Pox: An American History

Pox: An American History

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by Michael Willrich

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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


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.

Editorial Reviews

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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What People are saying about this

Charles Rosenberg
"Pox is a scholarly rarity: an important and deeply-researched book that speaks not only to historians, but to any thoughtful reader. Michael Willrich has rescued and elegantly re-created a neglected episode in American history. In clear yet nuanced prose, he has made a lasting contribution to our understanding of the complex and tangled relationship between the powers and responsibilities of the state and the autonomy of individual men and women."--(Charles Rosenberg, author of The Cholera Years)
David Hackett Fischer
"In one of American history's ironies, a nation fiercely supportive of individual liberty also developed a public health movement that may have become the most violently invasive of individual rights in the world. These tendencies collided at the turn of the 20th century, when a smallpox epidemic spread through much of the country. Michael Willrich tells the story of Americans who fought for liberty from vaccination while others were vaccinated by brutal force at the hands of New York Police, Texas Rangers, and even the U.S. Cavalry. A torrent of litigation followed, some of it carefully balanced, much of it very unwise, and it still reverberates in American jurisprudence. These were hard cases, but in the highly skilled hands of Michael Willrich, hard cases make great history. We all have much to learn from this excellent book."--(David Hackett Fischer, author of Champlain's Dream and Washington's Crossing)
Michael J. Klarman
"Michael Willrich has written a fascinating, fast-paced story of America's last major smallpox epidemic. Pox is a tale of race, class, violence, political resistance, intergovernmental conflict, and, most importantly, the age-old tension between individual rights and government regulation for the common good. Writing with passion and verve, Willrich weaves riveting anecdotes and vivid portraits of previously unknown players into a compelling historical narrative with resonance for today's debate over the constitutionality of federal health care reform. This is history at its best written by a master of his craft."--(Michael J. Klarman, author of From Jim Crow to Civil Rights)
Hampton Sides
"In Pox, Michael Willrich melds meticulous research with elegant writing to create a richly-textured social history about a horrible disease at the charged intersection of science, politics, race, and culture. Willrich deftly traces the great clashes between government epidemiologists and civil libertarians at an uneasy time when a burgeoning American Empire was field-testing the public consequences of germ theory. After reading Pox, you'll never think the same way again about the now all-but-mechanical ritual of rolling up your shirtsleeve for a vaccine needle."--(Hampton Sides, author of Hellhound on His Trail)

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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Pox: An American History 2.8 out of 5 based on 0 ratings. 4 reviews.
Man_Of_La_Book_Dot_Com More than 1 year ago
"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.
Anonymous More than 1 year ago
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.
Anonymous More than 1 year ago
Anonymous More than 1 year ago
I dont like this book at all