USA > Massachusetts > Commonwealth history of Massachusetts, colony, province and state, volume 5 > Part 50
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75
553
DEPARTMENT OF PUBLIC HEALTH
He was appointed the first medical examiner for the southern district of Suffolk county-the largest district-and served until incapacitated by illness, having investigated during his term of service over 8000 deaths and performed 3000 autopsies. His experience was summarized in a treatise for the use of future students of the subject, entitled: A Text Book of Legal Medicine (1905). Draper was one of the prominent medical experts of his time and was often in court, having a reputation for fairness and impartiality that recom- mended him to the attorneys on both sides of a case at trial. He set an example which has been followed by competent of- ficials through the succeeding fifty years.
The system has been adopted by all the New England states, except one, and by New York. In thickly settled communities the medical examiner is provided with an automobile, with a camera and instruments of precision, ready at a moment's notice to hasten anywhere in his district. The courts at their inquests rely on him for the results of his careful scientific examinations and deductions. He determines whether a given death was due to criminal intent or was from natural causes or accident. The question of ascertaining who caused the death is the function of the law.
STATE DEPARTMENT OF PUBLIC HEALTH (1847-1930)
We have seen that the legislature passed a law in 1797 authorizing the appointment of local boards of health in cities and towns of the Commonwealth. It was not until 1847 that a committee was appointed by that body to make a sanitary survey of the state. This was done at the instigation of Dr. Henry Ingersoll Bowditch, who in that year asked the Amer- ican Statistical Association and the Massachusetts Medical Society to approve such a survey. A committee of three members presented a report of 500 pages in 1850, signed by Lemuel Shattuck as chairman, and detailing a complete plan for a board of health. Sanitary experts have designated the report as a remarkable document which has been the basis of all sanitary legislation since.
Nothing was done by the Legislature about the recom- mendations of this report until June 21, 1869, when the act
554
MEDICINE
creating the first State Board of Health was passed and signed by Governor Claflin. In 1862 Dr. Bowditch had delivered the annual discourse before the Massachusetts Medical Society with the topic: "Topographical Distribution and Local Origin of Consumption in Massachusetts." This brought him into prominence in connection with public health. He kept up his agitation for the State to take an active interest in the physical welfare of its citizens. Finally the act was passed and he be- came chairman of the new board of seven members. This board originated and put through the Legislature many meas- ures affecting public health.
After ten years it was combined with the State Board of Lunacy and Charity, as a political measure, and against Bow- ditch's strenuous opposition. He resigned. In 1886 the Board of Health again became a separate body under the chairman- ship of Dr. Henry Pickering Walcott of Cambridge, who was also chairman of the Metropolitan Water and Sewerage Board. From this time until 1914, when the State Department of Public Health was organized, with a Commissioner of Health and an Advisory Council, the state board accomplished much in the way of water purification, and in establishing an anti- toxin laboratory under the auspices of Dr. Theobald Smith. Dr. Charles Harrington (1856-1908), as secretary of the board, succeeded in obtaining clean milk for the State and secured a law providing for state inspectors of health in the different districts of the Commonwealth. Since the establish- ment of the Department it has had three commissioners, the present commissioner being Dr. George Hoyt Bigelow of Bos- ton, a graduate of Harvard and a doctor of public health, with a further training in the clinics of Cornell University in New York City. The Department maintains the following divisions, besides caring for the tuberculosis sanatoria: Ad- ministration, Communicable Diseases, Sanitary Engineering, Water and Sewage Laboratories, Food and Drugs, Biologic Laboratories and Hygiene.
TUBERCULOSIS SANATORIA (1891-1930).
One of the greatest advances of medicine during the last quarter of the nineteenth century was Koch's discovery of the tubercle bacillus in 1882. The finding of this character-
555
TUBERCULOSIS SANATORIA
istic bacterium in the tissues of the body and in the sputa from the lungs, in phthisis, or consumption as it used to be called, revolutionized the treatment of that great curse to humanity, tuberculosis. The laboratories of Massachusetts soon confirmed Koch's work, and his methods of staining the bacillus for study under the microscope were adopted. In this state, Vincent Yardley Bowditch, son of Henry I. Bowditch, organized a body of charitably disposed persons into a board of managers of the Sharon Sanatorium for the treatment of hopeful incipient cases of tuberculosis. The doors of the sanatorium were thrown open in February, 1891; the original number of beds was eight; at present, it is forty-five. Dr. Alfred Worcester of Waltham became interested in the Sharon Sanatorium and, joining with Dr. William J. Gal- livan (1865-1921) of South Boston, succeeded in getting through the legislature a bill for the founding of a State tuberculosis sanatorium. Not only that but Worcester was successful in changing the character of the new institution from a "consumptive home" for advanced hopeless cases, as at first planned by the legislators, to a hospital where patients in the early stages of the disease might have their tuberculosis arrested.
This first state sanatorium for tuberculosis in the United States was opened at Rutland in 1898. It has now 370 beds, and a record of much accomplished in the way of arrested cases of the great white plague. Since the opening of the Rutland Sanatorium four other sanatoria have been built in this State, including the state Infirmary at Tewksbury. One of them is now devoted exclusively to the care of cases of non-pulmonary tuberculosis, and another to the treatment of tuberclosis in children. Other States have followed the lead of Massachusetts in founding State sanatoria.
Recently there has been a marked increase in the study of tuberculosis in childhood, that is, in the earliest detection of the disease. Knowledge of heliotherapy-treatment by the sun's rays-has led to its adoption as a potent method of treatment in all non-pulmonary forms, such as tuberculous disease of the bones and joints. The ultra-violet ray lamp has been much in use. The profession has come to realize that surgery plays an important rôle in the treatment of tubercu-
556
MEDICINE
losis of the lungs. Space permits the mention of only a few names of those who have been prominent in the fight against the dread disease in this State: H. I. Bowditch, A. T. Cabot, V. Y. Bowditch, C. S. Millet, E. O. Otis, A. K. Stone, and J. B. Hawes, 2d.
STATE DEPARTMENT OF MENTAL DISEASES (1848-1930)
The Department of Mental Diseases succeeded the State Board of Insanity in 1916. It consists of a commissioner and four associates, the commissioner and one associate being physicians. It has charge of the insane, the feeble-minded and the sane epileptics. Two unique features of this depart- ment in Massachusetts are the Psychopathic Hospital, founded in 1912, where persons of questionable sanity are sent for observation; and the highly developed care of the feeble- minded.
The story of Massachusetts efforts to better the condition of that large class in every community, the feeble-minded, centers round the name of Walter Elmore Fernald (1869- 1924), a native of Kittery, Maine, who built a school for the feeble-minded at Waltham, developed it so that it was a model which attracted medical visitors from all over the world, and preached a constant crusade up and down the state, advocat- ing more intelligent attention to the needs of these unfortu- nates. Following an appropriation by the legislature in 1848, a school for feeble-minded children had been opened in South Boston under the auspices of Dr. Samuel Gridley Howe (1801-1876), the man who first trained the blind in the Commonwealth.
For the next forty years, the school was carried on in a desultory fashion without a resident superintendent. Dr. Fernald became superintendent in 1887 and spent the next four years constructing the new buildings in the Waverley section of the township of Waltham. Beginning with about 400 charges, the school now houses 1600 inmates, and is provided with an out-patient department and a farm where all of the milk and vegetables used in the school are produced. He studied the problem of the feeble-minded with painstaking care; instructed physicians in the diagnosis between true men-
557
DISEASES OF CHILDREN
tal disease and deficiency; and brought out the latent qualities of the deficient in his handicraft shops, which were the wonder of all beholders. He never rested and when an attack of pneumonia removed him from his field of labor, the legis- lature gave his name to the school he had made.
DISEASES OF CHILDREN (1888-1930)
Massachusetts has led in the study and teaching of pediatrics since Dr. Thomas Morgan Rotch (1849 -1914) was appointed assistant professor in this department in Harvard Medical School in 1888, the first in the country to hold such an ap- pointment. He became a full professor in 1893, filling the chair until his death. Rotch took up the problem of milk analysis and how to obtain pure cow's milk for the feeding of infants; he established a model farm in Needham and a laboratory in Boston, where milk adapted to the needs of any particular baby was put up by prescription, having regard to its different ingredients of casein, fats, salts, and water. By patient persistence through a series of years he succeeded in improving the milk supply of the State and put infant feeding on a scientific and rational basis. His good work was con- tinued by his successor in the chair of diseases of children, Dr. John Lovett Morse, one of the most widely known clini- cians in the United States.
Boston was the first city either in this country or abroad to require, through its Health Department, a system of daily medical inspection of the children in its public schools. This inspection was begun in a small way in 1890 and officially in 1894. It was made compulsory in all the cities of the Com- monwealth in 1906. Measurements of school children were made by Dr. Henry Pickering Bowditch, the psysiologist, in 1877. This is the initial work of the sort in America; and a second study was made by Dr. William Townsend Porter, professor of comparative physiology at Harvard. Much attention has been devoted in this state to the nutrition and development of children, notably the nutritional clinics for delicate children, established by Dr. William Patten Robie Emerson, and copied throughout the country.
The Boston Board of Health established a Division of Child
558
MEDICINE
Hygiene in 1911. Although this city was not the first to create health centers, which serve as local mediums for the dis- semination of the principles of preventive medicine, Boston now has health units that are more complete than those else- where. The first tentative center was in Blossom Street, or- ganized in 1915. Since then, centers have been opened in the North End, in East Boston, in South Boston, in Roxbury and in Charlestown.
CHILD DENTISTRY
The Forsyth Dental Infirmary for Children was the first charitable dispensary for the care of children's teeth in the world, and is still unique. Founded in 1910 by four brothers who provided an endowment of over two million dollars, it occupies a handsome marble building on the Fenway in Boston. In the well-lighted main dental room, 64 dentists are working at as many chairs every day, to care for the teeth of the children of Greater Boston, appointments being made in ad- vance for different schools and institutions. A training school to educate young women for dental public health work is maintained in affiliation with the Tufts College Dental School, which is near by.
ORTHOPEDICS (1844-1930)
Orthopedics is a branch of surgery that has to do with the treatment of chronic diseases of the joints and the correction of bony deformities. In that field Massachusetts has been a leader. Dr. Henry J. Bigelow published as long ago as 1844 a monograph on orthopedics, that was accounted the best exposition of French orthopedic surgery of the day. Buck- minster Brown (1819-1891) was the first in this country to devote himself exclusively to the practice of orthopedics. Being humpbacked he had a constant reminder in his own person of the handicaps experienced by the victims of Pott's disease of the vertebrae, and was the more ready to assist others to obviate them. He and his father, John Ball Brown (1784-1862), published in 1850 reports of cases treated at the Boston Orthopedic Institution. Buckminster Brown opened the first ward in a public hospital for the treatment of ortho- pedic cases in the House of Good Samaritan; at his death
559
ORTHOPEDICS
he left a sum of money to establish a professorship of ortho- pedic surgery.
Edward Hickling Bradford (1848-1926) was made clinical instructor in orthopedic surgery in 1880; he succeeded Brown in care of the orthopedic ward at the Good Samaritan; he trained himself in surgery as visiting surgeon at the Boston City Hospital; and became surgeon-in-chief at the Children's Hospital, founded in 1869. In 1894, Bradford organized the School for Crippled and Deformed Children in Boston, a private day school which transports its pupils from different parts of the city in busses, the forerunner of similar schools in other communities. He fomented its activities until his death and also served as chairman of the trustees of the Massa- chusetts State School for Crippled Children at Canton, now called the Massachusetts Hospital School-a home with 400 beds-from its founding in 1907 until he died. In conjunc- tion with Robert Williamson Lovett, who died two years before him, Bradford issued a standard textbook on ortho- pedic surgery in 1890 that went through five editions.
Lovett, who succeeded him as professor of orthopedic surgery at Harvard, originated and promoted the Peabody Home for Crippled Children, now in a new building at Oak Hill, Newton. He early developed an interest in the victims of infantile paralysis, investigated epidemics of that disease in Vermont and New York, and became chairman of the Harvard Infantile Paralysis Commission in 1916.
Another important Massachusetts orthopedist is Joel Ernest Goldthwait, who described sacro-iliac sub-luxation-too great freedom of motion in the joints connecting the spine with the hip bones-and the disabilities which go with it. During the World War, Goldthwait showed how to correct faulty posture and minor defects of the feet in the soldiers of the American army, thus returning to the ranks countless men who had been incapacitated. His unusual executive abilities had full play, and on retiring from the service he was given the rank of Brigadier General in the Reserve Corps. Many students of orthopedics have gone out from Massachusetts to different parts of the country to practice their specialty.
560
MEDICINE
DIABETES (1916-1930)
The treatment of diabetes mellitus has received able exposi- tion in Massachusetts by Elliott Proctor Joslin, Professor of Clinical Medicine in the Harvard Medical School. This chronic disease, which has been known since the fifth century A. D., is characterized by the inability of the body to use sugar, due to changes in the pancreas. As all starchy foods are absorbed into the blood as sugar, after being digested, this means that the sugar in the blood of diabetics is in excess of normal and is excreted by the kidneys. The pancreas, which lies under the stomach, has two functions. It secretes digestive juices, which are poured into the intestine through a duct, and it makes a product that is absorbed directly into the blood. This product, "insulin"-from insula, an island, be- cause it comes from cells that are grouped in islands in the pancreas-controls the amount of sugar in the circulating blood. Dr. F. G. Banting of Toronto made the discovery in 1921 that an absence of this insulin caused diabetes. Therefore he made an extract of the islands of the pancreas of the pig and ox and injected it under the skin of a diabetic, with the result that the blood sugar was reduced to normal and the sugar disappeared from the urine. Before he had made this discovery, Dr. Joslin and Dr. Frederick M. Allen, a research worker in Harvard Medical School, had worked out a system of careful dietary and hygienic control of diabetics that length- ened the lives of patients nearly six years.
Today both diet and insulin are used in severe cases, while diet alone will control the moderate ones. Joslin's book, en- titled The Treatment of Diabetes Mellitus, appeared first in 1916. Four editions have followed and also a little book, A Diebetic Manual, helpful both to the profession and to those afflicted with the disease. Joslin has talked about this malady at numerous medical meetings, and has reached many laymen by broadcasting over the radio. He is regarded throughout the country as one of the foremost authorities on diabetes.
CANCER (1889-1930)
The control of cancer has been for a long time an object of the medical profession in Massachusetts, especially since
561
CANCER
statistics have shown a distinct increase in the disease among the population. A survey of the situation reported by Dr. Herbert L. Lombard of the Massachusetts Department of Public Health showed that the average cancer patient comes to a physician for advice eight months after noticing the first symptoms. Notwithstanding that the cause of cancer is still shrouded in mystery, every effort has been made to discover it. The profession tells the public what the symptoms are, and urges them to seek early advice and to combat the spread of the disease by prompt resort to surgery, the X-ray and radium. Delay in treatment means only one thing-death.
The Cancer Commission of Harvard University was founded by Caroline Brewer Croft in 1889, Dr. J. Collins Warren (1842-1927) instigating the organization and serving as its first chairman. The work of the commission was facili- tated by the opening in 1912 of the Collis P. Huntington Memorial Hospital for Cancer Research with laboratories and twenty-two beds.
The contributions to the literature of cancer by the members of the staff of this hospital now number more than two hundred. Through the hospital, the state conducts a free service of tissue diagnosis for the profession. The Palmer Memorial Hospital for the treatment of cancer was opened not long ago. It has every facility for treatment and an able staff. The State Department of Public Health, under the lead- ership of Commissioner George H. Bigelow, has recently taken a forward step in coping with cancer in this Common- wealth. Under his stimulus, the Legislature passed a bill in 1926 authorizing cancer clinics throughout the State and the conversion of the disused dipsomaniac hospital at Pondville, Norfolk County, into an up-to-date hospital of ninety beds, with every facility for the treatment of cancer.
Cancer clinics have been established in various large cities throughout the Commonwealth, and have been well attended. They cooperate with the hospital at Pondville. The Depart- ment aims to educate the public by these clinics and by furnish- ing speakers for public meetings as well as by radio broad- casts. The periodic health examinations, that have been ad- vocated by, the State medical society, have done something toward the early discovery of cancer.
562
MEDICINE
MEDICAL SOCIAL SERVICE (1905-1930)
The story of the development of social service work at the Massachusetts General Hospital by Dr. Richard Clarke Cabot in conjunction with Miss Ida M. Cannon, beginning in 1905, is of special interest to the student of medical progress. Cabot was at that time a visiting physician to out-patients at the hospital and instructor in medicine at Harvard. His book Clinical Examination of the Blood had become a standard. He called attention to the well-known fact that in an out- patient department of a hospital the treatment given the patients by the busy physicians in charge left a serious gap. For instance, patients were advised to take a vacation, to get a new job, to obtain a truss, but were quite unable to follow directions because of poverty or their circumstances of life. In other words the hospital issued directions but did not see that they were carried out.
Cabot therefore organized a social service department, made up largely of voluntary workers, to do these necessary things. From October, 1905, to October, 1906, 684 new patients and 857 former patients were cared for and visited by the new department. Persons who were interested in charities con- tributed two thirds of the funds needed to carry on the under- taking during this first year, while Cabot paid the remaining third from his own pocket. The success was immediate. The medical profession of the country awoke to the inadequacy of the treatment of hospital patients in the past. The social service plan was copied by hospitals in New York and else- where, so that it now is a part of the regular equipment of a hospital. Cabot's book on Social Service and the Art of Healing appeared in 1909.
HOSPITAL EFFICIENCY (1914-1930)
Connected with social service is hospital standardization, in- troduced by Dr. Ernest Amory Codman of Boston. This was a crusade to force hospitals to do something more for their patients than to treat them while within their doors. They were urged to search out the results of their treatment and to record them. This task could be accomplished only through a fearless puritanical truth-speaker, who would call the atten-
563
ANEMIA
tion of the profession, as well as the public, to the sloppy manner in which hospitals were being managed.
Each hospital had been a law unto itself; to the trustees it was a question largely of the per diem charges; no one cared what became of the patients after they had been discharged, or tried to discover whether the attempts at making them well had proved successful. Hence there was no check for the advantage of future sufferers, and faulty methods were perpetuated. The system needed a cleaning up-an effort to place the care of the sick on a rational and business-like basis. Codman published his first paper, "The Product of a Hos- pital," in the monthly magazine, Surgery, Gynecology and Obstetrics, in April 1914; having earlier put on record the results which had been obtained in the surgical service of Francis B. Harrington at the Massachusetts General Hospital in 1900-1901.
Codman wrote other articles on hospital efficiency, including case reports of the first five years of his own private hospital, 1911 -1916, in which he made a frank statement as to the good and bad issues of his surgery. He wrote that "money spent on hospitals is for the cure of the patient." Under his guidance the matter of registering the subsequent course and health of hospital patients was taken up by the American College of Surgeons, which devoted a session to its consideration in 1923. The following year he read a paper on "The Factors which Indicate the Professional Efficiency of a Hospital" at the annual Congress on Medical Education, Medical Licensure, Public Health and Hospitals, of the American Medical Asso- ciation, at Chicago.
At the present time the hospitals of the country are regis- tered by the national association and by the College of Sur- geons in their publications, according to the minimum require- ments of hospital standardization. The movement thus started by Codman has done an immense amount of good and has turned the medical profession into a path of greater honesty and straightforwardness in the care of the sick.
LIVER DIET IN PERNICIOUS ANEMIA
A recent and a notable advance in the treatment of pernicious anemia, a disease heretofore incurable, was in-
564
MEDICINE
troduced in 1926 by Dr. George Richards Minot and Dr. William Parry Murphy, working in the clinics of the Peter Bent Brigham Hospital and the laboratories of the Collis P. Huntington Memorial Hospital. This disease, characterized by a continued reduction in the number of red corpuscles in the blood, has been observed to progress over a brief number of years, interrupted by remissions, to a fatal termination. The anemia is usually of a severe type, due to the inability of the body to develop new mature red cells. The liver, which is known to have important offices in the economy besides secret- ing bile, appears to have importance in the diet of carnivorous animals, for hunters tell us that when a stag is killed by wolves or dogs the abdomen of the dead animal is first torn open and the liver devoured.
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.