CHAPTER VII


Massachusetts, Boston, and Public Hygiene


            Knowledge is proud that he has learned so much
            Wisdom is humble that he knows no more.
                                         WILLIAM COWPER, The Task


            Solon, asked how justice could be secured
            in Athens, replied, "If those who are not
            injured, feel as indignant as those who are."


A long nineteen years elapsed between Shattuck's masterly sanitary
survey of Massachusetts (185o) with his emphasis on vital statistics,
the bookkeeping of life, before the State Board of Health was estab-
lished by act of June 21, 1869.1 Henry I. Bowditch, first chairman of
this board, was highly influential in continuing the stress on sanitary
surveys and epidemiological studies. His report on consumption in.New
England (1862) emphasized this major disease and his own lifelong
interest. His investigation of public hygiene in America, a request study
presented at the International Medical Congress at our Centennial
Exposition in Philadelphia (1876) was eye-opening in exposing our al-
most complete lack of awareness of public responsibility for the health
of the citizens. Twenty pertinent, reasonably specific questions were
sent widely to appropriate physicians, authorities, and college leaders,
with responses (1876-77) largely negative or indefinite in character.2
In the meantime Griscom's excellent study, "The Sanitary Condition of
the Laboring Population of New York City"3 (1845), the repeated surveys
of some of our larger cities by members of the Committee on Hygiene
of the American Medical Association (1847 et seq.), and gleanings
from the growing European literature, especially that from England,
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