INTERNATIONAL J OURNAL OF L E PROSY Volume 40. N umber 3 Prin ted in the U.S.A. The Strange Case of john Early

A Study of the Stigma of Leprosy 1

Philip A. Kalisch 2

Leprosy has undoubtedl y been the least When Early was stationed at Plattsburg understood disease of man in the United Barracks in 1905, he and several other States. To the public it has been regarded soldiers drifted into a hall where a Salva­ as a disease apart, not only a manifestation tion Army meeting was in progress, attract­ of uncleanliness but also deeply discredit­ ed by the music and the warmth. He later ing to the person who is so affiicted and reminisced that at the time he was just "a feared as a highly contagious calamity ris­ big hulking kid, fresh from service, and ing out of the dank mists of the medieval without respect for anything on the face 'of ages. When one is pronounced a "leper" in the earth except my mother and my flag." our society, he is often stigmatized, denied While sitting in a side seat listening and full social acceptance and shorn of his seeing what was going on, Early was struck individual rights. Such a man was John by the sight of: Early, not only the most flamboyant and .. . this slip of a gi rl go t up-little bit of a girl she bizarre victim of leprosy in Am erican his­ was. only six teen; she could walk righ t under my tory but also one of the more tragic. This arm. Lord, but she looked pretty in the blue unlikely candidate, in his unique way, did bonnet! She h ad a guitar slung across her shoulder more to improve the plight of persons with on a red ribbon, and she sang and played up there leprosy in the United States than did al­ on the platform. She sa ng hymns my mother used to sing-'Throw Out the Life- Line' and 'Let a Little most anyone els e of his time. Sunshine In: and that other one, 'If You Love Your John Ruskin Early was born on a farm in Mother, Meet H er in the Skies.' A fellow don't quite the western part of North Carolina in 1874 ge t the grip on those unless he h appens to have los t and lived in that area until he was twenty­ his mother. I had (23) . three years old. In 1896 he enlisted in the The sixteen year old girl later recounted United States Army and served for nine that she had noticed Early as well and that years, rising to the rank of corporal. Taking "when I was singing, he looked at me. part in the Spanish-American War, Early He-he testified that night." Lottie wouldn't was stationed in Cuba from 1898 to 1900 marry an army man however, since "I don't and suffered severely from malaria. Subse­ think it's right for them to be married when quently, he was sent to the Philippine they have to go away off and leave their Islands until 1902, where he saw action families behind." Thus when John's term of against the Filipino insurrectionist army of military service expired the following year, Emilio Aguinaldo, and was then trans­ they were married (23). ferred to San Francisco and then to Platts­ burg, New York. All this while, with the Two years later with his wife and a one exception of his bout with malaria, this year old baby, Early moved to Canton, large, well-built man, had always enjoyed North Carolina, and began work at a pulp good health. The likelihood of his exposure mill known as the Champion Fibre Compa­ to leprosy while in the Philippines is cOlTob­ ny. At this time he was supposedly in orated by the studies of Aycock and Gor­ perfect health. At first he was assigned to don (2), and Hasseltine (25). the bleach room, handling chloride of lime, but this caused him to cough so much that he became too sick to work on some days. 1 R eceived for publication 7 J anuary 1972. 2 Philip A. Kalisch. M.A .• Ph.D .• Assistant Pro­ Early was then transferred to the leach fessor of History and Director of the Program in room where he was constantly in touch Social Science. University of Southern Mi ss issippi, Southern Station, Box 5204, Hattiesburg, Missi ssippi with what was known as "black ash," in­ 39401. haling the fumes and dust, and coming in • 291 292 International Journal of Leprosy 1972

constant contact with a very strong, poi­ of smallpox and other contagious diseases, sonous "caustic liquor" made from the ash Early innocently remarked, "What have I which was largely a heavy solution of caus­ got, doctor, leprosy (40)?" tic potash, intensely corrosive to the skin Remembering that Early had admitted (7. 40). to military service in the Philippines, the While working in the room one day, doctor, in fear of contagion, retired precipi­ some of the caustic liquid dropped off the tously. He returned shortly with Dr pipes and fell on Early's skin causing burn­ William C. Fowler (1864-1937), inspector ing and itching sores. Eventually, his face for contagious diseases in the District of and neck became very much inHamed. Columbia, who had never seen a true case Moreover, the caustic ash dust seemed to of leprosy in his life. After a brief look, the be affecting his respiratory system. This two medical men went out, carefully lock­ condition forced John to give up his work ing the door behind them but soon return­ at the mill on August 7, 1908. He later ing with Dr. Joseph J. Kinyoun reminisced: ( 1860-1919) , pathologist at Washington When I left, there were between a dozen and University and founder of the U.S. Public twenty in the same fix, and it was common talk Health Service Hygienic Laboratory. After among the workers that no m an could work there a brief examination, Kinyoun remarked more than two years without being poisoned by the that the case was "strongly suspicious" and ash . You not only get the ash dust all over you, but took a small cutting of Early's facial skin to you must of necessity get the pulp on you as well. I know one poor fellow whose leg was so badly his laboratory. There he reported finding poiso ned that it swelled up to the size of a bacilli "corresponding morphologically with boot (40) . those of leprosy." These findings were speedily endorsed. by Dr. William C. After talking it over with his wife, who Woodward (1867-1949), health officer of was six months pregnant with another the District of Columbia and expert in child, Early, on August 18th, decided to medical jurisprudence, and Early was travel up to Washington, D.c., alone to see immediately removed from the locked about a pension claim for his recently ag­ room at the doctor's office and forcibly gravated malaria. Lottie later remembered: quarantined in a hastily erected tent down I urged him to leave me and go. H e kissed baby on the marshy bottom adjacent to the and me good-by, and we watched him ever so far eastern branch of the Potomac River (7. when he went down the road. He turned back and 30) . waved his hat and laughed to make me cheer up. I was crying. Up to this time Lottie heard from John every day and he had written her that he She further recalled: expected to get the pension and if he That was the last time he kissed me, and I didn't didn't, he would find work and send for her know it was to be the last time. I think, if I had, I'd and the baby. "Then I didn't hear from him • have run after him and held him back-I think so. for several days," she recalled, but "we But we nei ther of us knew, and he left me (23) . expected John would send for us any time, Upon his arrival in Washington, Early until that morning when the news came." secured a room at the Salvation Army lodg­ Early's brother suddenly came running ing house; then he contacted the pension along the road waving a newspaper board and began processing his claim. His shouting, "John's got leprosy." In spite of face, however, had become so acutely her condition, Lottie, learning that John inflamed and swollen that his eyes were was isolated all alone without any friends almost closed. Moreover, the affected skin or help of any kind, decided that she must burned and itched severely. Hoping for go to him (23 .34 ). relief, Early, on August 21, contacted a After finally making it to Washington, general practitioner in the city, named nearly a week later, Lottied found that: Stuart, who was completely befuddled by They would let me talk to him from a distance. the case. As the local physician examined They said he was a leper, and under strict quaran­ him and began to allude to the possibility tine. And they gave me the choice then of what I 40, 3 KaUsch: Strange Case of John Early 293

FIG. 1. John Early in his quarantine tent in May, 1909, nine months after he was charged with having a case of leprosy. (Munsey's photograph) might do. I could share his quarantine, if I wanted Not wanting to lose the children, Mrs. to run the ri sk . They cou ld not pre\ ent me being Early promised the health authorities that with him if I wished. But if I did- if I stayed and she wouldn't touch him, if they would just nursed him a nd was near him-then I, too, had to be placed under q uarantine; and they would take let them live near each other so that she Manly from me, and the baby as soon as it was could see and talk to him from a distance born. (23) . 294 International Journal of Leprosy 1972

The answer of the Washington officials able nation al attention. The New York Sun was to move Early into an old weather­ wondered what the government was about, beaten, ramshackle house four miles out and asked if Early was to be a victim of a from the Capitol where a lonely, dead-end tangle of futility and ineptitude. The New road terminated next to the mud flats of the York Times suggested it was a case of river. However, as one entered the door, he medievalism, for according to that newspa­ saw a strange sight as the doorways be­ per, a member of the Army Medical Corps tween the two halves of the house were had proved fairly conclusively that the dis­ crudely walled-up. Mrs. Early was all owed ease was not really infectious, but a form of to live on one side and John on the other. A tuberculosis contracted from eating bad full -time policeman was hired by the gov­ food at sea. The New York World offered ernment to make sure that the couple did the consolation that Early's solitude "has not go near each other. A sentry box was becn mitigated to some extent by leave to erected in front of the back porch and see as much of his wife as the law admits." equipped with a large searchlight which The controversy even carried across the shone directly on the door leading from Atlantic to the pages of the London Times Early's room every night. She painfully ( 34, 30). remembered how: Meanwhile back in Washington, on long We were all alone here in this big house, and it was winter nights, the Early's only communica­ bitterly co ld and bare. There was onl y one stove. tion was by rapping on the wall. Lottie The plaster was all fa llen off the wa ll s in places, remembered that: and the rats-ugh ! ... They came out and stared at me. I could sec their eyes in the dark. Manly was I would rap on it, and he would answer. It was lots afraid of them (23). of fUll. And I brought my little army organ with me, you kll ow- the kin9 the Salvation girls sing to The Early case now attracted consider- ou t in the streets. Here it is. I could move it up

FIG. 2. The brjck wall between John and Lottie Early as depicted by a Munsey's Magazine artistin May, 1908. 40, 3 Kalisch: Strange Case of John Early 295 close to the wall, and John had his mandolin, and with each other." Mrs. Earl y cooked John's we would sit here and play to each o ther for food and passed it to him over a fence company all the h ymns we li ked the bes t, and John's army songs. I could hear his voice through outdoors. His hair hung very long over his the wall, you see, and he could hear m y playing, shoulders as the health officers had refused and it wasn't so lonely. to let anyone cut the '1eper's" hair ( 7 ) • During the following week, Dr. Bulkley Soon, however, it became time for her baby to be delivered. She recalled that the gave Early a very thorough medical exami­ nation, even to the extent of making a night that her baby was born: hundred needle pricks on all parts of the ... we were all alone, mother and T, and we body to check for anesthesia, which is a could n't get help. Joh n and the guard were down in the ten t, half a mile away, and mother said we symptom of leprosy. The results were all mustn't let h im know, for fear he'd break quaran­ negative. To be even more accurate he cut tine and come to me. She went across th e road in out different portions of skin and prepared the snow and called for help, and the neighbors several dozen preparations for bacteriologic were a fraid to come. Why? Because I was the leper's study and sent them to Dr. William H. wife. So mother went out there on the porch and blew the police-whistle of distress that they had Welch ( 1850-1934 ), Professor of Pathology given to us to use in case of extreme danger (23). at Johns Hopkins University and Dr. Wil­ liam H. Park ( 1863-1939 ) Director of New After giving birth to the second child, the York City's Health Laboratories. Both of twenty-one year old Mrs. Early engaged in these men reported that their microscopical a constant fi ght to keep her children and study of the tissue had yielded no leprosy improve John's plight. She wrote to Mrs. bacilli. As a result of his investigation, Dr. Theodore Roosevelt and the incoming Pres­ Bulkley insisted that "Mr. Early had not ident Taft, as well as skin specialists and never had leprosy." In an editorial in throughout the country. As the months the Medical Record of June 19, 1909, Bulk­ went by, Washington officials were at a loss ley cited Dr. Welch of Johns Hopkins Hos­ as to how to dispose of Early and his very pital, who, in reference to the Early case, expensive quarantine arrangement which had remarked that '1eprosy is practically was costing the District about $3,000 per the least contagious of all infectious dis­ year. There was talk of shipping him to eases (6)." either the Philippine or Hawaiian leprosy colonies. In the meantime, his skin condi­ The Washington health authorities, how­ tion had improved and eight and one ever, still stubbornly held to their diagnosis half months following his arrest his skin of nine months previous and would not problem had completely disappeared ex­ even examine Bulkley's specimens of Ear­ cept for a slight redness on the forehead ly's skin. Bulkley reported his findings to (7,23 ). the newspapers and public pressure began A prominent New York dermatologist, to mount for Early's release (6, 35) . Finally Dr. L. Duncan Bulkley ( 1845-1928), was one month later on July 3, 1909, Early was then persuaded by a lady from the Salva­ shipped to N ew York in a locked baggage tion Army to look into the case. Dr. Bulk­ car (1). There he was carefully examined ley, widely respected as the founder of the again by numerous skin speci alists who New York Skin and Cancer Hospital and found nothing to indicate that he had lep­ former editor of the Archives of Dermatolo­ rosy (35, 40) . gy, first asked a certain Washington derma­ At a special news conference on July 10, tologist to investigate the case but the latter Dr. Bulkley pointed out that whereas F owl­ declined to do so, and wrote Bulkley that. if er and Kinyoun had examined only one it were known that he had visited a case of specimen, he had taken seven. Moreover, leprosy, it would ruin his practice (7) . he had offered to divide each piece of skin Taking up the cause himself, Bulkley into two parts, giving half to the Washing­ journeyed to Washington on May 9, 1909, ton physicians and retaining the other half and found the Early family walled-off from for himself and his associates at the New each other with "a policeman on guard out­ York Skin and Cancer Hospital, but Fowler side to prevent their having anything to do and Kinyoun would have none of this. 296 International Journal of Leprosy 1972

Bulkley emphatically observed that every verdict on the basis of a single microscopic intelligent physician:: examination of a specimen of Early's skin that had previously been supplied him by . . . will first study car~fully and minutely the Dr. Woodward in Washington, D.C. features of any case and then seek the aid of whatever scientific instruments of precision he can The London Times remarked that "the employ. In this instance there was apparently no controversy regarding this famous case may attempt to study the case clinically very carefully, now be regarded as definitely settled and there was no effort made to seek the aid of an (11)." Thus, when John went to Washing­ expert in skin diseases, or the mistake of even ton to receive the payment of his back imagining that Early had leprosy would have been avoided in the very beginning (40). pension on December 2, 1909, the Health Department secured a warrant for his ar­ Mter' two weeks of being closely ob­ rest, charging him with being an exposed served at the New York Skin and Cancer contagious disease carrier and he was hus­ Hospital and being presented for examina­ tled off to his former quarantine quarters tion at the September 1909 meeting of the on the muddy banks of the river (17). New York Dermatological Society, Early Rushing to his aid, John's lawyer and family gained his freedom ( 40). Lottie and the friend, Judge Egbert C. Everest of Platts­ two children now joined John and they burg, New York, began an active fight for settled in the suburbs of Brooklyn under an his liberty. Finally the Washington health assumed name. But his identity was soon officers agreed that John would be sent to learned, and then began the "hounding" New York, again in a sealed baggage car which has been the lot of the suspected which was to be afterwards disinfected and leprosy victim down through the ages. Doc­ for which he was required to pay $89.00 tors or no doctors, neighbors with children ( 26). Early was not allowed to send any were determined to take no chances. The letters in the mail and the check for his Early family was virtually driven out of back pension which was all the money he Brooklyn and they fled to a Connecticut possessed was fumigated before it was farm. Here again the·pressure·of local stigma cashed so that he could pay for the rental forced them out. The Early's were driven of the baggage car (7) . from Connecticut in October, 1909, and He arrived in New York on December settled subsequently upon a few acres in 11, 1909, and was again subjected to a Virginia (7. 15). minute examination by Dr. Bulkley and In the meantime, the Second Interna­ other leading skin specialists with the end tional Conference on Leprosy met in Ber­ result being that there was no evidence of gen, Norway, in August 1909. The previous leprosy, contrary to the esteemed Dr. Han­ winter, John had cut out a portion of skin sen's diagnosis. Bulkley publically labeled with a pen knife and Lottie had sent the Early's experiences with the Washington, specimen to the illustrious Dr. Armauer D.c., health officials as "one of the greatest Hansen (1841-1912), the discoverer of the outrages ever officially perpetrated upon leprosy bacillus and president of the con­ an American citizen," and pOinted out that ference, hoping that Hansen, regarded as Welch of Hopkins, Park of the New York the world's greatest authority on leprosy, City Health Department, and Captain would find John free of the disease and Dutcher of the Army Medical Corps totally alleviate the pressure against them. At the supported him in his contention that Early conference, however, Hansen declared in a was not and never had been tainted with personal statement to a United States dele­ leprosy (26). At a meeting of the New gate, Henry Shively of New York, that after York Society of Medical Jurisprudence on a long search he had found the bacillus of December 13, Bulkley told how: leprosy in the section of skin Mrs. Early Dr. Woodward. of the Washington Health Depart­ had sent him. Simultaneously, the eminent ment, who caused Early's imprisonment and recent Danish leprologist, Edvard L. Ehlers, edi­ rearrest. was himself apparently assured that there tor of Lepra, and author of numerous schol­ was no danger in his case. arly articles on leprosy, endorsed Hansen's Said Dr. Bulkley: 40, 3 Kalisch: Strange Case of John Early 297

... for when Earl y was arres ted while seeking his without money or many friends do (21)?" pension a t ' ·Vashington a (ew days ago, Dr. W ood· Several months later the Early family is ward himself took him in his automobile, covering him with hi s lap robe, and shook hands with him . known to have settled on a small farm on He likewise permilled Early to raise chickens and the outskirts of Tacoma, Washington, under eggs for the public markets, Yet they would not let another name, hopeful of beginning a new him write to his people; and all checks and life. A third child had been born to Lottie vouchers that came and went were fumigated. I feel that they realized their mistake early, but were and it was imperative that John earn an afraid to acknowledge it, thinking that it would adequate living. His pension had been cut blow over. T hanks to the activity of the press in the off back on August 26, 1909, and he de­ case it did not. I have a Jetter hom Dr. Woodward, cided to file a claim for restoration by mail in answer to one from me d emanding why Early was ( 42 ). not sent to me as fin all y promised, in which Dr. W oodward writes tha t in view of a possible suit for The U.S. Bureau of Pensions now raised damage later, they were unwilling to Jet Early out some questions regarding the exact nature of their jurisdiction. of his disability and ordered him examined When reporters asked Early whether he by a board of surgeons in Tacoma along would attempt to recover damages, he with the city bacteriologist and a mission­ sighed, "I don't know. I am very tired of it ary physician who had seen leprosy cases in all. If only they would let me go home China. This body of medical men pro­ (36) ." nounced him again "a leper" on September 6, 1911. When word on this diagnosis Again exonerated by New York derma­ leaked out to Early's neighbors, they indig­ tologists, Early was then allowed to leave nantly demanded his removal. It was first New York and in the spring of 1910, was proposed to enclose one acre of his farm reported to be living somewhere in the with two rows of barbed wire fences six West under an assumed name. His attorney wrote Surgeon General Walter Wyman of feet apart, thereby shutting him off from contact with any other person, but even the U.S. Public Health Service on January this plan did not satisfy the local citizens 31, 1911, asking that John be allowed to go ( 5, 13, 29). to Washington "on private business of im- Lottie again wrote to President Taft, portance." The lawyer testified that both "appealing to you for help as you have Early and his wife were "continually in fear much authority." She told' him that their and trembling that his identity may be little home was heavily mortgaged and discovered and he will be quarantined as a asked his aid in getting John's pension from leprosy suspect and stamped unclean the time it was cut off two years previous. (21) ." She claimed that this "would enable us to Wyman wrote back that inasmuch as a clear our mortgages and so save the little diagnosis of leprosy had been made by the home for our children's sake and would be health authorities of Washington, D.c., and a very small sum to the government com­ by Dr. Hansen, the discoverer of the lepra pared with what it will mean to us and our bacillus, the U.S. Public Health Service little ones (16)." "cannot do otherwise than treat him as a It was finu ally decided with the approval leper (43)." Early's lawyer now concluded of President Taft to give Early a pension at that "it is now perfectly apparent to me $30.00 per month and employ him at $50.00 that they propose to adhere to their diagno­ per month to attend to the needs of a sailor sis in regard to Mr. Early-be it right or who had an advanced case of leprosy and wrong." Indeed he could see now that John was isolated at the quarantine station near was doomed for life with the brand of Port Townsend, Washington (4. 14). Sur­ leprosy and was as a result to be "an geon General Rupert · Blue noted that "of outcast of society ... an object to be feared course his family could not be taken to the and hunted out for the purpose of being quarantine station (S) ." , Thus, John and quarantined." Lawyer Everest confided Lottie parted on March 23, 1912. Their that John "cannot stand the intolerable situ­ relationship had broken under the strain by ation longer; but what can he a poor man this time as a friend, George N. Taus an, 298 International Journal of Leprosy 1972 local commander of the Spanish-War John had a far better understanding of Veterans, several weeks later testified that mass psychology than most medical men Lottie '1ived in constant fear that Early and combined within him was the promot­ will sometime leave the station and come er's urge for fantastic success as he pOinted home to her" and that "he is little better out to his audience that: than a beast in his treatment of her sexually To demonstra te how easy it is for a leper to mingle and otherwise, and that his religious pre­ in ci ties, I planned my present trip six months ago. tentions are simply a mask to hide his I knew that it is only when a great truth is sent animal nature." Whatever the case might home to the hearts of the people th a t atten tion is have been, Lottie applied for and secured a paid to it. I knew that if I mingled among the well-to-do and the rich and exposed them to divorce a short time later (14 , 37) . contagion that they would arise out of self­ About one year later the Public Health protection and further m y plan of a national home. Service admitted to a correspondent for the That is wh y I chose the Pullman car, wh y I slept a t the best hotels, ate in the best res taurants. No one New York Times that John Early had "gone cares what happens to the poor. If I had kept to the insane as the result of his experiences slums in my travels, the agitation would h ave been (18) ." What is more, on May 17, 1914, he li ttle. I had no desire to hurt an yone. I do not escaped from the quarantine station and believe that the present stage of my disease is was traced to Victoria, British Columbia, contagious. I had the money to travel as I did . I saved m y wages and my pension for months to do were officers lost track of him. Then two so, and I hope the lesson has struck home (9) . weeks later the front pages of newspapers across the country announced that John The same afternoon the W ashington Early had been discovered as a guest in the Times showing a rare insight into the aff air, exceedingly fashionable Hotel Willard in editorialized that: Washington, D.C., and the other occupants The case of John Early, leper, has been an amazing were "thrown into a panic." He had been series of demonstrations that American civilization staying for the past several days at the is yet afflicted with a good deal of the barbarism of same address as Vice President and Mrs. the Middle Ages. Early had been h andled .. . in a Thomas R. Marshall, numerous senators way that shows how liable the public is to fall into panic over that which it does not understand . . . and representatives, as well as a number of Nobody wants him, and nobody, in the face of the ambassadors. Indeed, a leprosy patient had strange, medieval terror inspired by his disease, "tainted" the establishment "frequented by seems concerned whether he shall be given civilized the highest circle of official diplomatic, treatment; to get him as far away as possible and to insure that he will not return is the uttermost congressional, and residential Washington ambition of everybody and every community that life (31)." he might possibly impose himself upon. It is a Early had dramatically made his pitiful refl ec tion of the inefficiency of provi sion for presence known by telephoning Dr. such cases (9). William C. Fowler, Chief Medical Inspec­ Whatever the reactions of the press tor of the city health department and tell­ were, the spectacular appearance of Early ing him that he, a diagnosed '1eper," was at the Willard Hotel was a matter of grave registered at the Willard under the name of concern to Congress and that afternoon his E. J. Watson. Dr. Fowler later recalled, '1 appearance was the subject of debate in did not know whether it was someone the House of Representatives. Congress­ joking with me or not, but I went, however, man John Raker of California was of the to the hotel named, and on entering the opinion that letting Early loose upon this room found John Early in consultation with country was "worse than turning loose a several newspaper reporters." Early told band of murderers ." Representative Albert these uneasy reporters: Johnson of Washington suggested that one The John Early that was is dead to the world. I of the Aleutian Islands could be used as a have put the world behind me. From now on I am leprosy colony, where Early and the others willing to be isolated, to have the warning bell of like him "could be put to gardening and the unclean rung as I approach, to feel that men shrink from me with the world-old fear of the homesteading." He noted that the climate terrible disease that has been laid upon me, but I there was good even though it was perhaps wa nt my appeal to be heard. a little damp in the winter. This recom- 40, 3 KaUsch: Strange Case of John Early 299 mendation, however, elicited bitter protest ued to turn exceedingly slowly and it was from the delegate from Alaska. Representa­ not until December 15, 1914, that hearings tive Johnson then introduced a bill which were held by the House Committee on would simply provide funds for the erec­ Interstate and Foreign Commerce re­ tion of a national leprosarium. Even a third garding the necessity of a nationalleprosar­ similar bill along with a joint resolution was ium. At these hearings, much testimony put forth regarding leprosy and John Early was given in which Early's name was men­ on the same day, followed by yet another tioned (20). Although a bill was reported on September 15, 1914. None of these bills, out favorably to the fl oor and passed the however, were reported out by the Com­ House on February 24, 1915, the Senate mittee on Interstate and Foreign Com­ failed to take action before the 63rd Con­ merce during that session (12) . gress terminated. The next session, howev­ Upon receivin g the ncws that Early had er, saw a similar piece of legislation which turned up in the nation's capital, Governor was again introduced and again passed the Ernest Lister of the State of Washington House and was again referred to the Sen­ telegraphed the state delegation in Con­ ate. Long-awaited Senate hearings were gress that : finally held on February 15, 1916 (28) . As part of these hearings, Dr. Fowler narrated Understanding that the District of Columb ia Com · the current status of John Early and his missioners are urging the Secreta ry of the T reasury testimony was illustrative of the social to retu rn leper Early to Diamond Head, in this state, on the ground that tha t point is an offi cia l fo rces generated by the leprosy stigma: leper colony, I beg to p rotest as chid executive of this state against his return. Hope yo u will be able Dr. Fowler. We have Early in this b rick b uild ing at to convince the Secreta ry of the Treasury that such the present time; the windows are barred, and the action would be unfair to this state and to the door is barred. residents in the vici nity of Diamond Head (12). The Chairman. Barred with steel? Dr. Fowlei'. Yes, J ohn E arly ~ at the presen t time, is Since the State of Washington adamantly under arrest under the laws of the District of refused to take Early back, it was finally Columbia, for co ming in to said Di strict whi le decided to imprison him in the same house suffering from leprosy and withou t a permit so to down by the river in Washington, D.C., do. where he had been isolated twice previ­ The Chairman. He is under arrest beca use he ca me here, bei ng a leper? ously. Dr. William C. Rucker, following close Dr. Fowler. Yes; and knowing it. T he grou nds su rroundin g the home a re enclosed wi th a barbed · on the heels of the publicity, used his " 'ire fence. appearance before the annual convention T h e Chainllan . Abou t how h igh? of the American Medical Association on June 23, 1914, to denounce the inhuman Dr. Fowler. Abou t eigh t feet in heigh t. treatment of "lepers" and also urged the The Chairman. W ith a p rojection over at (he top? founding of a federal leprosarium. The next Dr. Fowler. Yes; sort of a T.shape top. day the New York Times approvingly com­ The Chairman . So it would be almost im possible mented in an editorial that : for him to ge t ou t? Dr. Fowler. I t would be q uite diffi cult, I sh ould say If lepers must be segregated, they should not be treated as wild and dangerous animals. T he case of John Early, who has been d riven to post a ll over Sellalol' W orks. You are treating him practi call y as the U nited States, is in point. Communities refused a wi ld animal? to ca re for him. Bills to establish hospitals for his Dr. Fowler. Practi call y, I am afraid; we h ave to in pitiable kind never reached a vote ill the state order ( 0 keep him (8). legislatures. Dr. Rucker would have the U ni ted States appropriate enough money to establish a na tional hospital fo r the unfortuna tes, wherein they Early now wrote the following letter to may have the treatment of human beings (33). Senator Joseph E. Ransdell, Chairman of the inquiring Committee on Public Health Despite the clamor of Early's vi sit, the and National Quarantine, who had visited wheels of congressional procedure contin- his prison several days earlier (8). 300 International Journal of Leprosy 1972

DEAR SENATOR: Sunday you asked the question belatedly founded at the old Louisiana is there enough lepers in the United States to Leper Home after a long and futile search justify a national leprosarium, to the which I will answer through the foll owi ng facts: There are for a better location (28). He reportedly about 500 known cases in the United States that made inflammatory speeches on that occa­ have developed mos tly within the past 10 or 15 sion. Early did not stay long thereafter, years . .. leprosy is spreading in the country to an however, finding the security system at extent that calls forth sharp local attention and Carville to be of no restraint to his freedom certainly should call forth national. To segregate a leprous person is wise and humane thing to do, but to come and go at his pleasure (41). to let matters to drift on in the present road is Indeed a little more than two years later another thing. As soon as a leper is found, under he was in Washington, D.C., on his fourth present conditions, he finds himself out of a horne escape, and drew attention to himself by and absqlutely unwelcome in the jurisdiction where he is found . . . R emember we are outcasts of calling the local health authorities after society; yes, with human tastes and feelings. touring half the country (32). Dr. Fowler Yours very truly, told the press that although fifteen years JOHN EARLY had passed since Early had first come to P.S.-Please pardon mistakes. I had to write in Washington, "the man looks better today haste. than when I saw him last." Sent back to The committee was impressed by this Carville, he arrived in time to be the first and other testimony and as a result the subject of Dr. L. L. Cazenavette of Tulane long-awaited bill was reported on favorably University, the visiting neurologist and psy­ and passed the Senate, January 25, 1917. chiatrist at the national leprosarium, who President Woodrow Wilson signed the leg­ observed him and several other patients islation, authorizing $250,000 to provide for from 1923 to 1926 in an attempt to corre­ the care and treatment of persons afBicted late leprosy with mental abnormalities with leprosy, into law on February 3, 1917. ( 10). Cazenavette 'noted that shortly after The bill, in effect, established a national readmission: policy of segregation and permanent care . . . he became greatly agitated and excited because for all persons suffering from leprosy within he had been apprehended and returned to the the United States at federal expense, in­ leprosarium against his wish. This he considered a personal offense. During the time of my first cluding their transportation from the place examination, four months after his readmi ssion. he of origin to the national leprosarium. From was at first co urteous and affable, though ev incing what we know of the origins of federal some surprise at my unex pec ted call, the purpose of concern over the leprosy problem, the im­ which he would not understand, even though petus for its action came for the most part explained to him. He gave the examiner little chance to say anything. He was very loquacious, from outside. There was no concerted effort and kept himself much in the center of the stage. on the part of the Wilson administration to At time he was rather hostile and suspicious, and create a national leprosarium until Early's displayed much arrogance in his m anner of expres­ exploits had stirred up Congress and the sion. He was restless and agitated. His emotional reactions disclosed mark ed fluctuations. He public over the matter. manifested no reserve in expressing his indignation John Early was confined in the brick at what he termed the absolute unfairness of the house in Washington until November, officers in charge, meaning the physicians and health 1918, when a special arrangement was officers in general and the attendants, in all owing the present state of affairs to go on. He believed made, which calling for a payment of $5,000 that they should be censured and proposed to enter in advance, allowed the District of Colum­ a protest to the effect that these offi cials be made to bia to admit him to the leprosy home of the suffer for not doing their duty toward enli ghtening State of Louisiana at Carville. There he the public and showing them the truth. became a patient, number 306, and was Subsequent examination led the psychia­ listed as having a mixed type of leprosy but trist to the conclusion that Early's: being in an "improved" state of health. Forty-seven year old John Early was thus ... querulousness, and the delusions of persecution on hand more than two years later for the in which he imagined himself and others at the leprosarium unjustly treated. brought forth a reac­ ceremony that occurred on February 1, tive mental disturbance of a paranoid type not 1921, when the national leprosarium was unlike the psychotic reactions of prisoners. 40, 3 Kalisch: Strange Case of John Early 301

FIG. 3. Early was instrumental in arousing governmental action which turned thjs decrepit "Louisiana Leper Home" into a modem national leprosarium. (National Li­ brary of Medicine, Bethesda, Maryland)

His later medical record at Carville re­ grant his demands .... I have also about become veals that he "continually complained and satisfied that he is very much of a hypocrite and a grafter and particularly anxious for newspaper referred to this facility as a jail and to its notoriety (14). administration as tyrannical." Moreover, he wrote to Presidents Calvin Coolidge and Thus, one wonders to what degree his Franklin D. Roosevelt protesting the treat­ behavior was the result of his social treat­ ment accorded inmates at the leprosarium ment. (37). The onset of Early's querulousness, Be that as it may, Early soon escaped however, corrolates with his conduct when again, attempting to go into seclusion at his he was taken from his family at Tacoma, brother's farm in North Carolina but Washington, and quarantined at Port finding, in his own words, that: Townsend, Washington; as the medical officer there had noted back in May of 1912 This the Public Health Service refused, sending marshal, sheriff, doctor, and a ham·headed deputy that: up and in our blessed mountain retreat and Mr. Early has shown a disposition to be surly and secluded isolation, the last Sunday morning of very suspicious of us all and to want to run things August, 1927, they hunted me down like I was a generally at the Station since his arrival there, desperado, manhandled and lugged me out of my frequently threatening what he will do through the hiding place in the shrubbery ... brought me to combined influence of the Elks, the Spanish· Spartanburg, South Carolina, . where the health American War Veterans, and the newspapers, if we doctor and the ham·handed deputy entrained with at the Station and even the Bureau and the me back to the swamp·polluted, mosquito·infested Department did not allow him to have his way and and the thell flood ·threatened leprosarium where I 302 International Journal of Leprosy 1972

landed in a concrete jail cell abou t midnight . Carville, and Dr. Victor G. Heiser, pres­ August 28. 1927. and in which jail ce ll I am sti ll ident of the International Leprosy Associa­ locked at this writing. March 6. 1928 . " (3 8) . tion, had embarked on the Italian liner Amazingly, he was 'returned to Carville Conti di Savoia to attend the Fourth Inter­ only to be discharged as "cured" less than national Leprosy Conference at Cairo, six months later. In an announcement on Egypt ( 22) . By odd coincidence, thirty the occasion, Public H e<.tl~ h Service officials years before, Dr. Armauer Hansen had hailed Early's case as "another triumph in sealed John Early's fate as the "wandering modern medicine that was brought about leper" of modern times at the second con­ by the injection of chaulmoogra oil." Fur­ ference. thermore, they credited the mountaineer's The medical side of the Early case is still "eccentrjcs" with having contributed much a puzzle. Why did Bulkley, Welch, Park, to the passage of the law creating the and Dutcher not see the same leprosy leprosy hospital and to "awakening public bacilli in Early's skin that Kinyoun, Ehlers, interest in the leprosy problem in this coun­ and Hansen saw, and why did Woodward try (19)." He left for North Carolina saying and Fowler isolate him like a wild animal, he was going to his farm near Tyron but but, at the same time, privately show no came back for some reason in 1930, sup­ fear of him? Carville reports indicate that posedly a relapse, and again became a he died of cancer, that he had, at times, patient. Early was once again discharged as positive skin smears for bacilli and had bacteriologically negative several months neural involvement resulting from leprosy. later but was readmitted in April, 1931. Thus, hindsight indicates that he probably His fellow inmate Stanley Stein later suffered from slight to moderately ad­ recalled: vanced neural leprosy for some thirty years. Whatever the diagnosis of the case, it I was proud of the title of crusader. but I could not claim to be the Carville Crusader as long as John remains frankly incredible. No other lepro­ Ruskin Earlywas alive and ki cking. During my sy patient has ever been the subject of period of "retrogression" his kicks were not as study for so much dermatological talent. strenuous as they once were. as he was bedridden From a social and psychological point of and almost blind. Yet from h is hospital bed he continued to dictate his vitupera tive letters to the view, the case of John Early illustrates how Presiden t of the U nited States or the world at leprosy status in American society, quite large. H e was a religious fanatic. a bigot, an recently, mandated a life-long form of rank exhibitionist. and. I think. at times bordered on the complete with a unique type of stigma. psychotic. Yet I must admire him for his long and Society failed to accept leprosy in reality dedicated fight for the ca use of Cat'vi lle patients (38) . terms. The disease was popularly regard­ ed as highly infectious, grossly destructive, From the time of his ninth and last and absolutely incurable. One could escape admission on April 20, 1934, until his death these limitations in approved fashion only on February 28, 1938, at age 64, Early by death. Social disapproval of the patient largely maintained his home at the lepro­ who violated society's prescribed norms sarium, continually agitating and was stringent and effective. Individuals preaching. Just before his death he an­ who were publicly identified as having nounced in his privately published pam­ leprosy were denied the social, economic, phlet, John Early, World-Famous Leper: and legal rights of normal people. Socially Twenty-eight Years at the Quarantine Bat, they were treated as objects of fear, ridi­ that '1eprosy is NOT a contagious disease; cule, and scorn; economically they were it is remotely infectious, and that by sexual summarily dismissed from employment in or venereal route, like gonorrhea or syphilis disgrace; legally their personal rights and (15) ." freedom were violated and they were On the same pages as his lengthy obit­ hunted down by police and health authori­ uary in the New York Times was the ties as common criminals (27). notice that Dr. H. E. Hasseltine, director of The sociologist Erving Goffman, an au­ the United States Public Health Hospital at thority on stigma theory, observes that 40, 3 KaUsch: Strange Case of John Early 303 those who have dealings with the stigma­ presents the problems of a patient with tized person "fail to accord him the respect leprosy in a relatively advanced society, and regard which the uncontaminated as­ the United States, having relatively few pects of his social identity have led them to patients but never-the-Iess possessed of a anticipate extending, and have led him to strong opprobrium towards this disease. anticipate receiving; he echoes this denial Though the incidents here recorded essen­ by finding that some of his attributes war­ tially took place during the first three dec­ rant it." The final blow occurs and the ades of this century, and though the treat­ vicious circle is completed when the lepro­ ment of patients with leprosy is today far sy victim agrees with his detractors and different from that prevailing during the considers the discriminatory treatment time of John Early, one may even today which is meted out to him as deserved and find reactional remnants to leprosy in this the prejudicial attitude which underlies it society similar to those which John Early as justified. Thus the victim is not only experienced. discriminated against, but is made to un­ derstand that he deserves it, and eventual­ RESUMEN ly comes to regard his treatment as just El estudio del caso de John Early presenta (24) . el problema de un paciente con lepra en una It is clear that our society created the socieded relativamente avanzada, los Estados apparent menace of leprosy through a sym­ Unidos, que tiene relativamente pocos pacien­ bolic social process of labeling. Since other tes, pero, sin embargo, posee un fuerte oprobio people saw John Early as so "different" as hacia esta enfermedad. Aunque los incidentes to be "frightening" it was most diffi cult for que se registran aqui tuvieron lugar esencial­ mente durante las tres primeras decadas de este him to see himself otherwise. Furthermore siglo y aunque el tratamiento de los pacientes the actions that society took in regard to his con lepra es hoy muy diferente del que pre­ existence contributed to his image of being valeda durante el tiempo de John Early, completely apart from his fellow man. todavia uno puede encontrar en esta sociedad Thus, John Early's incarceration appears to reacciones a la lepra similares a aquellas que have accentuated in his own mind as well experimento John Early. as that of his wife, that he deserved to be set apart. An almost inevitable corollary to RESUM:E his institutionalization was the increasing L'etude du cas de John 'Earl y permet de dependency he exhibited along with his prese nter les problemes qui se posent a un self-view as sort of an Old Testament malade atteint de lepre, dans une societe prophet whose mission was to proclaim the relalivement avancee, celie des Etats-Unis, cause of "the unclean." ayant relativement peu de mal ades, mais To be confined because of a diagnosis of temoignant cependant d'un opprobre tres leprosy, then freed after examination by prononce envers cette maladie. Encore que les incidents rapportes dans cette etude aient eu specialists, only to be imprisoned again lieu essentiellement au cours des trois premieres when other authorities reached contrary decennies de ce siecle, et quoique traitement conclusions and all the while to see himself, des rnalades de la lepre soit aujourd'hui fort his young wife, and children disgraced and different de celui auquel on avait recours au find that men fled from him when they temp" de John Early, on peut encore actuelle­ learned his identity-this was the thirty ment deceler dans cette societe des reactions year fate of John Ruskin Early. Behind the envers la lepre tout a fait semblables a celles multitude of news dispatches telling of his dont John Early a souffert. sensational escapes and wanderings is, the tragedy of a man who felt the full force of a REFERENCES stigmatized status in our society, and as a 1. Alleged leper sent here. New York Times, result, lost his wife, his family, and peace of July 4, 1909, p 12. mind. 2. AYCOCK, W. L. and COHDON, J. E. Lep­ rosy in veterans of American wars. Amer. SUMMARY J. Med. Sci. 214 (1947) 329-339. This study of the case of John Early 3. BLUE, R. Memorandum to Assistant Secre- 304 International Journal of Leprosy 1972

tary Bailey, March 4, 1912. Leprosy File, 23. FORRESTER, r. The strange case of John Records of the U.S. Public Health Service Early: The true story of the closed door (Record Group 90), National Archives, in the brick wall between the outcast hus­ Washington, D.C. (Hereafter cited in ref­ band. Munsey's Magazine 41 (1909) 773- erences as NA) 781. 4. BLUE, R. Telegram to Quarantine Officer 24. GOFFMAN, E. Stigma: Notes on the Man­ B. H. Earle at Port Townsend, Washing­ agement of Spoiled Identity. Englewood ton. March 29, 1912, NA. Cliffs: Prentice-Hall, 1963. 5. BLUE, R. Letter to E. Kelley, April 25, 25. HASSELTINE, H. E. Leprosy in men who 1912, NA. served in United States military service. 6. BULKLEY, L. D. Leprosy. Med. Record 76 Internat. J. Leprosy 8 (1940) 501-508. (1909) 45-47. 26. John Early may sue for last detention. 7. BULKLEY, L. D. Medico-legal aspects of New York Times, December 13, 1909, p 6. the case of John Early, suspected leper, 27. KALTSCH, P. A. Tracadie and Penikese long quarantined in Washington. Read Leprosariums: A comparative historical before the Society of Medical Jurisprud­ analysis of societal response to leprosy in ence, December 13, 1909, NA. New Brunswick, 1844-1880 and Massa­ 8. Care and treatment of persons aillicted chusetts, 1904-1921. Presented at the 45th with leprosy. Hearings before the Com­ Annual Meeting of the American Associ­ mittee on Public Health and National ation for the History of Medicine, Mon­ Quarantine, United States Senate, 64th treal, Quebec, May 4, 1972. Congress, 1st Session, Washington: Gov­ 28. KALTSCH, P. A. Federal reaction to leprosy ernment Printing Office, 1916. in the United States, 1889-1920. Unpub­ 9. Case of Early. Washington Times, June lished paper to be presented at the 87th 4, 1914, pp 1, 5. Annual Meeting of the American Histor­ 10. CAZENAVETTE, L. L. Mental aspect of ical Association, .New Orleans, Louisiana, leprosy. J. Amer. Med. Ass. 89 (1927) December 28-30, 1972. 1496-1500. 29. KELLEY, E. Letter to R. Blue. April 19, 11. Conference on leprosy. The Times (Lon­ 1912, NA. don), August 19, 1909, p 3. 30. Leper in Washington. New York Times, 12. Congressional Record, June 4, 1914, pp August 24, 1908, p 7. 9822-9823. 31. Leper a prisoner after tour deluxe. New 13. DAVENPORT, J. Letter to President Taft. York Times, June 3, 1914, p 4. March 12, 1912, NA. 32. Leper in Capital on his 4th escape. New 14. EARLE, B. H. Letters to R. Blue. March York Times, June 17, 1923, p 5. 23, 1912; May 20, 1912, NA. 33. Lepraphobia. New York Times, June 25, 15. EARLY, J. Jolm Early, World-Famous 1914, P 8. Leper: Twenty-eight Years at the Quaran­ 34. Leprosy. New York Times, August 31, tine "Bat." Carville, Louisiana: Privately 1908, P 6. printed, 1935, pp 3-46. 35. Man isolated not a leper. New York Times, 16. EARLY, L. Letter to President Taft. March May 24, 1909, P l. 2,1912, NA. 36. May ask Congress for justice to Early. 17. Early is arrested again as a leper. New New York Times, December 14, 1909, p 5. York Times, December 3, 1909, p 8. 37. Records pertaining to John R. Early, U. S. 18. Early the leper, goes crazy. New York Public Health Service Hospital, Carville, Times, July 11, 1913, p 7. Louisiana. 19. Early, famous leper, will go home, 'cured.' 38. STEIN, S. Alone No Longer. New York: New York Times, November 19, 1928, Funk and Wagnalls, 1963. p 21. 39. Supposed case of leprosy. The Times 20. Establishment of a national leprosarium. (London), September 2, 1908, p 5. Hearings before the Committee on Inter­ 40. Supposed leper now free of disease. New state and Foreign Commerce, 63rd Con­ York Times, July 10, 1909, p 4. gress, 3rd Session, December 15, 1914. 41. Thirteenth Biennial Report of the Board 21. EVEREST, E. Letters to W. Wyman. Janu­ of Control for the Leper Home of the ary 31, 1911, February 8, 1911, NA. State of Louisiana to the Governor and 22. Famous fugitive of leper city dies. New General Assembly. New Orleans: Perry York Times, March 1, 1938, P 22. and Buckley Co., 1920. 40, 3 Kalisch: Strange Case of John Early 305

42 WICKERSHAlI l, G. W. Letter to Charles D. diagnosis would fit with some of the confu­ HiIles, Secretary to President Taft. Febru­ sion in the diagnosis detailed in the paper ary 26, 1912, NA. by Kalisch. It might well explain why some 43. WYMAN, W. Letter to E. Everest. Febru­ physicians did not find bacilli and others, ary 7, 1911, NA. perhaps with greater patience and experi­ [Editorial Note: The following photo­ ence, or good fortune, did. It might also ex­ graph of John Early, dated 1916, is a repro­ plain why he was at times regarded as duction of an old print brought to our at­ cured despite the absence of effective spe­ tention by Dr. Chapman Binford, Geograph­ cific tJ1erapy. This historical presentation ic Pathology Division, Armed Forces Insti­ does remind us that, dcspite ongoing mis­ tute of Pathology, Washington, D.C. Though conceptions and unwarranted fears, the not well-lighted for diagnostic purposes situation with respect to thc trcatment of the lesions are apparent, especially on the leprosy has changed very strikingly since neck, suggests that John Early may have the time of John Early. The U.S. Public had what would now be diagnosed as bor­ H calth Service Hospital at Carvillc is today derline or intermediate type leprosy. This a dramatic witness to this fact.]