Temporarily detained: Tuberculous alcoholics in Seattle, 1949 through 1960

American Journal of Public Health

Volumn 86, Issue 2, 1996, Pages 257-265

  Lerner, Barron H ^a  

^a Columbia University ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALCOHOLISM; ARTICLE; DISEASE ASSOCIATION; HEALTH PROGRAM; INFECTION; INFECTION CONTROL; INSTITUTIONALIZATION; LAW; PUBLIC HEALTH; TUBERCULOSIS;

EID: 0030020142     PISSN: 00900036     EISSN: None     Source Type: Journal    
DOI: 10.2105/AJPH.86.2.257     Document Type: Article

References (133)

1. Thomas R. Frieden et al., "The Emergence of Drug-Resistant Tuberculosis in New York City," New England Journal of Medicine 328 (1993): 521-526; Alan B. Bloch et al., "Nationwide Survey of Drug-Resistant Tuberculosis in the United States," Journal of the American Medical Association 271 (1994): 665-671.
2. Thomas R. Frieden et al., "The Emergence of Drug-Resistant Tuberculosis in New York City," New England Journal of Medicine 328 (1993): 521-526; Alan B. Bloch et al., "Nationwide Survey of Drug-Resistant Tuberculosis in the United States," Journal of the American Medical Association 271 (1994): 665-671.
3. Nancy N, Dubler et al., "Tuberculosis in the 1990s: Ethical, Legal, and Public Policy Issues in Screening, Treatment, and the Protection of Those in Congregate Facilities," in The Tuberculosis Revival - Individual Rights and Societal Obligation in a Time of AIDS (New York: United Hospital Fund, 1992), 1-41; George J. Annas, "Control of Tuberculosis - The Law and the Public's Health," New England Journal of Medicine 328 (1993): 585-588; Lawrence O. Gostin, "Controlling the Resurgent Tuberculosis Epidemic. A 50-State Survey of TB Statutes and Proposals for Reform," Journal of the American Medical Association 269 (1993): 255-261; Rosemary G. Reilly, "Combating the Tuberculosis Epidemic: The Legality of Coercive Treatment Measures," Columbia Journal of Law & Social Problems 27 (1993): 101-149.
4. Nancy N, Dubler et al., "Tuberculosis in the 1990s: Ethical, Legal, and Public Policy Issues in Screening, Treatment, and the Protection of Those in Congregate Facilities," in The Tuberculosis Revival - Individual Rights and Societal Obligation in a Time of AIDS (New York: United Hospital Fund, 1992), 1-41; George J. Annas, "Control of Tuberculosis - The Law and the Public's Health," New England Journal of Medicine 328 (1993): 585-588; Lawrence O. Gostin, "Controlling the Resurgent Tuberculosis Epidemic. A 50-State Survey of TB Statutes and Proposals for Reform," Journal of the American Medical Association 269 (1993): 255-261; Rosemary G. Reilly, "Combating the Tuberculosis Epidemic: The Legality of Coercive Treatment Measures," Columbia Journal of Law & Social Problems 27 (1993): 101-149.
5. Nancy N, Dubler et al., "Tuberculosis in the 1990s: Ethical, Legal, and Public Policy Issues in Screening, Treatment, and the Protection of Those in Congregate Facilities," in The Tuberculosis Revival - Individual Rights and Societal Obligation in a Time of AIDS (New York: United Hospital Fund, 1992), 1-41; George J. Annas, "Control of Tuberculosis - The Law and the Public's Health," New England Journal of Medicine 328 (1993): 585-588; Lawrence O. Gostin, "Controlling the Resurgent Tuberculosis Epidemic. A 50-State Survey of TB Statutes and Proposals for Reform," Journal of the American Medical Association 269 (1993): 255-261; Rosemary G. Reilly, "Combating the Tuberculosis Epidemic: The Legality of Coercive Treatment Measures," Columbia Journal of Law & Social Problems 27 (1993): 101-149.
6. Nancy N, Dubler et al., "Tuberculosis in the 1990s: Ethical, Legal, and Public Policy Issues in Screening, Treatment, and the Protection of Those in Congregate Facilities," in The Tuberculosis Revival - Individual Rights and Societal Obligation in a Time of AIDS (New York: United Hospital Fund, 1992), 1-41; George J. Annas, "Control of Tuberculosis - The Law and the Public's Health," New England Journal of Medicine 328 (1993): 585-588; Lawrence O. Gostin, "Controlling the Resurgent Tuberculosis Epidemic. A 50-State Survey of TB Statutes and Proposals for Reform," Journal of the American Medical Association 269 (1993): 255-261; Rosemary G. Reilly, "Combating the Tuberculosis Epidemic: The Legality of Coercive Treatment Measures," Columbia Journal of Law & Social Problems 27 (1993): 101-149.
7. Recent work has demonstrated how language may both reflect and promote the ideological agenda of those who employ it. See, for example, JoAnne Brown, "Professional Language: Words That Succeed," Radical History Review 34 (1986): 33-51; James A. Trestle, "Medical Compliance as an Ideology," Social Science and Medicine 27 (1988): 1299-1308. This type of analysis likely applies to the events described in this article. That is, health officials' use of the pejorative term recalcitrant to describe alcoholics who disregarded treatment recommendations likely encouraged the adoption of a particularly coercive approach to this population. Having stated this caveat, I will continue to use the terminology employed during the 1950s.
8. Recent work has demonstrated how language may both reflect and promote the ideological agenda of those who employ it. See, for example, JoAnne Brown, "Professional Language: Words That Succeed," Radical History Review 34 (1986): 33-51; James A. Trestle, "Medical Compliance as an Ideology," Social Science and Medicine 27 (1988): 1299-1308. This type of analysis likely applies to the events described in this article. That is, health officials' use of the pejorative term recalcitrant to describe alcoholics who disregarded treatment recommendations likely encouraged the adoption of a particularly coercive approach to this population. Having stated this caveat, I will continue to use the terminology employed during the 1950s.
9. Cedric Northrop, "Field Activities Report for January, 1954." Health Department Administrative Files, Washington State Archives, Olympia, Washington (hereafter cited as WSA), box 6, folder: tuberculosis control, 1953-54.
10. David F. Musto, "Quarantine and the Problem of AIDS," Milbank Quarterly 64, supplement 1, (1986): 98.
11. Ibid., 104-106; George Rosen, A History of Public Health, expanded edition (Baltimore, Md: Johns Hopkins University Press, 1993), 251-254.
12. Ibid., 104-106; George Rosen, A History of Public Health, expanded edition (Baltimore, Md: Johns Hopkins University Press, 1993), 251-254.
13. Allan Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States Since 1880 (New York: Oxford University Press, 1987), 40-47, 94, 95; Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers University Press, 1992), 106-137.
14. Allan Brandt, No Magic Bullet: A Social History of Venereal Disease in the United States Since 1880 (New York: Oxford University Press, 1987), 40-47, 94, 95; Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers University Press, 1992), 106-137.
15. Rogers, Dirt and Disease, 30-44; Edgar A. Jonas, "Law Enforcement in the Control of Tuberculosis," American Journal of Public Health 13 (1923): 113-118; Stuart Galishoff, Safeguarding the Public Health. Newark, 1895-1918 (Westport, Conn: Greenwood Press, 1975), 29-34. The most infamous case of enforced isolation is probably that of Typhoid Mary. See Judith W. Leavitt, " 'Typhoid Mary' Strikes Back. Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis 83 (1992): 608-629.
16. Rogers, Dirt and Disease, 30-44; Edgar A. Jonas, "Law Enforcement in the Control of Tuberculosis," American Journal of Public Health 13 (1923): 113-118; Stuart Galishoff, Safeguarding the Public Health. Newark, 1895-1918 (Westport, Conn: Greenwood Press, 1975), 29-34. The most infamous case of enforced isolation is probably that of Typhoid Mary. See Judith W. Leavitt, " 'Typhoid Mary' Strikes Back. Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis 83 (1992): 608-629.
17. Rogers, Dirt and Disease, 30-44; Edgar A. Jonas, "Law Enforcement in the Control of Tuberculosis," American Journal of Public Health 13 (1923): 113-118; Stuart Galishoff, Safeguarding the Public Health. Newark, 1895-1918 (Westport, Conn: Greenwood Press, 1975), 29-34. The most infamous case of enforced isolation is probably that of Typhoid Mary. See Judith W. Leavitt, " 'Typhoid Mary' Strikes Back. Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis 83 (1992): 608-629.
18. Rogers, Dirt and Disease, 30-44; Edgar A. Jonas, "Law Enforcement in the Control of Tuberculosis," American Journal of Public Health 13 (1923): 113-118; Stuart Galishoff, Safeguarding the Public Health. Newark, 1895-1918 (Westport, Conn: Greenwood Press, 1975), 29-34. The most infamous case of enforced isolation is probably that of Typhoid Mary. See Judith W. Leavitt, " 'Typhoid Mary' Strikes Back. Bacteriological Theory and Practice in Early Twentieth-Century Public Health," Isis 83 (1992): 608-629.
19. Dorothy Porter and Roy Porter, "The Enforcement of Health: The British Debate," in AIDS. The Burdens of History, ed. Elizabeth Fee and Daniel M. Fox (Berkeley, Calif: University of California Press, 1986), 107.
20. Allan M. Brandt, "AIDS: From Social History to Social Policy," in AIDS. The Burdens of History, ed. Elizabeth Fee and Daniel M. Fox (Berkeley, Calif: University of California Press, 1986), 151.
21. Musto, "Quarantine," 109-112; Alan M. Kraut, Silent Travelers: Germs, Genes, and the "Immigrant Menace" (New York, NY: Basic Books, 1994); Howard Markel, "Layers of Separation: Epidemics and the Quarantining of East European Jewish Immigrants in New York City During the Late 19th Century" (Ph.D. diss, Johns Hopkins University, 1994).
22. Musto, "Quarantine," 109-112; Alan M. Kraut, Silent Travelers: Germs, Genes, and the "Immigrant Menace" (New York, NY: Basic Books, 1994); Howard Markel, "Layers of Separation: Epidemics and the Quarantining of East European Jewish Immigrants in New York City During the Late 19th Century" (Ph.D. diss, Johns Hopkins University, 1994).
23. Musto, "Quarantine," 109-112; Alan M. Kraut, Silent Travelers: Germs, Genes, and the "Immigrant Menace" (New York, NY: Basic Books, 1994); Howard Markel, "Layers of Separation: Epidemics and the Quarantining of East European Jewish Immigrants in New York City During the Late 19th Century" (Ph.D. diss, Johns Hopkins University, 1994).
24. Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Anchor Books, 1961), 6. See also David J. Rothman, Conscience and Convenience. The Asylum and Its Alternatives in Progressive America (Boston, Mass: Little, Brown, 1980), 324-421; Elizabeth Lunbeck, The Psychiatric Persuasion. Knowledge, Gender, and Power in Modem America (Princeton, NJ: Princeton University Press, 1994). Lunbeck has built on the work of Michel Foucault, as documented in Discipline and Punish: The Birth of the Prison (New York, NY: Pantheon Books, 1977).
25. Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Anchor Books, 1961), 6. See also David J. Rothman, Conscience and Convenience. The Asylum and Its Alternatives in Progressive America (Boston, Mass: Little, Brown, 1980), 324-421; Elizabeth Lunbeck, The Psychiatric Persuasion. Knowledge, Gender, and Power in Modem America (Princeton, NJ: Princeton University Press, 1994). Lunbeck has built on the work of Michel Foucault, as documented in Discipline and Punish: The Birth of the Prison (New York, NY: Pantheon Books, 1977).
26. Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Anchor Books, 1961), 6. See also David J. Rothman, Conscience and Convenience. The Asylum and Its Alternatives in Progressive America (Boston, Mass: Little, Brown, 1980), 324-421; Elizabeth Lunbeck, The Psychiatric Persuasion. Knowledge, Gender, and Power in Modem America (Princeton, NJ: Princeton University Press, 1994). Lunbeck has built on the work of Michel Foucault, as documented in Discipline and Punish: The Birth of the Prison (New York, NY: Pantheon Books, 1977).
27. Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (Garden City, NY: Anchor Books, 1961), 6. See also David J. Rothman, Conscience and Convenience. The Asylum and Its Alternatives in Progressive America (Boston, Mass: Little, Brown, 1980), 324-421; Elizabeth Lunbeck, The Psychiatric Persuasion. Knowledge, Gender, and Power in Modem America (Princeton, NJ: Princeton University Press, 1994). Lunbeck has built on the work of Michel Foucault, as documented in Discipline and Punish: The Birth of the Prison (New York, NY: Pantheon Books, 1977).
28. Henry I. Bowditch, "Consumption in America," in From Consumption to Tuberculosis. A Documentary History, ed. Barbara G. Rosenkrantz (New York, NY: Garland Publishing, 1994), 57-96. First published in the Atlantic Monthly (January-March 1869).
29. Henry I. Bowditch, "Consumption in America," in From Consumption to Tuberculosis. A Documentary History, ed. Barbara G. Rosenkrantz (New York, NY: Garland Publishing, 1994), 57-96. First published in the Atlantic Monthly (January-March 1869).
30. Michael E. Teller, The Tuberculosis Movement. A Public Health Campaign in the Progressive Era (New York, NY: Greenwood Press, 1988), 93, 94; David F. Musto, "Popular and Public Health Responses to Tuberculosis in America after 1870," in AIDS and the Historian, ed. Victoria A. Harden and Guenter B. Risse (Washington, DC: US Department of Health and Human Services, 1991), 14-20; Sheila M. Rothman, Living in the Shadow of Death. Tuberculosis and the Social Experience of Illness in American History (New York, NY: Basic Books, 1994), 191-193. On Biggs's outstanding work in tuberculosis control, see Charles E-A. Winslow, The Life of Hermann Biggs, M.D., D.Sc., LL.D.: Physician and Statesman of the Public Health (Philadelphia, Pa: Lea & Febiger, 1929).
31. Michael E. Teller, The Tuberculosis Movement. A Public Health Campaign in the Progressive Era (New York, NY: Greenwood Press, 1988), 93, 94; David F. Musto, "Popular and Public Health Responses to Tuberculosis in America after 1870," in AIDS and the Historian, ed. Victoria A. Harden and Guenter B. Risse (Washington, DC: US Department of Health and Human Services, 1991), 14-20; Sheila M. Rothman, Living in the Shadow of Death. Tuberculosis and the Social Experience of Illness in American History (New York, NY: Basic Books, 1994), 191-193. On Biggs's outstanding work in tuberculosis control, see Charles E-A. Winslow, The Life of Hermann Biggs, M.D., D.Sc., LL.D.: Physician and Statesman of the Public Health (Philadelphia, Pa: Lea & Febiger, 1929).
32. Michael E. Teller, The Tuberculosis Movement. A Public Health Campaign in the Progressive Era (New York, NY: Greenwood Press, 1988), 93, 94; David F. Musto, "Popular and Public Health Responses to Tuberculosis in America after 1870," in AIDS and the Historian, ed. Victoria A. Harden and Guenter B. Risse (Washington, DC: US Department of Health and Human Services, 1991), 14-20; Sheila M. Rothman, Living in the Shadow of Death. Tuberculosis and the Social Experience of Illness in American History (New York, NY: Basic Books, 1994), 191-193. On Biggs's outstanding work in tuberculosis control, see Charles E-A. Winslow, The Life of Hermann Biggs, M.D., D.Sc., LL.D.: Physician and Statesman of the Public Health (Philadelphia, Pa: Lea & Febiger, 1929).
33. Michael E. Teller, The Tuberculosis Movement. A Public Health Campaign in the Progressive Era (New York, NY: Greenwood Press, 1988), 93, 94; David F. Musto, "Popular and Public Health Responses to Tuberculosis in America after 1870," in AIDS and the Historian, ed. Victoria A. Harden and Guenter B. Risse (Washington, DC: US Department of Health and Human Services, 1991), 14-20; Sheila M. Rothman, Living in the Shadow of Death. Tuberculosis and the Social Experience of Illness in American History (New York, NY: Basic Books, 1994), 191-193. On Biggs's outstanding work in tuberculosis control, see Charles E-A. Winslow, The Life of Hermann Biggs, M.D., D.Sc., LL.D.: Physician and Statesman of the Public Health (Philadelphia, Pa: Lea & Febiger, 1929).
34. Musto, "Popular and Public Health Responses," 17.
35. Musto, "Quarantine," 107. One exception was California, which began a program of detention in 1931.
36. Barron H. Lerner, "New York City's Tuberculosis Control Efforts. The Historical Limitations of the 'War on Consumption.' " Americin Journal of Public Health 83 (1993): 758-760 Although detention was infrequent ring this era, public sanatoria were sty strict. Control of daily activities was seen as crucial to "chasing the cure."
37. Recent memories of World War II undoubtedly contributed to the rejuvenation of the "war on tuberculosis" in Seattle and across the country. For an insightful analysis of how military language and metaphors have permeated tuberculosis control, see JoAnne Brown. "Playing the Game: Tuberculosis, Medievalist Nostalgia, and the Great War" (paper presented at the Organization of American Historians, Atlanta, Ga, April 1994). As we shall see. Seattle's "new" sanatorium in 1947 was an old naval hospital, and detention of patients occurred in the former naval brig.
38. Marcelle Dunning and Robert Heskett, "Diseases Through the Century: Public Health Becomes Involved," in Saddlebags to Scanners. The First 100 Years of Medicine in Washington State, ed. Nancy Rockafellar and James W. Haviland (Seattle, Wash: Washington State Medical Association, 1989), 133-154.
39. The history of preantibiotic therapeutics is actually much more complex and includes the use of alternative remedies and nostrums. See, for example, Linda Bryder, Below the Magic Mountain. A Social History of Tuberculosis in Twentieth-Century Britain (Oxford, England: Clarendon Press, 1988), 157-198. For the triumphant story of the discovery of antibiotics, see Frank Ryan, The Forgotten Plague. How the Battle Against Tuberculosis Was Won - and Lost (Boston, Mass: Little, Brown, 1993).
40. The history of preantibiotic therapeutics is actually much more complex and includes the use of alternative remedies and nostrums. See, for example, Linda Bryder, Below the Magic Mountain. A Social History of Tuberculosis in Twentieth-Century Britain (Oxford, England: Clarendon Press, 1988), 157-198. For the triumphant story of the discovery of antibiotics, see Frank Ryan, The Forgotten Plague. How the Battle Against Tuberculosis Was Won - and Lost (Boston, Mass: Little, Brown, 1993).
41. Annual Report, Firland Sanatorium, 1960, p. 12.
42. William B. Tollen, "Irregular Discharge: The Problem of Hospitalization of the Tuberculous," Public Health Reports 63 (1948): 1441-1473; Godias J. Drolet and Donald E. Porter, A Study of "Why Do Patients in Tuberculosis Hospitals Leave Against Medical Advice" (New York, NY: New York Tuberculosis and Health Association, 1949).
43. William B. Tollen, "Irregular Discharge: The Problem of Hospitalization of the Tuberculous," Public Health Reports 63 (1948): 1441-1473; Godias J. Drolet and Donald E. Porter, A Study of "Why Do Patients in Tuberculosis Hospitals Leave Against Medical Advice" (New York, NY: New York Tuberculosis and Health Association, 1949).
44. The discovery of antibiotics did not automatically change longstanding notions about the chronicity or incurability of tuberculosis. In this light, it is not surprising that a concept such as compliance with one's antibiotic therapy may have remained foreign to many patients and that discharges against medical advice persisted.
45. Cedric Northrop et al. "The Practical Management of the Recalcitrant Tuberculous Patient," Public Health Reports 67 (1952): 894-898; Barbara Dike, "A Study of Clinical Records to Determine Some of the Factors Involved in Irregular Discharges of Ninety-Four Patients Who Left Firland Sanatorium Against Medical Advice During the Period of January 1, 1950 to June 30, 1950" (master's thesis, University of Washington, 1953), 58-63; Evelyn N. Hadaway, "A Medical Social Study of Fifty-Four Tuberculosis Patients Who Left Firland Sanatorium Against Medical Advice in 1952" (master's thesis, University of Washington, 1953), 52-57.
46. Cedric Northrop et al. "The Practical Management of the Recalcitrant Tuberculous Patient," Public Health Reports 67 (1952): 894-898; Barbara Dike, "A Study of Clinical Records to Determine Some of the Factors Involved in Irregular Discharges of Ninety-Four Patients Who Left Firland Sanatorium Against Medical Advice During the Period of January 1, 1950 to June 30, 1950" (master's thesis, University of Washington, 1953), 58-63; Evelyn N. Hadaway, "A Medical Social Study of Fifty-Four Tuberculosis Patients Who Left Firland Sanatorium Against Medical Advice in 1952" (master's thesis, University of Washington, 1953), 52-57.
47. Cedric Northrop et al. "The Practical Management of the Recalcitrant Tuberculous Patient," Public Health Reports 67 (1952): 894-898; Barbara Dike, "A Study of Clinical Records to Determine Some of the Factors Involved in Irregular Discharges of Ninety-Four Patients Who Left Firland Sanatorium Against Medical Advice During the Period of January 1, 1950 to June 30, 1950" (master's thesis, University of Washington, 1953), 58-63; Evelyn N. Hadaway, "A Medical Social Study of Fifty-Four Tuberculosis Patients Who Left Firland Sanatorium Against Medical Advice in 1952" (master's thesis, University of Washington, 1953), 52-57.
48. Hadaway, "Medical Social Study," 32.
49. There is a large literature on changing concepts of alcoholism after the repeal of Prohibition. See Elvin M. Jellinek, The Disease Concept of Alcoholism (Piscataway. NJ: Alcohol Research Documentation. 1960); Ronald Roizen, "The American Discovery of Alcoholism, 1933-1939" (Ph.D. diss, University of California al Berkeley, 1991).
50. There is a large literature on changing concepts of alcoholism after the repeal of Prohibition. See Elvin M. Jellinek, The Disease Concept of Alcoholism (Piscataway. NJ: Alcohol Research Documentation. 1960); Ronald Roizen, "The American Discovery of Alcoholism, 1933-1939" (Ph.D. diss, University of California al Berkeley, 1991).
51. Interview with Firland Sanatorium sociologist Joan K. Jackson, December 5, 1992. Firland physicians generally only labeled as alcoholic those Skid Road patients who admitted to extensive past drinking or who drank on the premises.
52. Skid Road earned its name because loggers dragging lumber to the Seattle waterfront greased the road so that the logs would skid. Skid Road later referred to the area south of the original pathway.
53. On the Skid Road alcoholic in Seattle, see Joan K. Jackson and Ralph Connor, "The Skid Road Alcoholic," Quarterly Journal of Studies on Alcohol 14 (1953): 468-486; James P. Spradley, You Owe Yourself a Drunk: An Ethnography of Urban Nomads (Boston, Mass: Little, Brown, 1970). There was also a large population of Native Americans on Seattle's Skid Road, whose experiences at Firland I will explore in future work.
54. On the Skid Road alcoholic in Seattle, see Joan K. Jackson and Ralph Connor, "The Skid Road Alcoholic," Quarterly Journal of Studies on Alcohol 14 (1953): 468-486; James P. Spradley, You Owe Yourself a Drunk: An Ethnography of Urban Nomads (Boston, Mass: Little, Brown, 1970). There was also a large population of Native Americans on Seattle's Skid Road, whose experiences at Firland I will explore in future work.
55. Dike, "Clinical Records," 62; Annual Report, Firland Sanatorium, 1950, pp. 6-8; Daniel Widelock et al., "Public Health Significance of Tubercle Bacilli Resistant to Isoniazid," American Journal of Public Health 45 (1955): 79-83.
56. Dike, "Clinical Records," 62; Annual Report, Firland Sanatorium, 1950, pp. 6-8; Daniel Widelock et al., "Public Health Significance of Tubercle Bacilli Resistant to Isoniazid," American Journal of Public Health 45 (1955): 79-83.
57. Dike, "Clinical Records," 62; Annual Report, Firland Sanatorium, 1950, pp. 6-8; Daniel Widelock et al., "Public Health Significance of Tubercle Bacilli Resistant to Isoniazid," American Journal of Public Health 45 (1955): 79-83.
58. Northrop, "Practical Management," 895.
59. Ibid., 895, 896.
60. Ibid., 894-898; Roberts Davies, "Isolating the Recalcitrants," Bulletin of the National Tuberculosis Association 10 (1954): 121, 122; Mark A. Linell, "The Detention Ward and Its Place in the Control and Treatment of Tuberculosis," American Review of Tuberculosis and Pulmonary Diseases 74 (1956): 410-416.
61. Ibid., 894-898; Roberts Davies, "Isolating the Recalcitrants," Bulletin of the National Tuberculosis Association 10 (1954): 121, 122; Mark A. Linell, "The Detention Ward and Its Place in the Control and Treatment of Tuberculosis," American Review of Tuberculosis and Pulmonary Diseases 74 (1956): 410-416.
62. Ibid., 894-898; Roberts Davies, "Isolating the Recalcitrants," Bulletin of the National Tuberculosis Association 10 (1954): 121, 122; Mark A. Linell, "The Detention Ward and Its Place in the Control and Treatment of Tuberculosis," American Review of Tuberculosis and Pulmonary Diseases 74 (1956): 410-416.
63. Linell, "Detention Ward," 411.
64. Roberts J. Davies, "The Prerequisites for a Successful Campaign of Tuberculosis Eradication," Health Pilot 29 (1947): 6-8, 11.
65. Annual Report, Washington State Department of Health, 1949, p. 9.
66. Northrop, "Practical Management,'' 895, 896; Interview with Firland Sanatorium staff physician Walter T. Miller, October 19, 1992.
67. Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 411.
68. Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 411.
69. Miller interview, October 19, 1992.
70. Notices of Quarantine. Health Department Administrative Files, WSA, box 6, folder: tuberculosis control, 1953-54.
71. Diagnostic Standards and Classification of Tuberculosis (New York: National Tuberculosis Association, 1950), 36, 37.
72. Linell, "Detention Ward," 415.
73. Ibid., 411.
74. Davies, "Isolating the Recalcitrants," 121. Quoted phrase is from Miller interview, October 19, 1992.
75. Resolution 10289, January 6, 1947, King County Commissioners, King County Archives, Seattle, Washington, box 29.
76. Linell, "Detention Ward," 411; "Doctor's Report. Only 20 Per Cent at Firland Diagnosed as Alcoholics," Seattle Times, 2 September 1960, p. 6.
77. Linell, "Detention Ward," 411; "Doctor's Report. Only 20 Per Cent at Firland Diagnosed as Alcoholics," Seattle Times, 2 September 1960, p. 6.
78. Linell, "Detention Ward," 415.
79. Northrop, "Practical Management," 896; Miller interview, October 19, 1992.
80. For a similar discussion of punishments and privileges, see Goffman, Asylums, 51-53; Julius A. Roth, Timetables: Structuring the Passage of Time in Hospital Treatment and Other Careers (Indianapolis, Ind: Bobbs-Merrill, 1963), 52-56.
81. For a similar discussion of punishments and privileges, see Goffman, Asylums, 51-53; Julius A. Roth, Timetables: Structuring the Passage of Time in Hospital Treatment and Other Careers (Indianapolis, Ind: Bobbs-Merrill, 1963), 52-56.
82. Notices of Quarantine. Health Department Administrative Files, WSA, box 6, folder: tuberculosis control, 1953-54.
83. Others have characterized tuberculosis sanatoria as "total institutions." See Goffman, Asylums, 4; Rothman, Living in the Shadow, 227; Bryder, Below the Magic Mountain, 200-214.
84. Others have characterized tuberculosis sanatoria as "total institutions." See Goffman, Asylums, 4; Rothman, Living in the Shadow, 227; Bryder, Below the Magic Mountain, 200-214.
85. Others have characterized tuberculosis sanatoria as "total institutions." See Goffman, Asylums, 4; Rothman, Living in the Shadow, 227; Bryder, Below the Magic Mountain, 200-214.
86. Goffman uses the term rationalization to describe the process by which institutional policies are justified on other grounds. See Asylums, 46, 47.
87. On the disciplinary authority of the medical profession, see Lunbeck, Psychiatric Persuasion, 81-96.
88. Linell, "Detention Ward," 413.
89. Jackson interview, December 5, 1992.
90. Davies, "Isolating the Recalcitrants," 122; Interview with Firland Sanatorium staff physician Helen S. Marshall, September 2, 1992.
91. Northrop, "Practical Management," 896; Emily B. Fergus and Joan K. Jackson, "The Tuberculous Alcoholic Before and During Hospitalization" (editorial), American Review of Tuberculosis and Pulmonary Diseases 79 (1959): 659-661.
92. Northrop, "Practical Management," 896; Emily B. Fergus and Joan K. Jackson, "The Tuberculous Alcoholic Before and During Hospitalization" (editorial), American Review of Tuberculosis and Pulmonary Diseases 79 (1959): 659-661.
93. D.H. to Governor Albert Rosellini, January 21, 1957. State Department of Health, Director's Files, 1954-57, WSA, box 1, folder: 59.
94. Ibid.
95. A.P. to To Whom it May Concern (no date). American Civil Liberties Union of Washington papers, University of Washington Archives, Seattle, Washington (hereafter referred to as ACLU-W), box 25, folder: due process committee, Firland Sanatorium.
96. Harvey Hurtt to Governor Albert Rosellini, March 28, 1957. State Department of Health, Director's Files, 1954-57, WSA, box 2, folder: 86.1.
97. Washington State Department of Health, "Objectives of Tuberculosis Hospital Survey Team, March 21, 1957." Department of Social and Health Services 300 Files, WSA, box 42, folder: consolidation (history).
98. Minutes of the Board of Directors, February 7, 1957, and December 5, 1957. ACLU-W papers, box 15, folder: 1957.
99. Byron F. Francis, "Policies Covering the Operation of the Detention Ward at Firland Sanatorium, 1960." Department of Social and Health Services 300 Files, WSA, box 40, folder: Firland (1968).
100. Lerner, "New York City's Tuberculosis Control Efforts," 672.
101. Northrop, "Practical Management," 898; "Doctor's Report," 6.
102. Northrop, "Practical Management," 898; "Doctor's Report," 6.
103. Davies, "Isolating the Recalcitrants," 121.
104. "Compulsory Isolation - Its Ingredients. New Mexico Reports on Questionnaire Survey," National Tuberculosis Association Rehabilitation Events, 6, no. 1 (1960): 1, 2.
105. Ibid., 1; National Tuberculosis Association, "Report on Compulsory Isolation in the United States, December 1955," American Lung Association Archives, New York, NY, folder: 2708.
106. Ibid., 1; National Tuberculosis Association, "Report on Compulsory Isolation in the United States, December 1955," American Lung Association Archives, New York, NY, folder: 2708.
107. Northrop, "Practical Management," 894-898; Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 410-416; Cedric Northrop, "Compulsory Isolation," Bulletin of the National Tuberculosis Association 42 (1956): 149-150.
108. Northrop, "Practical Management," 894-898; Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 410-416; Cedric Northrop, "Compulsory Isolation," Bulletin of the National Tuberculosis Association 42 (1956): 149-150.
109. Northrop, "Practical Management," 894-898; Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 410-416; Cedric Northrop, "Compulsory Isolation," Bulletin of the National Tuberculosis Association 42 (1956): 149-150.
110. Northrop, "Practical Management," 894-898; Davies, "Isolating the Recalcitrants," 121, 122; Linell, "Detention Ward," 410-416; Cedric Northrop, "Compulsory Isolation," Bulletin of the National Tuberculosis Association 42 (1956): 149-150.
111. Andrew L. Banyai and Anthony V. Cadden, "Compulsory Hospitalization of Open Cases of Tuberculosis," American Review of Tuberculosis 50 (1944): 136-146; Robert L. Kennedy, "Recalcitrant Patients," Bulletin of the National Tuberculosis Association 43 (1957): 55, 56.
112. Andrew L. Banyai and Anthony V. Cadden, "Compulsory Hospitalization of Open Cases of Tuberculosis," American Review of Tuberculosis 50 (1944): 136-146; Robert L. Kennedy, "Recalcitrant Patients," Bulletin of the National Tuberculosis Association 43 (1957): 55, 56.
113. Edward Kupka and Marion R. King, "Enforced Legal Isolation of Tuberculous Patients," Public Health Reports 69 (1954): 351-359; Stuart Willis, "The Case for Forcible Hospitalization of the Recalcitrant Tuberculosis Patient, Rhode Island Medical Journal 42 (1959): 650, 652, 654, 655.
114. Edward Kupka and Marion R. King, "Enforced Legal Isolation of Tuberculous Patients," Public Health Reports 69 (1954): 351-359; Stuart Willis, "The Case for Forcible Hospitalization of the Recalcitrant Tuberculosis Patient, Rhode Island Medical Journal 42 (1959): 650, 652, 654, 655.
115. "The Recalcitrant Tuberculosis Patient" (editorial). Journal of the American Medical Association 167 (1958): 74.
116. Sidney H. Dressler, "The Case Against Compulsory Isolation of the Recalcitrant Tuberculous," Rhode Island Medical Journal 42 (1959): 651, 653.
117. Regarding the rise of due process, see David J. Bodenhamer, Fair Trial. Rights of the Accused in American History (New York, NY: Oxford University Press, 1992), 113-125. I will discuss events in the 1960s in subsequent work.
118. Sue Etkind et al., "Treating Hard-to-Treat Patients in Massachusetts," Seminars in Respiratory Infections 6 (1991): 273-282; Mireya Navarro, "Confining Tuberculosis Patients: Weighing Rights vs. Health Risks, New York Times, 21 November 1993, pp. 1, 45; Donna Leusner, "State Drawing Plans to Quarantine Uncooperative Tuberculosis Patients," Star-Ledger (Newark, NJ), 28 April 1994, p. 14; "Quarantine Center Proposed for Recalcitrant Tuberculosis Patients," San Francisco Chronicle, 14 June 1994, p. 17.
119. Sue Etkind et al., "Treating Hard-to-Treat Patients in Massachusetts," Seminars in Respiratory Infections 6 (1991): 273-282; Mireya Navarro, "Confining Tuberculosis Patients: Weighing Rights vs. Health Risks, New York Times, 21 November 1993, pp. 1, 45; Donna Leusner, "State Drawing Plans to Quarantine Uncooperative Tuberculosis Patients," Star-Ledger (Newark, NJ), 28 April 1994, p. 14; "Quarantine Center Proposed for Recalcitrant Tuberculosis Patients," San Francisco Chronicle, 14 June 1994, p. 17.
120. Sue Etkind et al., "Treating Hard-to-Treat Patients in Massachusetts," Seminars in Respiratory Infections 6 (1991): 273-282; Mireya Navarro, "Confining Tuberculosis Patients: Weighing Rights vs. Health Risks, New York Times, 21 November 1993, pp. 1, 45; Donna Leusner, "State Drawing Plans to Quarantine Uncooperative Tuberculosis Patients," Star-Ledger (Newark, NJ), 28 April 1994, p. 14; "Quarantine Center Proposed for Recalcitrant Tuberculosis Patients," San Francisco Chronicle, 14 June 1994, p. 17.
121. Sue Etkind et al., "Treating Hard-to-Treat Patients in Massachusetts," Seminars in Respiratory Infections 6 (1991): 273-282; Mireya Navarro, "Confining Tuberculosis Patients: Weighing Rights vs. Health Risks, New York Times, 21 November 1993, pp. 1, 45; Donna Leusner, "State Drawing Plans to Quarantine Uncooperative Tuberculosis Patients," Star-Ledger (Newark, NJ), 28 April 1994, p. 14; "Quarantine Center Proposed for Recalcitrant Tuberculosis Patients," San Francisco Chronicle, 14 June 1994, p. 17.
122. See reference 2.
123. A debate has arisen over what constitutes "less restrictive alternatives." See, for example, New York City Tuberculosis Working Group, "Developing a System for Tuberculosis Prevention and Care in New York City," in The Tuberculosis Revival-Individual Rights and Societal Obligation in a Time of AIDS (New York, NY: United Hospital Fund, 1992), 51-58: Ronald Bayer and Laurence Dupuis, "Ethical and Legal Issues in Tuberculosis Control," Annual Review of Public Health 16 (1995): 307-326.
124. A debate has arisen over what constitutes "less restrictive alternatives." See, for example, New York City Tuberculosis Working Group, "Developing a System for Tuberculosis Prevention and Care in New York City," in The Tuberculosis Revival-Individual Rights and Societal Obligation in a Time of AIDS (New York, NY: United Hospital Fund, 1992), 51-58: Ronald Bayer and Laurence Dupuis, "Ethical and Legal Issues in Tuberculosis Control," Annual Review of Public Health 16 (1995): 307-326.
125. Dubler et al., "Tuberculosis in the 1990s," 22-25; Mindy T. Fullilove et al., "Psychosocial Issues in the Management of Tuberculosis, " Journal of Law, Medicine & Ethics 21 (1993): 324-331.
126. Dubler et al., "Tuberculosis in the 1990s," 22-25; Mindy T. Fullilove et al., "Psychosocial Issues in the Management of Tuberculosis, " Journal of Law, Medicine & Ethics 21 (1993): 324-331.
127. Michael D, Iseman et al., "Directly Observed Treatment of Tuberculosis. We Can't Afford Not to Try It," New England Journal of Medicine 328 (1993): 576-578.
128. For a similar discussion, see Nancy N. Dubler, "Jail and Prison Health Care Standards," in In Search of Equity. Health Needs and the Health Care System, ed., Ronald Bayer et al. (New York, NY: Plenum Press, 1983), 69-94.
129. Trostle, "Medical Compliance," 1299-1308.
130. Stephen E. Weis et al., "The Effect of Directly Observed Therapy on the Rates of Drug Resistance and Relapse in Tuberculosis," New England Journal of Medicine 330 (1994): 1179-1184.
131. The "co-opting" of medical goals within a prison setting is discussed in Dubler, "Jail and Prison Health Care Standards," and Nancy N. Dubler and B. Jaye Anno, "Ethical Considerations and Interface with Custody," in Prison Health Care: Guidelines for the Management of An Adequate Delivery System, ed. B. Jaye Anno (Washington, DC: U.S. Department of Justice, 1991), 53-69. For a recent example of custodial problems at a detention center for tuberculosis patients, see Mireya Navarro, "Four Patients at TB Center are Arrested in Attack," New York Times, 27 January 1994, p. B8.
132. The "co-opting" of medical goals within a prison setting is discussed in Dubler, "Jail and Prison Health Care Standards," and Nancy N. Dubler and B. Jaye Anno, "Ethical Considerations and Interface with Custody," in Prison Health Care: Guidelines for the Management of An Adequate Delivery System, ed. B. Jaye Anno (Washington, DC: U.S. Department of Justice, 1991), 53-69. For a recent example of custodial problems at a detention center for tuberculosis patients, see Mireya Navarro, "Four Patients at TB Center are Arrested in Attack," New York Times, 27 January 1994, p. B8.
133. The "co-opting" of medical goals within a prison setting is discussed in Dubler, "Jail and Prison Health Care Standards," and Nancy N. Dubler and B. Jaye Anno, "Ethical Considerations and Interface with Custody," in Prison Health Care: Guidelines for the Management of An Adequate Delivery System, ed. B. Jaye Anno (Washington, DC: U.S. Department of Justice, 1991), 53-69. For a recent example of custodial problems at a detention center for tuberculosis patients, see Mireya Navarro, "Four Patients at TB Center are Arrested in Attack," New York Times, 27 January 1994, p. B8.