While the first hospital in the western portion of Haywood County was opened just in time to meet a deadly Spanish flu crisis, the first hospital in the eastern portion was a rapid-fire response to an epidemic of another kind — typhoid.
The town of Canton took a beating in the press across North Carolina for failing to take precautions with its water supply, precautions that might have prevented the outbreak. But thanks to Champion and its president, Reuben B. Robertson, the community’s response to typhoid may have saved lives when the Spanish flu hit the region a few months later.
Typhoid hit Canton in March of 1917, when the town was bursting with growth. The opening of Champion Fibre’s pulp and paper mill in 1908 caused the town’s population to spike. The concentration of people, upheaval of the water supply system with rapid construction and road development may have contributed, if not to contamination of the water, at least to the spread of the disease.
Typhoid is a water-borne illness, caused by salmonella bacteria which in turn causes fever, headaches, abdominal pain and distress. Patients can die from bleeding in the intestines. Though vaccines that could provide some protection were available at the time of the outbreak, few people were vaccinated. In fact, typhoid outbreaks from 1917 to 1919 prompted the state to start a massive vaccination program that carried into the early 1920s. At the time of the Canton outbreak, before development of antibiotics, about 20% of those who contracted typhoid would die of the disease.
Canton’s water supply was the Rough Creek and its reservoir, north of town. While the water was pristine at its source, research also indicates some residences between the headwaters and the town may have been a source of contamination. At that time, it was not uncommon for personal privies to be built over a creek.
Whatever the source of the disease, the outbreak caught the attention of state officials and newspapers across the state, with both institutions declaring the town had not heeded warnings to install a water purification system.
“Dr. A. McR. Crouch, State Epidemiologist, was called to Canton, Haywood County, yesterday to take charge of a recent outbreak of typhoid fever at that place,” the Raleigh News & Observer reported in March of 1917. “Up to the present time as many as twenty-five cases have been reported.” Crouch had just assumed charge of a new Bureau of Epidemiology in the State Board of Health, in charge of preventing and controlling infectious diseases.
Typhoid ‘no surprise’
In May, the Raleigh News & Observer reported, “the cause of the epidemic was found to be a polluted public water supply. For a number of years, according to the State Board of Health, recommendations have been made to this city by the state concerning its water supply, which were not adopted. Consequently, it is no surprise to the board that the town is now suffering from an epidemic of typhoid fever, or has not suffered from this at some other water borne disease long ago.”
“Canton appreciates value of vaccination,” the same article stated, quoting Dr. Crouch: “It’s no trouble to get people vaccinated against typhoid fever in Canton now, they are almost begging for it.”
The Charlotte Observer titled its story “The price of Indifference.”
“The people of Canton are now boiling their water and vaccinating themselves — and suffering the penalties for a warning permitted to pass unheeded,” it added.
None of the articles offered statistics on the number of fatalities in Canton from typhoid, though a couple of small local articles refer to individuals who died of the disease, including Delmer G. Smith, a member of Canton’s Ambulance Corps, who died in June after battling the illness for three weeks.
The Asheville Citizen, on June 27, carried a statement from the Canton board of health. “The typhoid epidemic in Canton. N.C., presumably caused by pollution of the water supply, is, we believe, under control. Since the installation of a hypochlorite plant the analysis of Canton’s water supply, as furnished by the state board of health, showed the water to be free from either colon bacilli or acid-producing bacteria. Furthermore, only four cases of typhoid fever have developed since June 5.”
Champion steps in
Champion Fibre had purchased the old Episcopal Mission School building on Hill Street just north of the mill, with plans to renovate it as a clubhouse. With the typhoid outbreak, Champion general manager Reuben B. Robertson met with the Canton Board of Health, local doctors and the town board, and offered the building as a hospital. Robertson had a practical purpose in organizing the hospital; the epidemic threatened the reliability of his workers. But as decades of service to the community would show, Robertson was likely more motivated by concerns for Canton citizens — reflected in later actions he initiated, including donation of a building for a library, and a company store with unusual and worker-friendly policies.
The company newsletter, the Log, reported that the building was turned over to master mechanic William Battison with instructions to remodel it into a hospital “with haste.” It took Battison and his crew one week to pull off the job. Champion employees, including carpenters, electricians, masons, painters and plumbers went to work on the project. Meanwhile, their wives and other local women were sewing sheets and hospital gowns from materials supplied by Champion. The mill’s purchasing agents telegraphed orders for hospital equipment. A large order of beds and furnishings that was to go to the new hospital in nearby Waynesville was diverted to Canton instead.
Five nurses and one probationer nurse were hired and present when the furniture arrived. “Within 12 hours from the time the carpenters stopped their hammering, five patients were occupying beds,” the Log reported. On June 26, 16 patients were in the hospital, with 15 of them suffering from typhoid.
The new hospital’s supplies and equipment, according to the May 26 Asheville Citizen, were “the most modern that can be bought. Sanitary plumbing, portable bath rub, a dumb waiter and 25 hospital beds are included …”
Then came the flu
A year after the typhoid epidemic, the Spanish influenza, the deadliest pandemic of the 20th century, swept through Haywood County. While Waynesville was hard-hit, Canton was not stricken with as many flu cases as its neighbor. Local history writer Peggy Gosselin believes the hard lessons learned during the typhoid epidemic were a factor. Canton leaders rapidly closed schools, businesses and places of worship, and the hospital was well-equipped to handle flu patients.
The hospital was so successful and welcome that Robertson organized a corporation, with stock being held by local supporters, including himself, to keep it going after the typhoid epidemic. Champion continued support of the Canton hospital, with what “Heritage of Healing: A Medical History of Haywood County” termed the first known hospital insurance program in the county. Workers were assessed 50 cents a month to cover the hospital’s operating expenses. Employees and their immediate family members had first priority at the hospital, but other patients were also accepted. In time, the hospital would participate in the county’s widespread efforts to prevent childhood diseases by removing tonsils and adenoids. At one point, the Log proclaimed that the hospital had performed 74 operations on children in four days.
“That means that seventy-four Canton children will be given a better chance in life, a better chance for full development and the attainment of success, for every one of them was handicapped, some of them seriously with adenoids and diseased tonsils,” the article declared.
By 1922, according to local historian Edie Burnette, health care had improved enough throughout Haywood County that Champion was prepared to get out of the business of providing medical care. Notices that the hospital corporation would be dissolved were published in March of 1922.
Research for this article drew heavily from previous material written by Edie Burnette and Peggy Gosselin for The Mountaineer. In addition, Burnette, Gosselin and Canton Historical Museum director Caroline Ponton created a video in 2020 discussing the typhoid and Spanish flu epidemics, which was also used as a resource for this article. The video was produced in conjunction with an exhibit at the Canton museum.