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 When Dr. Samuel J. Crumbine came to Topeka to serve as secretary of the Kansas State Board of Health in 1904, his brief biography in The Topeka State Journal included qualifications brought to the job. “He then took up the study of medicine, completing the course in 1889, graduating at the head of his class, and is the proud possessor of the first prize gold medal. Dr. Crumbine has been in continuous practice in Dodge City since that time. On February 26, 1902, he was elected grand medical examiner of the A.O.U.W. which position he now holds. A year ago, he was elected president of the Sixth District Branch of the State Medical society, which comprises twenty-four southwest counties of the state.” (#1-The Topeka State Journal, June 9, 1904)

In 1920, sixteen years later, after numerous public health battles and legislative victories, Dr. S. J. Crumbine was once again re-elected to serve as secretary of the Kansas State Board of Health. The Topeka Merchants Journal reflected on how, “you don’t hear as much about Crumbine as you used to.” The reason for the lack of publicity was that “the department is working so smoothly now that you don’t hear the wheels grate, or the cogs grind together.” The battles, the paper said, were necessary for Dr. Crumbine to do his pioneering work, and “pioneers always have to subdue the wilderness and the savage inhabitants therefore.”

The article summarized the health department’s ambitious agenda and the results that brought healthy food and drugs to Kansas households. “Now, of course, the old pure food battles are all over. They no longer put paint in the catsup or embalming fluid in the pickles. They even have been forced to tell the truth on their labels. It is pretty generally conceded that honest weights and measures are the best policy, and there is a strongly growing belief that it is improper to sell rotten eggs to an innocent consumer." (#2-The Merchants Journal, Topeka, July 3, 1920)

The Kansas State Health Board was established in 1885. J. W. Redden, secretary of the health board’s nine members, sent the first annual report to Governor Martin at the end of its first year of operation. Within the 184-page report, the secretary wrote that the prevention of disease would be the focus of the health board. “Hundreds of thousands of lives are annually, prematurely cut short, that might be prolonged for years were the people instructed to look after their sanitary condition. We know there are many who think we are governed too much and have too many officers; yet these must admit that the health of the people is of greater importance than that of our domestic animals.” (1885-First Annual Report of the Kansas State Board of Health)

In the early years, the Board worked closely with the Kansas legislature. The legislature provided the vehicle for an effective and operative health board laws. These laws brought attention to the purity and quality of food and drugs. The legislature also gave the Broad power and authority to implement jurisdiction over public water and food purity.

The Kansas Session Laws of 1889 state, “That no person shall within this state manufacture for sale, offer for sale, or sell any drug or article of food which is adulterated within the meaning of this act. Sec. 328-The term “drug,” as used in this act, shall include all medicines for internal or external use, antiseptics, disinfectants, and cosmetics. The term “food,” as used herein shall include all articles used for food or drink by man, whether simple, mixed, or compound.” (Session Laws of 1889, Chapter 29, Section 2323-2324)

Fines were implemented when merchants were found to be selling adulterated products. “The new law, in relation to the adulteration of food, is now in force, and is very rigid in its provisions; it provides a fine of one hundred dollars and imprisonment for one hundred days for any person who manufactures or offers for sale any adulterated drug or article of food. It is important that people selling goods should be careful what they sell.” (#3-Enterprise Eagle, Enterprise, Kansas, March 21, 1889)

That same year, empowered by legislative support and legal jurisdiction, the Board analyzed and published the results of hundreds of food and drug samples. “The results of analyses of food and drugs made and published each month by the State Board of Health, makes some startling disclosures in regard to the character of that which we eat and drink. For instance, it appears from the summary of the April analyses, that of 522 articles of food or of drugs examined, 205 were adulterated.” The report said that 132 out of 258 samples of milk were found to vary from the legal standard. There were 11 out of 16 samples of maple syrup that had been adulterated.” (#4-The Elk City Eagle, June 18, 1889)

In 1891, the health board created a standing committee whose focus would include the adulteration of food, drinks, and drugs. Nine years later, in 1904, Dr. Samuel J. Crumbine would join this standing committee while serving his first year on the health board.

The Board increased its staff as funding allowed. In 1897, they appointed Dr. E. B. LaFevre, M. D. from Abilene, as their first chemist and in 1898 they employed their first bacteriologist, Paul Fischer from Manhattan who served in this capacity until 1901. That year, Dr. Sara E. Greenfield, M.D. became the health board’s bacteriologist. Dr. Greenfield served in this capacity for the next 19 years. Dr. Greenfield received her education at the University of Kansas and attended College of Physicians and Surgeons at the University of Illinois. She earned her M. D. in 1900. Not only did she serve as the bacteriologist for the health board, but she also taught at the Kansas Medical College. (“Women, Medicine, and Science: Kansas Female Physicians, 1880-1910”, by Gail McDaniel, Kansas History, Summer 1998, v. 21, n. 2)

As the powers of the Kansas State Board of Health widened, it became apparent that a lack of funding was hampering the health board’s investigations into food and drug adulteration. In 1905, legislation was passed that coordinated food and drug adulteration analysis between the health board and the chemistry departments of the State University (Lawrence) and the State Agricultural College (Manhattan). Legislation outlined the duties of these two departments “to make a thorough and complete analysis of all samples of food products and beverages manufactured or prepared for domestic use.” -Session Laws of 1905, Chapter 482. (January 1906-Bulletin of the Kansas State Board of Health)

In the early twentieth century, laws to regulate the meat packing industry were minimal and working conditions were unsafe and unsanitary. The Jungle, a book by Upton Sinclair, a book thought at first to be too shocking to be released to the public, was published and released on February 28, 1906. This book’s portrayal of unsanitary work conditions at meat packing plants outraged the nation and most notably President Theodore Roosevelt, who encouraged Congress to pass The Pure Food and Drug Act and the Meat Inspection Act, in June 1906. This bill paved the way for the establishment of the Food and Drug Administration (FDA).

Since its inception, the Kansas Board of Health had significant power and authority and passed numerous, “Rules, Regulations, Resolutions and Formulas” that governed Kansas public health. However, the 1906 Pure Food and Drug Act and the Meat Inspection Act lent publicity and credibility to the Board's operations.

Not everyone was happy with the new federal regulations, especially those industries that for decades had ignored healthy practices and procedures to a make a higher profit. “A law was never passed by Congress or any other legislative body that pleased everybody. Some people are not ready for the pure food laws, notwithstanding everybody is in favor of pure food and pure drugs for medical purposes. The objects sought and the requirements of the pure food law are such that no honest businessman or manufacturer need object to them.” (#5-The Wichita Daily Eagle, October 23, 1906)

“The national pure food law, which will go into effect January 1, 1907, will, if it is enforced, bring about a radical change in the foods and candies which are put on the market. Although the lobbying wholesale and retail grocery houses will be given until October 1, 1907 to get rid of their eatables which do not come up to the requirements of the pure food laws, the manufacturers of food and candies will be prohibited from making impure goods after January 1.” (#6-The Emporia Gazette, December 20, 1906)

The passage of the federal food and drug law gave the Board the authority to inspect businesses for compliance with this law and to prosecute, with fines, businesses for infractions. The first individual on record to be prosecuted under the new law was reported in the health board’s biennial report as C. L. Hess of Lawrence. He was fined in November 1907 for sulfites in meat. It cost him $1.00 plus costs. Other individuals were notified of non-compliance and fined $1.00 for substandard milk, $20 for obstructing inspection, $5.00 for misbranding, $1.00 for adulterated candy, $18.00 selling rotten eggs and the highest fine $300 for selling diseased meat. (1907-1908, Fourth Biennial Report of the Kansas State Board of Health)

(Image from kansasmemory.org photo, Kansas State Historical Society, copy and reuse restrictions apply)

Wide variety of foods were analyzed in the health board’s laboratories. Dr. Crumbine believed the majority of chewing gum product on the market was adulterated and he expected a big fight with the gum manufacturers. “Dr. Crumbine has written to Dr. Wiley chief of the food inspection department at Washington, asking his opinion. If Wiley holds that all chewing gum is adulterated, a big fight among chewing gum manufacturers is expected. The particular thing that puts gum in the adulterated class is the fact that it is rolled in talac [sic], which is prohibited in food products of confections.” (#7-The Kincaid Dispatch, June 14, 1907)

In 1907, Kansas legislators passed their own pure food and drug law, and the Kansas Board of Health gave druggist and merchants until October 1, to dispose of goods that did not comply with the requirements of the law. “All goods must now conform to the law, but many merchants are going to have much dead stock left on their hands. After that date many a ‘total abstainer’ will go into a drug store for a bottle of patent medicines, which, perhaps has been a stand-by in his family for many years, and will no doubt be very much surprised when he reads the labels on the bottle, and finds himself and members of his family have been taking into their stomachs a sufficient amount of ‘booze’ to almost given that a good sized ‘jag’.” (#8-The Leavenworth Times, September 25, 1907).

Also in 1907, brewing companies agreed to abide to the new regulations regarding their products after meeting with Secretary Crumbine. “Schlitz, Pabst, Anheuser-Busch and Val Blatz Brewing Company representatives agreed to obey the Kansas pure food laws explicitly regarding the labeling of liquors. Beer will be branded as “beer”, malt must be so labeled, and its exact alcoholic contents noted. No more liquor will be sold in Kansas under the name of “hop tea” or kindred titles.” (#9-Douglass Tribune, October 25, 1907)

On October 26, 1908, the Board filed a complaint with the U. S. District Attorney against forty-one cases of Muco-Solvent, a drug product found at the Gatlin Drug Company in Topeka. The court decreed that that the product was misbranded and violated the federal act. The cases of this product were destroyed, and the Board sent a letter to wholesale druggists in Missouri and Kansas. It read, “I desire to call your attention to the article in the last issue of our Bulletin (No. 11), under the caption of United States versus Muco-Solvent, and to give you notice that sales of this preparation under its present wrappings shall be contested in court. Sincerely yours, S. J. Crumbine, M. D., “Chief Food and Drug Inspector.” 1907-1908, Fourth Biennial Report of the Kansas State Board of Health)

Inspections made by agents of the health board were made throughout Kansas in the enforcement of the state pure food and drug law. 22,598 inspections were made during 1909 and 1910. There were 5,444 drug inspections and a total of 17,154 food inspection made in 1,214 towns. (#10-Lawrence Daily World, April 25, 1910)

“Half of Drugs Are Impure” was a headline in the April 26, 1910 issue of The Wichita Daily Eagle. The article said, “More than one -half of the drugs sold by the druggists in Kansas are not prepared correctly by the druggists themselves or by the manufacturing chemists in the Eastern cities. In three years, careful analysis made by the state chemists of 2,640 samples of the most common drugs found, and 57.79 per cent of all these were illegally prepared or adulterated, or had deteriorated to a point where they were unfit for use.” (#11-The Wichita Daily Eagle, April 26, 1910)

It was during this phase of public health legislation, during 1907-08, that the health department started one of many campaigns used to educate and encourage the public to adopt positive public health practices. “Swat the Fly” was a successful and popular state and national campaign. The campaign challenged people to take an active role in controlling the spread of contagious diseases by killing houseflies. City and county ordinances were put into place to address environmental conditions that would harbor the breeding of houseflies. Boy Scouts actively participated in the campaign, spearheaded citywide cleanups, and distributed fly swatters to the public so they could “Swat the Fly”. (Kansas State Board of Health. Part 2, The Fly Must Go, kslib.info)

Numerous papers across the state published the success of the “Swat the Fly” campaign. The Wichita Beacon headline for November 6, 1912 read, “State of Health and State of Kansas May Mean the Same Thing if Original ‘Swat the Fly’ Man Keeps Up His Work”. The article went on to say, “Since Crumbine coined the phrase, ‘Swat the Fly’, others all over the world have hearkened to the injunction and whole cities have turned in and awaited as they never thought of doing before. Kansas has every year since then, followed in Dr. Crumbine’s battle line and swatted flies. The Kansas ‘healther’ has time, you see, between swatting flies to slap, pound and maul food adulterators, as well. It’s his idea to make Kansas the healthiest place in America for anyone but a fool adulterator to live in.” (#12-The Wichita Beacon, November 6, 1912)

“Don’t Spit on the Sidewalk” was another successful health board campaign that caused widespread attention. Bricks were manufactured by a Topeka company, Capital City Vitrified Brick and Paving Co.  that reminded people to refrain from this distasteful public act. In Dr. Crumbine’s book, Frontier Doctor, he writes about the “Don’t Spit on the Sidewalk” campaign. “Many prefer the word expectoration to spit. But the shorter word drove the idea home and a brick maker in Topeka helped it along by having the phrase engraved on bricks to be laid in the sidewalk.” (Frontier Doctor, The Autobiography of a Pioneer on the Frontier of Public Health, Samuel J. Crumbine, M. D.,  c. 1948)

(Image from kansasmemory.org, Kansas State Historical Society, copy and reuse restrictions apply.)

Many Kansas towns had created anti-spitting ordinances prior to the Board’s campaign. In 1900, Wichita passed an ordinance that would cost the spitter “twenty-five dollars in cold cash”. Some felt the ordinance was unconstitutional. “That’s the question asked by everybody. Veteran spitters say it is not. They claim that it is against the rights of man. Spitting, they insist, is a necessity and not a habit, except in the case of men who use tobacco. Then spitting becomes a habit and a nuisance.” (#13-The Wichita Daily Eagle, July 11, 1900)

In 1905, the health board asked for legislation requiring transportation companies doing business in Kansas, to improve their sanitary conditions by complying with certain, well-known public health and sanitation practices. This request died in the legislative transportation committee. The health board decided to talk directly to the transportation companies about adopting a set of sanitation rules for railroad cars.

“It is with pleasure we are able to announce the acceptance of those rules in a somewhat modified form by most of the transportation companies doing business in Kansas. First, we have the written assurances of the Pullman Company that their cars are thoroughly and efficiently fumigated at monthly intervals.” (January 1907-Bulletin of the Kansas State Board of Health)

The first of the transportation companies to accept the complete rules was the Union Pacific Railroad. The Union Pacific Railroad was congratulated by the health department for having equipment that was kept in a hygienic condition. The Missouri, Kansas, & Texas railroad adopted the rules in a briefer form. Rule number 2 addressed spitting within the railroad car, "Coaches shall be provided with cuspidors. Placards shall be displayed in all railway waiting-rooms of the company, having plainly displayed thereon the following notice:

In 1908, the Board created four pamphlets in its vigorous campaign to rid the state of contagious diseases. The pamphlet addressed the “Prevention of Tuberculosis”, “Prevention of Smallpox”, “Scarlet Fever”, “Treatment of Diphtheria”, and the “Adulteration of Foods”. Within the tuberculosis pamphlet, Dr. Crumbine claims that the disease can be prevented, and measures for prevention were outlined. He suggested regulations for public buildings and urged ordinances and laws regarding the spitting on sidewalks. (#14-Parsons Palladium, June 17, 1908)

The “Don’t Spit on the Sidewalk” campaign’s main purpose was to educate people concerning the connection of spit with the spread of tuberculosis or consumption. An article entitled, “No Spit; No Consumption” made that connection. “Don’t spit on the sidewalk, or on the floor of any building, street car or other conveyance, where the sputum will become dry and permit the spread of the germs which it may contain. When you must spit, do so in a gutter, especially one containing water, in the opening of a sewer or into a spittoon. No spit; no consumption.” (#15-The Stockton Review and Rooks County Record, Stockton, Kansas, May 5, 1911)

The abolishment of the common drinking cup in 1909 came about after a well-crafted campaign by the health board. “The attorney general has given an opinion to sustain the right and authority of the State Board of Health to make an order to abolish the common drinking-cup upon the railroad trains, in the railway stations and the public and private schools of the state. That the use of the common drinking-cup in the state of Kansas is hereby prohibited, from and after September 1, 1909.” (1919-February Bulletin of the Kansas State Board of Health)

Dr. Crumbine deemed the abolishment of the common drinking cup as one of the most important acts accomplished by his department. “With one-third of the deaths in Kansas every year caused by preventable diseases, all diseases which may be and are transmitted through common drinking cups, I regard the order of this department abolishing the public drink cup as one of the most important things the department has ever done.”

Dr. Crumbine went on to describe a scene that confirmed his abhorrence of the common cup. “A short time ago I was on a Santa Fe train going southwest. There were several tubercular patients on board going to milder climates. One of them was in the last stages of consumption. He would cough and expectorate all around his seat, then every few minutes would walk to the water tank to quench the burning fever within him. He carried no private cup. There were nearly always men, women and children following him and waiting for their turn at the cup. I watched and was horrified at it.” (#16-The Topeka Daily Capital, July 22, 1909)

The common towel or roller towel was next on the purge list. “Kansas was the first state to abolish the common drinking cup in hotels, railroad trains and stations, and in the common schools. It has gone one step farther and the common towel will soon disappear from all public places. The order means that all the schools will furnish paper towels for the children.” (#17-Norton Courier, August 3, 1911)

A ruling by board of health read: "The use of the common roller towel in hotels, railway trains, railway stations, public and private school is prohibited from and after September 1, 1911. No person or corporation shall place, furnish or keep in place any towel for the common public use."

“A watertight order forbidding the use of common towels was drawn by our attorney yesterday afternoon and will be issued from Topeka in a few days. The Board of Health has never inaugurated a reform on circumstantial evidence. All our radical-appearing orders have been preceded by searching investigations, stated Dr. Crumbine this morning.” (#18-The Wellington Journal, June 15, 1911)

The article went on to state, “We secured towels from six representative Kansas hotels, made solutions from them, and conducted a long series of laboratory tests. The results were surprising. They found that twenty-five per cent of these towels had fecal contamination. “Perhaps only a physician can realize the danger which lurks in towels of such disgustingly filthy character. By fecal contamination, the vilest as well as the most dangerous diseases can be transmitted. The germs of typhoid fever were found on towels, together with pus forming bacteria, and epithelial cells. We have not only come to the conclusion that the common towel is bad, but we are prepared to prove it.”

A headline for the April 23 issue of The Wichita Daily Eagle read, “Making Kasnas [sic] the Healthiest State in the Union-You Must Carry Your Own Towel, Brush, Comb and Drinking Cup When Traveling Now”. The article said, “Kansas is being sterilized, cleaned and fumigated from Garden City to Fort Scott and from the Missouri river to the Colorado line. No state in all the world is having its health more seriously guarded than in the Sunflower state. All the school children of Kansas have been carrying their own drinking cups for a year or more, and now the health board comes forward demanding that all the pupil in schools under the control of the state be given individual paper towels for use in the wash rooms of the school buildings.” (#19-The Wichita Daily Eagle, April 23, 1911)

Kansas public health policies led the nation in the early twentieth century. A New York newspaper article dated January 8, leads with the headline, “Old New York Trails Kansas, Movement Started by Crumbine”. The article begins, “The Towel Brothers, Hand and Roller, went into retirement yesterday, following the lead of their near relative, Drinking Cup, who was put out of business some months ago and whose absence from accustomed haunts has been noted. The disappearance of the Towel Brothers from public places will doubtless cause as much comment. The idea of abolishing towels and drinking cups in public places originated in Kansas where Dr. Crumbine and the state board of health, first took up the fight. The movement was at first ridiculed, but many states are following.” (#20-Fort Scott Tribune and The Fort Scott Monitor, January 8, 1912)

In 1911, Dr. Crumbine would add to his health board duties, the position and responsibilities required as the dean of the University of Kansas School of Medicine. During Dr. Crumbine’s tenure, from 1911 to 1919, the medical school would offer the nation’s first postgraduate courses for public health officers. The school also saw an increase in curricular standards, an impovement in the quality of its graduating physicians, and a rise in the overall standing in the minds of many formerly hostile members of the state medical community. (“Who Would Command Greater Respect?, December 9, 1910”, KU History Project, kuhistory.ku.edu)

Dr. Samuel Crumbine would remain as the secretary of the Kansas State Board of Health until 1923. He described his decision to leave as a turning point in his professional life. In 1922, Kansas elected Governor Jonathan M. Davis who soon after his election sent word to the board that he wished to make 40% new appointments to the staff. “A suggestion that shocked me, as it had always been understood that two departments of the government in Kansas, Health and Agriculture, were exempt from political interference. In view of this, I refused to comply with the wish expressed by the new governor.” (Frontier Doctor, The Autobiography of a Pioneer on the Frontier of Public Health, Samuel J. Crumbine, M. D., c. 1948)

During this period, Dr. Crumbine had received an invitation from the American Child Health Association to join their staff. “While I was considering this,” Crumbine wrote in his autobiography, “the offer was reinforced by a telegram from the President of the Association, Herbert Hoover, who wired me: ‘Urge your acceptance of important position with our association.” (Frontier Doctor, The Autobiography of a Pioneer on the Frontier of Public Health, Samuel J. Crumbine, M. D., c. 1948)

In 1923, Dr. Crumbine left the Kansas State Board of Health and his beloved Kansas, moved his family to New York City, and began work as the general executive officer and medical consultant for the American Child Health Association, which was established in January 1923.

In 1948, The New Yorker magazine did a two-part profile on Dr. Crumbine. Dr. Crumbine told the magazine that he and his wife found the East filled with jangling crudities after the life in Dodge City and Topeka, but that they had settled down, determined to rough it, rode subway trains and buses and fought the crowds with flinty resignation. “Oh, we were soft at first, but we toughed up in no time. A Kansan can get used to anything,” he said in the eight-page interview. (The New Yorker, Profiles, “Swat the Fly!-II”, July 24, 1948 - Pay per view site)

The New Yorker opened its profile on Dr. Crumbine with, “Dr. Samuel J. Crumbine’s career as a public-health office began in Topeka on June 2, 1904, a date hallowed in Kansas and esteemed by doctors everywhere. He proved to be a good choice. For the next nineteen years, he was to rage over Kansas like a tornado, obliterating plague spots and sweeping aside miscellaneous opposition. ‘Dr. Crumbine is a deceptively mild man,’ a former associate of his said not long ago. ‘When he says no, most people think he means maybe. What he means is ‘Hell, no!’” (The New Yorker, Profiles, “Swat the Fly!-II”, July 24, 1948 - Pay per view site)

The American Child Health Association was dissolved in 1936 and in 1938; Dr. Crumbine became the child health consultant for the Save the Children’s Federation. In the fall of 1948, Dr. Crumbine’s autobiography Frontier Doctor was be released. The book would recount and reflect on his decades of service as a public health advocate.

In the final words of his autobiography, he writes, “Since my retirement, I’ve had plenty of time to look back and evaluate my busy years as physician and health officer. I think they have been, as a rule, quite interesting with hard work, sometimes exciting with adventure and on the whole quite satisfying years, with an occasional interlude of anxiety or sorrow, the greatest of which was the death of our son Warren in 1916 in Shanghai, China. Our dear boy’s memorial, the Pullman Health Car Warren, is now serving as the children’s ward in the Topeka Tuberculosis Sanatorium.” (Frontier Doctor, The Autobiography of a Pioneer on the Frontier of Public Health, c. 1948, Dorrance and Company, Inc. Find a library near you holding this book)

In 1954, the Conference for Food Protection established a prestigious national award in honor of Dr. Samuel J. Crumbine’s lifelong career in pioneering public health protection. The award, in recognition of outstanding food protection services to a community, was first given to Dr. Earle G. Brown for his work as Kansas State Health Officer from 1925 to 1937. During his term, he initiated a diphtheria-prevention campaign and initiated studies on accident prevention in the home and on the farm. (#21-Daily News, New York, New York, March 4, 1954) In 2020, the Samuel Crumbine Award for Excellence in Food Protection was given to Southern Nevada Health District, Las Vegas, Nevada.

Dr. Samuel Jay Crumbine died in 1954, at the age of 91. The Hartford Courant in writing about the passing of Dr. Crumbine wrote, “It is an interesting commentary on human values that there is not one in a thousand who could today, offhand, identify the man who gave the good part of his long life to furthering the nation’s health. If he had saved as many dollars as he had lives, he probably would have been acclaimed more widely for his achievements. Fortunately, however, for the rest of us there are men like Dr. Crumbine who seek to be useful. They do so not for acclaim, but because it is in their nature to seek that which is good.” (#22-Hartford Courant, Hartford. Connecticut, July 17, 1954)

In 2018, a statue of Dr. Samuel J. Crumbine was dedicated in Topeka next to the Kansas Health Institute. Artists Carson Norton of Great Bend and Charles Norton of Leoti, Kansas created the statue. (Photo by Bill Sowers, 2020)

Read the other two parts of this series on the Kansas State Board of Health early history:
 
Kansas State Board of Health. Part 1, Prevent the disease
 
 Kansas State Board of Health. Part 2, The Fly Must Go