The Coronavirus pandemic of 2020 changed routines and behaviors around the globe. The way we work, play or worship and the daily hum of life was upended almost instantly. Attempts to halt the COVID-19 disease challenged our personal autonomy -- can a government compel citizens to do something they do not wish to do? This new demand gave rise to both protest and compliance.

The Muncie smallpox epidemic of 1893 brought out many of the same attitudes and opinions as felt in the 2020 pandemic. As in 1893 crisis, the year 2020 saw conflicting medical opinions, refusal to obey mandates (or even suggestions), and fear of strangers or "the others."

In 1893, an outbreak of smallpox occurred in Muncie, Indiana which ultimately killed 22 and sickened 150. During the course of the epidemic, conflicting opinions of physicians and slow response by local health authorities did little to slow the spread of the disease. Compounding the problem, many local residents were angered by the imposition of a restrictive ordinance's ban on public gatherings, prohibition of religious services, and a mandate for vaccination. 

In 1876, Muncie experienced a smallpox breakout that killed 5 and sickened 50. The memory of that was on the mind of public health officials when smallpox emerged again in the city.

April 1983

A young woman from New Jersey visits the Dilks family. She infects a child of that family. A second child is also infected but the child's symptoms are so mild that she continues to attend school, although she has a rash.

May 10 The mother of a child of the Murray family who attends Blaine School takes her to see Dr. Ralph Bunch, who diagnoses her as suffering from chickenpox.

May 20 Dr. Bunch visits another child in the Murray home, again diagnosing chickenpox


July 5

A neighbor of the Murrays calls Dr. Bunch to see their daughter, who had convulsions and a temperature of 102. The child does not present a rash until the next day, when her face, neck, and limbs break out.

August 15 Dr. Bunch visits A. N. Shuttleworth's daughter who had a fever of 105 and numerous eruptions over her body.


August 17

Bunch decides there is a contagious disease in the community and notifies the Muncie Health Officer, Dr. Jackson. Bunch still doesn't think it is smallpox. There are now fourteen people suffering from smallpox in six different families.


Discussion questions

Why was there confusion about the diagnosis of the disease?

What were the doctors biases?

Dr. Ralph Bunch was a graduate of the Eclectic Medical Institute of Cincinnati and a member of the Indiana Anti-vaccination Society . 


Smallpox vs. chickenpox is all about location, location, location. 

Chickenpox sores are mostly on the stomach, chest, and back, and rarely on the palms or the soles of feet.

Smallpox sores appear all over the body at the same time (mostly on the face, arms, and legs, and sometimes on the palms and soles).

       Vaccination Needles

                            Vaccination      materials

August 21

Dr. Henry Jamison arrives to examine the patients, confirming that all the patients has smallpox. Jamison meets with the city council and recommends absolute quarantine and creation of a pest hospital for those already infected.


August 22

The council decides not to establish a pest house because many people still believe Dr. Bunch and the doctors who agree with him that there is no smallpox in Muncie. The council wishes to avoid the violence that occurred in Montreal in 1885 when some citizens of that city who opposed vaccination rioted when officials tried to remove smallpox patients and their children from their homes.

"Incident of the Smallpox Epidemic, Montreal" by Robert Harris,  (courtesy New York Public Library).From

September 7

The State Board of Health becomes involved. At the end of August and early September, several more smallpox cases emerge. Sixteen year-old Mary Emma Russell dies and it is clear that the disease is now outside of the original quarantine area.

Travel out of Muncie is limited to vaccinated persons. At the train station, their luggage is fumigated before they can travel. 

During the epidemic, some physicians who oppose the vaccination order write false certificates of vaccination so people can travel out of the area.



Discussion questions

What is the role of government in issues that threaten the public's health?

What points of this historical event intersect with constitutional rights?

September 9-17

The city council gets serious about the situation. Muncie is suffering economically because farmers will not come into town to shop. Councilors agree to  establish a pest hospital. Father Wm. Schmidt of St. Lawrence Catholic Church asks two Sisters of Charity from Fort Wayne to staff the hospital. The nuns are experienced in caring for smallpox cases. They have no doubt that the disease is smallpox.


September 19

 Some residents are vehemently opposed to removal from their homes.

September 22

All Delaware County schoolchildren must produce a certificate of vaccination before being allowed to enter schools when they reopen on October 9.


When the ambulance was sent to the home of a ten year-old boy to remove him to the pest hospital, his father met the drivers at the door with a rifle.



Physicians who belonged to the Indiana Anti-Vaccination Society continued to insist that the disease was not smallpox. They declared that vaccination was useless and possibly dangerous. 

October

As the number of cases begin to decrease, people are weary for the quarantine to be lifted.


In October of 2020, the World Health Organization recognized 'pandemic fatigue' as demotivation for continuing practices and activities recommended to help contain the SARS-CoV-2 epidemic.

November 3

City health Officer Jackson and Father Schmidt go to Indianapolis to appeal that the quarantine be lifted.

November 4

The quarantine order is lifted. Five thousand people go to the streets to celebrate with horns and bells.

November 6

Schools open. No students are admitted without a vaccination certificate. The school board prohibits students with certificates from the non-regular physicians from entering.


Discussion questions

Can you make comparisons between the 1893 Muncie smallpox epidemic and the 2020 SARS-CoV-2 pandemic?

Aftermath

Physicians agreed that vaccination , isolation, and disinfection were the most important aids in stemming the spread of the disease and that at-home quarantine was ineffective--the patient should be placed in the pest hospital and the house disinfected. 

The city suffered economically. One bank closed and businesses were cut off from people living outside the city. Thousands of people were vaccinated, in spite of protests that it was not necessary.

The conflicting opinions of the doctors revealed the deep rift between the different types of physicians and their approach to the epidemic. In 1897, medical licensing was instituted in Indiana. Eventually, medical schools that taught philosophies of medicine outside of the allopathic or "regular" medical practice, would no longer be recognized by medical licensing boards. The requirements to become licensed would ultimately eliminate homeopaths and eclectic physicians from practicing in the state.

Sources:

Jones, Kelly Hacker (2010) "Rebelling against Lawful Authority? The Vaccination Controversy during the Smallpox Epidemic at Muncie, Indiana, 1893," Journal of the Indiana Academy of the Social Sciences: Vol. 14 : Iss. 1 , Article 10.

Eidson, William G. Confusion (1990) "Controversy, and Quarantine: The Muncie Smallpox Epidemic of 1893," Indiana Magazine of History , December 1990, Vol. 86, No. 4.

Kemper, G.W.H (1911) A Medical History of the State of Indiana, American Medical Association Press, 1911.

https://www.who.int/news-room/feature-stories/detail/who-europe-discusses-how-to-deal-with-pandemic-fatigue (accessed 11/27/2020)

https://www.webmd.com/children/vaccines/smallpox-chickenpox-differences#1 (accessed 11/28/2020)

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