USA > Georgia > Memoirs of Georgia; containing historical accounts of the state's civil, military, industrial and professional interests, and personal sketches of many of its people. Vol. II > Part 19
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The principal local boards of health are those of Augusta, Atlanta, Savannah, Macon, Brunswick and Darien. The board of health of Augusta is organized under a special act of the legislature, and vested with plenary power to enact and enforce sanitary ordinances in Augusta. It has power to promulgate and enforce quarantine regulations against all persons coming from localities where infectious and contagious diseases dangerous to the public health exist. The board has quarantine jurisdiction for forty miles surrounding it on all sides within the state of Georgia. It likewise has sole control of the construction and inain- tenance of the sewerage and drainage systems of the city. The work of the board in Augusta has been most successful, having reduced the death rate from 30 per 1,000 inhabitants in 1871 to 19.61 in 1893. This has been accomplished by vigilant sanitary police of lots, alleys and streets, as well as private and public sewers, prevention and control of contagious and infectious diseases and extension and perfection of the system of sewerage and drainage, etc. Five sanitary inspectors constantly overlook all lots, alleys and streets, sewers, drains, etc. Every sewer in the city is flushed and disinfected twice each month. The outlet to the sewerage system is the Savannah river at lower end of the city limits. The sewerage and drainage systems are being extended each year, and the beneficial result upon the public health has been strikingly apparent. The board consists of the following members: Eugene Foster, M. D., president; T. D. Coleman, M. D., G. C. Dugas, M. D., chemist; E. C. Goodrich, M. D., W. C. Jones, W. B. Young, J. H. Alexander, mayor; G. J. Howard, J. J. Dicks, A. F. Austin, G. R. Lombard and A. J. Barnes, representatives from the city council, and C. S. Bohler.
I35
MEDICAL HISTORY.
The board of health of Macon is organized under a special act of the legislature -- the law is substantially a copy of the act organizing the Augusta board of health. Rigid sanitary police, prevention and control of contagious and infectious diseases with perfection and extension of the sewerage and drainage systems constitute the main work of the board. Macon is now constructing a separate sewer system for the entire city. This must of necessity greatly improve the public health. The board of health of Macon is constituted as follows: W. R. Winchester, M. D., chairman; N. G. Gewinner, M. D., chairman pro tem .; J. A. Etheridge, M. D., Max Jackson, M. D., John Ingalls, Chas. Wachtel, Wm. A. Goodyear, Bridges Smith, secretary.
The board of health of Atlanta is organized under the ordinance of the city council. The board has authority to elect all officials serving under its authority and affix the pay of each. It also has authority to enforce the sanitary ordinances of the city, though it has no power to enact such ordinances. The latter power vests in the city council. The board has plenary authority over the subject of quarantine, personal or otherwise. The board of health of Atlanta is financially better supported than that of any other board in the state-the city of Atlanta expends $63,000 annually for maintenance of her health department. The board of health is constituted as follows: J. F. Alexander, M. D., president; J. C. Avery, M. D., secretary; F. W. McRae, M. D., R. T. Dorsey, John Tyler Cooper, John B. Goodwin, A. J. Shropshire.
The board of health of Brunswick has only an advisory relation to the city council. The power to enact sanitary ordinances vests in the latter body. A board of health having only an advisory relation to the city government can never do a highly efficient service in maintenance of the public health, no matter how honest, faithful and competent the membership of such board may be. An efficient sanitary board must needs be composed of men possessing special knowledge of hygiene, and be vested with adequate power to enact and enforce sanitary regulations. The average councilman is utterly devoid of the technical education necessary to enable him to wisely enact sanitary laws, and this lack of knowledge of hygiene forbids an intelligent conception of the necessity of strict enforcement of such laws. Again, a board of health should be wholly separated from politics. The defect of the board of health of Brunswick, as also of Savan- nah, lies in want of plenary power to enact and enforce sanitary regulations. The boards of health of these two cities are composed of good and true men, but their powers should be enlarged so that each of them should possess plenary power in public matters. The members of the board of health of Brunswick are: H. Burford, M. D., president; A. V. Wood, secretary; S. C. Littlefield, C. G. Moore, C. D. Ogg, J. P. Harvey, superintendent, and H. M. Branham, city physician. Sanitary committee: H. T. Kennon, chairman; A. J. Crovatt, C. Downing.
Sanitation in Savannah is under the supervision of a board of sanitary com- missioners, consisting of the mayor, the health officer, two aldermen and three citizens appointed by the mayor. The sanitary ordinances of the city are enacted by the city council, the board of commissioners' duty being to supervise the administration of all the health laws of the municipality. The commissioners have actively, faithfully, discharged the duties imposed upon them. But the high annual rate of mortality in Savannah shows that there is a vast improvement needful in the sanitation of the city. The commissioners are: Mayor J. J. Mc- Donough, chairman; R. B. Harris, M. D., W. F. Brunner, M. D., health officer; B. I. Purse, M. D., H. Meyers, P. J. O'Connor, J. F. B. Beckwith.
The following tabular statement shows the annual death rate in the three principal cities of the state for the thirteen years-1880 to 1892 inclusive:
I36
MEMOIRS OF GEORGIA.
AUGUSTA. .
SAVANNAH.
ATLANTA.
YEARS.
Total Annual
Death Rate.
Annual Death
Rate, White.
Annual Death
Rate, Col-
ored.
Total Annual
Death Rate.
White.
Colored.
Years.
Total Annual
Death Rate.
White.
Colored.
1880
23.36
18.62
29.90
1880
34.73
21.29
48.57
1880
17.08
13.00
23.08
188 1
29.56
22.82
38.85
1881
37.29
25.00
50.21
1881
24.66
19.22
31.70
1882
24.85
18.20
33.90
1882
34.84
20.83
49.33
1882
21.00
13.84
31.33
1883
21.45
17.65
26.53
1883
34.75
26.36
43.93
1883
21.74
14.86
32.20
1884
23.38
16.80
32.06
1884
34.38
24.98
45.40
1884
21.33
13.34
33.52
1885
20.94
14.00
30.13
1885
28.35
16.66
42.45
1885
20.23
13.06
31.26
1886
23.97
16.48
33.86
1886
38.55
21.52
58.50
1886
14.86
10.10
23.71
1887
26.25
17.31
38.32
1887
33.94
20.80
49.39
1887
20.87
14.82
32.13
1888
21.37
14.34
31.39
1888
26.43
16.13
39.II
1888
20.63
13.13
35.27
1 889
21.53
13.41
32.25
1889
26.07
16.69
40.29
1889
19.87
12.73
32.72
1890
18.72
10.83
23.61
1890
31.34
19.95
45.79
1890
23.05
15.71
36.28
1891
19.47
14.16
27.23
1891
27.00
18.56
37.30
1891
22.17
15.25
34.48
1892
2I.C2
13.56
32.00
1892
27.70
18.00
40.66
1892
20.12
13.80
30.66
THE STATE BOARD OF HEALTH.
In February, 1875, the legislature, after persistent efforts of the physicians of the state under the leadership of Dr. J. G. Thomas of Savannah, enacted a law creating "The Board of Health of the State of Georgia." The law required the gov- ernor to appoint nine physicians of skill and experience, regular graduates of medicine, and practitioners of not less than ten years, one from each congressional district in the state, who, together with the comptroller-general, and attorney- general and state geologist, shall constitute the board of health, to be called the board of health of the state of Georgia, the term of each member being six years. The members of the board received no salary, but the actual personal expenses of each member while engaged in the duties of the board were allowed. The salary of the secretary was $1,000. The principal features of the law organizing the board were as follows: To take cognizance of the interests of health and life among the people of the state; they shall make inquiries in respect to the cause of diseases, and especially epidemics, and investigate the sources of mortality, and the effects of localities, employments, and other conditions upon public health. They shall obtain, collect, and preserve such information relating to deaths, diseases, health, etc., as may be useful in the discharge of its duties, and contribute to the promo- tion of the health, or the security of life, in the state of Georgia; and it shall be the duty of all health officers and boards of health in the state to communicate to said state board of health copies of all their reports and publications; also, such sanitary information as may be useful; and said board shall keep record of its acts and proceedings as a board; and it shall promptly cause all proper informa- tion in possession of said board to be sent to the local health authorities of any city, village or town in the state which may request the same, and shall add thereto such useful suggestions as the experience of said board may supply; and it is hereby made the duty of said health authorities to supply like information and sug- gestions to said board of health; and said state board of health is authorized to require reports and information (at such times, and of such facts, and generally of such nature and extent, relating to the safety of life, and the promotion of health,
.
Years.
I37
MEDICAL HISTORY.
as its by-laws or rules may provide) from all public dispensaries, hospitals, asylums, prisons and schools, and from the managers, principals and officers thereof; and from all other public institutions, their officers and managers, and from the pro- prietors, managers, lessees, and occupants of all places of public resort in the state; but such reports and information shall only be required concerning matters and particulars in respect of which it may, in its opinion, need information for the proper discharge of its duties. Said board shall, when requested by public authori- ties, or when they deem it best, advise officers of the state, county, or local gov- ernments, in regard to sanitary drainage, ventilation, and sanitary provisions of any public institution, building, or public place. They shall also give all informa- tion that may reasonably be requested concerning any threatening danger to the public health, to the health officers of the ports of Savannah, Darien, Bruns- wick and St. Mary's, and to the commissioners of quarantine of said ports, and all other sanitary authorities in the state, who shall give the like information to said board; and said board and said officers, said quarantine commissioners and sani- tary authorities, shall, as far as legal and practicable, co-operate to prevent the spread of diseases, and for the protection of life, and the promotion of health within the sphere of their respective duties. The board shall have the general supervision of the state system of registration of births, marriages, and deaths; the said board shall recommend such forms of amendments of laws as shall be deemed to be necessary for the thorough organization and efficiency of registration of vital sta- tistics throughout the state; the secretary of said board shall be the superintendent of registration of vital statistics, as revised by said board; the clerical duties and safe keeping of the bureau of vital statistics thus created shall be provided for by the comptroller-general of the state, who shall also provide and furnish such apartments and stationery as said board shall require in the discharge of its duties. To make annual reports to the legislature of all its acts, as well as the sanitary condition and prospects of the state; also reports upon vital statistics, and such other useful information as the board may deem proper, together with sugges- tions for any further legislative action or precautions deemed proper for the pro- tection of the public health. To require of every practitioner in the state to report to the ordinary of his county all births and deaths occurring in his practice, and affix a penalty for every failure to comply with this law. There was appropriated $1,500 for expenses of the board for the year 1875.
The governor appointed the following physicians as members of the board: J. G. Thomas, Savannah; Benjamin F. Cromwell, Albany; George F. Cooper, Americus; G. W. Holmes, Rome; Henry F. Campbell, Augusta; H. H. Carlton, Athens; F. A. Stanford, Columbus; C. B. Nottingham, Macon; Joseph P. Logan, Atlanta. The above named, together with N. J. Hammond, attorney-general; W. L. Goldsmith, comptroller-general; and George Little, state geologist, constituted the state board of health of Georgia. Dr. J. G. Thomas of Savannah was elected president and Dr. V. H. Taliaferro of Atlanta secretary. During the first year of its existence the board did valuable work in efforts to educate the people of the state upon questions of public hygiene. One of the first acts of the board after organizing was, as it should have been, to invite the cordial support and co-opera- tion of local boards of health and physicians of the state in its work, and invited suggestions in furtherance of its duties. The first annual report of the board sub- mitted Nov. 15, 1875, is a valuable document, embracing 215 pages of printed matter. It contains: Law creating the board; its proceedings and its organiza- tion; address to the medical profession; constitution and rules, together with the laws; form of a return of a birth to ordinary; form of a return of a marriage to ordinary; form of a return of a death to ordinary; form of a transcript from ordi-
.
I38
MEMOIRS OF GEORGIA.
nary's record of births; form of a transcript from ordinary's record of marriages; form of transcript from ordinary's record of deaths; form of ordinary's record of births; form of ordinary's record of marriages; form of ordinary's record of deaths; circular of instructions to ordinaries; report of expenditures; report of vital statistics; books of record of births, marriages, and deaths for secretary's office; report upon the organization and duties of local boards of health. In addi- tion to the above, and many valuable suggestions in the minutes as printed, I find the following able papers: "Registration of Sanitation-Their Value," by Henry F. Campbell, M. D., of Augusta; "The Hygiene of Schools," by C. J. Notting- ham, M. D., of Macon; "Hygiene of Schools," by F. A. Stanford, M. D., of Columbus; "The Influence of Trees on Health," by B. F. Cromwell, M. D., Albany; "Sale of Poisonous and Other Articles Detrimental to Health," by F. A. Stanford, M. D., of Columbus; "Poisons-Their Sanitary Condition and Needs in Georgia," by G. F. Cooper, M. D., Americus; "The Most Effectual Means of Preventing Smallpox in Georgia," by Joseph P. Logan, M. D., Atlanta.
FIRST YEAR'S WORK.
As previously stated, the first year's work of the board was almost wholly of an educational nature, the board wisely realizing the fact that public instruction as to the possibilities and necessities of sanitary measures must always precede the enforcement of sanitary laws. The duty of public instruction was ably dis- charged by the board. The act creating the board of health was radically defective in several particulars. First, The law conferred upon the body no power to enforce one single necessary sanitary law already existing, nor did the board possess the power to enact necessary sanitary laws. Its sole power consisted in an advisory relation to the people of the state, with the one power to collect vital statistics. Second, Insufficient funds. The legislature voted the board $1,500 for public health administration in Georgia-including instruction upon hygiene. What a spectacle! A great and powerful state doling out the pitiful sum of $1,500 a year to promote the health of 1,360,000 citizens-a sum not one-third as large as is annually expended in an average-sized county in Georgia to suppress crime within its liinits.
During 1876 the board of health continued its labors, to the greatest possible advantage, according to the scope of its powers. The second annual report (1876, a volume of 186 pages) shows in detail the work of the board, and presents sug- gestions for additional sanitary laws, and enlargement of the powers of the board. This report also contains all the facts relative to yellow fever in Georgia in 1876, by testimony taken by the board in the various cities in which the disease appeared. In this volume is a valuable and instructive paper from the pen of Dr. Ely Mc- Clennan, surgeon of the United States army, on The Relations of Health Boards and Other Sanitary Organizations with Civic Authorities. Also one from Judge B. H. Bigham on Lunacy in Georgia.
The law creating the board was amended in 1876 so as to organize a county board of health in each county to co-operate with the state board. The county boards to have supervision of the santitary condition of their counties respectively, subject to the direction of the state board of health. Every county board was to consist of three members, the ordinary and two practicing physicians, the latter to be appointed annually by the grand jury of the county. The following coun- ties organized boards of health under the law: Campbell, Cherokee, Decatur, Dougherty, Echols, Effingham, Fannin, Fayette, Fulton, Harris, Lowndes, Macon. Mitchell, Monroe, McDuffie, Pulaski, Randolph, Richmond, Rockdale, Troup,
I39
MEDICAL HISTORY.
Quitman. The state board was active in efforts to organize a county board in every county in the state.
While the effort to collect vital statistics was but partially successful, yet the success of the undertaking was as great as could have been reasonably expected. Physicians and laymen had to be educated up to an appreciation of the fact that a complete registration of vital statistics was of fundamental importance to the successful administration of a public health service. Had the board been main- tained with sufficient power and money, Georgia would to-day have had a complete record of vital statistics from each county in the state, and would thereby have known the sanitary condition and needs of every community in the state. As a consequence of failure to collect vital statistics, no citizen or official of Georgia has even an approximately correct idea of the prevailing diseases in the various counties, except as they are gathered once each decade by the United States census enumerators, and these, being obtained from non-medical sources, are necessarily inexact. In vain the board labored to educate the legislature to an appreciation of the fact that maintenance of the public health is the greatest element, indeed the first cause of prosperity and wealth to the state. Utterly devoid of appreciation of the possibilities and economy of a public health service, the Georgia legislature, in 1877, blotted the state board of health out of existence by refusing to vote the paltry sum of $1,500 a year for its maintenance. This one act, resulting from shameful ignorance, has done more to retard the prosperity of the state than any other act done since the settlement of the colony. An examination of the mor- tuary record of Georgia for 1880, as compiled from the United States census, shows a total mortality numbering 21,549. Of this number 1,905 died of unknown causes, leaving 19,634 from known causes. I cite the mortality resulting from each of the following diseases: Smallpox, 2; measles, 496; scarlet fever, 31; diph- theria, 488; whooping cough, 650; typhoid fever, 986; malarial fever, 1,050; erysipelas, 60; total, 3,833 deaths from above specified causes. Every one of these diseases, and many others causing a large mortality, are preventable under thor- ough sanitation. The state in failing to maintain an efficient public health service is responsible for these deaths. Laying aside the sacredness of human life, let us ascertain the loss to the state in dollars and cents by this neglect to provide and sustain an efficient public health service. Political economists estimate every citizen to be worth to the state $1,000. Taking this as a basis of calculation, we find an annual financial loss to the state amounting to $3,830,000, resulting from preventable deaths. Sanitarians, from reliable data, have shown that for every preventable death during the year there are five preventable cases of sickness. This would give us 19,165 unnecessary cases of sickness each year. So that count- ing the financial value of citizens, the cost of funerals, the loss of time, and expenses consequent upon unnecessary sickness and death in Georgia, amounts to fully $5,000,000 each year. As an evidence of the "penny wise and pound foolish" policy of Georgia in neglecting the health of her citizens, I cite the fact that the epidemic of yellow fever in Savannah in 1876 resulted in a financial loss to that city amounting to $2,500,000. Savannah's loss is the loss of the state. Dani- age to Savannah is damage to the entire state. If Georgia would maintain her proper position among the states she must protect the health of her citizens as the other commonwealths are doing.
INDIFFERENCE TO THE LAWS OF HYGIENE.
.
One of the chief impediments to the upbuilding of Georgia is the popular impression in northern and western states that yellow fever is one of the endemic
140
MEMOIRS OF GEORGIA.
diseases of our commonwealth. As already shown, this disease is not, and never has been, endemic among us. It is always imported when it reaches us. It is a historic fact that from the settlement of the colony to the present day yellow fever has prevailed less frequently in Georgia than in any northern or southern state bordering the Atlantic and Gulf. It is a fact that the one epidemic in Memphis, Tenn., in 1878, was attended with a mortality three times greater in number than the total mortality from yellow fever in Georgia during her entire history. Yet the authorities of Georgia do not publish these facts to the world and thus remove the unjust and damaging impression that this pestilence is gen- erated in our state. Though it may reflect upon the high officials of Georgia, the fact should be published to the world that yellow fever has never existed in Georgia except through ignorance of or indifference to the laws of hygiene. The ignorance and indifference of our citizens in sanitary matters is amazing. Our legislators and governors have vied with the populace in displaying ignorance of or indifference to hygiene. It is a disgrace to Georgia that she has not even the semblance of a state sanitary organization. In this day of rapid transit by steamships and railways distance has been abolished, and through the daily com- mingling of states and nations they are really one people. Thus the deadly porta- ble diseases of one nation are the common heritage of them all, except as they are restrained by the faithful, intelligent application of sanitary measures. A moment's thought on this subject will convince the most skeptical person of our danger. Let us illustrate it. Havana is the hot-bed of yellow fever every year. Individuals can imbibe the poison of the disease in Havana, cross over into Florida, and, by railways, reach almost any state in the union before falling ill of the malady. Individuals can imbibe the poison of smallpox, measles, etc., in France, England, or Germany, travel by steamship to America and reach almost any state in the union before the disease manifests itself. With these established truths of medical science staring us in the face this grand old state-a model in all things else-does absolutely nothing to protect her citizens against "the pestilence which walketh in darkness and the destruction that wasteth at noonday." A scene occurred two years ago which fully demonstrated the estimate which high officials of Georgia placed upon the health of our people. Yellow fever-a portable dis- ease-was prevailing as an epidemic in Florida, and the citizens of infected places, by hundreds, began to crowd into Georgia, bringing with them their infected baggage, and were only stopped by the United States authorities, and detained at camps just within our state until the period of incubation had passed, and all baggage disinfected. And thus some portion of Georgia was saved from pesti- lence. The governor, like his predecessors on similar occasions, went not in person, nor even sent an official, to the state line to protect our people to whom the constitution guarantees protection of the commonwealth in the enjoyment of life, liberty and property. Last year two sluggers went to Florida for a prize- fight, and being fearful that the governor would prevent the bout in that state, as he threatened to do, it was rumored that they would cross over the line into Georgia and fight. Immediately after this rumor reached our capital the gov- ernor of Georgia opened telegraphic and mail communication with the sheriffs in the counties bordering the Florida line and ordered each of them to summon a posse to arrest the sluggers should they dare to attempt to profane Georgia soil by a prize fight. Not only were the civil authorities instructed to prevent this slugging match, but the governor, as commander-in-chief of the military forces of Georgia, went in person to the rumored seat of war, ordered the military com- panies to his aid, threw a military cordon around the Georgia-Florida line, and awaited the appearance of the enemy. But the foe appeared not. In the fash-
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