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Strange as it may sound, not long ago a large segment of the United States was being terrorized by a flea. Combining medical and social history with a remarkable study of the personalities involved, Marilyn Chase casts a fascinating light on a nearly forgotten time in American history: the hunting down of infected rats and fleas transmitting the deadly bubonic plague.
The history begins with a lumber salesman's death in 1900, setting off a wave of hysteria in San Francisco's Chinatown. The decade that followed was marked by mutual suspicion between Chinese immigrants and their white counterparts, and shameful finger pointing and denials of the existence of a health crisis. Into the maelstrom walked Rupert Blue, an undistinguished doctor appointed to investigate the epidemic by the federal government. Blue had a surprising ability to ease racial tensions and a relentless devotion to finding the cause of the mounting epidemic. His discovery that the transmission of the plague was caused by common fleas led him to erect an extraordinary mission, eradicating millions of rats in San Francisco and saving countless human lives.
Chase's research is formidable, but her literary talent brings this harrowing episode to life with exacting detail, offering a nervous post-9/11 public some historical perspective on our nation's ability to deal with deadly biological threats.
(Spring 2003 Selection)
Perhaps because of its experience with plague, San Francisco proved different from most cities in the early days of the AIDS epidemic: "When denial or discrimination clouded the country's vision, San Francisco was a model of swift and compassionate care," Chase writes. — Deirdre Donahue
The Los Angeles Times
The plague outbreak and its impact is a big story to tell and, except for some overwriting, Chase tells it with thoroughness and clarity in The Barbary Plague.. — Anthony Day
The Washington Post
It is, then, more a story about human nature than about disease and medicine. Marilyn Chase tries hard to present it as a medical detective story with dire possibilities resting on the outcome, and since she knows her medicine well (she covers it for the Wall Street Journal) she has assembled a fair amount of evidence. But the most interesting and convincing aspects of her tale are those about fear, deceit and denial, and about the handful of purposeful people who managed to overcome these obstacles. — Jonathan Yardley
The New York Times
Chase researched the archives and found family papers still in private hands, allowing her to tell the stories of the public health officials with a lot of new, personal detail. She uncovers the Chinese points of view, especially the individual stories of plague victims, not covered as fully in previous studies. This all makes The Barbary Plague a pleasure to read, full of people, dramatic situations, individual foibles and collective hard work. I closed the book wishing it had been longer. — Judith Walzer Leavitt
In 1900, a ship called the Australia docked in San Francisco, carrying infected rats that launched a plague epidemic in the city, which raged sporadically for five years before it was subdued. Chase, a reporter for the Wall Street Journal, argues in this engaging narrative that social, cultural and psychological issues prevented public health officials from curtailing the outbreak. Relying on published sources, diaries and letters, Chase shows how the disease first hit Chinatown and explains that most San Franciscans denied the outbreak, while others blamed the city's Chinese population (city officials hid behind worries about tourism and the city's reputation). But Chase goes beyond sociological analysis in this lively work and focuses on the players. While the first public health official assigned to stem the epidemic, Joseph Kinyoun, was an innovative scientist, Chase shows how he lacked the strategy and tact necessary for the task-his plan to quarantine Chinatown caused as many problems as it solved. Only when Rupert Blue, a new official, was assigned to the case after a second outbreak five years later, was the epidemic quashed. Avoiding pedantry and tediousness, Chase tells a story that highlights the true nature of epidemics-and how employing a combination of acceptance, perseverance and diplomacy are key to solving them. As she notes in her final pages, the parallels with the AIDS crisis are striking, and the lessons worth salting away for any future epidemics. (Mar.) Copyright 2002 Cahners Business Information.
As San Francisco celebrated the new 20th century, the dread bubonic plague entered its port. This book chronicles its arrival and spread and the protracted battle to eradicate it, led by two very different public health doctors. As with so many epidemics, the efforts of the public health officials were attacked and seriously hampered by those in government and the press who called them alarmists and feared the economic damage publicity could cause. Quarantine officer Joseph Kinyoun first sounded the alarm and battled the early epidemic in Chinatown, but he was unsuccessful, in large part because of his lack of diplomacy. The epidemic became much worse after the great San Francisco earthquake and fire in 1906. The subsequent battle was fought, ultimately successfully, by Dr. Rupert Blue and his associates, but not before the disease had infected native rodents in much of the western United States, where it remains and sickens people today. This account by Wall Street Journal reporter Chase is at once a portrait of early San Francisco, the stories of these two very different doctors, and the chronicle of an epidemic. It should appeal to anyone interested in the history of epidemics or in early San Francisco. [Previewed in Prepub Alert, LJ 11/1/02.]-Marit MacArthur Taylor, Auraria Lib., Denver Copyright 2003 Cahners Business Information.
School Library Journal
Adult/High School-Chase's knowledge of the city and skill for making scientific concepts accessible to educated lay readers make this snapshot of a relatively unknown event vivid and thought provoking. Bubonic plague entered the port of San Francisco with the 20th century. For the next decade, it defied both medical and political efforts to eradicate it from an urban landscape fraught with ethnic distrust, new money, and old customs. The author offers a clear and telling portrait of the roles played by Chinese merchant societies, the white press, and Sacramento officials that initially enabled the disease to gain a foothold. She then turns most of her attention to detailing the scientific and personal strengths and weaknesses of the national public health officials who worked to determine efficient ways to diagnose, treat, and eventually halt the spread of the disease. In addition to finding readers among students already interested in modern medicine, Chase's book is a fine selection for ethnic studies and political science classes. Although the few photos do little to expand the narrative, the thumbnail descriptions of the disparate lives altered, ended, or detoured by San Francisco's experience with rats, fleas, and disease provide concrete images for readers with any imagination.-Francisca Goldsmith, Berkeley Public Library, CA Copyright 2003 Reed Business Information.
Real-life medical thriller providing a slice of history we don't want to repeat. The bubonic plague threatened San Francisco for a decade at the turn of the century. In her debut, Wall Street Journal reporter Chase documents how federal authorities put an end to the epidemic. Public health disasters can only be averted, she learned from her research, if local, state, and federal health agencies work together. When the plague arrived in 1900, racism against Chinese immigrants, its initial victims, kept federal health inspectors from documenting and instituting measures to eradicate the scourge. Then boosters in the Golden State's railroad and agricultural industries stymied federal decontamination efforts, because they didn't want anything to impede California trade. Finally, disputes in Washington agencies bogged down the cleanup. Chase's narrative focuses on two pioneers in American public health, Joseph Kinyon and Rupert Blue, to convey the difficulty of overcoming the public's ignorance about how the plague spread and the importance of education and a good public relations campaign in saving lives. If San Franciscans had listened to self-righteous and rough-edged Kinyon instead of running him out of town on a rail, they would never have needed the brilliant and diplomatic Blue, who saved the city from mass death in the wake of the Great Earthquake, which drove hordes of plague-bearing rats out of their warrens in 1906. Much space is devoted to old-time medicine-rudimentary testing for plague bacteria, transferring blood samples from a human corpse to a guinea pig, inoculating people with serums derived from horses-and sometimes these scenes make for a plodding read. But usually there'ssatisfaction to be found in being lost in Chase's narrative. Blue's meticulous cleanup campaign provides plenty of color as he burns down entire city hospitals and cleans up slaughterhouses teeming with rodents. Armchair historians, San Francisco-philes, and doctors interested in their profession's past will find this particularly gripping.
From the Publisher
A pleasure to read, full of people, dramatic situations, individual foibles and collective hard work...The story, 100 years old, has much to teach us about today.”
—The New York Times Book Review
“An involving medical detective story...richly atmospheric [and] consistently enthralling.”
—San Francisco Chronicle
“Chase, with her elegant, subtle writing, brings alive the human victims, particularly the often-tragic lives of Chinese laborers trying to make a life for themselves.”
“If the folks at Homeland Security read one book this year, let it be Marilyn Chase’s The Barbary Plague, for the way it captures in precise detail how political and business imperatives can impede the battle against a deadly epidemic, in this case the bubonic plague—the fabled Black Death—in old San Francisco. The city’s leaders, even its health department, fought the news of the plague’s arrival more aggressively than the disease itself, despite the deaths of dozens of victims. But Chase’s book is also simply a great story of a long-past time when a few heroic men, armed with only the most basic knowledge of infectious disease, stood up to the powers arrayed against them and, through ingenuity and intuition, at last ran this epidemic to ground.”
—Erik Larson, bestselling author of The Devil in the White City
"Outbreaks of disease can catalyze either courage or cowardice in individuals and society. Chase brings to life a largely forgotten storyin vivid prose and at a pulse-quickening paceof a time when America's character was tested. There is much to learn about how to confront uncertainty from this remarkable tale."
-Jerome Groopman, M.D., author of The Measure of Our Days; Second Opinions; and the forthcoming The Anatomy of Hope (Random House, Spring 2004)
“The Barbary Plague is a thoroughly engrossing tale of mankind’s battle with the most stubborn of foes, infectious disease.... Chase’s vast experience in medical reporting keeps her writing not only accurate but highly entertaining.”
–Dean Edell, M.D., medical TV correspondent for ABC-TV 7, San Francisco, and host of the syndicated radio talk show, The Dr. Dean Edell Show,
“At a time when fear of anthrax and smallpox are very much in the public consciousness, it's interesting to go back and look at an outbreak in this country of perhaps the most frightening and deadly of all scourgesthe bubonic plague. Everything that we imagine today in our worst nightmares happened in San Francisco in the early part of the 20th centurya population in denial or panic, politicians refusing to tell the truth, and the sadly inevitable blame on racial grounds. Yet even during the worst days, men like Dr. Rupert Blue rose to the occasion in the most amazing, humane, and courageous ways. This story of the past gives me great hope for the present.”
-Lisa See, author of On Gold Mountain: The One-Hundred-Year Odyssey of My Chinese-American Family
Read an Excerpt
The Year of the Rat
The new year of 1900 ushered in dangerous times. In San Francisco, it was, as always, a holiday with two faces. Downtown, white celebrants raised their usual end-of-year ruckus. In the streets of Chinatown, a shadow fell over the Lunar New Year, in an ominous prologue to the year ahead.
Rain spattered the boardwalks on New Year’s Eve. When the skies cleared, the merrymakers came out. A band of maskers gathered on the corner of Market and Kearny streets, just below Union Square and Chinatown. Blowing horns and clanging cowbells, they hurled confetti and thrashed passersby with evergreen boughs left over from Christmas. Then the celebration turned ugly. Charging north up Kearny for five blocks, the carousers reached Chinatown and started grabbing Chinese musical instruments from the shops, banging the gongs, and blasting away on the winds. The din was so loud, it pierced the paneled recesses of the nearby men’s clubs. Bystanders cringed to hear the strains of “Auld Lang Syne” mingling with what sounded like the minor wails of a Chinese funeral band.
But funereal sentiments were very much in order in the year 1900. For death was the uninvited guest at this New Year’s feast although, like the maskers, it came in disguise.
In Chinatown, the approach of the Chinese New Year—the turning over of the lunar calendar in February—usually was heralded by the hiss and bang of firecrackers, warding off demons and trailing smoke that pricked the nostrils with excitement. Sidewalk stands traditionally sold stacks of juicy sugarcane and mounds of crackling melon seeds. To perfume the spring banquet tables, people would buy pots of narcissus bulbs, crowned with stiff green shoots and buds that burst into white trumpets with a center of gold that symbolized good fortune. People wearing silk tunics in peacock hues would call on family and friends with gifts and cakes. Children in embroidered skullcaps and jeweled headdresses would parade hand in hand.
All this would happen in a festive Lunar New Year. But not in this year of 1900. Instead of fireworks, gunfire rang through the streets, and the alleys ran with blood. Gang warfare had struck again. As punishment, the San Francisco Police Department cracked down on the whole district, canceling all holiday celebrations. Sidewalks were barren of flowers, parties were banned, and the streets were still.
So the Chinese New Year crept in, as gray and drab as its namesake on the great wheel of the astrological calendar, for 1900 was the Year of the Rat.
According to Chinese astrology, people born in the Year of the Rat are clever and resourceful. Family loving to the point of being clannish, rats are also frugal, sharp-witted, and good companions in adversity.
This year, however, rats were to become harbingers of evil. Merchants awoke to find grizzled pelts of dead vermin in their alleyways and courtyards. Dull-eyed, stiff, shaggy cadavers sent a shudder through the neighborhood.
In the old country, they portended epidemics—in any house where rats had died, human deaths were sure to follow. In 1792, the poet Shih Tao-Nan had written:
The coming of the devil of plague Suddenly makes the lamp dim, Then it is blown out, Leaving man, ghost and corpse in the dark room.
In the old country, households would flee at the sight of a dead rodent. But here, there was nowhere else to go. Discrimination hindered Chinese from living elsewhere in town. Fearing an avalanche of bad luck in the New Year, they filed complaints with the city. As usual, nothing was done. Many people considered rats as the inevitable companions of human settlements, even as natural garbage collectors performing a salutary service. And this was, after all, Chinatown.
March blew in, raw and unsettled. In the late winter mist, a fever stole up from the waterfront. It skulked in on four legs, and invaded the bunks of the working poor who slept layered in dense tenements.
Many kinds of illness, from typhoid to diphtheria, raked the city’s poor. But this disease was different. This was the scourge that for centuries had come in the wake of a rat invasion. When the rats died, the fleas abandoned their corpses, seeking new blood, human blood, in the warrens of the poor. The disease attacked with a violent rush of fever and shuddering chills. A headache seemed to core out the skull. Victims weakened and took to their beds. Penetrating pains raked the back and limbs. Red lumps erupted from the armpits and groin, excruciating to the touch. Hemorrhages would burst beneath the skin, causing black bruises. Senses wandering, the sick would chatter and fidget restlessly, plucking at their bedclothes. Their agitation subsided only as they sank into a coma, ending in death.
Late on the afternoon of Tuesday, March 6, 1900, the phone rang at the police headquarters. A dead man was in the Chinese undertaker’s shop at 814 Clay Street, and the police physician needed to issue a burial certificate. The corpse bore no gross signs of foul play, no bulletholes or knife wounds, but the man had died of a violent disease.
The dead man’s name was Wong Chut King. He was a forty-one-year-old lumber salesman, living the lean life of a bachelor laborer in the Globe Hotel at 1001 Dupont Street on the corner of Jackson. The Globe Hotel, a once fashionable spot turned flophouse, was known as the “Five Stories.” Its cramped cells sheltered hundreds of Chinatown’s workingmen, sharing their life of expansive dreams and narrow bunks in their adopted land.
Now he was middle-aged and sick. When he felt too weak to drag himself to work at the lumberyard, Wong Chut King took to his spartan quarters at the Globe. The gaslight shed a weak gold halo over the bunk where Wong lay, drawing his knees up to cradle a knot of pain that pulsed in his groin. He shifted uneasily on his cot. Local healers offered herbs to ease his aches, ascribed to a cranky middle-aged bladder. A fierce fever made him sweat and shiver by turns. He threw up his last meager meal. He fell into a fiery delirium.
As his fever soared, his mind became unmoored, floating freely in and out of consciousness. Where Wong wandered in his delirium—back to his native village or on to some fever dream of Gold Mountain—only he could see. Perhaps in febrile visions, Wong saw his barren cell pulse with unearthly colors. Perhaps he saw himself as a young man, leaving his village of Pei Hang, in the county of Ling Yup. Crossing the Pacific to Gold Mountain, he discovered a town more gray than gold. Perhaps he saw himself in the sea of Chinatown bachelors, growing old an ocean away from their families, easing their bones by visiting “hundred-men’s-wives” in brothels called “green mansions.”
Now, as Wong sank, the bacteria flourished in his glands and blood. Although it takes few plague bacteria to cause infection, the flea that bit Wong probably injected a lethal dose of fifteen thousand bacteria. Like most victims, he likely would have scratched at the bite, driving the germs deeper. At once they multiplied, spreading from the flea bite on his leg up toward the lymph node in his pelvis. Lymph glands, the sentries of the immune system, struggled to contain the invaders. The lymph node grew swollen, inflamed, and tender to the touch. His fever rose. His tongue turned white and furry, and sores crusted his lips. Eventually the infection spilled over into his bloodstream. Giant germ-eating cells—macrophages—rushed to devour the plague bacteria but were overcome. Some bacteria were killed by antibodies that converged on the scene. But as they died, the bacteria detonated a final weapon—deadly toxins. These poisons ran riot in the blood, vandalizing the tissues of the heart, liver, and spleen. Under this assault, the organs began to hemorrhage and disintegrate. Vessels dilated, and blood pressure plunged. Septic shock set in. Wong Chut King descended into a coma.
Bad luck was believed to visit any house where a tenant died, so Wong’s inert body was hauled from the Globe’s basement and carried to a nearby coffin shop. The sau pan po was literally a shop for selling “long-life boards.” But there, Wong’s life ended. His agonal gasps slowed, their intervals lengthening. His chest contracted. He exhaled his last breath.
When police surgeon F. P. Wilson arrived at the Wing Sang coffin shop, he unwrapped the corpse. His fingers began palpating the contours of Wong’s livid form, where rigor mortis was beginning to set in. His fingers found the swollen lymph glands. Plainly visible on the dead man’s thigh was a small sore, festering where Wong had scratched at some irritation. Perhaps it was an insect bite. The police surgeon sent for city health officer A. P. O’Brien. Together they telephoned a young city bacteriologist named Wilfred Kellogg.
As midnight approached, Wilson, O’Brien, and Kellogg performed a postmortem examination, mining the body for clues. They pierced the lumps and withdrew fluid from the knot of inflamed glands. They extracted blood and straw-colored lymph fluid, with bits of pink pulpy tissue from the body, saving it for analysis. Under the microscope lens, a swarm of bacteria swam into focus—clusters of short, rod-shaped germs with rounded tips that, when stained, turned pink and looked like closed safety pins.
It looked suspiciously like plague.
Plague reports had been trickling out of Hong Kong and Hawaii for some time, putting the city’s health officers on alert for any sudden death from fever. But the city’s bacteriology laboratory needed to confirm these suspicions. A final diagnosis required a senior expert, someone with a more sophisticated lab outfit and time to corrobo- rate the findings. They knew where to find such an expert, at the quarantine station on Angel Island, but city officials didn’t wait for a definitive diagnosis.
Police officers descended on Chinatown in the darkness, stringing ropes around its dozen square blocks. Whites were ushered out of Chinatown, and the Chinese were sealed inside. Panic exploded among the confined. Some raced the length of the barriers, pacing the perimeter, looking for a way out. But police patrolled the barricades, clubs at the ready. Only police and health officers could cross the cordon sanitaire.
Making his evening rounds, a reporter for Chung Sai Yat Po, the Chinatown daily newspaper, saw the siege unfold. He raced back to the newspaper headquarters to prepare his report:
The Caucasian doctor examining the body was shocked to find that the person died of an epidemic illness. That is why they put the quarantine on Chinatown to prevent spreading of the disease. Alas, the epidemic was caused by the imbalance of Qi, the energy of the four seasons. It cannot be spread from person to person. . . . By Friday, it is hoped that we will know that this was not the plague. Otherwise what happened in Honolulu might happen to us.
“Honolulu”—fear clutched the throats of all who whispered the word. Chinatown’s residents knew all about the incineration of Honolulu just a couple of months earlier. As the crowds milled about in increasing alarm, they watched as Wong Chut King’s clothes and bedding were pitched into the street and set alight. Flames crackled and smoke curled up, showering ashes like gray snow. Health officers lugged in sulfur pots and began fumigating the coffin shop. The air smelled of rotten eggs. Wong’s body was wrapped in a linen shroud that had been soaked in an antiseptic solution of bichloride of mercury and sealed in a lead coffin lined with powdery chloride of lime. The coffin was loaded onto a horse cart and driven over cobblestones west of downtown to the Odd Fellows Cemetery. There, the body was given to the flames.
Autopsy and cremation was the fate prescribed by health departments for any victim of an epidemic disease. But cutting and burning of the body violated the Confucian principle of filial piety. Autopsy was considered an affront to the parents of the deceased, who gave him life; and cremation was the final desecration. Such practices left a disembodied spirit in the void. “The ashes will be scattered in the air,” wrote the reporter for the Chinese daily, “and let go to the home of nothingness, the cave of emptiness.”
Chinatown had its own view of what ailed Wong Chut King, and it was certainly not the plague. Elders confided that the lumberman, like many bachelor workers who visited the green mansions—suffered from “notorious gonorrhea,” also known as “poisonous mango-shaped lump.”
In a community of lonely laborers living a continent away from their wives, such ills were as common an occupational hazard as callused hands. Although venereal disease was an unsavory topic, it would not bring down the fiery retribution on the neighborhood that was promised by a diagnosis of plague.
Speculation about the torching of the Globe Hotel reached the ears of its tenants, who fled their bunks and vanished like smoke. But the Globe wasn’t burned to the ground. Instead, the city continued its chemical assault, fumigating and spraying acrid chemicals in hopes of purging the disease. The sanitation had its drawbacks. The smoking pots of sulfur smudged paint, spoiled hangings, and ruined upholstery. In neighboring stores, it would yellow pale silks and silt carvings with gritty smoke residue. Thick, rank clouds blinded residents with tears and sent them choking and sputtering into the streets for air. If the disease didn’t kill them, they guessed the cure surely would.
From the Hardcover edition.