Contributed by Cathy_Labath
Description: Physicians Discuss Smallpox for EdificationDate: February 20 1901
Newspaper published in: Davenport
IT WAS CLINICAL
Physicians Discuss Smallpox for Edification
TWO QUARANTINES RAISED
Interesting Session of the Health Officers and How the Doctors Describe the Disease.
That the epidemic now existing in the eastern part of the city is smallpox of a pronounced but not of a malignant type can not any longer be doubted since our physicians have emphatically stated it to be so before the alleged doubting Thomases of the board of health, at the meeting of that body yesterday afternoon. All of the physicians who were present at the session open invitation were agreed upon the existence of the disease in this city as also upon its mildness of form and the general value, efficacy and necessity of
vaccination. Three of them stated that the disease produced a voraciousness of appetite and suggested that rigidity be made the feature in the matter of the enforcement of the quarantine laws. The session of the board was a protracted one. It was called to order by Mayor Heinz at 3:15 o'clock and was adjourned upon motion of Alderman Lindholm at 5 o'clock, after a two and a half hours interesting symposium upon smallpox, chickenpox, vaccination, quarantine laws, citizens' protests and other miscellaneous subjects.
Those Who Were Present
There were present besides the members of the board and the representatives of all of the city papers, the following physicians and citizens:
Dr. A.W. Bowman, Dr. Henry Mathey, Dr. J.P. Crawford, Dr. Custavus Hoepfner, Dr. Fred Lambach, Dr. Benjamin Carmichael, J.W. Ballard, chairman board of supervisors: George Causby, Claus Jipp, Henry Holm and Henry P. Barnholt. Claus Jipp's Request
The first matter which the board considered was the request of Claus Jipp, a contractor, who owns tow houses recently constructed down on West Fifth street, near Pine street. Being compelled to return to his work at once he was given the floor immediately after the meeting was called to order.
Mr. Jipp stated that a sewer was being constructed along West Fifth street, and that since the lots which he owns as also those owned by Mrs. Claus Bischoff (four in number) and by Rudolph Rolfs (three in number) were lower than the street and therefore retains water which seeps into the cellar the parties named be allowed to connect spouts of their houses with the sewer. The necessary permission was granted subject to revocation by the board at any time.
Opinions Sometimes Diverge
Dr. Paul then stated to the board that since honest differences has arisen as to the nature of the disease which the board of health was now quarantining against, he had invited the doctors who had examined the cases and who had originally diagnosed them to be present at the board meeting with the request that they describe the said disease. "Well, let's take them up in order the same as we did at the last meeting," suggested the mayor.
It was so done.
The first case was that of Ernst Bruhn, but as that had already been disposed of by the lifting of the quarantine, no attention was paid to it. The next case was that of Helen Pauli.
Pauli Quarantine Raised.
This case had been diagnosed by Dr. A.W. Bowman. According to the rigid quarantine laws of the state board of health the term of isolation must be 40 days. However, 30 days for such a mild case was deemed sufficient. Seventeen days after recovery, was included with this term, and therefore upon motion of Dr. C.H. Preston, it was voted that the quarantine should be raised on the 24th inst., (next Sunday) This will relieve two watchmen who have been employed, one on at day and the other at night, at a wage of $2.25 per day.
Dr. A.W. Bowman's Statement
Dr. A.W. Bowman was asked to tell about the Pauli case. He stated that he had been called there and found that smallpox oxiated. He knew the symptoms and diagnosed them. The vescular eruptions were there. He at once notified Dr. Preston, and thought by so doing he was notifying the board of health, and had therefore performed his duty. The intelligence of the existence of the disease had thereby reached the board 18 hours sooner that it would have done had he committed a return card to the mails. The doctor had no doubt whatever as to the nature of the disease first diagnosed by him.
The Alma Thuenen Case.
Concerning the next in order, Dr. Preston reported that while Alma Thuenen was progressing nicely, and otherwise would soon be out of quarantine, the discovery of two other more recent cases in that household precluded the present raising of the quarantine.
Dr. J.P. Crawford, the family physician of the Thuenens, had originally diagnosed the case.
When asked to describe the case Dr. Crawford said: "I was called to the Thuenen home and found Alma ill. She had been out of school for several days. She had a high fever, a backache, and other symptoms which might indicate any disease. Two days later I again visited the Thuenen home and then discovered a papular eruption on the forehead and face of the child, which indicated either smallpox or varioloid. "I think I know smallpox when I see it. Nineteen years ago, in 1882, I had the privilege to take care of 30 or 35 cases of smallpox when I was home surgeon at the Mercy hospital. Some four or five of the patients died. I saw them constantly for I was there constantly and visited them through all states of their illness, had noted all from a clinical point of view. I have a right to my opinion as to what smallpox is. " I reluctantly reported the case to the city physician, because I am the family physician of the Thuenens and I would have liked to take care of the case myself. However, the other patients I have, and my duties to them, forbade this."
The Sanford Case.
"Next was the Sanford family. Here were different conditions. I found there only a few papules or eruptive spots, which were only in the vesicular stage. This has a slight similarity to chickenpox. Therefore, I advised the patient to be held as a suspect. I did this because I was not yet certain as to the true character of the disease. "The child was therefore held on parole and in due course of time a marked eruption made its appearance. This was of varioloid. Another Sanford child was also infected.
What Chickenpox is.
"There is a question," continued the doctor, " as to the situation, and we must face it. I have been asked by the gentleman (Alderman Phillips) for the difference between smallpox and chickenpox. In chickenpox there is no pre-eruptive fever. The eruptions are a bleb, or bladder-like, like a blister, all the time. The vesicular stage does not reach the pustular stage as in smallpox. The doctor also stated that varioloid is a mild form of smallpox resultant after vaccination. The symptoms of smallpox were given as a high fever, backache, papular eruptions changing from the vesicular to the pustular stages, and often attended in severe cases by secondary fever and death.
"We have other evidences of the malignity of this disease right here in this city. A deaconess of the Methodist church, a sweet-faced lady, contracted the disease here in Davenport and she will now be pit-marked for life, her sweet-faced beauty converted into deformity. "The strictest measures ought to be taken that this disease which has done this for her should be stamped out of this city. This commends itself to all. Quarantine is a hardship, but this is better than having a scourge in this city.
Reasons for Quarantine.
"Not having deaths every week is no reason for not enforcing the strictest measures to stamp out the disease. It is a fact that it is in mild form. The same might be said of the modified form of the scarlet fever. Several years ago the scarlet fever used to be the most dreaded of all diseases, even more so than diphtheria, which was prevalent among children. Now we are having it in a mild form, but it still possesses the danger of becoming an epidemic.
Doctors Showed No White Feather.
Dr. Crawford took exception to the statement that after the doctors had diagnosed a case as one of smallpox they skipped by the light of the moon." He said emphatically that the physicians have not shown the white feather. They have done their duty and it remained the duty of the board of health to do the rest. "There are ten to twelve cases of smallpox in the city today.," said he, " and if each case had its attending family physician there would be all the more danger of spreading the disease. If each of these physicians had 15 families which he attended, just think of the possibility of infection. By the very supposition that the family doctor should take care of each of the cases diagnosed by him, the spirit of the quarantine law is violated. The disease should be treated and attended to by one doctor and not by many. This one physician should be one who relinquishes his practice for the time being for a remuneration." Dr. Crawford made a statement in his own behalf wherein he said that when he found smallpox existed in the Thuenen and Sanford families he promptly vaccinated all of the members of those families, procured medicines himself for them and with their full and free consent turned them over to the city physician and supposed, and had reason to suppose, that the patients would then be taken proper care of by some physician appointed to or retained by the board.
What Dr. Cantwell Did
Dr. Crawford paid a tribute to the late Dr. A.W.C. Cantwell, the late eminent physician of the board of health. He said that during the epidemic of 1882 Dr. Cantwell gave up his regular practice for a part of two months, and devoted himself entirely to the care of the numerous smallpox patients at that time. he was ostracized by his regular patients. He presented a bill for something like $600 or $800 and it was paid. "The citizens of Davenport," concluded the doctor," and public sentiment is in favor of a strict quarantine. Our schools demand it. Our commercial and business and social interests also demand it. We should not advertise Davenport as the abode of continual smallpox pestilence."
"Don't Let Down the Bars."
The doctor suggested that those who had been quarantined had been encouraged from some sources to protest. He insisted that the board of health standing by the quarantine. Dr. Palmer and other diagnosticians might say this is not smallpox, but he could absolutely say that it was. Henry Thuenen, city attorney (interrupting), "Doctor, don't you think that the quarantine is satisfactory?" The doctor replied that it was "Keep up the bars" said he, "Let the taxpayers come up and assist these poor people who are quarantined. They will be in favor of paying these expenses if a scourge is saved the city. Be loyal to the situation." Dr. Matthey's Experience. Dr. Henry Matthey, a member of the Iowa state board of health and a local physician of much knowledge and experience, was called upon. He spoke for several minutes and furnished much interesting data concerning the late epidemic in Muscatine. He stated that in his official capacity as a member of the state board of health he had visited many cities and investigated many cases of smallpox. Notably he had visited at Muscatine last year on Feb. 20 (one year ago today) and diagnosed the cases he met with there as genuine smallpox. The mayor of Muscatine, himself a physician, opposed the diagnosis. The doctor had gone over the city with Dr. Schmidt of the Muscatine board of health and found very severe cases which without the least possibility of doubt were those of the genuine article. Both he and Dr. Schmidt then made an effort to get the newspapers of Muscatine to suppress ridicule of the matter and to warn the people of the peril. For five months, the mayor, the board of health, and the newspapers made a joke of it. There were 400 cases and that was no laughing matter. Finally the board of health took decisive action and the disease was soon stamped out. But it cost Muscatine county a pile of money. The doctor did not care to see Scott county or Davenport, go through the same experience. For himself, he would not look after a smallpox patient less than $25 a visit. He stated, however, that he had not yet been called by Doctor Preston to observe any of the cases existing here at the present time. His charges evidently had been considered too high. City Attorney Thuenen asked Dr. Matthey if he thought that even in a mild case of smallpox such as exist here, it would be advisable to leave the patients without an attending physician. Dr. Matthey replied that it was very bad to do so. The Mayor's Remarks.
When Dr. Matthey had replied to Mr. Thuenen's question, Mayor Heinz stated that without a doubt whether the prevailing disease was smallpox or chickenpox, the question remained as to what should be done with the poor people, who were infected, and whose houses were quarantined. He was satisfied that the sufferers ought to have all of the necessary medical attention, and therefore he had prepared the following resolution which he thought embodied the opinions of the doctors on the subject and he submitted the same to the board as follows
The Text of the Resolution
"Whereas it appears to be a fact that it is not the duty of the city physician to attend to persons who are sick and quarantined, as a physician, and, "Whereas, it appears to be a fact that no physician is legally bound to treat professionally or personally any person who is sick or quarantined and as we believe that all persons who are quarantined should have all necessary medical attendance therefore be it "Resolved that a committee of two be prepared to find out whether some competent physician can not be employed by this board whose duty it will be ????????? to all sick people who are quarantined and who are ?????? own means to procure the proper medical attention."
Upon motion of Dr. Preston the resolution was adopted.
Aldermen Phillips and Lindholm were nominated as that committee and they were directed to enter into a contract and to report the same at the next regular meeting of the board of health which will be held on March 5.
The Supervisors' Statement
J.W. Ballard chairman of the board of supervisors was present and he was asked to make a statement. He said that the board of supervisors depended upon the board of health doing its own duty. He thought that all dangers of an epidemic ought to be diminished and suggested that no half way measures should be taken. He stated that Dr. Preston and Hon. W.C. Hayward, of the school board, had appeared before the supervisors at the recent session and asked that it order general vaccination of the school children or second the efforts of the school board in that direction. This, he said, the board could not do because it was solely and simply within the province of the board of health, acting under the sate board regulations. The chairman of the board of supervisors, however, stated that the county would agree to pay for the vaccination of all those who desired to be innoculated and who were unable by reason of poverty to pay the fee.
Hoy! Prussia Made a Test
Dr. Henry Matthey then had some thing to say upon the subject of vaccination, which Mr. Ballard had called up by his remarks. The doctor stated that the Prussian government had strong laws regarding vaccination which dated from the '50s. There was an epidemic of smallpox at the time and vaccination was broached as a preventive. The government decided to make a heroic test. This was done in a fort where two regiments were quartered. One of the regiments was ordered to be vaccinated. The epidemic spread to the two regiments. In the one innoculated only two members became ill with smallpox and none died. In the other regiment all were taken down with the disease and 55 per cent of the cases were fatal. This he said was the reason why the Prussian government took such rigid measures regarding vaccination. Now a certificate of vaccination in that country immediately follows the birth certificate.
What Salt Lake City Shows
Salt Lake City, Utah, according to Dr. C.H. Preston, is much like Davenport. Not in the fact that she harbors Mormons but rather in the fact that she has smallpox. Salt Lake City, so says the recent issue of the Medical News, in the last three months had 334 cases of smallpox out of which number only seven patients had been vaccinated within the last twenty years. In Davenport, by comparison, he found 26 cases in the last six months with only two patients out of the 26 who had been vaccinated.
Vaccination for 25 Cents.
The doctor thought that school No. 1 should not be the only school looked after in the matter of vaccination. Hence he desired to report to the board that he had secured the agreement of the Drs. Stiles, Peck, Sala, Rodgers and Decker to vaccinate the school children all over the city for 25 cents apiece, the usual charge being $1, although 50 cents was charged in
times when epidemic existed. The doctor listed 753 vaccinations made by the five doctors at 25 cents each, all paid for and performed principally at schools Nos. 1 and 13 in East Davenport, where the infection was most likely, if at all, to spread. The doctor also stated that he himself had vaccinated 210 persons for which he had not yet received a penny and for which he intended to submit a moderate bill, although he thought it was for the board of supervisors to pay the same upon order of the board of health "O.K"ing of the same.
Dr. Hoepfner's Statement.
Dr. Hoepfner, who was called into the George Thuenen family after Mildred and the hired girl had been infected, was the next physician to make a statement. He said that he agreed with his colleagues as to the identity of the disease. He had ordered ventilation of the rooms of the Thuenen home and left disinfectants there. He said that one of the children, Mildred, had three vesicles or papules and that a child 2 years old and a babe 9 months old were uninfected. The hired girl had the varioloid. He agreed with Dr. Preston's diagnosis.
Dr. Preston then asked that the board authorize him to have 1,000 blank vaccination certificates printed for distribution among the physicians whereon the medical fraternity members might place the name, day and date of the party and the innocula. The doctor was authorized upon a motion to have 2,000 instead of 1,000 of the blanks printed. This action was taken in order to secure uniformity in the text of the certificate.
Virus is Innocuous
Dr. Gustavus Hoepfner asked to say a few words about vaccination. He was granted the permission. The doctor stated that the virus or lymph which was now used was innocuous. It was no longer secured from cows which might be infected with tuberculosis, but from especially bred calves which do not become infected with that disease. There is no longer the arm-to-arm vaccination used or what is known as the human virus innoculation in vogue sometime ago. Hence, in vaccination there is absolutely no danger as to the contracting of syphilis or tuberculosis in the operation which he stated was a sure and safe preventative of the smallpox.
The Causby Case Next.
The next case considered was that of George Causby, Jr., who resides on East Locust street. Dr. Braunlich had attended the case but that physician was not present at the meeting of the board. Dr. Preston thought that the quarantine established there might be raised on the 24th inst. (next Sunday). A night watchman had been dispensed with there at the last regular meeting of the board. Upon motion it was decided that the aforesaid quarantine be raised on the date mentioned. Mr. Causby's Statement. Mr. Causby, the father of the quarantined lad, was present at the meeting. He asked permission to address the board and it was granted. He prefaced his remarks by asking Dr. Crawford if smallpox was always preceded by a fever. "Always!" replied the physician. "That's all I want to know," said Mr. Causby. "Those who know me know
that I am a law abiding citizen. I know that Dr. Preston is a thorough gentleman. But doctors even make some mistakes. I honestly believe that my boy has not got the smallpox, because simply my boy has never been sick. He is the healthiest looking patient in the city. He never had a fever. The whole trouble is the boy was constipated and had a very bad cold and his mother gave him the old-fashioned remedy, sassafras tea and a hot foot-bath. The next day he had eruptions. "My boy simply has the chickenpox and under the circumstances I think I have been harshly treated. "I've seen the real article in Old England when it was rampant there. I tell you, gentlemen, it is one of the most loathsome of diseases.
Fever Hard to Discover
Dr. J.P. Crawford, when Mr. Causby had concluded, arose and stated that it was difficult to detect fever without the physician's thermometer which is always carried by practitioners. He said that not even a physician could tell without the instrument and a variation of three degrees from the normal temperatures and this could only then be discovered by a morning and evening test. The doctor stated that we have today typhoid fever in the "walking" form, wherein the patient does not even have to take to bed, but it is typhoid fever just the same. Varioloid is a smallpox which does not reach the pustular stage. It is papular and vesicular, but not pustular and hence the distinction in the names. When the eruption is in a confluent form a secondary fever is apt to result which makes the disease grievous and dangerous.
A Big Appetite
Dr. Crawford, Dr. Lambach and Dr. Matthey stated that smallpox patients who are suffering from a mild form of the disease are usually of a voracious appetite much similar to the "hard coal stove" appetite alluded to in a recent article contributed to the evening paper. This stirred up Dr. B.F. Carmichael who had diagnosed the case of Frank A Logan who is now quarantined at the Hitchcock home on East Fourteenth street. He said that the "hard coal stove appetite" article had compromised him. He defied any one to say that the Logan case was not a genuine one of smallpox. He registered his protest most emphatically. Clerk Smith, however, had a letter on hand from the author of the published open letter in which apologies were made to the board for the "harshness" of the criticism contained in the published communication. Upon suggestion of the mayor this effusion was not read. Dr. Lambach stated that he had diagnosed both of the Ward cases as being smallpox and that his diagnosis was correct. The typical eruptions were in evidence.
These Cases Yet Quarantined.
The following quarantines are still in force by reason of other outbreaks of the disease in the place or by the recentness of the discovery: Wietz case a recent development, the quarantine obtained. Iles case, another case having developed, quarantine still obtaining. Bennet case, a recent development. Ward cases, recently developed. Cook case, recent development, still under quarantine. Logan case, recently developed, must obtain until March 13. Second Thuenen cases (2) only recently developed. Upon motion it was ordered that the quarantine rules obtain in all of the above cases until next regular meeting of the board of health which will convene on March 5. The city clerk then presented the following payroll of the smallpox or
quarantine guards from Feb. 1 to Feb. 18, inclusive, which was approved and recommended to the board of supervisors for payment. The pay roll involves over $170.
Henry Gardner, 18 days, $40.50.
Hans Jochim, 18 days, $40.50.
Jud Irish, 18 days, $40.50.
Chas. Carstens, 13 days, $29.25
Max Roege, 5 days, $11.25
Fred Schultz, 18 days, $40.50
Frank Connell, 18 days, $40.50
Joseph Cummings, 13 days, $29.25
Henry Ramm, 18 days, $40.50
Peter Vogt, 18 days, $40.50
Peter Brehmer, 12 days, $27
A.D. Fien, 7 days, $15.75
J. Vonder Geest, 6 days, $13.50
John Dwingle, 7 days, $15.75
Oliver Evans, 6 days, $13.50
Robert Oakes, 5 days, $11.25
Detlef Hafel, 1 day, $2.25
The total amount of the payroll is $172.25