Willrich (City of Courts: Socializing Justice in Progressive Era Chicago) chronicles the U.S. smallpox epidemic at the turn of the 20th century when American expansionism, migrant work patterns, and cramped tenement living created a massive public health disaster with far-reaching implications. He traces the creation of smallpox vaccine technology, still known as "the most dangerous vaccine," from Edward Jenner's late 18th-century development of the cow pox vaccine to recent freeze-dried versions. He describes the disfiguring suffering of smallpox victims in cringe-worthy, heartbreaking detail. Willrich shines when illuminating the profound civil rights and medical ethics issues that arose at a time when national, state, and local public health authorities were just being formed. Heavy-handed government health-care workers would handcuff resistors to vaccinate them. Poor black and immigrant families routinely revolted against the compulsory vaccinations, either hiding their sick or burning "pest houses" built in their neighborhoods. The anti-vaccinationists of the time parallel a modern movement against vaccines for purported dangers, whether scientifically proven or not.
VERDICT There is fertile ground for debate here among public health professionals, medical ethicists, those involved in current health-care issues, and historians.
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