“The appearance at this time of three suspicious cases was a surprise and a matter of regret,” Blue said. “I presume they are the result of the dry weather we have had since December 21st.” The weather was only an excuse; the city was still infected.13
The solution lay underground. This trio of cases clustered around the intersection of Jackson and Fish Alley, near the Jackson Street Theatre. Blue sent inspectors out to poke around. Searching the underground pipes, they traced the probable infection source to a broken sewer pipe harboring vermin under the theater. Workers patched the pipe, doused the buildings with bichloride of mercury, then sprinkled them with lime. They also gutted the wooden basements and poured a concrete rat barrier.
The gritty work ground on door-to-door. In the week ending January 9, the health officers inspected 1,916 rooms. They checked 1,998 people. They limed and disinfected 967 sites around Chinatown. Week in, week out, they took temperatures, felt glands, scrubbed houses, and cemented cellars. It was sidewalk sanitation as much as it was medicine.
The board of supervisors’ finance committee now put the Washington doctors on month-to-month funding. Blue attended the supervisors’ meetings, hoping for more but willing to economize. His bigger fear was that City Hall would revert to the old practice of denying plague. To arouse public awareness and support, he needed City Hall to admit the truth, or at least to not lie about it.
But if the politicians unsettled his hopes in January, a cluster of new cases would all but shatter them in February.
The Seamstresses
KATIE CUKA WAS AN eighteen-year-old Ohio native who came to San Francisco and ended up working as a seamstress. At the S. N. Wood Company clothing factory on Geary Boulevard, she helped turn bolts of tweed woolens into $10 men’s suits. While working one afternoon, she complained of a chill. Suddenly she felt woozy; her head spun, and then everything went black.
Following her fainting spell, Katie was rushed to the city’s French Hospital, where doctors found she had a high fever and swollen glands. After drawing fluid from her lymph glands, they recoiled to find it brimming with suspicious bacteria. The significance didn’t escape them. In a panic, the doctors sent Katie home to her lodgings on Natoma Street, south of the Market Street slot. The city health department, tipped off about the possible plague case, sent a horse-drawn ambulance to bring her to the City and County Hospital’s isolation cottage.
Federal doctors swooped down on the suit factory with questions. Were there any more seamstresses who were ill?
The foreman said he had two more girls on the sick list. Mary Fremont, a girl living near Katie, turned out to have a simple sore throat. But Irene Rossi, daughter of an Italian peddler, was down with a fever in the Latin Quarter. The doctors went to investigate.
When they arrived at the Rossi row house on Varennes Street,1 they saw that they were too late. They found the stricken family in black, planning Irene’s funeral. Their eighteen-year-old had gone downhill rapidly; from a fever, chills, pounding head, and aching chest, she had progressed to racking coughs that brought up streaks of blood, then a foamy fluid that looked like raspberry syrup. Pneumonia, they called it. As her parents hovered helplessly, she had died gasping. During their vigil, the Rossis bent close, inhaling the same air, until their prayers expired with her.
Bowed by grief, Luisa and Giuseppe Rossi raised haunted eyes from the waxen face of their child to the doctors, who no doubt felt stricken as they paused on the threshold, absorbing the awful scene. After murmuring condolences, the doctors asked permission to perform an autopsy.
Torn by grief, his eyes blazing darkly, Giuseppe Rossi said no. The doctors pressed gently, saying it was required for all suspicious sickness. Only if the autopsy took place that night, Rossi said, so that Irene could be buried the next day as planned. And only, he added, if he could accompany her to the morgue. The doctors had no choice.
Late that night, just outside the circle of lamplight, Giuseppe Rossi witnessed what no father should ever see: doctors making the long incision, cutting the snips of tissue from his daughter, preserving them in glass like relics of the saints.
Giuseppe’s frenzied mourning, his burning gaze, masked something more—something the doctors had missed. Later, Blue would recognize that the bereaved father was so “buoyed up by grief or excitement” that no one—least of all the father himself—recognized that he too was falling sick.2 But the day after the funeral, the fifty-four-year-old peddler collapsed, not from grief but from fever. Soon he was coughing blood as his daughter had. By February 12, four days after his daughter, Giuseppe Rossi himself lay dead.
Seventeen doctors crowded around the autopsy table, Rupert Blue among them. The incision parted skin, muscle, and bone to reveal the lungs, the bellows of the body that are normally a rich wine red with oxygen but were now clotted with the germs that killed father and daughter.
The autopsies of both found the cause of death to be pneumonic plague. Explosively contagious, it would have imperiled anyone who had visited the coughing girl in her sickroom and breathed its germladen air. Luisa Rossi, the girl’s mother, was in the most danger, but before she could be placed in isolation, she vanished. Health officers searched the Latin Quarter for her, to no avail. Finally, a doctor’s tip led them to the Richmond district out on the city’s western edge. There, they found Mrs. Rossi, who had taken refuge from her grief at her brother’s home on Lake Street and 13th Avenue. She was already burning with fever.
On February 17, the forty-five-year-old Mrs. Rossi followed her daughter and husband into death. At her autopsy, Blue and Currie saw her lungs congealed with pockets of infection. Pneumonic plague, again, was the diagnosis. That same day, Mrs. Rossi’s brother Joseph fell sick, with tender and swollen glands in his groin and armpit. The symptoms looked suspicious. But Joseph refused to let doctors pierce his glands to obtain a fluid sample.
Doctors reasoned, then argued, but they failed to persuade him. They fumed and swallowed their frustration. Joseph Rossi appeared to have a mild case of bubonic plague. But his was a case that would have to remain unconfirmed—a gap in the puzzle.
“Please send 200 bottles fresh Yersin,” Blue wired urgently to Washington.3 He would need that much plague antiserum and more if this cluster grew. Wyman shipped 150 bottles, and Blue ordered 50 more from Sharp & Dohme Chemists in New York City. Doctors canvassed the Latin Quarter for anyone who might have been exposed. Joseph Rossi stubbornly stood by his refusal to allow a biopsy. But hedging his bets, he agreed to take injections of the antiserum.
Sanitation workers engulfed the row house at 6 Varennes Street with sulfur fumigation, bichloride of mercury solution, and sprinklings of lime. They built a pyre in the street and burned the linens from the sickroom beds. Where the three Rossis once lived, only a rank ghost of sulfur and veil of chemicals hung suspended in the air.
Meanwhile, the factory girl Katie Cuka held her grip on life at the county hospital. The young seamstress would survive her ordeal. So would Joseph Rossi. But where the factory girls first became infected—at home or at work—was anyone’s guess. Neither site was anywhere near Chinatown. Once again, plague rats were outflanking the doctors with a pattern no one could explain.
After a harrowing two weeks, Blue could breathe again. Finally he felt confident enough to declare the cluster contained. “I believe,” he wrote the surgeon general on February 23, “we have seen the last of the pneumonic cases to be expected from the infection at No. 6 [Varennes] Street in the Rossi family.”4
Word that a white family was wiped out by plague raced through the medical community. For the first time, people felt a threat in their midst. Doctors telephoned Blue, anxiously asking about the availability of supplies of the antiserum. Along with a new sense of vulnerability, a new candor was born. For the first time, community physicians reluctantly admitted that they had seen such cases before.
“I am unable to decide whether these recent cases among the whites represent an increase, or whether they are the result of a desire on the part of physicians to openly diagnose plague,” Blue told Wyman. “It would appear from conversations we have had with some of them, that they have had such cases before, but were not willing to make the diagnosis.”5
