USA > Massachusetts > Suffolk County > Boston > The memorial history of Boston : including Suffolk County, Massachusetts. 1630-1880, Vol. IV > Part 70
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A charter for a hospital was granted by the Legislature, Feb. 25, 1811, containing a liberal gift, made on the condition that $100,000 more should be subscribed by individuals. Besides giving the Province House, the official residence of the Provincial Governors, for this object, the State helped along the matter in various ways. By a special resolve it was pro- vided that the stone for the building should be hammered by the convicts in the State prison at Charlestown. The work thus done is estimated at more than $30,000.2 The institution was opened in the autumn of 1821; though the McLean Asylum for the treatment of the insane, under the same board of managers, was in operation several years before this time.
The greatest boon to the human race, since the invention of printing, has been unquestionably the discovery of the anasthetic properties of ether; and this great fact was first demonstrated to the world at the Massa- chusetts General Hospital. It was on Oct. 16, 1846, that ether was here
1 [The Life of Dr. John C. Warren contains portraits of Dr. Warren; his father, Dr. John Warren; and of Dr. James Jackson. See also the History of the Mass. General Hospital. - ED.]
2 [Views of the Massachusetts General Hos- pital are in the Life of John C. Warren, p. 208; in the History of the hospital ; and elsewhere. -ED.]
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administered, under the immediate supervision of Dr. William Thomas Green Morton, in the presence of the surgeons of the institution. A full account of the affair, together with a detailed statement of the controversy connected with it, is given in Mr. Bowditch's history of the hospital.
The City Hospital, supported entirely by the city, was opened in the year 1864. It is situated in Harrison Avenue, and occupies a square con- taining nearly seven acres. It consists of a central building and several large pavilions for the treatment of medical or surgical cases. During the past year nearly five thousand patients were treated within the hospital, be- sides ten thousand six hundred and five out-patients.
The Massachusetts Homeopathic Hospital, in the immediate neighbor- hood of the City Hospital, was opened in the spring of 1876, and is con- ducted by physicians of the Homœopathic school.
The Carney Hospital, at South Boston, is a large and useful institution ; as is also the New England Hospital for Women and Children, situated in Roxbury.
There are numerous other Hospitals and Homes in various parts of the city for the treatment of the sick; notably among them is the Children's Hospital, first opened in the year 1869. A large and commodious building for the use of this institution is now erecting in Huntington Avenue, which will be finished during the coming year.
Samuel A. Preen.
ADDITIONAL MEMORANDA.
I. CHANGES OF CONDITIONS AND HABITS AFFECTING THE PUBLIC AND THE PROFESSION. - To write of " Medicine in Boston " is not unlike writ- ing of the tides in Boston Harbor. Boston is a fraction of the civilized world, as its harbor is a part of the ocean. In both we must expect to find general laws and phenomena, modified more or less in their aspects by lo- cal influences.
It is safe to say that our descendants who may read these pages will be very much the same kind of human beings that we are, as we are very much like those who have gone before us. Elderly people will talk about " old- fashioned snow-storms" as we do. They will speak of "good old-fashioned constitutions," and bewail the degeneracy of the times to which they have survived. It was so in the days of Nestor; it was so in the days of good Dr. Holyoke. Among the fragments left by that excellent and sensible, but not eminently poetical, old physician was one which embodies a feeling
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that doubtless extended to many others of the changes which he had lived to witness : -
" ... and smoak'd segars !
Vile substitute for that white, slender tube
Our fathers erst enjoy'd, in winter's eve,
When the facetious jest, or funny pun, Or tales of olden time, or Salem witch,
Or quaint conundrum round the genial fire The social hour beguil'd."
There are many changes in the conditions of society, and even in the aspects of Nature, taking place from generation to generation', some for the better, some for the worse; and it is not always easy to strike the balance between the helpful and the harmful ones. The clearing of the forests alters the whole face of the country, -to some extent modifying the climate. The damming of streams necessarily introduces new sources of disease. Look at our Boston as it was in 1630, and as we now see it! Faith, aided by cer- tain material agencies, has said to one of the hills of the Trimountain trip- let, " Remove hence to yonder place !" and it has removed, being literally " cast into the sea." The little neck which united Boston to the main land has expanded into a great territory, covered with costly edifices. The old " Mill Pond" has been so long a part of the solid territory that its former existence is only known to a few students of the past. A little brook of fresh water from the hills runs through every street, and waits at every man's door, ready to serve him at an instant's notice. These are changes which might well be expected to affect the health of the citizens, directly or in- directly.
There has always been a prejudice in the minds of some of the old in- habitants against the "made land" of Boston. The territory embracing what was once the Mill Pond is said to have been unfavorable to the health of its inhabitants. Some have felt apprehensive that the creation of the New Boston, as we might almost venture to call it, -the stately city lying west of the Common,-would call a malarious region into existence. So far as our present experience reaches, these apprehensions of timid citizens, -shared, if I remember right, by the late Dr. Buckingham, - have proved groundless. Dr. Edward H. Clarke said to me, some time before his death in 1877, that, up to that date, he had never had a case of typhoid fever in the newly-peopled quarter, where he found a large proportion of his patients. Dr. Charles F. Folsom, late Secretary of the State Board of Health, writes me (Oct. 18, 1881), in answer to my question on the matter, as follows: -
" As to the Back Bay land, there is no evidence of any conditions unfavorable to health which can amount to proof. If there is any injurious emanation through the gravel from the filth below that, it must be very difficult to prove the fact. There is so much space and sunshine that, on the whole, the mortality is the lowest in the city, - perhaps largely due to the character of the population."
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MEDICINE IN BOSTON.
Dr. Folsom says also : -
"There seems to be pretty clear evidence that typhoid fever diminished in Boston after the introduction of Cochituate water, the evidence being chiefly from the state- ments of physicians. (See Second Report of the State Board of Health, pp. 125 et seq.) I know of no way of ascertaining its effect on the general death-rate."
The question as to the former and recent origination of fever and ague in this section of the United States is of late years assuming a new interest. On this subject I can speak with some authority. In the year 1837 the Boylston Prize Committee proposed the following question : "To what ex- tent and in what places has intermittent fever been indigenous in New Eng- land?" This question I answered to the best of my ability, with the aid of letters from distinguished physicians all over New England in answer to my inquiries. My dissertation, published with other essays in 1838, is accom- panied by a map of New England, in which every locality where the disease could be shown to have originated is marked by an asterisk. Of the twenty- nine marked localities fifteen were in Massachusetts. Among these the town of Boston had its place, by the testimony of the earlier writers and on the strength of a single case given by me as related to me by Dr. James Jackson. The patient was a lady, under the care of the late Dr. Dixwell. She had lived in Essex Street for a year or two, and had not been travelling for some time previous, if for many years. "This is the only case," Dr. Jackson says, " I have ever known of intermittent fever in Boston, so far as I am acquainted with that vicinity ; nor have I heard on any good authority of a case of this disease in my day within these limits." Even this case he considered questionable. All my inquiries in 1837 failed to bring out evi- dence of any other indigenous cases. Neither have I been much more for- tunate, or unfortunate, in finding proof of the existence of the disease as native here in these later years. Dr. Folsom writes, in the letter above- mentioned : -
" I have never heard of any recent case of intermittent fever in the vicinity of Boston, except three cases near Fresh Pond, in Cambridge, this autumn. I think there were a few in Chelsea some years ago. Dr. Walcott [the successor of Dr. Fol- som] tells me that he has no further information. Doubtless you know that there has been a great prevalence of the fever in Western Massachusetts, Eastern New York, and Rhode Island for a few years."
I have recently made inquiries of several of our leading practitioners, but no one of them had seen, in the course of a long practice, a single case undisputedly originating in Boston. My record of more than forty years ago is confirmed by that of to-day. Boston has been, for several genera- tions at least, almost if not absolutely free from that form of malaria which produces fever and ague. That it was not so in the early periods of the settlement is rendered probable by the facts cited from old authorities by Dr. Green, as well as those collected by myself in the dissertation referred to. That it may not be so in the future is rendered, I do not like to say
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probable, but certainly not very unlikely, by the facts referred to, which have been observed within the last few years. The Medical Record for Oct. 8, 1881, makes the following statement : -
" It is, we believe, about five years since it [malaria, -meaning fever and ague, its effect] began to travel up the Connecticut and along the sea-coast. It has now reached some of the river towns in lower Vermont, and has been quite prevalent at several points in western Massachusetts, along the Connecticut River Valley. Cases also occurred at Providence, R. I., and in the vicinity of Boston. According to the Connecticut Board of Health, the malarial wave is gradually extending over that State. The only rule which seems to be observed is that it follows up the river valleys, spreading on either side. It also travels along the coast line, extending thence inland. Local causes do not apparently develop the disease, although marshy ground, newly-turned soil, etc., have in some cases increased the amount or modified its character."
The disease has appeared in the vicinity of New Haven, of Hartford, and of Springfield, at Greenfield, Lenox, and North Adams. The Boston Medical and Surgical Journal for Oct. 6, 1881, says : -
"We learn that eight or ten cases of intermittent fever, of unquestionable local origin, have been observed in Millbury in this State. 'Millbury, as our readers know, is a pleasant manufacturing town of about five thousand inhabitants, situated on the Blackstone River, not far from Worcester."
Whether the early experience of Boston and its neighborhood is to be repeated in coming years we can only conjecture; but there is reasonable ground for apprehension in the encroachments on New England territory which have occurred of late years.
Since writing the above paragraph, the Boston Medical and Surgical Fournal for Oct. 27, 1881, contains a statement, borrowed from the Report of the city registrar of Providence, that there are more than a hundred cases of fever and ague in that city at this time. In the same number of the Fournal it is stated that the malarial wave has extended up the Blackstone River as far as Lonsdale, where eight cases had been observed by the physician making this statement. Another physician reported thirty cases at Cranston during the present season. I must, therefore, confess that what I claimed for New England in verse so long ago as 1846 cannot be affirmed in truth-telling prose in 1881 : -
" Cold are thy skies, but ever fresh and clear, No rank malaria stains thine atmosphere."
As yet, however, it is true of Boston, and we may hope, rather than confi- dently trust, will remain so in the coming centuries.
With the swarming in of a new population of poor foreigners, new sources of disease have naturally come into being. The month of June is commonly the least sickly one of the year in Boston. As the hot weather
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MEDICINE IN BOSTON.
comes on, the better residences in the newer parts of the city are gradually left for the country, until the broad avenues of our Westminster and the adjacent streets are silent and lonely as Tadmor in the Desert. In July the ravages of the destroying endemic, cholera infantum, begin to be for- midable, and they continue until the cooler days and nights bring with them typhoid fevers and dysenteries. The large death-rate of Boston is in great measure due to the fearful mortality among children in the crowded streets and poorer dwellings of the city. . The malaria of filth and overcrowding takes the place of the marsh miasms which afflict other parts of the coun- try. Why our city should so long have enjoyed exemption from these also it is not easy to say. It has suffered from cholera, from diphtheria, from the ordinary eruptive fevers; in the earlier part of the century from slight inroads of imported yellow fever : but while it has shared the diseases which belong to the whole country and the whole world, and felt the usual effects of crowding common to great cities, it has never known any destructive lo- cal pestilence like the plague of London, or the yellow fever of New Orleans or of Philadelphia. A source of anxiety at the present time is the condi- tion of the water supply, which, though abundant, is so far from being sat- isfactory in quality that spring water is as much an article of commerce as ale or wine; and many families no more think of drinking the Cochituate in- fusion of organic matters than they would of drinking the salt water of the Charles.
The question as to a change of constitution in the American from the Old-World type and habit is under active discussion at the present time. Long before another century shall be completed, we may trust that a thorough investigation will have taken the place of vague impressions and partial statistics. The Rev. Samuel Stanhope Smith, sometime President of the College of New Jersey, maintained, as others have since his time, that the white man in America was becoming assimilated to the Indian in physical character. It has been generally believed that the American, as compared with the Englishman, is leaner, paler, more nervous; that his teeth are more liable to decay; that the young women, though singularly handsome in early life, fade much sooner than do their English sisters. All this was attributed to such causes as the climate, which is thought to be drying and stimulating; to the common food, which is accused of being indigestible and badly cooked; to the eager activity of the people in the pursuit of gain, with also a neglect of exercise and athletic amusements. On the other hand, I once heard it maintained by a well known writer that the American is "an Englishman reinforced." In a recent article, founded on long and careful observation in both countries, the characteristic Ameri- can and English types, as seen in ordinary representations, are said to be found as well marked in one country as in the other. There is at this time a rather common belief that the new generation in this city is breeding up to a higher standard than that of its ancestors. The prevalence of a pleasing embonpoint among our young women of higher social condition is
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spoken of as quite equal to that observed in England. We are beginning to export beauty with other live products.
Two obvious causes tend to improve the development of the new gen- eration. The first is the prolonged residence in the country of all who can afford it during the hot season. Man, but more especially woman, is a hot- house fruit in our inclement climate. To make up for long confinement under glass, free exposure, so far as the seasons permit, is essential. The second obvious cause of physical improvement is found in the great atten- tion now given to out-of-door exercises. Base-ball and cricket, lawn-tennis and croquet, football, lacrosse, boating, running matches, fencing, sparring, - all these have become serious pursuits, under the name of amusements. Training for athletic contests has been better than sermons in enforcing the connection between perfect health and temperate habits. Wholesome food, abstinence from alcoholic stimulants and narcotic nerve-poisoners have proved their value, or rather their necessity, as conditions of success in the rowing match and foot-race.
We have seen families, long resident among us, run down and die out. We have seen others breed up, showing a physical constitution far superior to that of their progenitors. The question of acclimation cannot be con- sidered fully worked out as yet. But we do know that, under proper influ- ences, vital capital may be accumulated here as well as any other and less valuable property. Daniel Webster and Jeremiah Mason strode in upon us from the hungry hillsides of New Hampshire. Two of the most athletic young men I have known traced their lineage backward through four or more generations to invalids of our city and its immediate neighborhood. How many centuries it may take to mould the true American type, or whether there will be one or many gradually taking shape on the Western Continent, we must leave it to the future to decide. 'This at least we know, that the fancies of Buffon and the whims of such ethnologists as the late Dr. Knox, of Edinburgh, are already rendered ridiculous by the history of many successive generations, represented at this day by men and women not a few of whom are far above the average European in bodily and mental vigor; while the beauty of American young women is generally recognized as a national characteristic. The causes of improvement and deterioration in the race will vary with time and circumstances; but we have a right to anticipate a constantly growing adaptation of the settlers of the New World to their atmospheric and other natural environments, so that we can hardly guess what physical and mental standard our descend- ants may reach after a thousand years of ancestral acclimation.
The death-rate among the poorer classes in a crowded city must always, it may be feared, remain large. But there are many circumstances favor- able to health in well-built, and especially in well-paved, cities; and we have a right to hope that our city will, by replacing its unwholesome tenements by habitable dwellings, the improvement of its drainage and, we must add, of its water supply, diminish a ratio of mortality now larger than it should be in a town so situated.
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II. MEDICAL PRACTICE AS IT WAS AND IS. - Our forefathers appear to have given more thought, a great deal, to the salvation of their souls than to the care of their bodies. Disease itself, the offspring of sin and penalty of a poisoned nature, was for them a theological entity rather than a disturbed . physiological process. The superstitions of the clergy were naturally, to some extent, reflected in the practice of the physicians. How far this was the case we have scanty means of knowing, for very little is recorded of the practitioners of medicine as compared with the abun- dant memoirs of the preachers. One curious fact hints at a difference of opinion and feeling in the two professions, which was probably more exten- sive and deeper than any record can show. In the endemic mania at Sa- lem the Swinnerton family are said to have been all along opposed to Mr. Parris, and to have kept remarkably clear from the witchcraft delusion. Dr. John Swinnerton, who died just before the reign of ghostly terror pre- vailed; was the chief medical practitioner of Salem; and we can hardly doubt that his influence had much to do with the attitude taken by the family with reference to the all absorbing question. But notwithstanding the proverbial freedom of thought characterizing the medical profession, we could hardly expect the earlier physicians to have been much in ad- vance of their age; and we can conjecture what must have been the state of medical belief and treatment among the colonists, by recalling the con- temporary conditions of medical science and art in the Old World.
If one of the earliest settlers, or of the next generation, had gone to England with a scrofulous child, Richard Wiseman, the distinguished author of Chirurgicall Treatises, member of the Honorable Company of Barber Surgeons, would have commended him to the touch of his royal master, as being the divinely appointed cure of the "King's Evill." If the traveller had been fortunate enough to carry an introduction to the Hon. Robert Boyle, one of the most illustrious philosophers of his age, that distinguished gentleman might have handed him a little book which the great man him- self had put forth, in which he would find the ashes of the "Sole of an Old Shoe worn by some Man that walks much," or the powdered warts from the leg of a horse, recommended for different affections, - the last for in- ternal use. Mr. Boyle would have very probably advised him to consult Mr. Valentine Greatrakes, the touch-doctor, or to procure some of the " Powder of Sympathy" of Sir Kenelm Digby, wherewith to anoint the weapon, not the patient, if one had been wounded. If the colonist had passed over to the Continent he might probably have sought the counsel of the world-renowned Van Helmont, the successor in some respects of Paracelsus, who would have explained to him the mysteries of the Archæus, the ruler of the living body, who was to be humored and coaxed or driven into good behavior; perhaps have commended him to his Irish friend, Butler, who would have tried the virtues of his famous pebble upon him. Not much could be expected of medical science in the New World if such was its condition in the Old. Physic was a lucrative calling,
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in which the desire of gain, joined to the benevolent purpose of relieving suffering, - aided also by the natural vanity which leads men to over- estimate their own powers and performances, - - conspired to attribute a much larger share in the movements of disease to medication than really belonged .to it. Mr. Ward, the Vicar of Stratford-on-Avon from 1648 to 1679, who might have told us so much, and has told us so little, about Shakespeare, quotes a lively description of the doctors quite as damaging to their patients as to them: "There are several sorts of physicians, said one; first, those that can talk but doe nothing; secondly, some that can doe but not talk; third, some that can both doe and talk; fourthly, some that can neither doe nor talk, - and these get most monie."
I had the privilege of examining and reporting to the Massachusetts Historical Society on a paper of medical directions placed in my hands by the Hon. Robert C. Winthrop, the president of the society. It is headed, " For my worthy friend, Mr. Wintrop," and signed "Ed. Stafford." Its date is 1643; and I was not able to decide whether it was intended for our Governor John Winthrop, or for his son, the Governor of Connecticut. The list of remedies is made up principally of simples, or vegetable substances. St. John's wort, black hellebore, great bryony root, the four great cold seeds, maiden-hair, fennel, parsley, witch-hazel, elder, clown's all-heal (stachys palustris), saffron, foxglove, jalap, scammony, snakeroot, are among these, many of them inert, some dangerous, if not carefully handled. Caranna and tacamahacca, - two gums, of which it used to be said, " Whatever the tacamahacca has not cured the caranna will,"- and Burgundy pitch are also enumerated. Of mineral substances, lime-water, salt, saltpetre, crocus metallorum (sulphuretted oxide of antimony) are mentioned. “ A Wilde Catt's skin on ye place grieved " is recommended for pains in the heart or limbs. More formidable to the imagination than any of these is "My black powder against ye plague, small-pox, purples, all sorts of feavers, poyson, either by way of prevention or after infections." This is made by burning toads to charcoal, and reducing this to powder. It belongs to that list of abominations which disgraced the old pharmacopias, but which have disappeared from the armamentarium of regular practitioners. As late, however, as the year 1789, Cullen had to censure Vogel for allowing burnt toads and swallow chicks to remain on his list of remedies.
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