Immunology and Cholera in New York City 179

Chapter Ten

Immunology and Cholera in New York City

“Since the summer of 1885 Sternberg’s professional pace had been tiring, if 

not grueling, and not completely as satisfying as he would have liked. On 

the home front, his mother died December 7, 1888, in Ellsworth. Levi 

wrote to his oldest son: “Ma left us at 12 PM today. Her death was quick & easy. 

She had her mind clear to the last. She was very anxious to go. She was reduced to 

a mere skeleton. Her last message to her children was, ‘Meet me in Heaven.’ I had 

hoped to keep up as long as she needed me. But I broke down completely...The 

world seems very lonely to me without Ma.”1 Margaret Sternberg’s apparently debilitating and wasting illness probably resulted from her earlier stroke or strokes. 

Although Sternberg knew that such a letter could come at any time, the knowledge 

did not soften the blow. Sixteen month later, in the spring of 1890, another letter 

informed him that his sister Emily, Mrs. Frank Humlong, had succumbed to cancer in Albion, Iowa.”2

The summer of 1890 appears to have been a relatively slow one for Sternberg; it 

was a refractory period in which he recovered physically, mentally, and emotionally from the rapid and intense pace that he had established for himself over the 

past three years and the recent family losses. It gave him time to put professional 

disappointment in perspective and philosophically reflect on the nature of life, 

death, and the will of God. The official army duties Mrs. Sternberg claimed always 

interrupted his research now furnished time for Sternberg to rest and refocus his 

scientific and military sights on future endeavors. He was still attending surgeon 

and examiner of recruits in Baltimore and served on numerous examining and 

promotion boards, and in July he assumed additional duty as post surgeon at 

Fort McHenry.3

In June, a letter from Major Charles R. Greenleaf to the surgeon general in reference 

to the ongoing revision of Personal Histories of Medical Officers of the Army set the 

bureaucratic wheels in motion that resulted in Sternberg being awarded another 

brevet commission for gallantry. Greenleaf ’s story began in Montana in 1882. In 
180 The Life and Science of Surgeon General George Miller Sternberg 

his travels he met an old friend, a retired army packer with one leg whom Sternberg 

had saved by candlelight on the dark and dangerous Clearwater battlefield in 1877. 

The crippled veteran related the story once again of how Sternberg stopped the 

bleeding in dim light and under fire, and nursed him carefully on the trek from 

battlefield to Fort Lapwai, and also how he had stubbornly refused amputation 

until he nearly bled to death again in the post hospital. The packer told Greenleaf 

that no other officer was there that night on the Idaho plateau, which accounted 

for the story being unknown to the Medical Department. Greenleaf apparently did 

not take notes during the interview because in his letter to the surgeon general he 

described the event correctly, but placed it on the trail to Fort Lapwai rather than 

on the battlefield. Sternberg was eventually asked to relate the facts of the episode 

that resulted in a brevet lieutenant colonelcy.4

The impending retirement of Surgeon General Moore in August generated the 

usual scramble among medical officers to present their credentials for review. 

Sternberg submitted his packet, which was more impressive because it contained 

a letter of endorsement from Army Commanding General John M. Schofield: 

“Surgeon Sternberg is one of the most eminent medical scientists of the age, and 

has contributed very greatly to the advancement of that science. He has also performed ably and bravely every variety of duty devolving upon a medical officer of 

the army, with an Army in the field in time of War, in campaigns against hostile 

Indians, and in the midst of epidemic diseases. Not only his medical and surgical 

skill, but also his administrative ability is of the highest order. He is thoroughly 

qualified to administer the affairs of the Medical Department of the Army. On 

no other ground but that of seniority in rank and greater length of service in the 

varied duties of a surgeon in the army could, in my judgment, any other officer 

be considered more worthy of appointment to the office of Surgeon General.”5

Those eager applicants for the Medical Department throne, however, need not 

have bothered. Colonel Jedidiah H. Baxter, senior ranking medical officer, chief 

medical purveyor since 1872, and perennial candidate for the office, was the clear 

choice well before Moore’s term as surgeon general ended. Secretary of War Redfield Proctor was a strenuous supporter, and President Benjamin Harrison was an 

old friend and patient. Baxter had a reputation as a volatile personality with strong 

opinions, but he was also known to have outstanding administrative ability. On 

August 16 he became surgeon general with plans for extensive and comprehensive improvements throughout the Medical Department. His ascension created 

a vacancy in the colonel’s ranks, thereby allowing each senior officer in the lower 

ranks to be promoted in turn. As Sternberg was the senior major in the corps, he 

was promoted in October to lieutenant colonel. He was 52 years old.6

Tied to the promotion was a permanent change of station. Sternberg was detailed 

as medical purveyor at San Francisco in early October. This order, Mrs. Sternberg 

declared, “caused them no little regret” as army duties and the well-known dearth 

of laboratory facilities on the west coast would interfere with experimental bacteriology.7

 Her husband, in his usual aggressive and optimistic manner, had already 

begun planning what scientific goals could be practically pursued in conjunction 

with the large logistic responsibilities he would assume in California. Sternberg 
Immunology and Cholera in New York City 181

set his sights on the completion of Manual of Bacteriology. Exactly when he 

determined to produce what would become the American gospel of bacteriology 

for many years is unknown, but why he did is obvious: it was the logical sequel 

to—and much needed revision of—Bacteria published in 1884.8

Between October 3, when he received his orders, and October 7 when he and 

Mrs. Sternberg boarded the train for their fifth transcontinental trek together, the 

Sternberg home was a flurry of activity. In that time, he put his laboratory corner 

at Johns Hopkins in order. The Sternberg’s household was packed up or disposed 

of at auction once again, and they said good-bye to many friends and colleagues. 

They arrived in San Francisco a week later, and Sternberg immediately began 

inventorying the medical and hospital property at the purveying depot with the 

outgoing purveyor, Colonel Bernard J. D. Irwin. He also—with a great deal of 

regret—tendered his resignation as director of the Hoagland Laboratory. However, the facility’s trustees were not disposed to let him sever his connections so 

easily with the laboratory merely because he now resided 4,000 miles away. The 

resignation was tabled, and a year’s leave of absence was granted.9

As medical purveyor at San Francisco, Sternberg was responsible for medical 

logistics support to 34 posts that comprised the Departments of California, 

Columbia, and Arizona, essentially every fort and barracks west of the Rocky 

Mountains. He contracted for every drug, chemical, dressing, instrument, and 

hospital furnishing used by the Medical Department, then received and stored 

these items, assembled them for unit issue, and shipped them to their final destination. Although the army was small in 1890, the job still demanded indepth 

knowledge of the army formulary and medical equipment required in the garrison 

and field environments, as well as foresight, planning, and attention to detail.10

That Sternberg dedicated nearly every waking moment to his logistic responsibilities and the compilation of his textbook are reflected by the minimal contributions 

he made to the professional literature over the next year. He did read Finlay’s 

report on yellow fever inoculations made with infected mosquitoes in the Medical 

Record and felt compelled to respond to his old friend and colleague in a professional forum. Finlay claimed to have successfully inoculated 92 percent of the 52 

volunteers in his study against yellow fever. Of these, only 12 developed disease 

symptoms in the 3- to 25-day incubation period Finlay allowed. Twenty-four of 

the remaining 40 volunteers had mild symptoms later on, four had severe yellow 

fever, and one died. Sternberg took issue with his friend’s experimental methods 

and presumed results. He commented “that 12 out of 52 unacclimated persons 

arriving in Havana should suffer mild attacks of fever...is not surprising; and 

inasmuch as 40 other persons inoculated did not suffer similar attacks within 

twenty-five days after the supposed inoculation, we see no reason for ascribing the 

slight attacks of fever suffered by these 12 to the application of a mosquito by 

Dr. Finlay.”11 He also noted Finlay’s incubation period was five times longer than 

the generally accepted timeframe, and the fact that 24 of his volunteers developed 

mild attacks of the disease later provided little support as such fevers were common in Havana. Moreover, although it could not have been known at the time, 

many of Finlay’s infected mosquitoes were not infectious at the time of application. 
182 The Life and Science of Surgeon General George Miller Sternberg 

Sternberg concluded kindly: “I esteem both of these gentlemen [Finlay and Delgado] very highly, and I would welcome most gladly a demonstration of the value 

of the method which they faithfully endeavored to test. But a justifiable scientific 

skepticism makes it necessary to demand more direct and satisfactory proof that 

the so-called inoculations produce any pathogenic effect before any great importance can be attached to the results of Dr. Finlay’s laudable efforts to discover a 

method of prophylaxis in yellow fever.”12

Sternberg’s main endeavor at the time was to gather and read the most current 

literature in bacteriological research, and then extract and concentrate the essence 

of these data for his textbook. His bibliography for the manual eventually encompassed more than 2,000 references, many of them in French, but the majority in 

German. He could read the French technical literature without difficulty, but without a translated text it was impossible for him to struggle through the overwhelming number of German articles with accuracy and efficiency. With a tutor’s help, 

Sternberg taught himself to read German between 1889 and 1892. It is a small 

and obscure episode in his life, but one that impressed Alexander Abbott with 

Sternberg’s “will and energy.”13 He probably engaged this academic goal with the 

same zeal as he did all other professional and scientific pursuits, leading Mrs. Sternberg to lament the fact that while in San Francisco “he scarcely gave himself an 

hour’s leisure.”14 An insightful woman, she realized the world of academia—in any 

form—was sustenance, not stress, to her husband. But she was also a devoted and 

caring wife in an era when 50 years was considered well past middle age and too 

much studying was detrimental to both mind and body. She also seems to have 

entertained the idea that Sternberg’s near fatal bout with yellow fever in 1875 had 

reduced his stamina and endurance, the Clearwater Campaign notwithstanding. 

Furthermore, and perhaps more to the point, she found herself once again vying 

for her husband’s attention. “It devolved upon me,” she asserted, “to plan diversion 

for his mental and physical welfare. His interest in botany gave me excuse to 

suggest short trips to Monterey and other coastal resorts, to the beautiful Santa 

Clara Valley and to San Jose. Many times we drove to Golden Gate Park, a magnificently cultivated tract of one thousand acres fronting the ocean.”15

In December 1890, a little less than four months after taking office, Surgeon 

General Baxter contracted pneumonia and died. Baxter’s untimely demise caught 

all contenders for his vacant chair—except those in Washington—completely off 

guard. Army Commanding General Schofield was looking after Sternberg’s interests, 

however. He and a contingent of senators, numerous physicians, and public health 

officials across the country, and prominent businessmen Andrew Carnegie and 

Enoch Pratt endeavored to have Sternberg installed as surgeon general. Moreover, 

Schofield, a strong advocate of the seniority system of promotion, worked diligently 

to ensure that politically connected junior ranking medical officers, such as Billings, 

did not obtain a prize that they could keep until the turn of the century. Part of 

the reason that this august group of supporters did not achieve their objective was 

not so much a failure on their part to present a worthy candidate as it was a reflection of the personality of the president. The dogmatic Benjamin Harrison ignored 
Immunology and Cholera in New York City 183

the proffered advice and selected Charles Sutherland, the senior Medical Corps 

officer. Schofield wrote to Sternberg after the decision was made in December: 

“Your position in the matter has been thoroughly understood both by me and the 

Secretary of War. I have watched the matter very carefully with the end in view 

that has finally been reached, and which will, I think, be gratifying to all, except the 

few who may have been more or less disappointed in their own personal ambition. 

I am glad to see that you are satisfied with the selection of the senior head of the 

corps, as indeed I knew you would be.”16 Sternberg, although undoubtedly disappointed, breathed a sigh of relief because Sutherland would retire for age in three 

years. He still had time to win the race.

It is unclear just when and how Sternberg developed this close relationship 

with Schofield, but it appears it was genuine friendship and mutual admiration 

that transcended army politics. Schofield was a strong advocate of increasing 

professionalism in the army through appropriate initial and continuing education. 

He not only appreciated Sternberg’s research in the abstract, but also was interested enough to visit Sternberg’s office during a trip to San Francisco, where the 

doctor showed him some of his bacteria and gave him “an idea of our methods 

of cultivating these minute plants.”17 As Sternberg neared the completion of his 

manual, he once again contacted Schofield concerning his future and his pressing need to be on the east coast: “You will remember...when you were here I 

spoke to you with reference to my reasons for desiring an eastern station. I have 

been devoting all of my spare time...to writing A Manual of Bacteriology, and 

the work is now approaching completion. In order to arrange for its publication & to see it through the press in good shape it is important that I should 

be on the eastern seaboard. Then, as you know, I am anxious to continue my 

bacteriological studies, and can only do so to advantage when stationed within 

reach of a well-equipped laboratory, such as the Hoagland laboratory...or the 

laboratories of Johns Hopkins University...I do not propose to allow these studies 

to interfere in any way with the duties to which I may be assigned, but by persistently devoting my spare time to this special department of research I hope 

to add something to the progress of scientific medicine & hygiene. I have had 

comparatively little duty on the eastern seaboard during my 30 years of service 

unless the department counts against me the time when I have been on detached 

service engaged in the study of yellow fever under the orders of the President. 

I look upon this duty as ‘field service’ & think it should be placed to my credit 

rather than charged against me...I have had more frontier service than many 

medical officers of my rank & have had an exceptional experience in encountering epidemics, which for medical officers are trying & protracted campaigns 

against an invisible but deadly foe.... I write to you because I feel assured of your 

friendship & kind interest in my efforts to accomplish something of value in my 

chosen field of scientific research. I wrote to the Surgeon General several months 

since telling him of my desire & the reasons for it, and as he has heretofore been 

friendly to me. I hope that he will be disposed to give me such a detail as I have 

suggested whenever a vacancy occurs.”18
184 The Life and Science of Surgeon General George Miller Sternberg 

Orders relieving Sternberg from duty in San Francisco were issued February 2, 

1892. As soon as his replacement, Lieutenant Colonel Joseph P. Wright, arrived 

from Fort Leavenworth and an equipment inventory was completed, Sternberg 

proceeded to New York City to assume duties as attending surgeon and examiner 

of recruits. According to Eggerth, in his The History of the Hoagland Laboratory, 

Sternberg did not resume an active role at the laboratory, with a tidy annual salary of $1,000, until September. But he was very much engaged in trying to define 

the practical value of the most recent bacteriologic discovery—the presence of 

antitoxins in blood sera—from the moment he arrived at his new station. As his 

research moved into the enigmatic realm of natural and acquired immunity, he 

again became a pioneer in a new science, one of America’s first immunologists.19

Immunity to certain diseases, such as smallpox and yellow fever, derived naturally 

by surviving an attack of the disease had been an accepted fact for generations. It 

was not a new phenomenon either that immunity could be induced artificially, or 

acquired, by deliberate exposure to a disease agent. Smallpox variolation and vaccination were examples of artificially acquired immunity, as were Louis Pasteur’s 

attenuated anthrax and rabies vaccines. Both of these vaccines resulted from the 

natural loss of virulence, known as attenuation, by these organisms when exposed 

to dry air over a given time period. Attenuation was a well-known phenomenon 

to bacteriologists. Sternberg and others had encountered it during their work 

with the pneumococcus, and he also found he could attenuate certain bacteria 

with disinfectants. What caused the organism to attenuate, how these less virulent 

strains induced an immune response, or how natural immunity was generated 

were unknown, but explanatory hypotheses were soon forthcoming.20

Based on observations of in vitro cultures of chicken cholera and other organisms, 

Pasteur offered the “depletion theory” that stated a disease organism obtained the 

vital material it required for life from its host just as it did from artificial culture 

media in flasks. Pasteur assumed the supply of this material in the chicken—just 

like artificial media—was exhaustible, and once consumed the organism inevitably 

died. Hence, multiple injections of attenuated organisms into chickens over time 

consumed this nutritional substance without causing disease, and thereby induced 

immunity. Pasteur also suggested waste products generated by the organisms may 

produce an environment ill suited for their continued growth. Hypotheses 

proposing that bacteria essentially poisoned themselves to death and, in the 

process, established immunity abounded. Jean Baptiste Chaveau’s “retention 

theory” held that toxic metabolic by-products did this very thing. Paul Baumgarten’s 

“osmotic theory” and Emil von Behring’s “alkalinity theory” were variations on 

this theme.21 In April 1881, Sternberg gave a critical appraisal of these theories in 

the American Journal of the Medical Sciences. The assumption that the human body 

produced and stored nutritional substances unique to each of the wide variety 

of infectious diseases it was subject to—without new production of the same—did 

not make biological sense to him. Neither did the idea that microbial metabolic 

waste products were somehow retained when the human economy provided so 

well for the elimination of toxic substances. Sternberg believed the explanation for 
Immunology and Cholera in New York City 185

immunity was to be found in the “peculiar properties of the protoplasm, which is 

the essential framework of every living organism.”22 He explained this by stating 

that “during a non-fatal attack of one of the specific diseases the cellular elements 

implicated which do not succumb to the destructive influence of the poison, 

acquire a tolerance to this poison which is transmissible to their progeny, and...

is the reason of the exemption...the individual enjoys from future attacks of the 

same disease.”23 He was essentially advocating what was known as the “adaptation 

theory,” by which the body adapts to pathogenic toxins during an illness similar 

to the way in which it adapts to the effects of narcotics or alcohol with increasing 

doses. Over the next decade, all of these theories were rendered untenable.24

At the American Public Health Association meeting in Memphis in 1887, 

Sternberg was appointed chairman of the committee on protective inoculations 

in infectious diseases. The final report of this committee was not presented until 

the annual meeting in 1892. He commented the tardy report was due “...partly 

to the pressure of other engagements...the magnitude of the subject, and...to 

the fact that experimental evidence...has been constantly accumulating during 

the past five years, and the fundamental question concerning the explanation of 

acquired immunity has not been answered in a satisfactory manner until very 

recently.”25 Great strides were made in humoral immunology during this time. 

In 1886, D. E. Salmon and Theobald Smith induced immunity in pigeons by 

injecting them with heat-killed hog cholera cultures. Two years later, George H. 

F. Nuttall discovered blood had bactericidal properties, and Hans Buchner confirmed 

this bactericidal blood component was a protein—which he named alexin—

unrelated to cellular blood elements. In Berlin in 1890, Emil von Behring and 

Shibasaburo Kitasato, working with diphtheria and tetanus, respectively, reported 

results that would have a profound impact on the practical application of acquired 

immunity against human disease. They demonstrated that blood sera from laboratory animals made immune to these diseases protected nonimmune animal 

subjects from fatal outcomes.26

Sternberg was fascinated with these discoveries, the results of which he called 

“so novel and so unexpected,” and he waded into this new science with gusto.27

By the end of June 1892, he had initiated his own immunological research and 

presented two papers, “Practical Results of Bacteriological Researches” and “Infectious 

Diseases, Causation and Immunity,” to the Association of American Physicians and 

the medical department of Yale University, respectively. It appeared to Sternberg 

that the morbid phenomena that resulted from ricin poisoning or infection with 

tetanus or diphtheria were “due to the specific toxic action of substances resembling the toxalbumins [antigens] already discovered, and that acquired immunity...results from the formation of an antitoxine [sic] [antibody] in the body 

of the immune animal....Evidently the production of antitoxine [sic] during an 

attack...would account for recovery in non-fatal cases; and it may be that this is 

the true explanation of self-limitation in this disease class. If nature adopts this 

method of cure, we but follow her if we seek to introduce more...antitoxine for the 

purpose of arresting the progress of cases of unusual severity and fatal tendency.”28
186 The Life and Science of Surgeon General George Miller Sternberg 

Referring to the attempts by German scientists to treat croupous pneumonia and 

tetanus with immune serum, Sternberg commented, “Although the production of 

these antitoxins...for therapeutic use will be attended with difficulties...methods 

will be devised for obtaining them on a large scale as soon as it is...established that 

they may be successfully used as specifics in the treatment of infectious diseases.”29

How would sufficient quantities be produced for strictly human maladies such as 

smallpox? While Sternberg admitted transfusion of a moderate amount of blood 

from immune to nonimmune humans was worth consideration, he sought a more 

practical and universal solution.30

Calves were used to produce cowpox virus for human vaccination. If these animals 

could be used as vaccine factories, could they also be used as smallpox immune serum 

factories? Sternberg contacted Dr. William E. Griffiths, a producer of vaccinia 

quills in Brooklyn, to assist him with an experiment to determine whether the calf 

did produce neutralizing antitoxin to vaccine virus. Sternberg and Griffiths combined serum from a recently vaccinated calf with fresh vaccine lymph in one test 

tube and with a fresh vaccine crust from a child’s arm in another. After these mixtures 

sat for 24 hours, they shaved and scarified the thighs of a nonimmune calf and 

rubbed the contents of both tubes into each of the scarified areas. Nine days later, 

the calf was noted to have had an entirely negative reaction to the vaccinations. 

An experiment using a nonimmune calf was performed as a control and verified 

that “the blood serum of an immune calf contains something which neutralizes 

the...virulence of vaccine virus, either bovine or...lymph-crust from the arm of a 

child.”31 Although he could not know it at the time, Sternberg had performed the 

first viral neutralization test. The Association of American Physicians received his 

results with caution. William H. Welch commented, “There can be no doubt...

the blood-serum of immunized animals may possess powerful therapeutic effects. 

As regards the practical application of this principle to the treatment of human 

beings, it does not seem to me that we...possess positive results entirely free from 

doubt as to the correctness of the interpretation put upon them.”32 Dr. Sewall, who 

had shown immunity to rattlesnake venom could be obtained by multiple small 

injections of venom components in 1887, questioned “whether this is not simply 

establishing a tolerance for the poison, instead of a true vaccine action,” and added 

that no pure toxalbumin had ever been distilled.33 Victor Vaughn remarked: “I 

wish to express my high appreciation of Dr. Sternberg’s paper, and especially of his 

own experimental work with regard to vaccine. Of course, the number of experiments is too limited...for positive conclusions to be drawn...we must be very slow 

to conclude...all of this is going to be of special benefit in medicine.”34 Dr. Lyman 

concluded, “we are not so very near, as some enthusiasts think, to the time when 

we shall be able to protect our patients from diseases.”35 Sternberg admitted he 

“admired conservatism and skepticism, but why Dr. Kitasato should be so very 

conservative about the results obtained upon a man when they correspond so entirely with the results which he and others have obtained on the lower animals I do 

not understand. When I see carefully reported cases...in which all the symptoms 

are carefully detailed and the results of treatment seem to be...definite, I feel like 
Immunology and Cholera in New York City 187

giving considerable credit to it without admitting that the thing is proved. I am...

free to say that I think the future of scientific medicine is in this direction, and that 

we have entered upon a field that is to be cultivated vigorously, and...will give you 

results that will knock the conservatism from under your feet before many years.”36

Sternberg also told the association it was his intention to isolate the antitoxin of 

vaccinia and test whether it could neutralize smallpox virus in infected patients. 

However, before he could do so he was called on to assist with a public health crisis 

that had the potential to devastate not only New York City, but also the nation.37

Cholera had reappeared in Central Asia. The disease spread from Afghanistan 

by railroad into the Russian heartland and reached Kiev by the summer. At that 

time, massive numbers of Jews were immigrating from Russia to the United States, 

a journey which took many of them—infected with cholera—to Hamburg where 

they secured passage in the cramped, filthy, and poorly ventilated holds of ocean 

liners. By August 14, the inadequate barrack latrines, chamber pots, and earth 

closets that were emptied into Hamburg Harbor and the Elbe River had seeded 

these waters with cholera. Less than a week later, contaminated river water had 

made its way into municipal reservoirs and was then pumped—without benefit of 

filtration—into city homes.38

Had the first few cases of cholera seen in the neighboring town of Altona been 

admitted for what they were by medical authorities, both Hamburg and Altona 

may have been spared a tragedy. Procrastination and prevarication by Hamburg 

civil and medical authorities not only allowed the epidemic to rage, but also 

allowed five cruise liners—the Moravia, Rugia, Wyoming, Scandia, and Normannia—to obtain clean bills of health and sail for New York.39

While the medical and political authorities in Hamburg were just beginning to 

feel the intensifying heat of public, professional, and international wrath for their 

stubborn complacency at the end of August, those in New York City were hoping 

their similar troubles were taking a cooler turn. Mayor Hugh J. Grant, a Tammany 

Hall Democrat, had systematically replaced almost all Republicans in municipal 

office, including the Board of Health, with loyal Democrats. This generated a hue 

and cry from the medical and lay press. Doctors T. Mitchell Prudden, Abraham 

Jacobi, Edward Janeway, and Stephen Smith resigned as consultants to the Board 

of Health in June, declaring it had lost all independence and become a haven for 

political hacks. Undaunted, Charles G. Wilson, President of the New York Board 

of Health, pompously commented, “We passed through the typhus and smallpox 

epidemics without calling on them for assistance, and can do very well without 

them.”40 New York politicians and health officers relied on the quarantine establishment in the lower harbor to accommodate, screen, and disinfect more than 

two-thirds of foreign imports and two-thirds of all immigrants into America, and 

to guarantee that no diseases would escape from Swinburne Island. This was a tall 

order considering the quarantine system in the United States had not improved 

substantially in the seven years since sanitarians had met in Rome to debate the 

issues that now faced the city. Furthermore, the same political and economic 

concerns that had stifled national quarantine legislation in 1879 and allowed the 
188 The Life and Science of Surgeon General George Miller Sternberg 

National Board of Health to die of neglect continued to sway decisions in the office 

of the Port Health Authority. In late summer of 1892, it appeared all of these sins of 

negligence were coming home to New York City simultaneously.41

From August 24, the day New Yorkers learned that cholera was coming, publicminded citizens and the Board of Health worked aggressively to preclude it from 

gaining a foothold in the city. An emergency fund of $200,000 was established; 

special funds for the Health Department were appropriated; Health Commissioner Joseph Bryant began inspections of tenements, the Croton watershed, and 

reservoirs; and public areas were cleaned. The Chamber of Commerce created an 

advisory committee of physicians mainly composed of the same doctors that had 

resigned from the Health Department’s advisory board only two months before. 

On August 30, the day before the Moravia arrived with cholera on board, a circular 

titled “Prevention of Cholera Easier Than Cure” was issued in six languages.42

Between August 31 and September 9, the five infected ships had anchored at 

the lower harbor quarantine station with their steerage decks teaming with passengers anxious to get to the mainland. Before they could be released, each had to 

undergo medical examination, including the sick and those suspected of incubating 

the disease would have to be hospitalized at facilities on Swinburne and Hoffman 

islands, and their clothes and baggage were disinfected. The magnitude of this 

public health crisis overwhelmed the resources on both islands as well as the 

capabilities of the Port Health Officer Dr. William Jenkins.43

The announcement by Board of Health President Wilson that cholera had been 

discovered in the city on September 14 and the arrival of another disease-ridden 

ship, the Bohemia, the following day only increased public fear and apprehension. 

There were now 5,300 immigrants being bathed and disinfected in a quarantine 

station fitted out for half that number, and a large amount of cargo also had to 

be disinfected. On September 16, the advisory committee of physicians of the 

Chamber of Commerce held a lengthy meeting to discuss the detention of 

passengers and the best method of disinfection to be employed at quarantine. The 

advisory committee was fully represented, and among others at the meeting were 

Jenkins; Dr. Joseph J. Kinyoun, representing the Marine Hospital Service; 

Dr. Edward O. Shakespeare, health officer of the port of Philadelphia; and Sternberg. 

This appears to be the first time Sternberg’s counsel was sought during the crisis. 

Although Sternberg assisted Hermann Biggs and Prudden in confirming cholera 

cultures—and most assuredly had opinions on the conduct of the quarantine—

he was specifically engaged for his expertise with disinfections. Jenkins requested 

Sternberg evaluate disinfection methods used on Hoffman Island, specifically, 

what articles needed disinfection and what method would be most expeditious 

and economical. The War Department temporarily assigned Sternberg as consulting 

bacteriologist at the quarantine station.44

A symposium to educate community physicians on the science of cholera and 

quarantine administration was held in the main assembly hall of the New York 

Academy of Medicine on the evening of September 19. Sternberg presented 

a paper that reviewed the biological characteristics of cholera and described the 
Immunology and Cholera in New York City 189

most appropriate cholera disinfectants, carbolic acid and chloride of lime, and 

how to use them. Two days later, Sternberg and Dr. Ezra Wilson, the new chief 

of bacteriology at Hoagland, began experiments at the disinfection facility on 

Hoffman Island.45 

To test the reliability of steam disinfection chambers, Sternberg placed swatches 

of cotton soaked in cholera bouillon cultures deep into piles of blankets and 

clothing brought in from passengers aboard the Scandia. After disinfection, 

Wilson prepared liquid and solid cultures and controls at the Hoagland Laboratory, but neither grew anything indicating they had been destroyed by desiccation. 

Sternberg commented, “In view of this fact and of the experimental evidence 

heretofore recorded, the question arises as to whether the exactions made by 

bacteriologists and sanitarians with reference to the use of steam as a disinfecting 

agent are not extravagant, and whether there is not some better way of disinfecting 

clothing, etc., in cholera.”46 To determine whether simple drying was an effective 

disinfection method, Sternberg put small squares of a cholera-soaked woolen 

blanket in sunlight and in the darkness of a closet. No growth was obtained after 

four hours of exposure to sunlight and after 48 hours in the closet. Wilson also 

tested contaminated articles of clothing in a drying chamber at 60° Celsius for 

four hours with the same results. Sternberg concluded that “desiccation is a reliable method of destroying the cholera spirillum, and...the International Sanitary 

Conference of Rome was justified in the conclusion that ‘disinfection of merchandise and of the mails is unnecessary’ if the merchandise was clean and dry when 

received on shipboard for transportation, and if it arrives at our ports in the same 

condition.”47 Furthermore, “disinfection would be accomplished quite as effectually 

by the free exposure of woolen garments, blankets, etc., in a hot-air drying oven 

or chamber...”48 Should disinfection facilities be overwhelmed by a large volume 

of articles for disinfection, as was currently occurring at quarantine, then 

Sternberg advocated sun drying as an adequate method, except for soiled undergarments and bed linens. The cholera scare, however, ended before Sternberg’s 

findings could be put to extensive practical use. Bacteriological science did little to 

preclude the disease spread at quarantine or in the city. Although he and Wilson 

would continue experiments with cholera into December, Sternberg’s special duty 

with New York Public Health Authorities ended on October 31. A month later, he 

headed to Madison Barracks at Sackets Harbor, New York, to conduct a thorough 

sanitary inspection of the post and investigate an outbreak of typhoid fever then 

in progress.49

Madison Barracks was on the shore of Black River Bay, just above the town of 

Sackets Harbor. Home to six companies of the 9th Infantry, it had a garrison of about 

400 soldiers plus ancillary personnel. The barracks were crowded, and the plumbing and sewers were in very poor condition when the index case arrived from the 

enlistment station at Binghamton, New York, on September 18. It took 4 weeks for 

the second case to develop. From then until December 13, when the last case was 

reported, 25 more cases and two deaths occurred. Sternberg arrived on the evening 

of December 5 with his field bacteriological kit and conducted his investigation 
190 The Life and Science of Surgeon General George Miller Sternberg 

over the next three days. This is the earliest example found by the author of what 

contemporary army preventive medicine physicians call an epidemiological 

consultation. Today an epidemiological consultation may be requested by a post 

commander or his preventive medicine officer when a disease or injury outbreak 

has occurred on his or her post that requires more expertise and resources than 

he or she can bring to bear or it may be directed by a higher command authority. 

Regrettably, when an epidemiological consultation is directed from a higher authority than the post commander, the consultation team is not always received 

with open arms. One wonders whether Post Surgeon Daniel G. Caldwell and Assistant Surgeon Frank T. Merriwether may have felt a bit under the gun upon the 

arrival of a deputy surgeon general so well versed in epidemiology and infectious 

diseases. If so, they worried needlessly. Merriwether, who was acting post surgeon 

when the first case was diagnosed, implemented all of the correct procedures to 

preclude the spread of Salmonella typhi. He directed all excreta from this patient 

to be disinfected before being discharged into the sewer, that water from the Black 

River Bay not be used for drinking, and all other water be boiled before consumption. In his report, Sternberg stated that because of the scattered cases across the 

post, indicating a common source of infection, he doubted if Merriwether’s disinfection orders were carried out quickly enough to preclude contamination of Black 

River Bay. The fact that 74 percent of cases were in enlisted men also indicated that 

they disregarded the order to boil their water. Furthermore, even though the sewer 

discharge pipe was only 500 feet from the drinking water intake well in the bay, 

he suspected—from talking with local physicians—that contamination may have 

originated from typhoid cases across the bay and cases in the village of Watertown 

some 10 miles upstream.50

The unexpected and hasty departure of Dr. B. Meade Bolton in early June left the 

bacteriology department at Hoagland without a chairman.51 Wilson and a recent 

graduate of the Long Island College Hospital, then working as a pathologist at the 

Norwegian Hospital by the name of Richard Slee, applied for the position. Wilson 

got the job on a part-time basis. Slee, however, had spent a great deal of time as 

a student working in the lab and had taken the postgraduate course in bacteriology the previous year. He was eager to work with Sternberg and persuaded the 

director to accept him as a part-time unsalaried assistant. With staffing in place, 

Sternberg focused on obtaining new equipment, supplies, and sufficient laboratory animals for spring classes. He also submitted plans for the reorganization of 

the postgraduate course for medical students and a modified course for women at 

the Pratt Institute in Brooklyn. Women were introduced to bacteriology through 

an eight-week course, which included routine culture exercises, experimentation 

with animals, and instruction in photomicrography, an essential skill for any bacteriologist according to Sternberg. The tuition was $30 and the women worked 

with nonpathogenic cultures. As the Pratt plan matured, Wilson felt it was 

appropriate to have a knowledgeable female chaperone for the Pratt students and 

suggested Mrs. Sternberg. She could take the course with the others because she 

already knew the basics having been her husband’s assistant for 20 years.52
Immunology and Cholera in New York City 191

Sternberg agreed and Martha proved to be not only a valuable resource for 

Pratt students, but also an astute laboratory technician. One day while examining 

drinking water samples, she found what looked like the tubercle bacillus. She realized 

this was an odd finding, made several cultures, and determined it was probably a 

contaminant from the inoculating needle. But the puzzle left her unsettled, and 

she mentioned it to her husband. Sternberg was certain her find could not be the 

tubercle bacillus, but he accompanied her to the laboratory one afternoon and 

watched as she prepared another slide of her discovery. He agreed that it did 

resemble the mycobacterium, but “cautioned against mentioning it lest all Brooklyn be wild to think that the water supply was contaminated.”53 The following day 

he determined that she had found a previously undescribed protozoa. She named 

the new organism after Cornelius Hoagland.54

All of these activities drew heavily on Sternberg’s time, but, along with Wilson 

and Slee, he pressed forward with smallpox research. In a calf shed built behind the 

laboratory specifically for this work, Wilson pursued investigations with calf antisera 

upon smallpox virus while Sternberg and Slee worked to improve immunization 

techniques. The potency of vaccine lymph dried upon points of ivory, bone, or quill 

was always questionable and frequently contaminated with bacteria. In 1891, Sydney 

M. Copeman, working in the Institute Pasteur, discovered that the addition of glycerol to the lymph slowly killed any contaminating bacteria, and the shelf life of the 

vaccine virus lengthened. After reading this development, Sternberg sent Slee to 

Paris to determine the value of the new method firsthand. The young assistant soon 

verified both of these sensational results, and together they devised a similar method 

of lymph preparation at Hoagland.55

In December 1892, Sternberg received the first of many compliments on his recently 

published Manual of Bacteriology. The first came from William Welch, and Dr. 

William Osler called it “magnificent.”56 Walter Reed wrote from Headquarters, Department of Dakota in St. Paul, “I have your new work...How an Army medical officer, in the midst of daily routine work, could have written so excellent and so exhaustive a work, I can’t understand...it must always stand as a monument to your energy 

and ability.”57 Colonel Charles Greenleaf wrote, “I rec’d yesterday from the publishers 

a copy of your great work on Bacteriology, and in congratulating you...wish to say 

that I am very proud of knowing as a friend the man who sheds such luster on our 

Corps & does so much for the advancement of our common interest.”58 These last 

laudatory comments from Deputy Surgeon General Greenleaf appear rather insincere when compared with the admonishment he gave two years earlier to budding 

army surgeon William C. Borden concerning the leisure time Borden spent staring 

into a microscope. Greenleaf saw no value in it and caustically remarked, “Look at 

Sternberg, over there in New York, spending all his time with a microscope. Can 

you tell me one earthly bit of good Sternberg is to the Medical Corps?”59 Perhaps the 

deputy surgeon general had experienced a scientific revelation in regard to medicine 

during the intervening months. It was fortuitous for him if he had because events 

were transpiring that would require him—at least officially—to acknowledge the bit 

of good Sternberg was to the corps and medical science as well.
192 The Life and Science of Surgeon General George Miller Sternberg