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ST. LOUIS – At the beginning of the American Century, premature babies were literally a sideshow exhibit. Visitors would pay to walk through rows of tiny babies in incubators. Hospitals had little regard for “weaklings,” as they were known, and desperate parents would flock to these fairs for a chance at survival.

Dawn Raffel, author of “The Strange Case of Dr. Couney: How a Mysterious European Showman Saved Thousands of American Babies,” tells the incredible account of a man who revolutionized neonatal care a hundred years ago. In her research, she explored how the exhibit went horribly wrong in St. Louis.

The concessions committee in St. Louis decided to shop the attraction to vendors who would offer them the highest cut of profits, she writes. They bypassed the men who had run the same exhibit at other fairs and awarded it to Edward Bayliss, a well-connected St. Louisan. He hired a doctor to run it who knew little about caring for premature infants.

“It was total greed,” Raffel told the Columbia Missourian. They were feeding the premature infants cow’s milk, cereal and egg. Infants were vomiting and having diarrhea. The machines were overheating. The conditions were filthy, with flies swarming around. Out of 43 babies, a reported 39 soon died.

“Left unsaid, hushed up as much as ossible in the interest of profit and image: the babies turning blue and dying in the incubator sideshow,” Raffel writes.

She cites a scathing letter the director of the St. Louis Humane Society sent to the fair’s president, David R. Francis, in which he writes, “There is no doubt about the character of this place and that the babies are deliberately murdered through neglect and carelessness, and it must be stopped at any price no matter who has money in this show.”

At the time, the Post-Dispatch published a very short blurb about the physicians being called before the health department _ but no follow-up articles.

The profitable exhibit was allowed to continue.

When Martin Couney, the competing bidder whose own previous exhibits had a survival rate of 85%, heard of the mass infant deaths, he published an open letter in the New York Evening Journal stating, “The crime of the decade is being committed here at this World’s Fair.”

A new doctor, Dr. John Zahorsky, took over managing the exhibit. He instituted better and more sanitary practices and “slowed the march of death.” He may have decreased the death rate, but Raffel argues that he may have had a far more damaging impact.

He concluded that premature babies shouldn’t be kept in incubation institutes on a midway nor in a hospital, but instead preemies ought to be sent home. A fear of hospitalism, along with the horrifying specter in St. Louis, helped scare the medical profession off the use of life-saving incubators for years, Raffel writes.

At these fairs, premature babies were medical oddities, the disabled were sideshow “freaks” and primitive tribes were billed as “savages.”

“People were organized in a way we would recognize as racist,” said Adam Kloppe, public historian at the Missouri Historical Society. There was a hierarchy underlying the exhibited people that went from most primitive to most “advanced.” White, Western cultures wre presumed at the top of the order.

At the time, “scientific” racial theories “proving” the natural inferiority of nonwhites were popular in the United States, and the fair was used to advance these ideas.

There were more than 50 different Native American tribes, native people from all over the world, such as the Ainu from Japan and Pygmies from South Africa, the Patagonian giants from Argentina and various Filipino tribes on the fairgrounds. Robert Rydell, professor of history at Montana State University, is a specialist on world’s fairs and author of “All the World’s a Fair.” He explained that contracts from the 1893 fair in Chicago with the concessionaires who were granted human exhibits mandated that the indigenous people act as “savages.” That same philosophy guided the human exhibits in St. Louis.

The Department of Anthropology, sponsored by the U.S. Government, offered visitors a chance to see different cultures in re-created habitats while the anthropologists purported to study them at the fairs.

“Show men, who were mostly white, tried to capitalize on the popularity of these living shows,” he said. St. Louis had the largest Philippines exhibit, with 92 buildings on 42 acres. About 1,100 Filipinos were brought to live at the fair.

Villages were built to replicate those of the Visayans, Bagobos, Samals, “Moros” (as they were called then), Igorots, Tingguianes, Negritos and 30 other tribes and were “stocked” with tribal men, women and children as living exhibits, according to Positively Filipino, which notes the exhibits helped popularize distorted images of the Philippines and its people.

“In our eyes today it is appalling,” Kloppe said. “For 1904 eyes, it was an opportunity to try to understand other cultures.”

Several Filipinos died en route, while on display or after the fair closed. Anthropologists removed the brains of some and shipped them to the Smithsonian. In the context of te fair, the “scandals” most 1904 visitors heard about were the “interracial” dates between Filipino Constabulary members and white “society” ladies, which nearly resulted in a riot. The society was also scandalized by the native dress of the Igorots, Rydell said.

“All of these issues came to light in the context of much discussion about whether to annex the Philippines and whether Filipinos should be accorded citizenship rights,” Rydell said.

One aspect of the Philippines tribal exhibit is that is spawned several urban legends that the Igorot tribe left the fairgrounds and stole dogs to eat on special occasions. There is no evidence of that, says Sharon Smith, curator of civic and personal identity at the Missouri Historical Society. Some rumors say this is how Dogtown got its name, but that neighborhood name predates the fair. The more likely explanation, according to Bert Minkin, an enthusiast who wrote “Legacies of the St. Louis World’s Fair,” is that some local people would take their dogs to the fairgrounds and sell them to the tribes.

While African Americans were allowed entry into the fair if they purchased admission, there was backlash to how they were treated inside. An article from the Globe-Democrat on July 3, 1904, states that “Plans for Negro Day at the World’s Fair have been abandoned. Discrimination alleged.”

The articles goes on to report, “A programme of addresses by some of the leading orators and scholars of the race, including Booker T. Washington, and a military and civic parade by several of the largest negro organizations of the country had been arranged for the occasion, but so many exaggerated stories of alleged humiliating discriminations that are being practiced against negroes at the World’s Fair have been circulated that many of the persons and organizations that had accepted invitations to take part later declined to do so . The incident that precipitated the decisive action . colored soldies would not be permitted to occupy the barracks at the World’s Fair grounds but would be required to provide their own tents and cooking outfit and be quartered elsewhere. As this negro regiment, consisting of 900 men, with negro officers from colonel down, was to be one of the most prominent features of the celebration, its refusal to participate decided the committee in its determination to abandon the movement.”

The meeting of the National Association of Colored Women ended up moving off the fairgrounds because of discrimination, Kloppe said.

The broader political purpose of the fair was to tell the story of American progress to the country and celebrate the Centennial of the Louisiana Purchase, while building political support for growing American markets overseas. American colonialism of the Philippines began in 1898 when Spain ceded the Philippines to the United States.

“A major purpose of the fair was to promote Manifest Destiny and get public buy-in for American imperialism,” Rydell said. This was very much linked to the massive Philippines Exhibit at the fair, he said.

“The imperialism that lay at the core of the fair is not very well remembered, or known _ except among academic specialists,” Rydell said.

The appearance of the ice cream cone is closely associated with the St. Louis World’s Fair, although its origin story is hotly contested. Author Pamela Vaccaro, a native St. Louisan who wrote “Beyond the Ice Cream Cone: The Whole Scoop on Food at the 1904 World’s Fair,” makes a distinction between the foods that were introduced at the fair versus popularized there by exposure to a mass market.

Legitimate firsts include puffed rice and “fairy floss,” now known as cotton candy. Other foods that became widely popular after being sold at the fair include peanut butter, hamburgers, hot dogs, Dr. Pepper and the ice cream cone.

Many visitors had their first taste of black olives and kumquats, whichwere only available in particular parts of the country at the time.

One of the most common questions about the fair is what happened to all those glorious, ornately carved, palatial structures? The buildings were made of a material called “staff,” a type of plaster mixed with fiber such as straw or hemp, that made it easier to carve. The staff was applied over wood structures designed to be temporary, placed over half of Forest Park.

St. Louis hosted the first American Olympics, where several world records were set. The athletes and teams were awarded gold, silver and bronze medals for the first time. The first marathon, however, is described as a dangerous disaster. Karen Abbott writes for that the man who first crossed the finished line actually rode 11 miles in an automobile. When he was found out, the competitor smiled and claimed that he had never intended to accept the honor; he finished only for the sake of a “joke.”

American Thomas Hicks, whose trainers gave him strychnine, egg whites and brandy to help him power through the course, actually finished first.

The Anthropology Department set up Anthropology Days in which they recruited people from the International villages and tribes people to compete with one another in athletic contests, such as a greased-pole climb, “ethnic” dancing and mud slinging _ for the amusement of Caucasian spectators, Abbott writes. She cites a disapproving observation by Pierre de Coubertin, a French historian and founder of the International Olympic Committee, about these events: “As for that outrageous charade, it will of course lose its appeal when black men, red men and yellow men learn to run, jump and throw, and leave the white men behind them.”

Mike Truax, president of the 1904 World’s Fair Society and co-author of “St. Louis: 1904 World’s Fair,” said it wouldn’t be fair to note mostly controversial aspects of the fair without mentioning many of the lesserknown achievements, as well. For example, St. Louis developed a technique to clean its water supply weeks before the fair opened. Wireless telegraphy was introduced, the Liberty Bell traveled west of the Mississippi River for the first time and the first successful controlled dirigible flight was accomplished there.

Even among the tragedies at the Incubators Exhibit, there’s a story of connection. A St. Louis policeman brought an abandoned 2-pound-11-ounce baby to the exhibit on July 1, 1904. She lived in the incubator for nearly two months. The policeman who rescued her brought his wife to the fair many times to visit the baby. They marveled at her progress.

On Dec. 1, 1904, they took her home as their adopted daughter.

She was named Frances after the president of the fair.