Plague in San Francisco: An Essay Review

Marilyn Chase.The Barbary Plague: The Black Death in Victorian San Francisco. New York, Random House, 2003. 277 pp., illus. $25.95. Nayan Shah. Contagious Divides: Epidemics and Race in San Francisco's Chinatown. Berkeley, University of California Press, 2001. xiv, 334 pp., illus. $19.95.

[Rieux] knew what those jubilant crowds did not know but could have learned from books: that the plague bacillus never dies or disappears for good; that it can lie dormant for years and years in furniture and linen-chests; that it bides its time in bedrooms, cellars, trunks, and bookshelves; and that perhaps the day would come when, for the bane and the enlightening of men, it would rouse up its rats again and send them forth to die in a happy city.

Albert Camus, The Plague

Thus ends Albert Camus's The Plague. Though an allegorical tale meant as political instruction, the novel conveys Rieux's sense of foreboding in a way that matters to medical history, too.

Some historians have been eager to apply presumed lessons from the past to the infectious outbreak du jour. As the SARS epidemic was playing out in early 2003, Iris Chang, author of The Chinese in America: A Narrative History,¹ wrote of its explicit connection with "the most severe example of medical panic transforming itself into racial prejudice"—the bubonic plague outbreaks in Honolulu in 1899 and in San Francisco the following year. "Suspicion of Chinese-Americans has waxed and waned over the twentieth century, but it has never completely gone away ... [Amajor university's travel] ban on Asians isn't protection against the [SARS] virus—it is simply discrimination under a different name."²

A bald recitation of the 1900 bubonic plague outbreak in San Francisco certainly has a contemporary ring: A communicable disease seems to originate in southern China, then crosses the Pacific to North America on the fastest transport of the day. Health officials in North America see it coming but think they can prevent its taking hold here. Immigrant communities are identified as the locus of infection. Political leaders in a major city object to travel advisories and quarantine as overreacting and bad for business. Public health measures and travel restrictions focus on Asians.

Of course, such a decontextualized description of an international disease's spread fits any number of "silent travelers"³ (the reader is free to choose her favorite), but it certainly applies to the bubonic plague outbreaks in San Francisco a century ago.

Bubonic plague came late to the United States, the outbreaks in question being the very first. In the early 1890s, the plague began spreading from a historic "reservoir" in southwest China, first to cities along China's coast, then along maritime trade routes emanating from Hong Kong and Canton. Given its fearsome association with the Black Death of late medieval Europe (more on this anon), news of its arrival in a given locality was of the gravest concern. When plague cases were definitively documented in Honolulu in 1899, the local authorities reacted by burning the houses of plague victims—who happened to be Chinese. The fire escaped their control and burned all of Chinatown.

Several months later, the plague arrived in San Francisco. Again the initial victims were Chinese. Again the health authorities reacted aggressively, attempting to isolate all the Chinese residents of Chinatown. This last distinction is important because application of the quarantine to Chinatown was clearly race-based, exempting the many whites who had business there. Local authorities' public denial of the existence of plague did not prevent them from pinpointing Chinatown as the focus of antiplague efforts.

This episode marked the first of what were really two eruptions of plague. The first, between 1900 and 1905, centered on Chinatown, both as the home of its victims and as the district where the remedies were applied. A second, distinct phase followed the 1906...