Howell County's Smallpox Epidemic 1899

As the 19th century came to a close, smallpox remained a scourge and one of the most successful viruses known to humanity. Smallpox controlled the population of Europe in regular epidemics that killed millions each year. Upon the arrival of Europeans in the new world, the disease they carried with them decimated native peoples on the American continent who had no natural immunity. Doctor Edward Jenner first developed a vaccination in 1796 that involved scoring or piercing the skin of the upper arm with a sharp instrument, and then dabbing the wound with live virus. 
Vaccination wasn't much further advanced in 1899 when a five-year epidemic started in the Midwest. The vaccine was then made from oozing cowpox sores from the underbelly of calves. The availability of affordable travel via the railroads contributed to the spread of the disease. 
Any case discovered in a community raised a lot of concern, and on January 27, 1899, the West Plains Journal Gazette reported to its readers, "West Plains has good reason for a smallpox scare. Right next to us, in Fulton County (Arkansas) and in Baxter county, are reported cases concerning which there can be no question. As to whether it is epidemic or not, we have not learned. However, we had better keep our eyes on that direction and, if it comes nearer, quarantine against them. Vaccination is also in order."
Sound familiar? The reaction here and across the nation was much like what we are seeing today in response to Covid-19. Some refused vaccination, quarantine, or any governmental efforts requiring mandatory action. This article is not an article to lead the reader in any direction in response to today's situation, but a historical accounting of what happened here in Howell County at the turn of the century.
In the same January 27th issue of the Gazette was printed a proclamation of the West Plains Board of Alderman and Mayor Richard Ramsey who issued a quarantine against Salem, Arkansas, prohibiting anyone living in town or vicinity from entering the city limits of West Plains. 
A quarantine against Mammoth Spring followed on February 3rd. It included a directive to the Kansas City, Fort Scott, and Memphis Railroad "Not to transport, carry or ship from said town of Mammoth Spring and vicinity any persons or passengers or any goods, chattels or merchandise of any description or character." The proclamation stipulated the city marshal and "as many assistants as may be necessary" to enforce the order's provisions that carried a misdemeanor charge and fine of not less than a dollar, or more than one hundred dollars.
Also, on February 3rd, the editor of the West Plains Journal Gazette, to reduce panic, told his readers, "No one on earth is more afraid of smallpox than the editor of the Gazette. We are watching this matter every hour that we are awake and dream of it while sleeping, so we can truthfully say to the public at large you need have no fears of this disease being upon you without first being warned. We have taken it upon ourselves to act as a semi-official mayor, board of aldermen and marshal, and no blind horse in a briar patch ever stepped higher than we are now, watching every corner. We say to our readers and the public in general, do not listen to wild reports. Do not become alarmed. Do not give credence to any report of an alarming character until you know it is true. The Gazette will not mislead. We do not wish anyone in West Plains or out of it to be exposed to the smallpox. Should it ever get here (which we think is impossible owing to the strict quarantine now in force), we will be candid with you and let you know. Until we 'holler' don't you get scared--we will yell quick enough."
Another article in the same paper reported that twenty-four-hour guards had been posted on the Thomasville, Mountain Home, and Salem wagon roads, and the West Plains City Marshal was watching every train, "so it is impossible for anyone to enter West Plains from the infected district." The Arkansas towns involved immediately suffered economic loss, as did cross-border trade in farming and commerce.
I checked the records to see if smallpox made a confirmed appearance in West Plains resulting in death during the remainder of the year. None of the papers reported a case. The Missouri legislature mandated death records in 1883, and the state printed forms for doctors to use. However, the legislature made no provisions for collecting and preserving those records and, in 1893, repealed the law. There are no death records available for Howell County in 1899, but I think it unlikely anyone died of smallpox here.
Howell County's best-known physician weighed in on the matter in a letter to the editor in the Gazette in late November 1899. Dr. J.C.B. Dixon was the first doctor in the area after the Civil War, practicing here since 1866. He wrote, "In consequence of the great excitement in regard to smallpox, I wish to give my experience in the dread disease. I have practiced in that disease more or less for forty years and am convinced that it can only be communicated by the virus coming in contact with the skin and not from breathing it as in measles or scarlet fever or many other diseases." 
"Chickenpox is often mistaken for smallpox, but it is quite easy to discriminate. In chickenpox, the skin between the pustules is of a normal color, while in smallpox, the cuticle or skin is rather red and shows inflammation. The roof of the mouth and the tongue in chickenpox are clear of pustules and not unusually red, like in smallpox, and fever in chickenpox is not generally very high and of short duration, while in smallpox, the temperature often runs up to 106 degrees and is often attended with delirium, also with bounding pulse, and very frequently to 125. I contend that smallpox cannot be taken from the patient when there is much fever, as 100 degrees Fahrenheit will destroy the virus of the disease. The best thing which can be done for a small town is to provide a suitable house, which is isolated as a pest house, and send all suspects to it, to be nursed by immunes."
The venerable doctor continued, "The physician should be selected who is an immune and no other, as it is often communicated through the dry virus falling on the skin of persons while perspiring, which is most sure to be absorbed and the system infected. The most dangerous time to take smallpox is when the patient dies, or seems to be about well. I assure you from my experience you cannot breathe smallpox like measles or whooping cough, so don't get excited, but go ahead with your business. But bear in mind to vaccinate all persons who have never been properly vaccinated. The above hasty remarks are free to the public. All papers, please copy, if you like the advice. I shall not suggest any treatment but get a good physician to attend the case."
Doctor Dixon had also weighed in publicly earlier with a letter to the editor dated November 11, addressed to the "Honorable Mayor of West Plains." He wrote, "I have made a thorough examination of Sheriff N. Thomas at his residence as per your order and find that he has yellow jaundice and is under the treatment of Dr. Martin of this city. The sheriff is clear of fever and has no symptoms of smallpox at this time. He has been in bad health for ten or twelve days past and is very bilious. Your humble servant, J.C.B. Dixon, M.D., City Physician of West Plains."
During 1899 Springfield did experience confirmed smallpox cases ending in death. As a result, a "pest house" was established in the northwest part of town staffed by the Sisters of Mercy (started St. John's Hospital), who volunteered to live there and bury some of the victims. There are believed to be around forty victims buried just north of the camp location. The Springfield African American community was hit hardest and suffered heightened discrimination during the pandemic.
By November 27, 1899, there was some question about the epidemic's identity. In an article entitled "The Strange Epidemic," the Gazette reported, "The epidemic prevailing in some of the towns of South Missouri, commonly known as smallpox, but denied as such by some, seems to be rapidly spreading over the country. All the Southwest Missouri towns have had a siege, Kansas towns are fighting it, and Arkansas and Texas are well up in the procession. Strange to say, few fatalities have resulted. The disease seems to be in a very mild form, and this fact has caused the discussion concerning the true diagnosis. Springfield has the epidemic well in hand, has reopened their schools, and is discharging the pest house patients. Willow Springs, our near neighbor, has a few cases which she has isolated and over which she is maintaining a strict guard."
West Plains experienced an alarming uptick in cases during December 1899. The Gazette agreed with the course of action taken by city officials in a tribute of "Honor to Our Officials," in the December 22nd issue of the paper: "The Gazette wishes to commend to our fellow citizens the efficient manner in which Mayor Ramsey and Marshall Pumphrey are prosecuting the fight against smallpox. It would probably have been wiser had the fight commenced earlier, but since it has commenced, the work has been thoroughly done. The bums have been sent out of town, all public gatherings postponed, and thorough fumigation of infected premises is now in progress. If the citizens will unite in their assistance to the officials, the time will be short when we shall be entirely rid of this epidemic. The number of cases are few, and the disease of a very mild form, but we want it entirely stamped out and that right quick. Support the officials in this work, and don't go around with a chip on your shoulder."
The situation seriously dampened the Christmas holidays, and rumors abounded. The Gazette reported "The Real Situation" in an article dated December 29. It noted that not more than twenty cases could be found in West Plains, and none were serious. They declared that "In the business section of this city, no danger exists. We have heard of no exposure, which resulted from an attendance upon business duties. As before stated, all cases are isolated, and a strict quarantine maintained so that no real danger is presented to the visitor who has business with our merchants. Keep out of the homes where the yellow flag is shown, and you are in no danger."
It was a bit late, but the Gazette of December 29 also reported that at a West Plains City Council meeting, "Dr. A.H.Thornburgh was appointed smallpox physician and will have charge of all patients. All other physicians will turn their smallpox patients over to his care. This is done because of the fear of some lest physicians might carry the disease. An extra supply of quarantine officers was sworn in and will assist the old officers to enforce the regulations." 
In the new year and first days of a new century, Doctor J.C.B. Dixon took up his pen and wrote the editor of the West Plains Daily Gazette on January 5, 1900, "I wish to state that there has not been a single death from smallpox or any other eruptive disease for the past year to the best of my knowledge, and I am willing to be sworn to this statement."
On January 5, 1900, The Journal Gazette also reported that the epidemic was under control, stating, "The total number of cases now know and under suspicion aggregates sixty-four. The city physician reports all to be getting along finely, no serious complications having, as yet, presented itself."
The scare continued to wind down during the first month of 1900, and for Howell County, the epidemic seemed to be over. In other parts of the midwest, a mild form of smallpox popped up in various communities and was controlled. In January 1901, the Missouri legislature enacted a bill "providing that the judges of each county court, together with a reputable physician to be appointed by them, shall constitute a county board of health. The board is given the same powers to establish quarantines and take measures to prevent the spread of contagious diseases in the limits of the county as well as are exercised by the state board of health, except that it cannot raise a quarantine established by the state board."
Many of us of the older persuasion can remember receiving a smallpox vaccination mandated if we were to attend public school. The whelp that was raised and the resultant scar on our upper arm was our "vaccination passport." In 1972 smallpox had been eradicated in the United States to a point that vaccination was discontinued.
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