Editor's note: We invite you to read the entire series here.
By Dan Olmsted
When Mrs. G.H. Franklin woke up after collapsing on the floor of her Brooklyn ice cream parlor on June 19, 1916, she found herself in a ward at St. Mary’s Hospital, paralyzed. She was 56 years old. Just two days earlier, the Brooklyn Daily Eagle ran a story on its front page headlined “24 Cases of Infant Paralysis in the Boro; Health Board Acts.”
Despite the timing, doctors were loathe to describe Mrs. Franklin's case as polio. For one thing she simply seemed too old for infantile paralysis -- the oldest person in the health department case files that summer. “The hospital records show that the case was considered some type of meningitis altho a lumbar puncture showed nothing abnormal,” according to a health department report. “On July 8 she was brought to her son’s home at 1250 Curtis Avenue, Woodhaven, Queens. On July 30, after she left, her grandsons Herbert and Calvin were taken acutely ill, the former promptly being diagnosed poliomyelitis, the diagnosis in the latter not yet known. “On July 15, Mrs. Franklin moved to 4559 Metropolis Avenue, Queens, and nine days after arriving there, her grandson Willy was taken ill and also Edith Smith, the daughter of another tenant in the same house. Both proved to have poliomyelitis.
“An interesting sidelight on this problem is the fact that on June 1, when Mrs. Franklin was first taken ill at 1295 Gates Avenue, an Italian baby on the top floor became suddenly ill and died within 24 hours, no diagnosis being made.” Trying to untangle the coincidences from the clues was beyond the health department’s ken. Yet the department spent a lot of its time building up voluminous files on each case and tracking down every possible contact. This was a misadventure if the hypothesis I've laid out in earlier segments is true, because it continually missed the environmental trigger -- low levels of arsenic in sugar that had recently arrived at the refineries from Hawaii.
The environmental toxicologist who’s been helping me commented: “Arsenic in sugar would result in intermittent dosing, which is more likely to manifest in some of the other known symptoms of arsenic toxicity such as GI upset. Orally ingested arsenic is very hard on the intestines. Orally ingested poliovirus enters the body through the intestines, which will be less able to fight off a viral invasion if arsenic-induced inflammation and necrosis is present.” Certainly plenty of polio cases I’ve read about from the 1916 epidemic began with that kind of stomach upset. I wonder if Mrs. Franklin got better just because she was no longer eating her own ice cream all day.
Brooklyn, where the Hawaiian sugar made port, had the first outbreak. Queens, where most of the raw sugar went to the refinery in Long Island City, had the highest polio rate per capita of the five boroughs. Yonkers, where a smaller amount went to the refinery there, had the highest number of cases of any city of its size in the country. That’s proof of nothing but it’s consistent with the “facts cluster around a good hypothesis” model.
In the health department's contact-tracing files now archived at the American Philosophical Society in Philadelphia, I came across a man who worked at the Long Island City refinery..
Dept of Health
City of New York
Memorandum for Dr. J.S. Billings, Deputy Commissioner of Health, August 28, 1916
Borough of Brooklyn
Maddie Violetta – Poliomyelitis
127 Eagle Street – first floor, front
Father works in sugar factory
9.1.16 Insp. Jones investigated above case and reports as follows. Patient treated at home. Another child 4 years also at home. Father Michael Violetta employed by the National Sugar Refinery Co., Front St. Long Island City. Interviewed father and instructed him to live away from home, or discontinue work. He stated he would stay at 44 Bradley Ave., Blissville, L.I., until recovery of child and completion of renovation. Will keep under observation.
Another reference to Long Island City comes from the most affecting article about polio I’ve ever read, by a nurse named Charlotte Talley in the November 1916 issue of the American Journal of Nursing. Despite its clinical title, “Tracing the Sources and Limiting the Spread of Infantile Paralysis: Second Paper,” it is heartbreaking:
“’Blease, blease, do something,’ pleaded a Polish mother hysterically, clasping her hands in supplication, her mouth quivering. ‘They took my boy to ‘ospital and see,’ showing the bathtub full of soiled clothing, ‘here are all the clothes from the sickness and no water to wash ‘em. Landlady said she get plumber today. She gets no one.’”
Such scenes of desperation flooded the city.
“A little girl of nine had died of paralysis after a few days of great suffering. She had been a beautiful, bright, lovable child, the pride of the household,” Talley wrote. “Apparently, despite all her parents’ precautions, she had played with a neighbor child with an inapparent infection and may have been exposed to the virus that way.”
Talley shows us why polio came to be so feared -- crippling, deadly, often agonizing and utterly unpredictable -- though its prevalence was never as high as other horrible childhood diseases. And she offers two more relevant stories. In one, a Long Island City food store was forced to shut down.
This is what "unbiased minds" around New York City had been reporting -- cases clustering around various food emporiums. In this case it was right next door to the sugar factory. Then there is this remarkable vignette which needs to be read in full:
Isn't this practically a field test of the sugar hypothesis? Five children more or less isolated, eating only garden vegetables … and foods with a lot of sugar. Condensed milk is just about half sugar. Let’s look again at the contemporary advertisement of four babies with their spoons, set to devour a can of condensed milk:
Yonkers was the other place in New York that Hawaiian sugar went. And it had the highest rate by far of polio for any city of its seize. Of course, it’s also closer to the center of the epidemic, Brooklyn, than many other places. But check out this list, which puts Yonkers far ahead of most other cities, including close-in ones like Bayonne and Hoboken.
AOA Contributor Lou Conte grew up in Yonkers and recalls ships offloading sugar along the East River. “You could smell the sugar in the air. It was incredibly messy process and it was obvious that some of the sugar powder became airborne.”
So the facts, and the polio cases, continued to cluster around the sugar-arsenic hypothesis. Interacting in people, mostly children, with active polio infections, a "light" arsenic exposure turned a benign summer bug into a poliomyelitis epidemic. We see the evidence in the way the early cases clustered around the Brooklyn port where the sugar arrived; we see it in Queens and Yonkers, with the two sugar refineries and the highest proportion of cases. We see it in the kinds of foods that ordinary people came to suspect; we see it in the health department's own list of "provision" stores around which cases repeatedly clustered, notably in Long Island City. We see it in the remarkable story of four out of five children in one isolated family.
And we see it in baffling sagas like Mrs. Franklin's. By early August, she was “able to get up and walk around, but when I saw her today she had a temperature of 100 2/3 and has not good use of her arms yet,” the public health worker said. “She has been attended by nine different physicians in the past 2.5 months. All diagnosed her case differently, but the last said she had a light case of meningitis." Which matches a "light" case of arsenic exposure.
As the epidemic began spreading beyond the confines of New York’s five boroughs, that diagnosis was about to change as well.
Dan Olmsted is Editor of Age of Autism.