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Island castaways don’t have it easy. Just ask Robinson Crusoe. Yet, for centuries, medical and political authorities relied on the general inaccessibility of islands to isolate patients for whom they had no effective therapies.

In that tradition, New England governments made routine use of coastal islands to isolate patients and to protect the mainland populations from potential contagion and epidemics.

Here are seven islands, once home to island castaways in New England.

Rainsford Island

Tiny Rainsford Island in Boston Harbor may get even tinier as rising seas threaten to cut it in two. But at one time its eleven acres held a quarantine hospital, an almshouse, a reformatory and a pauper’s graveyard. The quarantine hospital moved to Rainsford in 1737 from nearby Spectacle Island. A smallpox hospital was added to Rainsford in 1832.

Even as public health practices improved and vaccines for many communicable diseases became available, the island continued as an offshore dumping ground for delinquents, unwed mothers, the indigent, the mentally ill—in other words, society’s undesirables.

Today, according to a recent Boston Globe article, the island still holds the remains of 1,777 of “Boston’s poor, diseased, and unwanted from Colonial times to the dawn of the 20th century.”

Spectacle Island

The Boston Customs House maintained a quarantine hospital on Spectacle Island. In April 1721, a British ship arrived in the harbor with smallpox cases onboard. The infection spread ashore before authorities could move the ship and quarantine the infected crew and passengers at the island hospital.

The Puritan minister, Cotton Mather, noted in his diary, “The grievous calamity of the small pox has now entered the town.”

Mather had other worries. He advocated a primitive method of inoculating people against smallpox. Called variolation, the technique involved exposing healthy people to the exudate of other smallpox patients in the hope of producing a mild, manageable form of the disease.

The idea was wildly unpopular, and angry mobs threatened Mather and his allies. It was, in effect, the beginning of the anti-vaccine movement in America. Not until 1796 did Britain’s Edward Jenner use cowpox exudates to develop the first safe and effective vaccine against smallpox.

Noddles Island Castaways

Noddle’s Island doesn’t exist anymore. It belongs to the artificial peninsula that makes up Logan Airport. But once it was an island and the site of a hospital for the French naval fleet. During a smallpox outbreak in 1764, the island served as the site for an inoculation hospital.

Variolation inoculation against the pox was dangerous. So, an island seemed like the best place to contain the inoculated patients. It also kept out the anti-inoculation public.

In 1802, Harvard’s Benjamin Waterhouse used the island hospital to experiment with some of Jenner’s new cowpox vaccine. Waterhouse vaccinated 19 children with cowpox, then took them to the Noddle’s hospital to expose them to smallpox patients for 20 days. (They had no “informed consent” forms to sign in those days.) None of the vaccinated children developed smallpox.

Six years after the Noddle’s Island cowpox experiment, the Massachusetts Medical Society reported…”persons who undergo the cowpox are thereby rendered as incapable of being affected by the virus of smallpox as if they had undergone the latter disease.”

Deer Island

Deer Island in Boston Harbor lost its island status when the 1938 hurricane filled in the channel between it and the mainland.

But in 1677 it was an island and a convenient spot to establish a quarantine station for holding smallpox cases. It evolved into an important quarantine hospital in the late 1840’s as vast numbers of Irish refugees arrived.

Many already suffered from typhus and dysentery. Between 1847 and 1849 the island hospital received some 4,800 people. A few years later, the facilities expanded to support Boston’s regular population of criminals, delinquents and paupers—very much like the earlier residents of Rainsford Island.

Widow’s Island

Almost lost in the archipelago of Maine’s coastline off North Haven is Widow’s Island, sometimes written as Widow or Widows. In the 19th century, the U.S. Navy built a quarantine station on the island to house sailors suffering from a tropical disease called yellow fever. A deadly infection, it  regularly caused epidemics in the tropics and in American cities as far north as Boston. Scientists didn’t know what caused yellow fever or how it spread from person to person.

The Navy built a temporary facility in 1885, and then an imposing 50-bed hospital in 1888. But it never quarantined yellow fever patients on the island. An 1892 report from the Navy’s Bureau of Medicine and Surgery noted various repairs to the island hospital. But “no cases of yellow fever have been received at Widows Island.”

After describing the cleaning, fumigating and disinfecting of two ships in the New York Navy Yard, the report reached a conclusion. “It is probable that ships in the future infected with yellow fever will enter the quarantine port at New York….”

So much for Widow’s hospital.

In 1900, researchers in Cuba discovered mosquitoes transmitted yellow fever. So the elaborate and expensive efforts to disinfect and decontaminate ships and cargo was both unnecessary and useless. Eliminate the mosquito and you’ve eliminated yellow fever. The Widow’s Island hospital got torn down in 1935.

Gallops

Back in Boston, a 2018 winter storm exposed the forgotten graves of hundreds of smallpox victims on Gallops Island. Like many other islands scattered about Boston Harbor, the city used Gallops as a quarantine station.

A hospital for immigrants was built in 1866, and by 1886 the staff was examining over 33,000 passengers annually. A smallpox outbreak during 1872-73 sent a hundred Boston-area patients to the island. In 1873, two additional buildings were erected for cholera and yellow fever patients. In 1878, another hospital went up for passengers suffering from ‘ship fever,’ otherwise known as epidemic typhus. The following year, the old smallpox hospital was torn down and replaced.

Construction on the island, and the numbers of passengers with a variety of illnesses, hint at the vast number of immigrants passing through the port of Boston in the 19th century.

Despite the large number of ship passengers to examine and patients to quarantine and treat, the island also served as a site for the production of experimental anti-toxin. In 1891, German bacteriologists prepared anti-diphtheria anti-toxin in the blood of horses. They then used it to treat a patient dying of diphtheria. It worked, and serum-based anti-toxins, or ‘passive immunization’ became the standard treatment for many bacterial infections until the discovery of antibiotics.

(Passive immunization is now being revived to treat some COVID-19 patients.)

The Federal government took control of the island hospital during World War I and finally closed it in 1937. Today, the dead still remain at Gallops, now an island park.

Penikese

Stranger than a yellow fever hospital in chilly Maine is a leper colony in Massachusetts. The U.S. has never had a large number of cases of leprosy, now called Hansen’s Disease. Still, the social stigma associated with leprosy, and scientific ignorance about its transmission and pathology, compelled local, state and federal governments to quarantine anyone suspected of having this ancient affliction.

Massachusetts was no different. The first known case in the state occurred in 1875. The infected man was isolated on Gallops Island. Immigration brought more cases and Massachusetts began looking for a site to build a leprosarium. But no one wanted it at the state’s infirmary in Tewksbury or on Cape Cod. In 1905, the state bought the island of Penikese in Buzzards Bay.

For the next 16 years, 36 patients and their doctor lived on the island in a smattering of buildings and cottages.

The patients were prisoners, but not criminals. Communicable disease has often permitted  that tricky distinction. Yet, the Penikese patients—mostly immigrants—were not abandoned entirely. Doctors tried to treat their disease. A 1976 research paper described experimental “drug therapy at the Massachusetts Leper Colony, 1905-1921.” The invention of wireless radio in the 1910s also gave the islanders a link to passing ships and the Marconi News Service broadcasts.

The National Leprosarium in Carville, La., opened in 1921. The Massachusetts governor wasted no time packing the Penikese Island castaways onto a southbound train. The state fumigated the island’s emptied buildings and then dynamited them.

For the next 50 years, the island served as a bird sanctuary. Then between 1973 and 1980 the island again became a place of isolation for some of society’s troublesome members. The Penikese Island School for delinquent boys found a temporary home among the graves and wreckage of the vanished leper colony.

Island Castaways Remembered

Penikese may be an obscure island that once housed a small number of people with a rare infection, but it has not been forgotten. A book about the island’s inhabitants was published in 1997. The poet, Eve Rifkah, wrote Outcasts in 2010. She listed information about the island’s individual residents in the back of her book.

Islands often appear convenient solutions to all manner of problems. Alcatraz held criminals. Elba held a would-be emperor. Robben held apartheid’s political prisoners. North Brother held Typhoid Mary.

The islands all eventually gave up their inmates and patients to become parks, sanctuaries and tourist attractions.

For more information: See Paul Cyr’s The Exiles of Penikese Island: Politics, Prejudice and the Public Health. See also  Richard J. Kahn’s The Widow’s Island Yellow Fever Quarantine Hospital in Penobscot Bay, Maine, 1885-1904: A Medical, Political, and Social History.

The author of this story about island castaways, Edward McSweegan is a Rhode Island microbiologist who writes about infectious diseases and history.

Images: By Doc Searls from Santa Barbara, USA – 2007_02_19_iad-bos_41.JPG, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=2180315, and Widow’s Island courtesy Google Maps.