Pox: An American History

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The untold story of how America's Progressive-era war on smallpox sparked one of the great civil liberties battles of the twentieth century.

At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent ...

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Pox: An American History

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The untold story of how America's Progressive-era war on smallpox sparked one of the great civil liberties battles of the twentieth century.

At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century.

At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights.

At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease.

As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.

2012 Mark Lynton History Prize Finalist

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Editorial Reviews

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Smallpox made its first appearance at least as early as 10,000 B.C., but it wasn't until 1977 when the deadly disease that killed as many as a third of its victims was eradicated worldwide. We owe its total disappearance to the first successful vaccine. Implementing this successful device was, however, not without great struggle. In the nineteenth century United States, Great Britain, and other countries, enforcement of compulsory vaccination laws were met with legal appeals, resistance and sometimes violence. Michael Willrich's Pox returns us to Progressive era antivaccination movements that will remind many contemporary readers of much more recent events.

Megan Buskey
Part of the satisfaction of this lively and assiduous history is the discovery that though smallpox is long gone, the debates that swirled around it continue.
—The New York Times Book Review
Publishers Weekly
Today's controversies over vaccinations pale beside the pitched battles fought at the turn of the 20th century, to judge by this probing work. Historian Willrich (City of Courts) revisits the smallpox epidemic that ravaged the United States from 1898 to 1904 and sparked a showdown between the burgeoning Progressive-era regulatory regime and Americans fearful of the new Leviathan state and the specter of "state medicine." Anxious to stamp out the contagion, public health officials in the South quarantined African-Americans in detention camps if they were suspected of carrying the disease and vaccinated others at gunpoint; in New York "paramilitary vaccination squads" raided immigrant tenements, forcibly inoculating residents and dragging infected children off to pesthouses; their coercive methods sparked occasional riots and lawsuits that helped remake constitutional law. Willrich sees merit on both sides: draconian public health measures saved thousands of lives, but resisters did have legitimate concerns about vaccine safety and side effects, racial targeting and bodily integrity. He does tend to romanticize anti-vaccine activists, whose movement he associates with feminism, free speech, and abolitionism, styling them as "libertarian radicals" engaging in "intimate acts of civil disobedience." Still, his lucid, well-written, empathetic study of a fascinating episode shows why the vaccine issue still pricks the American conscience. Photos. (Apr. 4)
Library Journal
Willrich (City of Courts: Socializing Justice in Progressive Era Chicago) chronicles the U.S. smallpox epidemic at the turn of the 20th century when American expansionism, migrant work patterns, and cramped tenement living created a massive public health disaster with far-reaching implications. He traces the creation of smallpox vaccine technology, still known as "the most dangerous vaccine," from Edward Jenner's late 18th-century development of the cow pox vaccine to recent freeze-dried versions. He describes the disfiguring suffering of smallpox victims in cringe-worthy, heartbreaking detail. Willrich shines when illuminating the profound civil rights and medical ethics issues that arose at a time when national, state, and local public health authorities were just being formed. Heavy-handed government health-care workers would handcuff resistors to vaccinate them. Poor black and immigrant families routinely revolted against the compulsory vaccinations, either hiding their sick or burning "pest houses" built in their neighborhoods. The anti-vaccinationists of the time parallel a modern movement against vaccines for purported dangers, whether scientifically proven or not. VERDICT There is fertile ground for debate here among public health professionals, medical ethicists, those involved in current health-care issues, and historians.—Megan Curran, Univ. of Southern California Lib., Los Angeles
Wall Street Journal
In Pox: An American History," Michael Willrich meticulously traces the story of how the smallpox vaccine was pressed into service during a major outbreak. Sometimes the shots were physically forced on people, outraging their sense of personal freedom and—when the vaccine sickened some and killed others—galvanizing suspicion of vaccination programs. The episode, Mr. Willrich says, prompted large swaths of Americans to insist that "the liberty protected by the Constitution also encompassed the right of a free people to take care of their own bodies and children according to their own medical beliefs and consciences.--(SCOTT GOTTLIEB)
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Product Details

  • ISBN-13: 9780143120780
  • Publisher: Penguin Group (USA) Incorporated
  • Publication date: 3/27/2012
  • Pages: 432
  • Sales rank: 676,347
  • Product dimensions: 5.40 (w) x 8.30 (h) x 1.10 (d)

Meet the Author

Michael Willrich is the award-winning author of City of Courts. He is an associate professor of history at Brandeis University and a former journalist who wrote for The Washington Monthly, City Paper, The New Republic, and other magazines. He lives in Wellesley, Massachusetts.

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Customer Reviews

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Sort by: Showing all of 4 Customer Reviews
  • Posted April 2, 2011

    more from this reviewer

    Readable and Interesting

    "Pox: An American History" by Michael Willrich is a non-fiction book which traces how the smallpox vaccine was distributed during major outbreaks. Some of the vaccines were forced onto people which caused an outrage and the question made it all the way to the Supreme Court.

    The book clearly suggests that an overlooked legacy of American dissent was the antivaccinationists. An increasingly powerful government took on the progressive position that the benefit of all people outweighs the problems of the few and started mandatory vaccination campaigns.

    An interesting and informative part of American history.

    To my great surprise, "Pox: An American History" by Michael Willrich is an extremely readable and fast paced book. What I mean by "readable" is that the book does not simply recite facts, figures, laws, high level agenda etc.

    Yes, it does that as well but by telling stories of individuals on both sides of the debate, such as C.P. Wertenbaker, a federal surgeon who worked tirelessly to combat the deadly and preventable disease. On the other side there is Swedish Lutheran minister Henning Jacobson who took his battle to the Supreme Court battling against vaccination.
    Those stories, big and small, in context with the overall picture are what make the book a joy to read.

    Mr. Willrich goes beyond just reciting facts and figures; he also frames the debate around vaccinations. At a time when people believed that vaccinations are some sort of a vast government conspiracy (in a way it was), a cabal of the feds with the drug manufacturers - sounds familiar?

    The questions which were debated and to some extent still are to this day.
    What rights can or should the federal government ignore in order to protect us?
    What is the price we are willing to pay?
    What happens when the interests of the public at large collide with religion/personal conscience?

    The accounts detailed in the book are very interesting and I learned a lot from reading them. The research is meticulous but the elegant writing makes the book a joy to read, not only if you are interested in medicine, but also for those interested in history and especially the social classes in the United States.

    7 out of 7 people found this review helpful.

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  • Anonymous

    Posted September 29, 2013

    Glad Smallpox was Eradicate! Intersting Read.

    I enjoyed this book, although at times it was rather slow. What I liked was the challenges faced by the public health community to bring smallpox under control. The tactics and measures taken would not have been tolerated today. However, I am fortunate that the scourage of smallpox was eliminated when I was a child. I was vaccinated, but never knew of any cases in my lifetime, nor anything that my mother and father could recall, too. I was surprised that it was not until 1979 that the last case was identified in Somalia and eliminated. The approach to smallpox was drastic, but in hindsight probably necessary and fortunate for all the lives and suffering saved. This likely will be the last significant disease that will be eradicated. In our modern society, infectious and communicable diseases still strike, despite effective vaccines. My grandmother told me of stories of people she knew growing up who had died of diphtheria, scarlet fever and measles.

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  • Anonymous

    Posted December 27, 2012

    Get the sample first

    I dont like this book at all

    0 out of 3 people found this review helpful.

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  • Anonymous

    Posted July 17, 2011

    No text was provided for this review.

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