My training in biology and my interest in history make me curious about illnesses that were once common in the United States but are rare today. Who brought these diseases under control, and how did they do it?
While researching pellagra for my book Red Madness: How a Medical Mystery Changed What We Eat, I read about several typhoid fever outbreaks of the early 1900s. Public health officials were then battling both diseases. In 1903, my hometown of Ithaca, New York, suffered through a typhoid epidemic. Around the same time, the “Typhoid Mary” outbreaks occurred in New York City. When I realized that one man, George Soper, played a key role in both events, I was hooked on the typhoid story.
My goal in writing this book was to tell the story as accurately as possible. All direct quotations come from primary sources and are cited in the Source Notes. My descriptions of historical incidents and conversations are based on first-person accounts and on published interviews with the participants.
To find out what was known about typhoid fever in the early twentieth century, I read medical books and journals from that period. For twenty-first-century information, I interviewed medical experts and reviewed recent journal articles and books.
To learn about Ithaca’s typhoid outbreak in 1903, I turned to local newspaper articles, interviews, and reports of the scientific investigations from that period; George Soper’s book about his cleanup work; and scrapbooks kept by Cornell students throughout the epidemic. The Cornell University Library maintains an enlightening collection of letters and telegrams about the outbreak sent to and from the university’s president. Daily updates from the student infirmary document the spread of the disease. A secondary source, the 2011 book The Epidemic: A Collision of Power, Privilege, and Public Health by David DeKok, examines the politics and business dealings that surrounded the Ithaca outbreak.
I also relied on my personal knowledge of the city, university, and geography. My house is less than two miles from the probable source of the outbreak—Six Mile Creek.
Tracking down the truth about Mary Mallon was challenging. She never wrote an autobiography, and scant information exists about her life before her capture. Mallon was reluctant to discuss her status as a typhoid carrier or her experiences as a cook. She gave only two confirmed interviews with the press. One six-page letter, written in her own hand, provides insight into her thoughts and feelings during the early years of her quarantine.
In addition to Mallon’s letter and interviews, I gathered material from other primary sources, including court documents; S. Josephine Baker’s newspaper interviews and autobiography, Fighting for Life; and Soper’s newspaper and journal articles about his investigation.
Several people discussed their encounters with Mary Mallon in books, newspapers, magazines, and professional journals. I was cautious about the authors’ biases and faulty memories. Whenever reports of an incident differed, I stuck to the facts on which the most reliable sources agreed.
The best secondary source about Mary Mallon is Judith Walzer Leavitt’s well-researched book from 1996, Typhoid Mary: Captive to the Public’s Health. For information about the New York City Health Department in the early 1900s, I used various sources, including John Duffy’s work on public health and the book Hives of Sickness, edited by David Rosner. Charles-Edward Amory Winslow’s biography of Hermann Biggs and Baker’s autobiography provided additional details about the Department during this period.
I discovered that many published versions of the Typhoid Mary story contain mistakes or are fictionalized accounts. By exploring census data, obituaries, and New York City’s Social Registry, I was able to clear up some inaccuracies. One error has persisted for a hundred years: The Park Avenue home where George Soper discovered Mary Mallon was owned by Walter “Bowne,” not “Bowen.” The first known death attributed to Mallon—the Bownes’ daughter—has often been erroneously depicted as a little girl. She was a young woman.
Many questions about the Mary Mallon case have no clear answers. Did she genuinely believe that she was healthy and free of typhoid bacteria, as she claimed? Or was she aware that she was a carrier and simply not care whom she infected? New York City health officials felt it was their duty to protect the public from typhoid fever. But did they do the right thing when they isolated Mallon on North Brother Island? Should they have handled her differently? I leave it to the reader to decide.
In 1915, George Soper observed: “We have a great many lessons to learn from this Mallon case.” Today, the case still raises important issues that are worth considering. When a deadly, highly contagious, and untreatable disease strikes, what do we expect health authorities to do? What government actions would—or should—we tolerate? Does the protection of a city’s population trump the rights and freedom of an individual?
The events of a century ago can guide us as we confront these questions now and in the future.