Monday, December 28, 2009

Samuel Holmes Durgin

Years Served: 1867 to 1872
Born in Parsonfield, Maine on July 26, 1839, Samuel Holmes Durgin would become one of the greatest public health physicians in 19th century Boston. Durgin attended Dartmouth in 1861 and the following year, the Harvard Medical School. After his graduation in 1864 he was commissionmed asssistant surgeon to the 1st Massachusetts Cavalry. During his military service he was at the Appomattox Court House at the time of Lee's surrender. After the war he returned to Boston and became the port physician serving in that capacity from 1867 to 1872. Although described as a small, dainty, precise and pedantic man, was a brilliant administrator that brought Boston's quarantine system into the modern age. During his days as port physician, he also served as the resident physician at the Deer Island institution where he had direct responsibility for overseeing the Deer Island hospital and the smallpox hospital on nearby Gallop's Island. He kept meticulous records of hospital cases of communicable disease that have been preserved in the archives of the city of Boston. His efforts to segregate cases of communicable disease from other hospital cases on Deer Island was a major step forward in the prevention of smallpox in Boston.

His dedicated service as port physician probably helped him be selected to the three member Boston Board of Health, an institution to which he was appointed from 1873 to 1911. He served as the chairman of the Board of Health from 1876 to his retirement in 1912, a level of public service unrivalled in the history of the city's public health program. Indeed, the editors of the American Journal of Public Health (AJPH) said that "such a length of service as health officer is probably unique in the United States at least, where the demands of politics, rather than qualifications of officials, has been too often the cause of change of officials." Doctor Durgin, according to the AJPH editors, did not hold his position because of his ability as a political trimmer but quite the reverse. Working in a world in which political subservience was expected, he thought only of the public interest and his integrity, high sense of moral purpose and innate leadership abilities won the support of many who secretly desired to use his office for political purposes. He was not merely the leading voice of public health policy in Boston, he was a giant in the field of communicable disease and quarantine practice. Even though his public duties were extremely demanding, he found the time to serve as a lecturer at the Harvard Medical School, hold the high position of president of the American Public Health Association and Vice President of the Massachusetts Association of Boards of Health.

Despite managing the city's quarantine program for over 40 years he still found the time to stay abreast of the latest scientific developments in the fields of sanitation and quarantine practices as they affected his responsibilities as the city's chief public health official. He saw the errors of the old schools of thought that failed to understand the scientific basis of quarantine and the limitations to traditional sanitation practices. It was his constant commitment to the application of the latest scientific principles that enabled Boston to be one of the leading cities in the promulgation of scientific principles of quarantine, the use of baceteriological laboratories to validate the diagnosis of communicable disease and the use of cost effective ship disinfection strategies to thwart a variety of vector borne diseases.

The American Journal of Public Health lauded his adoption of scientific and effective methods of controlling disease in place of the less efficient and burdensome restrictions placed on commerce which he had found in vogue in his early years of public service. As early as 1894, he commenced the manufacture of diphtheria antitoxin. In this same year, at the height of a diphtheria outbreak, one of his signal achievements was the adoption of school inspections, making Boston the first American city to take a comprehensive approach to the eradication of disease in the public school system. His policies were subsequently adopted by cities throughout the United States and Canada.

Sources:

The National Cyclopaedia of American Biography, Volume XIII, 1906, p. 574.
Americal Journal of Public Health, 1912, May 2(5), pp357-358.
American Journal of Public Health, 1953, June, Vol. 43 (6 pt2), pp. 15-19.
American Journal of Public Health, 1940, January 30(1), pp. 88-89.

Sunday, December 13, 2009

Jerome Van Crowninshield Smith


Years Served: 1826 to 1849


Dr. J.V.C. Smith, as he was known, was the fifth Port Physician in Boston but the second under the city council form of government. Born July 20, 1800 in Conway, New Hampshire, he took the post at the young age of 26 and was apparently happy to take up residence on Rainsford Island in the summer of 1826. He carved his name and date of becoming the port physician into a rock outcropping on Rainsford Island in the summer of 1826 and this carving still remains visible today. He was a rare individual who combined eminent skills in medicine with considerable literary abilities which he demonstrated as the editor of the New England Journal of Medicine and Collateral Branches of Science, the original name of the New England Journal of Medicine. He studied surgery under Dr. William Ingalls, an eminent surgeon of Boston, and in his spare time took up sculpture, creating busts of Bishop Fitzpatrick and Bishop Eastburn, among others.

He became the editor of the Boston Medical Intelligencer, later known as the Boston Medical and Surgical Journal, editing more than forty volumes over this career. While his first public office was that of Port Physician in 1837 he was also elected to the state Legislature and was responsible for putting through a capitation tax on foreigners arriving at any port in Massachusetts, the money targeted to care for the poor and sick immigrants. The U.S. Supreme Court eventually declared this law unconstitutional. He was re-elected to the legislature in 1848 while he continued to hold the post of Port Physician. Smith used his post as Port Physician as a bully pulpit to speak out on a wide range of public health and medical issues. During the 1840’s, when the city of Boston had essentially “moth balled” the maritime quarantine program, Smith was virtually free to use Rainsford Island as a contemplative spot to write his lectures and articles for the New England Journal and Collateral Branches of Science without interruption. After all, the City had built him a comfortable cottage in 1830 which provided him with the ambience he needed to do his literary work.

He maintained his post as Port Physician from 1826 to 1849 at which time he decided that the level of effort required to manage the growingly complex quarantine program was simply too much for his interests. At forty nine years of age he was looking for a new challenge and new turned to local politics. He ran for Mayor in 1852 and lost but two years later was elected Mayor of Boston. While in office he advocated the introduction of pure water at the city’s expense and he also unsuccessfully urged the relocation of the various services for the poor from Deer Island to South Boston. As a physician he brought a sensitivity public health issues that many other mayors had not demonstrated. He died August 21, 1879.

To learn about other Port Physicians that worked on Boston's maritime quarantine program, go to the Port Physician blog: http://portphysicians.blogspot.com/

Sources:
Mayors of Boston, An Illustrated Epitome of who the Mayors have been and what they have done, Boston, MA, 1914, p. 24.

Vidich, Charles, Germs at Bay (forthcoming book on Boston Quarantine)

Thomas Welsh

Years Served: 1790 to 1825

Dr. Thomas Welch was one of the longest serving Port Physicians in the history of the Boston’s island quarantine program. He was born in Charlestown on June 1, 1752 the son of Thomas and Mary Welsh. He was fifth Thomas Welch in an unbroken line of Welch that extended back a century in the town to Sergeant Thomas Welch who was admitted to the Charlestown church in 1650. Thomas Welch went to Harvard and graduated in the class of 1772. He was an excellent student and was the faculty voted him the Hopkins Prize for his scholarly work at the end of his freshman year. His leadership abilities were noted at an early age when his fellow classmates chose him as the Vice President of the Speaking Club and later he was chosen the ensign, the fourth ranking officer, when the student body decided to organize a militia company in 1771.

After graduation he studied medicine with Dr. Isaac Foster (A.B. 1758) of Charlestown and when the Massachusetts Council of War engaged Foster to care for the wounded minutemen in April 1775, Welch assisted him. While he did not have a military appointment he assisted Dr. Foster in his care giving work. On October 21, 1775 he was given an appointment as a surgeon with the Nineteenth Regiment. The following year, he served with the twenty seventh infantry of the Continental Army in the campaign for New York and in New Jersey at the battle of Trenton.

He returned from his service in 1777 to marry Abigail Kent of Charlestown. They were married on December 11, 1777, eleven months after his discharge. His marriage brought him into contact with American royalty since Abigail’s was the first cousin of Abigail Adams. Through this connection the Adams family became good friends and frequent visitors when in Boston. His political connections included the Brooks, Gorham, Otis, and Warren families. Complementing his political affiliations, Welch had a growing number of medical friends especially after he helped form the Massachusetts Medical Society in 1781. He became its treasurer, a position he filled from 1782 to 1798. He later served as its corresponding secretary from 1805 to 1815 and its vice president from 1815 to 1823. Working with Nathaniel Appleton, one of his Harvard classmates, he served as an editor of the first volume of the medical society’s Medical Communications. He also served as the medical officer for the hospital built by the Treasury Department on Castle Island, temporary quarters for Boston’s marine hospital. His range of civic mindedness is revealed by his willingness to serve on the town’s school committee from its creation in 1789 to 1822.

Welch served as the town’s Port Physician, holding that office from 1790 to 1825, longer than any single man in the history of Boston’s quarantine program. He transformed maritime quarantine by establishing medical oversight of quarantine practices on Rainsford Island and relying on consultation with other physicians to improve medical decision making. For virtually the entire 18th century, Island Keepers ran the town’s quarantine station under the direction of the Selectmen. Prior to the Revolutionary War, the Selectmen occasionally brought physicians into consult on quarantine and contagious disease issues. However, after Welch was selected to the port physician post the duties of the island keeper gradually were subordinated to those of the physician and he was made the chief overseer of maritime quarantine affairs. This shift in power would not have happened without an individual with the medical knowledge, political connections and administrative abilities of Welch.

Unfortunately for all of his skills, he was not a great businessman. He tried his hand in commerce and failed miserably, filing for bankruptcy in April 1802. In later years, he relied almost exclusively on his salary as Port Physician to cover his expenses but even this salary was not always sufficient to cover his debts. Welch died in debt at his residence on Sudbury Street in Boston on February 9, 1831. No other physician had more influence on public health policies and quarantine practices in Boston than Dr. Welch.

To learn about other Port Physicians that worked on Boston's maritime quarantine program, go to the Port Physician blog: http://portphysicians.blogspot.com/

Sources:

Wright, C. E., & Hanson, E. W. (1999). Biographical sketches of graduates of Harvard University, in the Classes of 1772-1774. Boston, MA: Massachusetts Historical Society.

Vidich, Charles, Germs At Bay (forthcoming Book on Boston Quarantine)

Nathaniel Appleton

Years Served: 1787 to 1789

Dr Nathaniel Appleton was one of the first port physicians in Boston, serving in that position from 1788 to 1789. Dr Appleton like most boys with aspirations to attend Harvard went to the town’s Latin school which he entered in 1762. He graduated from Harvard in 1772 and two years later he went to work for Dr. Edward Augustus Holyoke, a cousin to his father who had his practice in Salem. With the exception of brief service as a surgeon’s mate at the siege of Boston, spent the next three years working for Holyoke. The Revolutionary War had a profound impact on medical practices in Boston. Prior to the war there were 21 physicians in Boston but after the British evacuation in the spring of 1776 only nine physicians had a practice there. Physicians were an unregulated profession prior to the war and he was mindful of the dangers such a situation posed to apprentice physicians like himself. Under the guidance of Holyoke, he played a central role in the creation of the Massachusetts Medical Society as its recording secretary. In that capacity he played a key role on various committees dealing with the qualifications for medical licensing and establishing the seal of the organization. He was never considered one of the most prominent physicians in Boston but was still a leader and he managed to build a devoted following including amongst the town’s selectmen who chose him to inspect vessels for contagious disease. He was a member of the First Church of Boston from 1786to 1787and again from 1789 to 1794. He was elected to the American Academy of Arts and Sciences n 1789.

After a series of illnesses he finally moved to Marietta, Ohio in 1794 and then eventually moved to Washington DC where he caught malaria. He returned to Boston, where he died on April 15, 1795. His obituary exalted him as a “Christian from inquiry and a Patriot from Principle.” His service to Boston’s quarantine program reflected his commitment to public service and this work brought him in touch with a wide range of public officials who came to appreciate his dedication, gentleness of manners and firmness of character.

To learn about other Port Physicians that worked on Boston's maritime quarantine program, go to the Port Physician blog: http://portphysicians.blogspot.com/

Source: Wright, C. E., & Hanson, E. W. (1999). Biographical sketches of graduates of Harvard University, in the Classes of 1772-1774. Boston, MA: Massachusetts Historical Society.

Joseph Whipple

Years Served: 1789 to 1787


Joseph Whipple, born in 1756, was a student of Joseph Gardiner and later in life served as the secretary of the Massachusetts Medical Society (1802 to 1804). He served as Boston’s first port physician serving from 1779 to 1787. He was a mere 23 years of age at the time of his appointment so it is clear that his affiliation with his mentor, Dr. Gardiner, must have played a role in his assignment. During his tenure as port physician, the Selectmen relied on him to inspect vessels and to provide professional opinions concerning the efficacy of routine decontamination procedures for people and goods. He acquired a large professional business in Boston where he resided. He died September 3, 1804 at the age of forty eight.

To learn about other Port Physicians that worked on Boston's maritime quarantine program, go to the Port Physician blog: http://portphysicians.blogspot.com/

Source: American Quarterly Register, Volume 13, American Educational Society, Boston, 1841, p. 86