. 43).

For an analysis of nineteenth century American medical practices see Warner John Harley , The Therapeutic Perspective: Medical Practice, Knowledge and Identity in Nineteenth-Century America, 1820–1855 (Cambridge, Harvard University Press, 1986). For specific treatments physicians used see Sweeter, A Treatise on Consumption p. 82, 172.

Drolet Godias J. Lowell Anthony M. , A Half Century's Progress Against Tuberculosis in New York City 1900–1950 (New York: New York Tuberculosis and Health Association, 1952) pp.iii, li-liv, quotes Billings . See also Billings John S. , Vital Statistics of New York City and Brooklyn Covering a Period of Six Years Ending May 31, 1890 (Washington D.C.: U.S. Census Office, 1894).

Even among immigrants there were not uniform mortality statistics. Apparently Jews, even those who lived in the most crowded tenement districts, had lower mortality rates than other groups. Fishberg Maurice , “The Relative Infrequency of Tuberculosis Among the Jews,” American Medicine (2) 1901 pp. 695–8. Historians have interpreted this disparity. Dwork Deborah , “Health Conditions of Immigrant Jews on the Lower East Side of New York: 1880–1914,” Medical History (25) 1981 pp. 1–40.

Knopf Adolphus , Tuberculosis as a Disease of the Masses and How to Combat It (fourth edition, New York: Fred P. Flori, 1907) p. 16.

Id. at 43–45, 83–86. For an overview of this medical social alliance see Teller Michael E. , The Tuberculosis Movement: A Public Health Campaign in the Progressive Era (New York: Greenwood Press, 1988).

See Smith Theobald , “Public Health Laboratories,” Boston Medical and Surgical Journal, 143 (November 15, 1900): 491–493.

Charles V. Chapin, “Dirt, Disease and the Health Officer,” in Gorham Frederic P. , ed., Papers of Charles V. Chapin, M.D. (New York: The Commonwealth Fund, 1934) pp. 22–23.

On transmission see Charles V. Chapin, “The Principles of Epidemiology,” in Gorham , Papers, p. 184.

Welch William H. , “What May Be Expected from More Effective Application of Preventive Measures Against Tuberculosis,” an address delivered in Albany N.Y. January 27, 1908, reprinted in Welch William H. , Papers and Addresses, edited by Burket Walter C. (Baltimore: Johns Hopkins Press, 1920) p. 632.

Charity Organization Society, A Handbook on the Prevention of Tuberculosis (New York: Charity Organization Society, 1903) p. 98.

Billings John S. Jr. , “The Registration and Sanitary Supervision of Pulmonary Tuberculosis in New York City,” New York City Department of Health, Monograph Series 1 1912 p. 57.

New York City Department of Health, Annual Report, 1894 p. 95.

On tactics the tubercular poor used to avoid detection see Biggs Hermann M. and Huddleston John Henry , “The Sanitary Supervision of Tuberculosis as Practiced by the New York City Board of Health,” The American Journal of Medical Sciences, (109) pp. 25–26.

New York City Department of Health, Annual Report, 1895 p. 96.

The law contained precise instructions for disinfection which became more stringent over time. At first landlords had ten days, later 48 hours. The costs were to be borne by the landlord. New York City Department of Health Annual Report 1894 p. 97. See also National Association for the Study and Prevention of Tuberculosis, Technical Series, A Manual of Tuberculosis Legislation 8 (1926): 37.

Biggs Hermann , “To Rob Consumption of its Terrors,” The Forum, 16 (February, 1894): 767.

Winslow C.E.A. , The Life of Hermann Biggs (Philadelphia: Lea and Febiger, 1929) p. 158.

Chapin Charles V. , “Pleasures and Hopes of the Health Officer,” in Gorham , Papers, p.6, supra note 9.

For detail see Winslow, Biggs, supra note 19, pp. 131–152. Public health officials defined tuberculosis as a communicable disease. “No reasonable sanitary officer,” Biggs maintained, “would expect to put in force regulations requiring notification of tuberculosis, with the same conditions and in the same way that a similar one with regard to small pox would be enforced” (151). For a fascinating analysis of the way Biggs's professional motivations shaped the battle see Fox Daniel M. , “Social Policy and City Politics: Tuberculosis Reporting in New York, 1889–1900,” Bulletin of the History of Medicine, 49 (1975): 169–195.

Winslow, supra note 19, p. 139.

Devine Edward , “A Working Program,” Transactions of the National Association for the Study and Prevention of Tuberculosis 1 (1905): 53.

Winslow , Supra note 19, pp. 144, 146. For an analysis of the composition of the city's medical profession in the city and its response to compulsory reporting see Fox, “Social Policy and City Politics,” supra note 21, pp. 169–195. For another view see Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1983) p. 187.

On the penalties contracting the disease imposed see Teller, The Tuberculosis Movement, pp. 77–78; 109–110.

See Pottenger F.M. , “Is Another Chapter in Phthisiophobia About to be Written,” California State Journal of Medicine 1 (1903): 81–84.

Winslow, supra note 19, p. 178.

For a discussion of legislation on involuntary confinement, see National Tuberculosis Association, A Manual of Tuberculosis Legislation Technical Series, New York: 1928 p. 38. Billings John S. , “Discussion,” Transactions of the Third Meeting of the National Association for the Study and Prevention of Tuberculosis (1906) p. 52.

Rhode Island State Commission on Tuberculosis, Report on Hospitals for Advanced Cases (Providence, Rhode Island, 1911), pp. 34–36.

Tobey James A. , Public Health Law (New York: The Commonwealth Fund, third edition 1947) p. 152.

Ingraham Charles Wilson , “Control of Tuberculosis from a Strictly Medico-Legal Standpoint,” Journal of the American Medical Association, 28 September, 1896 p. 694. Welch William , “Address,” Transactions of the Fifth Meeting of National Association for the Study and Prevention of Disease 1909 p. 36.

Conley Walter H. , “Detention of Consumptives in a City Hospital,” Journal of the Outdoor Life, 11 (1914): 104.

Wilson Robert J. , “Difficulties Encountered by Hospital Authorities in Detaining Homeless Consumptives,” Journal of the Outdoor Life, 11 (1914): 102.

Id. at 103. To improve discipline, Wilson advocated a form of medical parole.

Committee on Hospitals for Advanced Cases of Tuberculosis, “Report,” Transactions of the Ninth Annual Meeting of the National Association for the Study and Prevention of Tuberculosis 1913 p. 54–66.

On the difficulties of gaining the compliance of New York City physicians see Billings , “Registration,” supra note 13, p. 86. For a discussion of physician compliance see Teller , The Tuberculosis Movement, supra note 7, at 72–3.

Billings , Supra note 13, p. 14–17.

Huddleston Biggs , “The Sanitary Supervision of Tuberculosis,” p. 25–26.

Case #27, Ziselman M. Dr. to Spivak Charles Dr. , Beck Memorial Archives, Jewish Consumptive Relief Society Collection, University of Denver.

Sweet Ernest , “The Interstate Migration of Tuberculous Persons,” U.S. Public Health Reports, 30 (April 16, 1915): 1149.

Hall Sharlot M. , “The Burden of the Southwest,” Outwest, 28 (January, 1908): 9.

Ross Will , I Wanted to Live, Wisconsin Anti-Tuberculosis Association, (Milwaukee, Wisconsin: Anti-Tuberculosis Association, 1953) p. 51.

Webb Gerald B. Powell Desmond S. , Henry Sewall, Physiologist and Physician (Baltimore: Johns Hopkins Press, 1946) p. 276.

Galbreath Thomas , Chasing the Cure in Colorado (Denver: published by the author, 1909) p. 29.

For a detailed description of life in these colonies see Carrington Paul M. , “Economic Housing of Consumptives with Especial Reference to the Southwest,” Transactions of the Sixth International Congress on Tuberculosis (1908): 1042–1050.

Hall Dick , “Ointment of Love: Oliver E. Comstock and Tucson's Tent City,” Journal of Arizona History, (Summer, 1978): 112.

Ibid.

McClintock Marshall , We Take to Bed (New York: Jonathan Cape and Harrison Smith, 1931) p. 45.

Lowry Iva Marie , Second Landing (Philadelphia: Dorrance and Company, 1974) p. 53.

Drolet Godias J. Porter Donald E. , Why do Patients in Tuberculosis Hospitals Leave Against Medical Advice (New York: New York Tuberculosis and Health Association, 1949).

For a detailed account of the experiences of the sick in the sanatorium see Rothman Sheila M. , Living in the Shadow of Death: Tuberculosis and the Social Experience of Illness in American History (New York: Basic Books, 1994).