All natives of Japan in their mid-twenties, the women had worked at Yoshiwara House for about one year. In late Victorian parlance, such women were called “inmates”—their profession was a life sentence. Some were sold by impoverished families, others accepted passage to America for a job that turned out to be in the flesh trade. Most died young, drained and disfigured by disease.
Ryfkogel and the city health board rushed to the scene, followed by Blue and his men. The city doctors slapped a quarantine on the house, holding the other inmates for observation until Ryfkogel could make a diagnosis. Terrified of quarantine, a girl called Fuku Inaki slipped downstairs and ran four blocks away to a house on Pine Street.
The men proceeded to examine the three prostitutes. The symptoms looked like classic plague, but clinical impressions weren’t enough to confirm a diagnosis. Ryfkogel drew blood samples from Shina, Miyo, and Ume and hopped a streetcar back to his lab on Sutter Street. Confirmatory cultures and animal inoculation tests would take days. Until then, he could do a kind of quick antibody test called an agglutination reaction. In it, he mixed the girls’ blood with plague bacteria cultured in bouillon. If particles in the fluid clumped together, plague was present. The mix curdled into clots. “Immediate and characteristic,” Ryfkogel noted. The test “makes it absolutely certain that the three suffered from the same disease and this disease was bubonic plague.”18
Finding the culprit didn’t change the women’s fate; their illness was far too advanced for treatment. Just hours after they were examined, Shina and Miyo slipped into a coma. With their lymph glands hemorrhaging, the plague toxin raced through their bloodstream. Their blood pressure plunged, and shock set in. The ebony pools of their pupils were frozen, fixed and dilated. Around three A.M. on July 9, the two women died. Their colleague Ume, seething with a fever of 105, wasn’t expected to live.
At twelve noon, Miyo’s shrouded form was carried to the morgue on Commercial Street for autopsy. In attendance were federal and city physicians, with the state doctors hovering to quibble over points of lab technique. The federal doctors donned rubber aprons and began their barehanded autopsy of Miyo, a twenty-six-year-old female, stiffened by rigor mortis. The doctors made a long median incision from sternum to pubis, opened her peritoneum, pushed aside coils of viscera, and found the knot of inflamed lymph glands in her right pelvis. Her spleen was swollen to twice the normal size. The doctors carefully extracted bits of tissue to grow in culture.19
At three P.M., they began the autopsy of Shina, also just twenty-six. She was “a well-developed and well-nourished young woman,” with an unblemished complexion and no sign of venereal disease. After carving carefully around the buboes in her left and right pelvis, the doctors eased out the skein of inflamed lymph glands, which oozed blood.20
With the naked eye, they would later watch as cultures made from those samples, smeared across agar plates, developed into germ colonies with the classic “ground glass” texture of plague. Under the microscope, the colonies were made up of the short-rounded rods of plague bacteria. And the guinea pigs injected with the cultures developed the same swollen glands, the same fatal outcome.
Now Blue began using the health service codebook to wire the test results to Surgeon General Wyman: “Bumpkin malleate …”21 Plague diagnosis confirmed.
About the time her co-workers lay cooling on the autopsy slab, young Ume surprised the doctors by rebounding. Blue declared her to be the first patient ever to survive plague in San Francisco.
But the case of the fugitive Fuku Inaki was hopeless. Health officers caught up with the young prostitute on Pine Street and brought her back to the brothel in Chinatown for observation. The Chinese press protested her return to Chinatown as proof the federal doctors wished them ill and sought to concentrate all the plague in their neighborhood.22 By July 11, she was dead. Kimonos and bedding used by the Yoshiwara women were piled in the street and burned.
Blue’s next task was to worry about the men who had patronized the brothel. It wouldn’t be easy. Before they fell ill, Blue estimated, the women had serviced at least fifty men between them, and so far not a single case of suspicious illness had been reported. “Truly an anomaly,” he puzzled.23
Blue watched his men rushing from brothel to morgue, and morgue to laboratory, hastily disinfecting their equipment in between cases as best they could. With the fumes of formaldehyde and carbolic acid still singeing his nostrils, Blue hinted that the task was more than Wyman had envisioned. To protect themselves, the men were injecting each other regularly with Yersin’s plague antiserum. It was expensive, and it carried the same risks of serum sickness that had troubled Lewellys Barker. But as they were constantly being exposed to plague germs without the modern protection of latex gloves and face shields, it was their only option.
The outbreak also tested Blue’s diplomacy. “Much hard feeling has been engendered over these cases between Bursary [the code word for the California State Health Board] on the one side and Burlesque [the San Francisco Health Board] and Ryfkogel on the other,” he wrote. “Our laboratory technique has been unfairly criticised by [the state physician] Dr. Mathews, and I found it very hard to refrain a retort in kind. There is so much at stake, and as we are only seeking the truth, I shall always try to maintain a friendly relationship with them…. We have borne a good deal and can bear a great deal more for the good of the Service and the cause.”24
Blue had run into the same wall of denial and deceit that had bedeviled Joseph Kinyoun and Joseph White. Now those forces were obstructing his mission, complaining about the lab assistance of Drs. Kellogg and Ryfkogel. However, Blue’s way was not to collide head-on, but rather to circumvent.
“I humored them to the extent of saying that only our Service men should touch or handle preparations in the laboratory. I did this with a view to forestall any unjust criticism that might be given out by them. Of course, I know that Doctors Ryfkogel and Kellogg are as safe to have around as any men in the profession, but I did not want our work discredited on account of local prejudice,” he reported to Washington. “There is some amusement to be gained by yielding to some of their objections, for then we are put on the qui vive.”25 A soldier’s son, Blue remained on the alert, on the qui vive, a French sentry’s cry that means “Who goes there?”
Despite five new cases and four deaths, the newspapers largely ignored the outbreak, and most San Franciscans were oblivious to any hazard that might spoil their summer. Even Ho Yow, the consul of China, took a break from his diplomatic duties in August to attend the summer harness races in the hotbox of Sacramento. There, his mare Solo streaked ahead of the competition. Sore losers attributed Solo’s victory to her driver’s racing silks, with their coiled dragon, which mesmerized the competition.
The city’s long-festering labor unrest exploded in late summer. By a unanimous vote of the City Labor Federation, a general strike was called on July 29. City teamsters were idled, along with fifteen thousand sailors, longshoremen, and freight handlers on the waterfront. The port was paralyzed. Striking workers marched four abreast down Market Street. By August, the strike funds and patience were running out.
On August 28, as five hundred striking teamsters left a benefit baseball game south of Market Street, they ran into dray wagons driven by nonunion men. Hurling rocks, the strikers harried the strikebreakers up 6th Street to Market. The rioters were cheered by five thousand spectators. Special police fired guns to break up the mob. Scores were bloodied in the melee, but no one was killed.26