The 1902 Smallpox Epidenic

A Deadly Disease Hits Knightstown

The disease known as Smallpox came to Knightstown in June of 1902 and caused widespread fear and near panic throughout the citizenry. Smallpox is caused by variola virus is believed to have originated over 3,000 years ago in India or Egypt and is one of the most devastating diseases known to humanity. For centuries, repeated epidemics swept across continents, decimating populations and changing the course of history.
In some ancient cultures, smallpox was such a major killer of infants that custom forbade the naming of a newborn until the infant had caught the disease and proved it would survive.
Smallpox killed Queen Mary II of England, Emperor Joseph I of Austria, King Luis I of Spain, Tsar Peter II of Russia, Queen Ulrika Elenora of Sweden, and King Louis XV of France.
The disease, for which no effective treatment was ever developed, killed as many as 30% of those infected. Between 65–80% of survivors were marked with deep pitted scars (pockmarks), most prominent on the face. Blindness was another complication. In 18th century Europe, a third of all reported cases of blindness was due to smallpox. In a survey conducted in Viet Nam in 1898, 95% of adolescent children were pockmarked and nine-tenths of all blindness was ascribed to smallpox.
As late as the 18th century, smallpox killed every 10th child born in Sweden and France. During the same century, every 7th child born in Russia died from smallpox.
If a person was exposed to the virola virus, after an incubation period of about two weeks a sudden onset of flu-like signs and symptoms would occur. These would include: Fever, Overall discomfort, Headache, Severe fatigue, Severe back pain,Sometimes vomiting, diarrhea or both. A few days later, flat, red spots would appear first on the face, hands and forearms, and later on the trunk. Within a day or two, many of these lesions would turn into small blisters filled with clear fluid, which then turn into pus. Scabs would begin to form eight to nine days later and eventually fall off, leaving deep, pitted scars.
The rash would usually be most noticeable on the palms of the hands and the soles of the feet. Lesions would also develop in the mucous membranes of the nose and mouth and quickly turn into sores that break open, spreading the virus into the saliva.

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These pictures aren’t easy to look at but illustrate how really horrible the disease was.

It was a thoroughly nasty and horrible disease and the people of Knightstown were justified in their fear. The Smallpox Epidenic that hit Knightstown in 1902 was indeed pretty serious. I copied an article from the Indiana Journal of Medicine about it which follows:

The June-July Knightstown Epidemic of
Small-pox; 85 Cases and 15 percent, of Death.

Knightstown, Henry county, 34 miles east of Indianapolis, is a town of over 1,000 people, situated on the Pennsylvania Railroad and the present terminus of the Indianapolis and Greenfield Interurban road.
It has a perfect natural system of drainage, good water and has not had a case of typhoid fever in five years. The town has been singularly free from scarlatina, measles, whooping cough and diphtheria as testified by all the physicians. Its physicians are Drs. Olin E. Holloway, Omar H. Barrett, John B. Cress, F. J. Drake, 0. F. Fleenor, Wm. McGauran and L. V. Winston, men of high professional attainments and possessing the confidence of the community.

All of the physicians are advocates of vaccination and stand ready at all times to vaccinate the new-born, the child of 6 years entering the public schools, and any and all citizens who have not been vaccinated since smallpox began to spread over the United States four years ago. But the exceptional mildness of this epidemic, unparalleled in the history of smallpox, destroying less than a score of persons in four years among thousands of cases affected in Indiana, led the people to believe that it was not worth while to vaccinate, and that the people had better take their small chance of mild smallpox rather than the inconvenience of vaccination. The attitude of this community was not different from that of hundreds of other communities in the State of Indiana and throughout the United States, and they are not to be condemned or criticized over others.
But now all is changed. The people are ardent advocates of vaccination and there is not probably an unvaccinated person in Knightstown or in its adjacent farm-houses, hamlets and villages. And this simply because what has been feared since the mild smallpox became prevalent in Indiana four years ago has transpired. A virulent type of the disease was brought into Knightstown from the East or the South, where it has prevailed in both the mild and severe form, and the result was that from June 2 to July 20, there were 85 cases of smallpox with 13 deaths, or a mortality of over 15 per cent., which is about the mortality in New York City last year.

The first case was in the person of Jesse Swain, a young man of 24 years of age, who had worked in Ohio towns just preceding his coming to Knightstown, and who was seen by Dr. Chas. E. Ferguson of Indianapolis, to confirm a diagnosis of probable smallpox in an unvaccinated person, which at first simulated measles.
The case was confluent and died in a week. About June 18 to June 24, some 30 cases developed. These were scattered all over the town regardless of age, sex, locality, social state or wealth of the individuals, for smallpox is no respecter of persons unless they are thoroughly vaccinated. Stringent measures were at once taken by the efficient health officers of the town, Drs. Barret, Holloway, the town board and citizens. The Secretary of the State Board of Health, Dr. Hufty, had been to the town in March to look after stream pollution and at that time predicted to the Town Board that smallpox would visit that town as it had visited other localities—that the town could only escape the disease by general vaccination, a prediction that can safely be made of any town in Indiana where smallpox has not yet appeared.
Dr. Hurty’s next visit was not of his own motive or desire; he was sent for and was badly wanted and worse needed. Not only the Town Board and the Health Board were present, but the hall was crowded with citizens.

Nothing new was said as there is nothing new to say to an unvaccinated community afflicted with smallpox; it was the same old advice— “vaccinate at once the entire community; make vaccination free and thorough; do not depend upon the packets of salts and digitalis your druggists are selling by the hundreds to take internally to prevent the disease; do not establish domiciliary quarantine over forty different houses at a cost of $100 a day; quarantine is not needed if the people are vaccinated; offer free vaccination to everybody. Quarantine the man who refuses to be vaccinated, for while there is no law in Indiana compelling a man to be vaccinated, he can be kept lawfully in his house or arrested and quarantined as soon as he becomes a menace to the public health.

It is needless to say that the public at once worked together and all took the advice. The present writer and Dr. Hurty visited Knightstown Sunday, July 20, and spent the day with Drs. Barrett and Holloway and our four signatures at the leading hotel—the Arno—were the first that had been written from June 19 to that date. Senator Newby, one of the first victims of the disease was out of his guard ropes that day for the first time; he and many other citizens, including the doctors, said their work of vaccination and control was made easy by the address of Dr. Hurty, emphasized by the presence of a loathsome, preventable disease and needless death.
We visited the smallpox hospital, a large, roomy brick house on a high knoll across the river, costing $10,000, but purchased with 20 acres of land for less than $3.000. Here under the care of Dr. Holloway for the city and Dr. Smith of Greensboro, .for the township, were 27 cases all doing well. There was a family of seven in one room presenting every stage from perhaps 50 to 100 pustules on a little daughter of a nearly confluent pregnant mother, who was nearly well without abortion.
One case had secondary abscess. On the third floor was an old war veteran physician, Dr. L. V. Winston, unvaccinated in many years, suffering with a very mild varioloid. All were well fed, nursed and housed. We visited the home of Mrs. Wilson, a semi-confluent case still in great danger. Her husband had been nursed by Mr. W. B. Kitchen of the Senior class of the Medical College of Indiana, until he died and the nurse helped to bury him as he had done for four other victims—all were buried in corrosive sublimate sheets ten hours after death. Mr. Kitchen then nursed the woman a week till a female nurse could be procured and his kindness and efficiency endeared him to the Health Board and people.

Another confluent case was a niece of Senator Newby’s just across from the Wilson house, where she had contracted the disease when going over to “find out” how he was getting along,” as the Wilson case was not early reported to the health officers. This girl of 12 years is in a dangerous condition—confluent on the face, arms and neck.
Just such cases had proved very deceptive; they seemed to be doing well, and were taking abundant nutriment but developed sepsis, heart failure and death in a few hours.
Such was the epidemic of smallpox in Knightstown from June 2 to July 20, when it was thoroughly under control, 99 percent of the citizens having been vaccinated within that time. The last patient to take the disease was Dr 0. F. Fleenor, who was in the papular stage the day of our visit. He had been vaccinated he thought to the limit of safety, but had ”no take” for many years.

There were 16 confluent cases with 12 deaths. Some were badly pitted. No children died; comparatively few were affected. The dead were Jesse Swain, 24; Henry White, 24; Homer Roberts, 25; S. M. Steele; T. 0. Wilson, 36; John Davis; I. P. Stoner; H. P. Risley, 50, and his son, Risley, 21; Mrs. Dovey; Mrs. Rosa Brosius; Mrs. Florea; Geo. Cratt, a veteran soldier whose disease was regarded by some as purpura hemorrhagia, but by others as virulent smallpox, some of his household had smallpox after his death.

The general agreement is that most of the infection was from a single walking case which met many people in the streets and stores, as the cases broke out about the same time in separated portions of the town.

The disease has been handled in a manner which does credit to the Health Board, and the citizens—that is, those who remained, as over one-third of the people, it is estimated, left the town on the first outbreak.
The town was quarantined by outlying towns, -Charlottesville, Rushville and others – uselessly, with a show of guns and barricades. But there was no restriction on the railroad; people could go in and out on the Pennsylvania RR at their will, but no one cared to visit the town and the hegira was early completed.

The epidemic teaches that Indiana is not safe from smallpox; that there are yet many unvaccinated communities; that the virulent Eastern or Texan type may infest any part of Indiana; that quarantine is inefficient, expensive and useless, and that our only safety as a State is in enforced vaccination of school children, and the constantly urged and freely given vaccination and revaccination by every town and county health board in the State, of all adults.
Finally, in any epidemic of the severe type, when the entire or nearly entire community has been vaccinated, the people should rise as one man against those who refuse vaccination, as they are a menace to the health and welfare of the community at large and may properly be put under the police power of the State as common nuisances.

So the epidemic was surely pretty bad. My sister told me that once, years ago, she met an old man that remembered the citizens of Knightstown bringing their feather beds to the town square to be burnt. They thought this would help prevent the spread of the disease.
Ed Knight

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