Plague, Fear, and Politics in San Francisco’s Chinatown by Guenter B. Risse (review)

The author, a well-known historian of medicine long resident in San Francisco, has impeccable credentials to tackle one of the most complex and tortured episodes in the history of American public health. He does not disappoint. This book provides a clear path to understanding the biological, social, and cultural story of how Northern California bungled its handling of the bubonic plague epidemic of 1900–1904, and was fortunate to come away with a death toll officially recorded as 119, instead of the many hundreds, and even thousands, who succumbed in other urban settings during the third plague pandemic of the late nineteenth and early twentieth centuries. Using rich documentation from public archives, newspapers, and memoirs, which a number of secondary authorities have also consulted, the book also carefully examines Chinese sources, which have been little used to now, to provide a rich analysis of how the Chinese community of San Francisco responded to the scourge they faced.

This is a tale of antagonisms and shifting alliances, pitting public health officials, politicians, business, labor, and newspapers against each other. It is marked by strong prejudice and racism that dominated relations between white Californians and what they saw as Oriental inferiors, whose presence was necessary perhaps for economic reasons, but who posed a constant health threat because of their “filthy habits.” But it is the strength of this book to go beyond this reductionist formulation and document the shifting alliances among the Chinese on the one hand and the whites on the other. In San Francisco, Chinese merchants and diplomats representing the decadent imperial government of the Qing were contemptuous of poor Guangdong peasant laborers, and of Christian Chinese clergy and journalists; among the white majority, clashes between Democrats and Republicans at the municipal, state, and federal levels, competition among populist newspapers for readers, captains of industry fearful of how the plague would cost San Francisco and California its reputation, disputes between bacteriologists who tended to see the plague epidemic as a significant national threat, and physicians wedded to pregerm theory approaches, all were in play.

The story certainly has its villains and heroes. Joseph Kinyoun headed up the U.S. Public Health campaign in San Francisco in 1900, and he quickly was labeled “the wolf doctor” in the Chinese press for his anti-Chinese bias in administering plague measures. He narrowly avoided a criminal conviction for his arbitrary actions and was removed from office, and his reputation ruined by his political, not scientific, blunders. On the other hand, the federal officer in charge of plague control in San Francisco after 1904 was Rupert Blue, whose tact and diplomacy won him public cooperation for health control and helped him reach the top of the federal public health heap when he became surgeon-general in 1912.

Among the Chinese, their willingness to use the courts to fend off arbitrary Board of Health actions, which were ruled illegal under the protection of the Fourteenth Amendment, showed patience and confidence in the rule of law in their adopted country. Also impressive was the resolve of Chinese Americans like the clergyman Ng Poon Chow, who ran the daily newspaper Chung Sai Yat Po (Chinese Western Daily) to keep his community informed of daily events pertinent to the epidemic.

Risse recognizes that the withdrawal of plague after 1904 was a Pyrrhic victory for health authorities, owing more to ecology than their often maladroit intervention. Environmental conditions spared many San Franciscans because the dominant rat flea there was a less efficient vector of bubonic plague, and the relative dryness and lower humidity of flea breeding during early epidemic years kept transmission low.

Risse concludes his study on a note that holds for all studies of public health interventions in emergency situations. Successful campaigns require the cooperation of a public educated to the health dangers. Public health officials must avoid top-down decrees, scapegoating, prejudice, and...