HERITAGE – RIMJ NOVEMBER 1995

The Civil Rights of Mary Mallon

STANLEY M. ARONSON, MD

o one disputes the events after then several in Manhattan, then one at Willard Parker Hospital where she 74 N August 1906; the facts prior to this in Maine, then Sands Point in Long exhibited no ill health, but repeated 75 date, however, remain conjectural. Island, then Tuxedo Park, New York. stool cultures nevertheless demon- EN Gen. William Henry Warren, a promi- In each instance, one or more individ- strated an abundance of S. Typhi. By nent New York City banker, rented a uals in the household had developed order of the health authorities, she was summer house for his family of three typhoid, and in each instance, Mallon then remanded to a small bungalow in Oyster Bay, Long Island. In July 1906 was said to have discretely departed next to Riverside Hospital on North they moved in, bringing with them a to seek employment elsewhere. In the Brother Island in the East River. Her complement of seven live-in servants. seven households investigated, Soper cottage was provided with all necessary On August 27, one of the servants identified 53 cases of acute typhoid amenities and she was free to roam the became acutely ill with typhoid fever, fever (with three deaths), all temporar- island and use its facilities, including and by September 3, five more cases of ily associated with Mallon’s employ- the local chapel. typhoid had arisen within the house- ment as cook. Soper readily hold, including the general’s wife and admitted that these statis- Mary Mallon’s story became widely publicized daughter. There were no further cases tics were quite conserva- and the June 20, 1909 edition of William but the owner of the home, fearing that tive since many of Mallon’s the value of her property was now in known places of previous Randolph Hearst’s New York American vividly jeopardy, recruited an established epi- employment could no lon- elaborated on the morbid events, labeling her demiologist and sanitarian, Dr. George ger be investigated and as “…the most dangerous woman in America.” A. Soper, to seek out the origins of the not all of her tours of duty contagion. He quickly eliminated the had been obtained through The newspaper also provided her with a new usual sources of enteric fever (faulty the Stricker employment name: “Typhoid Mary.” privies, deteriorating sewer systems, agency. Furthermore, Soper contaminated water supply), leaving counted only those primary cases of In 1908, G.F. O’Neill, a local attor- him with the uneasy likelihood that a typhoid ascribable to direct contact ney, took on her case as an instance healthy human might be the carrier of with Mallon’s food preparations while of imprisonment without due process the pathogen. By bacteriologic assays, not considering the many secondary of law, without legal representation, he eliminated from suspicion Mr. War- cases stemming from the momentum indeed, without even a trial. The judge ren and six of the seven servants. The of the initial outbreaks. Soper fully dismissed a request for release, point- seventh, a Mary Mallon, had quietly acknowledged that the true number ing to a 1905 Supreme Court judgment resigned her job as the family cook most likely exceeded 1,000. regarding compulsory vaccination, shortly after the first case of typhoid Armed with circumstantial evidence which declared that prudent measures had emerged and had then disappeared. of a compelling association between undertaken to protect the public were She was described by her fellow house Mallon’s cooking and multiple out- a legitimate exercise of the state police servants as remote, unfriendly, at breaks of typhoid, Soper tracked her powers. By this time Mary Mallon’s times violently hostile and a “rather finally to a new sight of employment, story became widely publicized and dirty person.” confronted her with the epidemiologic the June 20, 1909 edition of William Soper felt obliged to pursue his one data and requested her voluntary coop- Randolph Hearst’s New York Ameri- remaining lead and he sought out a Mrs. eration in verifying her carrier state. can vividly elaborated on the morbid Stricker whose employment agency in Mallon’s pathologic temper was amply events, labeling her as “…the most Manhattan had originally recruited demonstrated and he barely escaped dangerous woman in America.” The Mary Mallon as the family cook. her wrath. Undeterred however, he newspaper also provided her with a Slowly and deliberately Soper recon- appealed to the New York Department new name: “Typhoid Mary.” structed Mallon’s employment history of Health and eventually Mallon was In February 1910, after 35 months as a family cook, going back many arrested, but only after a violent strug- of isolation (during which time she years. He then interviewed most of gle in which two policemen suffered repeatedly asserted her innocence these families. Beginning in 1900 there injuries, one losing most of one ear. claiming that her imprisonment was had been a household in Mamaroneck, Mallon was kept in an isolation ward a British plot to suppress her activities

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on behalf of Irish independence) Mal- long without some visible authority in where few if any immigrants had ven- lon was offered her freedom on two matters of health and social stability. tured. Indeed, in the United States conditions: that she refrain from any (Plato describes an important trial in Army of 1898 to 1900 with approxi- employment requiring direct contact Athens: “The judges: Tell us Socrates, mately 107,000 officers and men, most with food and that she report to the do you suppose a city can exist and not of whom were native-born, there were Department of Health at three-month be overthrown, in which the decisions 20,738 cases of typhoid, with 1,580 intervals. of law are powerless, set aside and deaths. She was then released and promptly trampled upon by individuals?”) Even if all immigrants had some- broke both promises, disappearing The debate regarding the civil liber- how been excluded from this nation, into the urban sprawl of municipal ties of the innocent carrier may have typhoid would nevertheless have con- New York. For the next five years she obscured yet another area of conten- tinued to exert its toll until American held various cooking posts at numer- tion. The arrival to the shores of some society could instill better personal ous homes and in restaurants, under a 36 million immigrants between 1880 hygiene habits in its residents and until number of aliases, producing a further and 1920 was greeted with varied emo- local communities were sufficiently series of typhoid fever outbreaks. tions, particularly so since most new- motivated to establish water supplies In 1915, there was an unexplained comers were poor, under-educated and free of fecal contamination. v cluster 20 cases of typhoid among with a greater vulnerability to such the patients at the Sloane Hospital infectious diseases as cholera, typhoid, [Editor’s Note: This article, written by for Women. Soper was called, and he tuberculosis and poliomyelitis. The the late Stanley M. Aronson, MD, found- immediately recognized the chef as waves of arriving Irish that, for exam- ing dean of Brown’s medical school and a Mary Mallon, now under the assumed ple, coincided with major outbreaks of former editor-in-chief of the Rhode Island name of Brown. She was promptly cholera and typhoid in East Coast cit- Medical Journal, first appeared in RIMJ’s remanded to the same East River cot- ies, and nativist hostilities to the new November 1995 edition.] tage. Some 17 years later, on Christmas immigrants, were translated readily to morning 1932, Mallon suffered a severe blanket accusations that the Irish were stroke, remaining in a semicomatose the cause of these outbreaks. These state for another six years, ultimately complaints ignored the fact that the dying on November 11, 1938. In what Irish were the chief victims of these con- some regarded as undue haste, she was tagions, which had been spread exclu- buried in a Bronx cemetery within sively by contaminated water supplies. hours of her death. The spread of poliomyelitis, between These, then, are the accepted details 1910 in 1920, was similarly blamed in the tragic life of Mary Mallon. upon immigrant Italians and Jews. Newspaper reports invariably men- Civil liberties vs. population safety tioned Mary Mallon’s Irishness, as The New York Department of Health well as her alleged temper, suggesting had been accused of abridging Mal- that a Celtic heritage and a confront- lon’s civil liberties; indeed, banishing ing personality were somehow the her without trial to life imprisonment. necessary preludes to the carrier state. Many claimed that a mere quirk of Epidemiologists, on the other hand, microbial happenstance, ultimately concluded that at least five percent of beyond her control, had somehow con- those exposed to the typhoid bacillus verted her into an unwilling chronic became chronic carriers, meaning that carrier. The department, on the other they were at least 20,000 carriers of all hand, pointed to as many attempts to ages and persuasions wandering the work out some sort of compromise streets and country roads of the United with Mallon; it insisted, nevertheless, States in 1906. Yet only Mary Mallon’s that it could never abdicate its obliga- name crops up as the evil exemplar of tion to protect the health of the larger the carrier state. community. It claimed that all soci- Some further observations need to be ety represents an uneasy equilibrium offered: without any help from carrier between private autonomy and the immigrants, typhoid fever had contin- needs of the community and that no ued to flourish throughout the United system of government can prevail for States, including those heartland cities

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