USA > Rhode Island > Providence County > Providence > State of Rhode Island and Providence Plantations at the end of the century : a history, Volume 2 > Part 5
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"But for the last fifty years Rhode Island, together with the larger part of New England, has had complete immunity. About twenty-five years ago, malarial disease began to spread eastward from the valley of the Hudson. The evil influence, whatever it was, crept slowly along the coast of Connecticut, and on reaching a river-mouth would rapidly spread from it up the valley. In this way the valleys of the Housatonic, the Connecticut, and, lastly, the Thames, as well as smaller streams, have become very malarious. New London was first visited in 1878, and it was then prophesied that our State would be the next to suffer.
"I have been told that cases of intermittent fever occurred in Providence three years ago, but none were publicly reported till the summer of 1880, the same year that the endemic occurred at Nayatt. While it was by far the most severe at that place, many other localities were somewhat affected, and a few cases occurred in Providence, all, I believe, in the neighborhood of Mashapaug Pond. During the sum- mer just past, a very large number of cases were reported, and the effort to tabulate them furnished the suggestion for this paper. En- quiries were made of one hundred and fifteen practitioners in this city. Replies were received from seventy-four. Of these, thirty-one reported cases, and forty-three reported having none. Three or four physicians practising in a locality to be mentioned, had a very large number of cases each, while of the remainder scarcely any one had more than half a dozen. In all there were about three hundred cases. About one hundred and eighty-seven, or more than sixty per cent., were within one-half mile of Mashapany Pond; twenty-six or eight per cent., were nearthe Oriental Mill ; and eight, or two and a half per cent., were near Red Bridge. This leaves seventy-nine scattered irregularly over the city. The population of the affected district near Mashapaug Pond is two thousand five hundred, as nearly as could be estimated. This makes the proportion of those attacked as one to fourteen. Probably it is much larger, as a great many sick with chills treated themselves, or applied to a druggist, and did not call a physician. The proportion affected in the remainder of the city was about one in twelve hundred and fifty. Not a single death occurred within the city lines."
Malaria has since spread over a considerable part of Rhode Island, but at present seems to be rather on the wane.
During the years 1876-77 some parts of Rhode Island suffered to an unusual degree from the diphtheria. The statistics show that the first death reported from this disease took place in August, 1858. During the period from that date until January 1, 1876, there were
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three hundred and thirty-five deathis in the State from that cause, and from January 1, 1876, to December 1, 1876, there were ninety-seven deathis, making a total of four hundred and thirty-two since the disease first made its appearance eighteen years before.1 The largest number in any one year previous to 1876 was forty-two in 1868, and the least number in any one year was five.
In the year 1877 there were reported in the towns of Warwick and East Greenwich forty-seven deaths from diphtheria, a number greater than from any other disease, not excepting consumption.2 The first death in Warwick from this disease occurred in 1861 and the first one in East Greenwich in 1864. From that time until June, 1877, the disease caused eighty-one deaths in those two towns: the number in each of those years was as follows : In 1861, 12; in 1862, 5; in 1863, 5; in 1864, 11; in 1865, 5; in 1866, 2; in 1867, 1; in 1868, 2; in 1869, 5; in 1870, 9; in 1871, 11; in 1872, 2; in 1873, 2; in 1874, 7; in 1875, 3; in 1876, 2. Sixty-six of these were under six years of age, about equally divided between the sexes. The disease seemed to break out sporadically, not becoming epidemic at any time. The eighty-one deaths would represent about five times as many cases. This epidemic affected Providence as it did the smaller towns, and in 1877 there were 295 deaths, and in 1878 the number was 246.
During the winter of 1889-90 the State was visited by an epidemic of influenza to such an extent that thirty-three per cent. of the in- habitants of the State were attacked and many deaths resulted from it and its complication with other ailments.
In the year 1899 three cases of small-pox were imported into Providence from Norfolk, Va., and during the past three years the disease lias existed generally in a mild form in many of the States of the Union. The three cases mentioned, and the only two others de- veloped, were taken in hand and further spread of the disease pre- vented. In 1901 the disease again appeared, the first case in East Providence. Later it appeared in Central Falls and afterwards in several mill villages in Providence county, and in Pawtucket and Providence. Under advice of the secretary of the State Board, the city and town authorities took up the task of quarantining, isolating and treating of cases, providing temporary hospitals, and all of the
1From paper read at the quarterly meeting of the Rhode Island Medical Society on December 20, 1876, by Walter E. Anthony, M. D.
2Paper read before the Rhode Island Medical Society on March 20, 1878, by Dr. James H. Eldredge.
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modern and effective means known to sanitary and medical authorities were brought to bear to prevent the spread of and eradicate the disease.
The work of boards of health and health officers has become an important factor in the life of the modern city and village. Since the creation of the State Board of Health, Rhode Island has been extremely fortunate in the selection of its members, but the legislature has not supported its diverse efforts with any great degree of liberality. Its work, too, has been rendered effective and encourag- ing by the earnest co-operation of the health authorities in many of
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the cities and towns; upon them has necessarily fallen the actual enforcement and execution of the provisions of laws and regulations relating to public health and sanitation, the State Board acting in harmony with them in an advisory capacity only.
A bill was introduced at the May session of the General Assembly, in 1877, providing for a State Board of Health and referred to the Committee on the Judiciary. It was not expected that this bill would at that time become a law; its introduction was the result of a sudden impulse to have the subject brought before the public for consideration
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during the recess prior to the following January session. The bill was transferred from the Judiciary Committee to the House Committee on Charities and Corrections who, with Dr. E. M. Snow, superin- tendent of health in Providence, and a committee from the Providence Medical Association and the senator who presented the bill, framed a new one, which was duly reported. Previous to the framing of the new bill the governor received from the secretary of the International Medical Congress of 1876 a communication containing a resolution requesting all governors to recommend the establishment of State Boards of Health. The new bill and this request were referred to a joint committee, who reported strongly in favor of the measure, and the bill became a law. The first State Board of Health consisted of David King, M. D., of Newport county, for six years ; Elisha Dyer, jr., Washington county, five years; Charles H. Fisher, M. D., Providence county, four years; George W. Jenckes, M. D., Providence county, three years; William T. C. Wardwell, Bristol county, two years; Albert G. Sprague, M. D., Kent county, one year. The first report of this board covered eight months of the year 1878, and contained a paper by George E. Waring, jr., on the causation of typhoid fever, and one by Dr. L. F. C. Garvin on the dietetic value of wine, beer, etc.
In the following year the board took up the work of registration of vital statistics, which had heretofore been carried on under direc- tion of the secretary of state, aided by a committee from the Rhode Island Medical Society. Circulars containing questions bearing upon sanitary matters were sent to all the towns of the State, to which twenty-three towns responded; the greater part of these towns re- ported that more or less effort had been made during the preceding years to improve the health conditions of the several communities. Among the important papers prepared and published in the report of 1879 was one on Ventilation of School Houses, by William A. Mowry, A. M. The report contained, also, tables showing a summary of acute diseases prevailing in the towns in each month of the year to each 1,000 population, and the birth rate to each 1,000.
The report of 1880 shows that circulars had been sent to health authorities throughout the State requesting information as to locali- ties, the conditions in which might foster any particular disease; as to contagious disease among domestic animals, and what had been done to promote health. To these circulars twenty-nine towns and cities re- sponded. During the early years of the existence of the board the reports show that many very valuable papers on sanitation, hygiene,
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and kindred subjects were written and placed before the board. Many sanitary tracts were sent out to the towns and cities, with the purpose of inducing the health authorities to use every effort to improve their respective localities.
In the report of 1882 appeared an exhaustive paper on the Com- position and Properties of Milk, by Edwin E. Calder, milk inspector of Providence. In that year the secretary of the board, Dr. Charles H. Fisher, made a tour of inspection of the summer hotels at Narra- gansett Pier and Block Island, and reported their sanitary condition. The reports made at this time and in following years, the annual re- ports to the State Board by the health officers in Providence, Newport, Pawtucket, and elsewhere, were exhaustive and valuable. In the re- port of 1884 much space was given to extracts from Samuel M. Gray's report on a proposed plan of sewerage and the disposal of sewage. Early in 1885 the secretary sent out a circular calling attention to the danger of a possible outbreak of cholera; this and the general interest that had been awakened throughout the State resulted in marked im- provements in sanitary conditions.
The proceedings of the board for 1887 include the secretary's report on the pollution of Providence River, which was made upon an investigation conducted in accordance with a request from the General Assembly. The report indicated that the stream was extensively polluted. In 1888 the subject of tuberculosis in cattle began to receive more attention by the board, and circulars were sent to butchers, veterinarians, cattle dealers, and personal visits were made by the secretary, with a view of having affected animals killed at the expense of the State.
At the July session of the Assembly, in 1891, an act was passed making it the duty of the State Board of Agriculture to give its at- tention to cases of suspected tuberculosis in cattle, and conferring up- on it authority to pay for all animals killed by its orders. This was the first positive authority to kill diseased animals and remunerate their owners for the loss.
On the 21st of October, 1893, Secretary Charles H. Fisher died, and Gardiner T. Swarts, M. D., was appointed to the position, in which he still serves. In this and the next preceding year the question of protecting the State from an invasion of cholera received attention. The secretary corresponded with the surgeon-general of the Marine Hospital Service on the subject, and arrived at the understanding that still exists on the subject, namely : That any infected vessel destined for any port between New York and Boston shall anchor at a pre-
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scribed distance from a landing, and the health officer or port physi- cian where there is no disinfecting facilities shall notify the surgeon- general, who will thereupon order the vessel to proceed to New York or Boston for disinfection. The cities of Providence and Newport have port medical officers.
Malignant scarlet fever prevailed extensively in 1893 in the towns of Johnston, Cranston, and Warwick, and Secretary Swarts took immediate steps to prevent its further spread and to control it in those localities; from that time to the present the board has continued to make the improvement of sanitary conditions in the various towns, through its advisory association with the local authorities and in other ways, one of tlic important branches of its work.
In 1894 the board took up a line of work which was destined to prove of great benefit to the inhabitants of all localities where there is a public water supply. An examination was begun of the sources of water supply, beginning with the Pawtuxet River, from which samples were taken from three separate points and analyzed. The supplies of Newport, Block Island, and Narragansett Pier were also studied. This work continued from year to year, and resulted, partly at least, in an enlargement of the Newport water works, the improvement of the Woonsocket source, and the removal of many causes of pollution in the Pawtuxet River. In the last month of 1894, also, was taken up the work of free examination for physicians of sputum for the diag- nosis of tuberculosis and the examination of secretions of the throat in cases of diphtheria. This was the first State Board of Health in the country to undertake this work. This practice has continued to the present with the most satisfactory results. In the same year the sum of $1,000 was appropriated by the State for the investigation of tuber- culosis in man, and a like sum in the next year for aid in controlling that disease and diphtheria. In January, 1895, an act was passed by the Assembly to control the practice of medicine; it made the State Board of Health an examining board, to control the issuance of cer- tificates and their revocation, and made it, through the secretary, a prosecuting body. The work entailed under this act included the consideration of over four hundred and fifty applications during tlic succeeding year.
The most recent important work of the board was the establish- ment in May, 1900, of a chemical laboratory, where potable waters are analyzed and other chemical tests and examinations made for general sanitary improvement. The State appropriated $6,000 for this undertaking and continues its support by annual appropriations of such sums as seem necessary.
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It will be seen that during the past five years the work of the Rhode Island Board of Health has been greatly broadened and made to include sanitary problems and tasks of the greatest importance to the general public throughout the State. Through the results of this work and the dissemination of sanitary knowledge, the people become better informed and consequently more clearly realize the importance to every community of individual effort for improvement in health conditions. The scientific work performed by the board enables it to give advice to town authorities which frequently results in improved administration and sometimes in public economy.
The registration of births, deaths, and marriages in this State was begun in 1853 under direction of Asa Potter, then secretary of state, but the credit for the movement should be given to Dr. Joseph Mauran. This system of registration is considered as the foundation of sanitary progress.
In this country towns and cities engaged in sanitary work long before State boards of health were created. In colonial times the regular town officials, or especially appointed officers, controlled nui- sances and combated epidemics. Sometimes temporary committees or boards of health were appointed for some special work. The first per- manent local sanitary organization in Rhode Island was established in Providence in 1856, sixty years after it was in Boston, Philadel- phia and New York. Owing to the epidemic of cholera in the previous year, public attention was called to sanitary matters, and through the efforts of Dr. E. M. Snow, who had done heroic work in the outbreak, the office of Superintendent of Health was created. Dr. Snow filled the office until 1884, when he was succeeded by the writer. Dr. Snow was considered one of the foremost sanitarians of his time, and his reports on births, marriages, and deaths in Providence have long been accounted as models and have a world-wide reputation.
By an act passed by the Assembly in 1885, every town in this State is required to appoint a health officer. In most of the towns the council is ex-officio a board of health.
The first medical school in this country was established in Phila- delphia in 1762; the second one in New York in 1768; the next in Boston in 1780, and one in Hanover in 1800. A very small part of the students of that period were able to attend either of those schools, the larger number being restricted to study in the offices and under guidance of regular practitioners. When the proper time arrived the student was given a letter of recommendation by his preceptor, which was his only means of gaining the good will and the business of the
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public. In 1810 a medical department was organized in connection with Brown University, and Drs. William Ingalls, Levi Wheaton, Solomon Drowne, and William C. Bowen were appointed professors. The school was not well supported in its early years; the first and the last named physicians gave two courses of lectures on anatomy and. surgery, and on chemistry, which branches were all that were then required to obtain a degree. Dr. Ingalls then went to Boston and there remained until 1822, when the school in Providence was re- organized with Drs. Levi Wheaton, professor of the theory and prac- tice of physic and obstetrics; John De Wolf, professor of chemistry ; Solomon Drowne, professor of materia medica and botany; Usher Parsons, professor of anatomy, physic, and surgery. During the years from 1822 to 1826, when the department was abandoned, the number of students ranged from twenty to fifty, and most of them took the degree of M. D. During the whole seventeen years of its existence this school graduated about ninety students.
Early in the present century many of the States in the Union passed laws authorizing the formation of medical societies, under the correct belief that by organized effort the character of the profession at large would thus be elevated.
At the February session of the Rhode Island General Assembly, in 1812, an act was passed "to incorporate certain physicians and surgeons by the name of 'The Rhode Island Medical Society' ". The names of the incorporating physicians were as follows: Amos Throop, William Bowen, Pardon Bowen, Levi Wheaton, Rowland Greene, Samuel Hudson, Daniel Barrus, Joseph Comstock, Niles Manchester, John Wilkinson, John M. Eddy, Thomas M. Barrows, Charles Eldredge, Jacob Fuller, Moses Mowry, Peleg Clark, John Mackie, Jeremiah Williams, William C. Bowen, Joseph B. Pettes, Walter Wheaton, Stephen Harris, Sylvester Knight, Abraham Mason, Ezekiel Comstock, August Torry, A. Waldron, Caleb Fiske, Solomon Drowne, Comfort A. Carpenter, Thomas Nelson, Thomas Warren, John W. Richmond, William G. Shaw, Cyril Carpenter, Thomas Carpenter, Gorton Jerauld, Chillingsworth Foster, Lemuel W. Briggs, John Aldrich, Eleazer Bellows, Eleazer Bellows, jr., Jonathan Easton, Ben- jamin Waite Case, Enoch Hazard, David King, William Turner, Edmund Thomas Waring, and Jonathan Easton, jr .- forty-nine in all.1 This list includes most of the prominent physicians in the State
'Of these forty-nine original members, fourteen, or just two-sevenths, be- longed in Providence, and just half as many in Newport. It is worth noting as a token of centralization of physicians as well as of the inhabitants of the
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at that time, notices of many of whom have been written in preceding pages of this chapter. The members of the society after its organiza- tion were given the title of Fellows. A list of the Fellows published in the year 1812 contains sixty-four names for the whole State.
The section of the incorporating act that had the most important influence upon the profession was the following:
"Sec. 7. And be it further enacted, That the President and mem- bers of said Society, or such officers or members as they shall specially appoint for that purpose, shall have full power and authority to examine all candidates for the practice of Physic and Surgery, who shall offer themselves for examination, respecting their skill in their profession; and if upon examination, the said candidates shall be found skilled in their profession, and fitted for the practice of it, they shall receive the approbation of the said Society, in letters testimonial, under the seal of said Society, signed by the President or such other person or persons as shall be appointed for that purpose."
Here was placed in the hands of the reputable physicians of the Commonwealthı a power for good, the early use of which wrought benefits that were of great good to the profes- sion. The "Medical Police, By-laws and Rules of the Society", as adopted, provided an annual meeting to be held in Providence on the first Wednesday in June, and for a semi-annual meeting on the third Wednesday in December; this plan was subsequently changed, and until 1861 the annual meetings were held alternately in Providence and Newport. Since that year they have been held only in Providence in June, with quarterly meetings in March, September, and December.
The first principal officers of the Society were as follows: Presi- dent, Dr. Amos Throop; recording secretary, Dr. John Mackie; corre- sponding secretary, Dr. William Turner; treasurer, Dr. Thomas Bar- rows. Dr. Turner held his office until 1832, a period of twenty years ; and Dr. Barrows was treasurer until 1830.
The by-laws provided also for the election of a board of eight censors, whose duties were, perhaps, more important than those of any other official. It was a part of their duty to "act as a committee ex- officio, or court of inquiry, for the purpose of receiving charges of any unprofessional conduct of the members, and if they shall consider them as sufficiently substantiated, to report the same to the society at the next annual meeting", etc. It was also their duty to receive applications for admission of any person to the society, a provision
State, that our last printed list of Fellows shows more than half belonging in Providence .- Paper read before the Medical Society June 15, 1882, by Dr. Charles W. Parsons, A. M., M. D.
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that gave them, through the name and authority of the society, almost unlimited power in respect of deciding upon the fitness of every person who aspired to become a member. Indeed, the effort to discriminate between the well-qualified practitioners and others was announced as one of the principal objects of the organization. The society may be said to have been reasonably successful in keeping the standard of its fellowship high, particularly in recent years.1
The Rhode Island Medical Society has exerted a strong and beneficial influence upon State legislation bearing upon matters in which the profession has always felt a deep interest. The first prominent instance in which this society adopted measures to procure special legislation was in connection with the law for registration of births, marriages, and deaths. At the annual meeting in 1849 the following resolution, offered by Dr. Joseph Mauran, was adopted :
"Whereas, The Legislature of this State has at the present session, passed to a second reading, certain resolutions touching the important question of Registration of Births, Deaths, and Marriages, and raised a committee of conference with this Society :
"It is therefore Resolved, That a special committee of three be appointed to confer with the Legislative committee, and report at the ensuing semi-annual meeting of this Society."
Drs. Mauran, Usher Parsons and Lewis L. Miller were appointed as the committee, and at the next semi-annual meeting reported the outlines of a more efficient law. The committee was continued and held various meetings and consultations, sending representatives
1In this connection the following quotation from a paper read before the Society at the annual meeting, June 15, 1882, by Dr. Charles W. Parsons, pos- sesses considerable interest: "Two questions connected with conditions of membership have come up at different times to vex our souls. One was that of our Fellows who practised homeopathy, and the admission of new Fellows more or less tinctured with that heresy. The general result of action has, I think, been this: Fellows who gave out that they had become homeopaths were gently and gradually dropped, without expulsion; the assumption of that name was held a bar to admission, but our members are left free to ad- minister any supposed remedies they may choose, if they find sufficient reason to think that they may be useful. What is regarded as a disqualification is not, I take it, the use of this or that drug, in large or small doses, but the assumption of a name which stands for an exclusive dogma, a revolt against the experience of the profession, and a claim to new and reformed principles of treatment. We disavow equally the nickname allopathist applied to our- selves, and the pretensions of homeopathy to represent a new departure in therapeutics. Happily the self-styled 'new school' has so far lost ground in general esteem, and looms up so much less portentiously, that we have almost ceased to think of the old disturbing question." This extract is important as admitting that the Rhode Island Medical Society did not oppose local home- opathy so intensely as many other organizations, and also that whatever oppo- sition had existed had largely disappeared in 1882.
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