Kansas State Board of Health. Part 1, Prevent the Disease
written by Donna Casement, State Library of Kansas
(Full digitized copies of newspaper articles cited here can be found at KGI ONLINE LIBRARY)
“In our judgement, a State Board of Health, amply equipped to do effective work, is of the greatest importance to our people. It is possible to greatly elevate the standard of health, by looking after the sanitary condition of our State, and thus save annually many valuable lives. Let Kansas take the lead in sanitary reform, as she has in all progressive movements of the last quarter of a century.” -State Board of Health President G. H. T. Johnson, Atchison. (1885-First Annual Report of the State Board of Health)
“What the Kansas State Board of Health Stands For”, Kansas Health Bulletin, December 1912
During the 1885 legislative session, the Kansas Legislature created the Kansas State Board of Health. The legislation was comprehensive and addressed the need for a statewide governing body to oversee the “health interests of the people of this state”. The legislation was called: An ACT to create a State and Local Boards of Health, and to regulate the Practice of Medicine in the State of Kansas. At the time of the organization of the state health department, all but six of the 85 organized counties in the state, had efficient and active local or county health boards. Health boards were required to appoint health officers who would become front line advocates for safe public health practices.
County commissioners were instructed to appoint Kansas county health officers who would supervise the registration of marriages, births and deaths and the registration of forms of disease prevalent in the state. The officers also enforced the rules for transporting the dead bodies of persons for burial. The rules included the engagement of suitable people to supervise, exam and investigate all sanitary services within the state and to oversee the duty of every physician whose job it was to keep a record of deaths and the cause of these deaths occurring in his practice. (#1-The People’s Reveille, Hill City, Kansas, April 10, 1885)
The first meeting of the Kansas Board of Health took place on April 10, 1885, in Topeka. The Board chose G.H.T. Johnson as their president. Upon election, President Johnson addressed board members, “The first duty of the Board is to aid in checking the spread of contagious diseases, and to prevent the development of all preventable diseases; in a word, to instruct our people in sanitary science. Within the last decade, great and rapid advances have been made in this science. He who prevents the development of disease is a greater benefactor of his race than he who cures the disease.” (1885-First Annual Report of the State Board of Health)
The new health department’s authority was created as an advisory agency. Rules and regulations would direct its efforts. Board President Dr. Johnson pointed out that in its advisory capacity, the Board had been deprived of the authority necessary to command respect. He also said the failure of the legislature to pass the necessary appropriations, so the Board could efficiently prosecute the sanitary work in every county, would hamper their public health agenda. He concluded, the Board would continue to educate the people as to improve their sanitary and hygienic condition, and educate the public and local government on how to avoid those diseases having their source in the neglect of sanitary rules. (1885-First Annual Report of the State Board of Health)
In its first year, the State Board of Health adopted rules, regulations and guidelines. The rules addressed the prevention of disease and created best practices. Rule Six stated that all sewer drains that pass within fifty feet of any source of water used for drinking or culinary purposes shall be watertight and in sandy subsoil and the limit shall be eighty feet. Rule Seven said no sewer drain shall empty into any lake, pond or other source of water used for culinary purpose, nor into any standing water, pond or running water within the jurisdiction of this Board.
In 1885, Topeka’s sewers drained directly into the Kansas River. Ice was harvested from the river just below these sewer outlets. “The importance and purity of our ice supply is a subject that demands the attention and thorough investigation of the state, county and municipal boards of health. Scientific and microscopical investigations have clearly demonstrated the fact that impure ice is one of the most subtle and dangerous agents and is liable to introduce germs into the human system. Dr. McClintock, chairman of the Board of Health of Topeka, has been investigating and analyzing the condition of the ice put up and dispensed by the different ice dealers in town and all varieties of ice put up below the sewers of the Insane Asylum Reform School.” (1885-First Annual Report of the State Board of Health)
Men cutting and hauling ice for storage, Pipe Creek, Ottawa County, date unknown. (image from kansasmemory.org, Kansas State Historical Society, copy and reuse restrictions apply)
At the December 1885 State Board of Health meeting, Dr. McClintock gave a disturbing report on the impure status of the ice supplied to the city of Topeka. He said the first source for contaminated ice was from the sewage received two miles above the city from the state insane asylum. He said it was not an unusual site to see workmen cutting ice within 25 feet of the mouth of the sewer. The other stream, that was the source of ice, was from Soldier Creek, north of the city. The doctor said the stream is contaminated by drainage from slaughterhouses and from the state reform school. He concluded that no ice was cut above these sources of contamination and that it would be a marvel if this ice was used. (#2-The Topeka Daily Capital, December 17, 1885)
“If the law rightly compels your neighbor, who has not the fear of cholera before his eyes, or who is too heedless to regard his own interests to keep his premises clean, and corrals persons with yellow-fever or small-pox, why should it not stamp out the disease by compelling the ignorant and reckless to protect themselves and the community against a justly dreaded disease by the simple operation of vaccination?” (#3-Dr. W. Schenck, M. D., The Osage City Free Press, May 21, 1885)
In 1882, Dr. A. M. Wassam sent an in-depth letter to a local paper concerning a smallpox outbreak in the small town of Severy. The doctor had visited a pastor who was reported as extremely ill. “Fully aware on the one hand of the dangers from the contagion and the transportable properties of smallpox; on the other hand, it must be considered the obligation of the physician to a suffering fellow creature, which in my opinion far outweighs the small chance of transporting a disease when preventative measures are strictly observed, all of which was done in this instance.” The doctor went on to describe in detail the events of his visit. (#4-The Eureka Herald and Greenwood County Republican, January 26, 1882)
In its first year, the State Board of Health passed a vaccination resolution that stated: That, by the authority vested in this Board, it is hereby ordered, that on and after December 1, 1885, no pupil shall be admitted to any public school in this State without presenting satisfactory evidence of a proper and successful vaccination. “The subject of vaccination is one of the utmost importance from a sanitary point of view, and should be rigidly, promptly and universally enforced.” (1885-First Annual Report of the State Board of Health)
“The State Board of Health has issued an order all school children shall be vaccinated, unless they have had it done with good effect. The County Health officer notified our school authorities regarding this matter and accordingly at the last meeting of the board, the Principals were ordered to see that all children observe the order to be vaccinated. Next week an examination will be made by a physician appointed for that purpose, and all will be expected to show a good scar on a vaccinated arm.” (#5-Chetopa Advance, October 8, 1885)
Dr. J. P. Lewis, M.D., the Topeka Shawnee County Health Officer, reported to the State Board Health on December 1, 1885, “The city laws have been adhered to closely, as no children have been permitted to attend school without satisfactory evidence of vaccination. In the country, from inquires of physicians, I think two-thirds would be a close approximate of the vaccinations. I have not heard of any formidable objection to the practice of vaccination.” (1885-First Annual Report of the State Board of Health)
However, Health Officer for Phillips County, Dr. Isaiah Miley, stated in his annual report to board in 1885, “The vaccination resolution has met with much opposition. A non-compliance with the resolution upon the part of some is from negligence, some from seeing the horror of the operation; and as its alleged effects, all manner of diseases is held up as sequels. In the villages, it has been reasonably well observed; in the country districts, but little vaccination has been done this year. The last enumeration (July) gives Phillips County a scholastic population of 4,058. Of this number, according to the data which I have been able to gather, about thirty per cent were vaccinated before 1875 and about 15 percent in 1885, leaving at least one half unprotected.”
In August 1894, the Board passed a resolution recognizing that pulmonary consumption would be added to the list of communicable diseases dangerous to the public health. The Board also required local boards of health to report consumptive cases within their jurisdiction. “This was the first instance in the western states, that these actions have been taken. It will be a great step in the line of protecting the health of school children particularly.” (#6-The Topeka Daily Press, August 31, 1894)
Also in 1894, the Board passed a new water works rule that stated every reservoir, settling basin and stand-pipe used by waterworks companies, either city or personal, furnishing water to cities and private individuals, shall be cleaned within the first two weeks of April and also, within the first two weeks of September each year. The rule included a fine of up to $1,000 for each infraction. (#7-The Ottawa Daily Republic, March 27, 1894)
“I again appeal to the state to make a more thorough investigation of water supplies. That is a matter that should be controlled by national legislation none can gainsay. I fear, though, that only some extraordinary outbreak of typhoid fever, cholera or dysentery will bring this mater of pure water supply forcibly to the minds of those interested and create a public sentiment in favor of the purification of all polluted public water supplies.” (Report by Secretary Thos. Kirkpatrick, M. D. to Governor E. N. Morrill in the 1896 yearly report. (1896-Twelvth Annual Report of the State Board of Health)
In 1897, the Kansas Board of Health passed a resolution that required the appointment of a sanitary inspector for each county. This officer would report on the sanitary conditions of their respective counties to the board and advise the governing bodies on the practices necessary to properly handle their sewage and improve their water supply. (1897-Thirteenth Annual Report of the State Library Board of Health)
In his January 1, 1898 report to Governor John W. Leedy, Secretary H. Z. Gill, M. D. said the Board was paying careful attention to the relationship of typhoid fever and the water supply. “While the powers of the Board respecting the public water supply of our cities is mostly advisory, yet we hope it may be empowered in the near future to enforce laws and rules for the protection of the public from polluted, dangerous, and disease producing water supplied by water companies,” said Dr. Gill. He went on to emphasize the relationship between typhoid outbreaks and polluted water. “This fact of water more or less polluted, being the source above all others of the dreaded disease typhoid fever, has now become simply a demonstrated proposition, concerning which there is no longer room for argument.” (1897, Thirteenth Annual Report of the State Board of Health)
Secretary Gill, Dr. Williston of Kansas State University and the new Board sanitary advisor, traveled throughout the state observing disease outbreaks in communities. In February 1898, the team assembled in Manhattan, where they investigated a fall outbreak of numerous typho-malarial fevers. After examination, Dr. Williston said the well water of Manhattan was unfit for use except after boiling. However, he said the city waterworks was first-class and as “pure as any water”. He concluded that the city water should not come from the river, but from an underground source, not effected by refuse and other foreign matter that finds its way to the river. (#8- Manhattan Nationalist, February 4, 1898)
In Secretary William B Swan’s 1899 annual report to Governor Stanley, the doctor challenged Kansas physicians to take on the responsibility of public health. “The physician’s most important duty is the conservation of individual and public health. All physicians do not regard themselves under obligations to promote the public health. They seem to think their only purpose is to cure the sick. Such physicians are a score of years behind the time. The healing of the sick is truly a noble purpose, but the prevention of disease is a far nobler mission.” (1899-Fifteenth Annual Report of the State Board of Health)
The Gove County Advocate reported three families quarantined with scarlet fever. The paper asked its readers to help prevent an outbreak. “Every citizen of Gove County should exercise the greater care and diligence in preventing a faster spread of the disease. The Health Officer, the local Health Boards and the City Council may make rules and regulations to prevent an epidemic, but this is to no avail unless the citizens cooperate with them in their efforts.” The paper included the State Health Department’s seven rules regarding contagious disease. (#9-Gove County Advocate, April 14, 1899)
By the end of the nineteenth century, the fifteen-year-old State Board of Health had expanded its expertise in public health by including a sanitary and civil engineer, a chemist and a bacteriologist to its advisory board. The Board had eight standing committees that evaluated an array of public health topics that included heating, light, ventilation sanitation, epidemic diseases and quarantine, water sources, disposal of substances dangerous to public health, inspection of public, state and charitable institutions, adulteration of foods, drugs and drinks, and vital statistics.
In 1899, the State Board of Health was joined by Dr. Samuel J. Crumbine, a first-year board member from Dodge City. Dr. Crumbine would eventually become Secretary of the Board of Health. While serving as Secretary, from 1904 to 1923, he initiated campaigns against the common drinking cup, spitting on sidewalks and the common towel. Crumbine’s “Swat the Fly” and “Bat the Rat” slogans gained nationwide public health attention.
"We Must Fight-TOGETHER!," Kansas Health Bulletin, February, 1915
An upcoming blog will describe Kansas State Board of Health’s continued fight against communicable diseases. Under the leadership of Dr. Crumbine, the board would receive legislative authority to mandate public health policies.