USA > Ohio > History of Ohio; the rise and progress of an American state, Volume Five > Part 16
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on a higher plane, scientific and ethical, and announce- ments of achievements in medicine and surgery electri- fied the audiences and called forth encomium and ir some instances criticism. The achievements of Dunlap and Buckner as ovariotomists drew fire as well as eulogy, and of M. B. Wright, in perfecting a technic of Bimanual Cephalic version, was received in much kindlier spirit. Not the least important of these movements was one looking to the creation of : Central Board of Medical Examiners to take the granting of degrees out of the hands of the teachers This had the support of not only the profession a large, but of the medical schools as well.
It would carry us far beyond the bounds allotted to the subject to even give passing notice to the score and hundreds of medical societies of every kind and description which sprang into existence as auxiliary to or independent of the State Society. Suffice it to say that by degrees, and in large measure as the resul of the perfect organization of the American Medica Association, the Ohio Medical Society became : delegated body, subsidiary to the supreme delegated body and thereby became an association by which title it is now known. As the American Medica Association is supreme in the land and all state asso ciations subsidiary to it, so all district and loca medical societies, by whatever name, in order to b eligible to recognition by the aforenamed associations must acknowledge allegiance to them. The organi zation is perfect, the scope of the work almost unlimited the character of the work excellent.
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OHIO STATE BOARD OF HEALTH
The Ohio State Board of Health superseded and had its inception in the Ohio State Sanitary Association. It was organized May 18, 1886, under an act of the legislature passed April 14, 1886. The members of this Board as originally created were, Drs. W. H. Cretcher, G. C. Ashmun, T. Clarke Miller, John D. Jones, S. P. Wise, D. H. Beckwith, Thomas C. Hoover and H. J. Sharp. Dr. Cretcher was chosen president and Dr. Ashmun became sceretary. Dr. Ashmun resigning, was succeeded in June by Dr. Guy B. Case, who in turn, the following month, gave way to Dr. C. O. Probst. Practically, then, Dr. Probst has been secretary of the State Board of Health ever since its organization. In the twenty-five years which he has served in that capacity he has kept the Ohio State Board of Health abreast of the leaders and has himself come to be recognized as one of the ablest and most efficient officers of the health department in the United States.
The Board as first constituted had no well defined functions, was limited as to its powers and powerless to enforce its decrees. It received scant recognition from the profession or the laity, and in some instances active opposition from the local health boards as a menace to their powers and privileges. There were in all about twenty-five local health boards in the State, and they were the creatures of the municipal councils and entirely subservient to them. In Cin- cinnati the health board was not even allowed to placard a house for contagious diseases lest it might
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drive away trade. In 1888 legislation was passed making it obligatory for the councils of all villages, towns or cities of five hundred inhabitants or more to establish a board of health and to appoint a health officer. In 1893 the boards of health were authorized by legislature to make their own rules and regulations and enforce them. In the rural districts the township trustees constituted the boards of health, and in 1892 they were required to appoint a township health officer. In 1902 the present health code was enacted. This permits villages to abolish a board of health and appoint a health officer instead. This was taken advantage of by about fifty per cent. of the villages.
The office of the Board at the beginning consisted of a desk in the Attorney General's office, occupied by the secretary. Some time later a stenographer and clerk were added, and in 1898 an engineering department and laboratory were established, making an addition to the working force of five engineers and two stenographers for the former and two chemists, two bacteriologists, one stenographer and one janitor for the latter. Instead of a single desk, as at the beginning, the offices of the board now occupy thirteen rooms. Instead of an appropriation of $5,000, as originally allowed for annual expenses, an appropriation of $51,000 was voted for 1907. The health service of the State has grown from a few local boards to 2,108, with a personnel of some ten thousand all told.
In 1891 the Board issued a call for a permanent organization of all boards of health and health officers, and, although the response was gratifying, it was not as general as desired, for the reason that it was optional
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with the members whether they attended or not, and for the additional reason that no provision was made for paying the expenses of the delegates. In 1896, by act of the legislature, each city, village and township was compelled to send a delegate to the annual meeting of the Board and pay expenses of such delegate. This greatly increased the efficiency of the cause.
The work of the Board has covered a wide scope, and it has inspired much wholesome legislation. Recognizing the number and gravity of water-bred diseases and the absolute necessity of pure water as a safeguard against the same, all the principal streams of the State were explored from mouth to source, the water tested, the environments observed and such measures instituted as to abate existing evils. In like manner and for like purpose epidemics of various kinds were dealt with, the object being to prevent invasion from without, to protect our com- munity from within and to stamp out the disease where it had gained a foothold. In this way a wide- spread invasion of smallpox was, after a hard fight, brought under control, some isolated epidemics of diphtheria nipped in the bud, the ravage of typhoid fever greatly reduced and attention given to rabies and other communicable diseases. The great fight against tuberculosis, which has taken on such pro- portions, not only in this State, but throughout the country, was, so far as this State is concerned, inau- gurated by the State Board of Health. Other measures have been projected, which, when fully matured and sanctioned by law, will extend the scope and value of the work far beyond anything yet realized.
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In time, when the profession and the people have been educated to it, the State Board of Health will be recognized as one of the valuable assets of our great commonwealth.
The Board as at present constituted consists of Dr. Frank Warner, President, Columbus; Dr. Oscar Hasencamp, Vice-President, Toledo; Josiah Hartzell, Ph. D, Canton; Dr. R. H. Grube, Xenia; John W. Hill, C. E., Cincinnati; Dr. H. T. Sutton, Zanesville, and Dr. William T. Milles, Cleveland.
THE OHIO STATE BOARD OF REGISTRATION
The first earnest effort at legislation in Ohio to regulate the practice of medicine was consummated in May, 1868, when the legislature passed an act entitled, "An act to protect the citizens of Ohio from empiricism and to elevate the standard of the medical profession." The provisions of this act were: "(I) that the practician must be a man of good moral character, (2) must have attended two full courses of lectures and graduated at some school of medicine, either in the United States or some foreign country, or (3) produce a certificate of qualification from some state or county medical society, or (4) have been continuously engaged in the practice of medicine for a period of ten years." The penalty for violation of this law consisted of a fine from $50 to $100 for the first offense and a jail sentence of thirty days for the second. This law, while doubtless enacted with the best intentions, was practically a dead letter from the start. This, simply for the reason that it
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was nobody's business to enforce it, and, although it remained on the statute books for a third of a century, there is no record to show that it was en- forced in a single instance. Subsequent legislation, of which there were several attempts, instead of strengthening this law in its weak parts to give force to its provisions, left it more and more a pitiable wreck and deprived it of all force and meaning. By an act of the legislature, May 1896, the State Board of Registration was created, Dr. N. R. Coleman, of Columbus, being its first president and Dr. Frank Winders, of Findlay, its secretary. Dr. Winders's ser- vice, which was very efficient, continued until March, 1905, and after a short interim, made so by the appoint- ment and prompt resignation of Dr. D. N. Kinsman, the present incumbent, Dr. George H. Matson, became secretary. As the result of this registration law, which was instinct with virility and had in it so much of the true ring of what it purported to be, a great exodus of ineligibles and incompetents took place from the State. Something near nine hundred non-graduates left Ohio and took shelter in other states, where the laws were not so rigid; while the tide of incoming imposters who had found Ohio good picking was checked and diverted in other directions. Within the few years succeeding this act, more prosecutions for the illegal practice of medicine, followed by a larger per cent. of convictions, took place in Ohio than in any other ten states in the Union. After strenuous efforts on the part of the physicians interested, the legislature was induced to pass certain very important amendments to the act of 1896. Those amendments,
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which became a law in April, 1900, provided for a high educational requirement preliminary to the collegiate course in medicine, and for the examination of all future applicants for registration, and also made radical changes in the section describing the offense of illegal practice. The provisions were all salutary and bore immediate fruit. The law describing the offense of illegal practice was a model of perspicuity and covered the ground so completely as to stand the test before the highest tribunal in the State. The difficulty in enforcing the law as it now stands is due in part to the apathy of the individual members of the medical profession, who are unwilling to take upon themselves the onus, and, in some instances, the public opprobrium of prosecuting witnesses; in part to the apathy or disinclination of the prosecuting attorneys of the various counties, who not infrequently ignore the specific and thoroughly substantiated charges of the Board of Registration and, in direct contra- vention of their sworn duty, utterly refuse to bring such cases before the Grand Jury, and in part to the apathy, or in some instances active sympathy of the public at large for the accused, who, without the slighest understanding of the great issues at stake, choose to regard the laudable efforts of the medical profession to protect them from vampires as an unwarranted restraint of trade. The remedy is through widespread organization of the profession, with committees to represent the different constituted bodies and a set purpose to oppose any officer of the law at the polls who fails to do his duty in this direction, as in others.
JEDEDIAH COBB
Born in Gray, Maine, February 27, 1800; graduated in medicine from Bowdoin College, 1823; came to Cin- cinnati to accept a chair in the Medical College of Ohio; noted as an anatomist; late in life retired to a farm in Manchester, Massachusetts, where he died in 1861.
JARED POTTER KIRTLAND
Born in Wallingford, Connecticut, November 10, 1793; received his degree in medicine from the Yale Medical College, and eventually established himself in Ohio; for many years a prominent member of the profession, and actively identified with medical education; died in Cleveland, December 10, 1877.
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HOSPITALS
To the average mind, the strongest and most convincing evidence of the progress of medicine in this State during the last century is to be found in new institutions for the care of the afflicted.
If all the hospitals of the State were moved together, allowing suitable grounds for each, there would arise before us a city of such splendor as the world has never seen, majestic and unique in its architectural effects, imposing structures, and the wondrous mag- nitude of many of the buildings. It is claimed, and with good reason, that the main building of the Colum- bus State Hospital is the largest building of the kind under one roof in the world. Not only so, but it is so artistic in design, symmetrical and equally balanced, as to be one of the most attractive of edifices. Not only are these hospital buildings impressive in number, size and as examples of classical architecture, but for the most part their appointments are of the best, as they are thoroughly equipped for the purpose for which they were intended. Compare this splendid aggregation of structures, as we have pictured it, and their marvelous up-to-date equipment, with the hospitals of earlier times, and note the difference. The first hospital erected in Cleveland was in 1812, and was built by Captain Sholes, of the U. S. Army. "I had two or three good carpenters in my company," writes Captain Sholes, "and set them to work to build a hospital. I very soon got up a good one, thirty feet by twenty, smoothly and tightly covered, and floored with chestnut bark, with two tiers of bunks
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around the walls, with doors and windows, and not a nail or screw or iron latch or hinge about the building. In a short time I had all the bunks well strawed and the sick and wounded good and clean, but some had fallen asleep."
This sounds cozy, and it is doubtful if it conveys any but a comforting impression, but if we go back to some of the old brick structures of a half century or more ago, ill-lighted, ill-ventilated, swarming with bacteria, reeking in noisome odors, then we may understand how to the people the hospital was a veritable chamber of horrors, and that it represented misery, suffering, privation, inefficient care and often- times neglect. People shunned the hospital for them- selves and friends, and regarded it as little short of calamitous when anyone except the most destitute and degraded was consigned to one. Now it is different. Owing to the splendid equipment, the devices for safety, convenience and comfort, the high grade of medical and surgical skill there attainable, the excellent and scientific methods of nursing, it is become generally recognized that the hospital is not only the safest but most comfortable, cheeriest and best place for the sick. It is no longer the exclusive resort of the poor and needy, but is utilized by all classes and to a larger extent, probably, in proportion to numbers, by the wealthy, because they realize that there, more than any other place, they can get the environments and skill to restore health. While it may not be practical in this connection to even enumerate the hospitals of Ohio, a word with reference to the largest of them may not be amiss.
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Of the State Hospitals there are nine, in most instances named according to locality. These are, taken in alphabetical order: the Athens State Hospital, Athens, Dr. O. O. Fordyce, Superintendent; Cleveland State Hospital, Cleveland, Dr. C. A. Clark, Superin- tendent; Columbus State Hospital, Columbus, Dr. Charles F. Gilliam, Superintendent; Dayton State Hos- pital, Dayton, Dr. Baber, Superintendent; Longview State Hospital, Cincinnati, Dr. F. H. Harmon, Superin- tendent; Massilon State Hospital, Massilon, Dr. H. C. Eyeman, Superintendent; Ohio State Hospital for Epileptics, Gallipolis; State Sanitorium for Con- sumptives, Mt. Vernon; and the Toledo State Hospital, Toledo, Dr. George Love, Superintendent. Of yet other large hospitals of the State, the Cincinnati Hospital, begun in 1866 and occupied in 1869, was in its day the most magnificent structure of the kind on the American continent. Its original cost was about $1,000,000. It occupies an entire square and accommo- dates about eight thousand patients per annum. Other large hospitals in Cincinnati are the Good Samaritan Hospital (Catholic), St. Mary's Hospital (Catholic), the Jewish Hospital, the Hospital of the German Protestant Deaconesses, Christ Hospital and the Presbyterian Hospital.
In Cleveland we find that magnificent modern charity, with its up-to-date equipment, the Lakeside Hospital; St. Vincent's Hospital (Catholic), Cleveland Homœopathic Hospital, the St. Alexis Hospital (Catho- lic), the City Hospital, St. John's Hospital (Catholic) and St. Luke's Hospital (Methodist).
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In Columbus there are four large public hospitals, three of which are Catholic and one Protestant. They are: the Hawkes Hospital of Mt. Carmel, the Prot- estant Hospital, St. Anthony Hospital and St. Francis Hospital. Besides, here is located the Grant Hospital, claimed to be the largest private hospital in the world. At Dayton, the St. Elizabeth Hospital (Catholic) has a capacity for from 2,500 to 3,000 patients annually.
All these hospitals are among the finest, and, for efficiency, will compare favorably with any in the country, though not so ornate or rich in setting as some of the endowed institutions of the great money centers in the East and on the Pacific Coast.
The wonderful advancement made by medicine since the pioneer days of Ohio is incomprehensible, even to the enlightened physician. It has gone out along so many lines, has effected such amazing changes, has undergone such a degree of specialization as to render detailed narrative in this connection quite out of the question. Specialism has been carried to such an extent that in the larger cities it would seem to have almost supplanted the old-time methods. While the field of medicine as it exists to-day is so vast and intricate as to place it beyond the power of any single individual to compass, still it is to be re- gretted that more serious effort has not been made by specialists and general practicians alike to acquire an outline knowledge of the entire field. This would save the specialist from narrowness and bigotry, take him beyond the horizon of his own little bailiwick and open his eyes to the many modifying influences affecting the cases brought before him. Oftentimes
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the specialist, in his self-inflicted myopia, fails to grasp the import of what he sees, and blindly follows a routine to his own detriment and that of the patient. On the other hand, broader and more definite knowledge and observation on the part of the general practician would enable him to refer his patients to the right specialist and to give to that specialist a working basis for the exercise of his art. The old-time physi- cian combined in himself all the knowledge and all the skill of all the departments of medicine. At the same time, taken all together, the entire field of medi- cine at that period scarcely exceeded that of one of our modern specialties. The old-time physician was oftentimes a good diagnostician, though he had nothing but his unaided senses to direct him. He diagnosed fever by the flushed face, the bounding pulse, the degree of warmth communicated to the hand. In time came the refinements in all departments. In- struments of scientific precision supplemented the unaided senses. Among the earlier of these was the clinical thermometer, by which not only the presence but degree of fever could be determined to a nicety. This threw a flood of light on various morbid conditions and became of immense value, not only in the diagnosis but in the treatment of disease. In many instances the temperature chart furnishes the key to the situation and the reading of the chart will enable the physi- cian to diagnosticate a case even in the absence of the patient, as, for example, the temperature curve in typhoid fever, especially if it be a typi- cal case, will be so characteristic as to be almost pathognomonic. Prior to the use of the clinical
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thermometer no one would have suspected a rise of temperature in the chill stage of fevers. The drop of the mercury to the subnormal will sometimes give the clue to a concealed hemorrhage, to a perforation of the bowel or to other hidden disaster which other- wise might not even be suspected.
The microscope was brought more and more into play, its technical advantages became more and more conspicuous, and its field of usefulness enlarged, until to-day it plays a role in practical medicine little suspected by the laity or the ordinary physician. Not only is the microscope used to determine tissue changes in disease, to examine the secretions and excretions, to determine the presence or absence of albumen, casts, bile and pancreatic salts, to make the blood count, to differentiate the nature and trend of morbid growths, but it furnishes an interpretation of many of its findings and throws a flood of light on conditions that otherwise must have remained enig- matical. Along with chemistry, it has pushed out into the dark mysterious regions of an unseen and unsuspected domain, and brought forth bacteria and bacterial products, and made us acquainted with the nature and significance of opso-nins, antibodies and many other things too numerous to mention.
Then came instruments to determine the pressure of the blood, the degree of arterial tension, which, being rightly interpreted, leads the investigator to the chambers of many occult processes and reveals to him the incipient stages of deadly disease. Then there is the hypodermic syringe, which gives wings to the anodyne and sends it forth in quest of pain. In
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the twinkling of an eye the most atrocious suffering is at an end and the patient falls into tranquil repose. Compare this with the slow, uncertain and in some instances dangerous action of drugs given by the mouth, and one may appreciate in part the value of the hypodermic. The crude and at times shockingly cruel methods of combating disease, as they existed in other days, have given way to humane and scientific methods which have for their aim the amelioration of human suffering, both in the agencies employed and as a result of their application. Now, instead of the impossible bolus and nauseating draught, we have the elegant multitudinous pharmaceutical preparations concentrated and minimized to the last degree, done up in sugar and gelatine to conceal the taste, doctored and disguised in pleasant tasting excipients so as to divest them of all objectionable qualities. Then come modern methods of treatment as we have them in organotheropy, serum therapy, vaccines, for all of which special potentialities are claimed for special diseased conditions. In the domain of surgery the advancements have been, if anything, more wonderful still.
First in order comes general anesthesia, that great boon to suffering humanity, under whose potent in- fluence the patient goes off into rosy dreamland while the surgeon with knife and fingers is toying with his vitals. Only can we bring ourselves to a realization of the magnitude of this blessing when we look back to the days of a little more than a half a century ago, when the most delicate, the most timid, the most highly sensitive among us were strapped to the table
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