Alameda County

History

Past and Present of Alameda County, California - S. J. Clarke Pub. Co., 1914

CHAPTER IX
HEALTH AND DISEASE, MEDICINE, ETC.

        In 1856 there were only four medical practitioners in Oakland—Doctors Newcomb, Edward Gibbs, J. C. Van Wyck and a Frenchman, De la Tavel. Doctor Newcomb was an enthusiastic conchologist as well as a doctor. He presented his shells to Johns Hopkins University about 1876 and about the same time accepted a professional chair in that institution.

        In 1860 the Alameda County Medical Association was organized. The original records are missing, but a reference to the association in a San Francisco newspaper states that six or eight physicians were present, among them being two from that city. Previous to this date health measures were taken by the city authorities and it is presumed that a health officer or a board of health was appointed. The county board, almost from the commencement, were required to appoint a county physician whose duty was principally to care for the sick indigents.

        The statutes of 1850 established a Marine hospital at San Francisco, to which the sick of that city could be admitted upon proper application. Further legislation in 1851 located state hospitals at Sacramento and Stockton, and in April following, $2,000 per annum was allowed to the city of San Diego for the care of indigent sick arriving at that port. In May, 1853, a general law was passed establishing a state "Indigent Sick Fund," providing means for its maintenance and prescribing the manner of its distribution to the organized counties of the state. This law was amended and its scope enlarged by the act approved April

1, 1855, which among other matters delegated the care of indigent sick to the boards of supervisors of the respective counties, giving them power to appoint physicians, to erect hospital buildings, to levy a tax and to draw from the state hospital fund the amount apportioned to their county quarterly. Under this act on May 1, 1855, the board of supervisors appointed Doctors D. C. Porter of Oakland, A. W. Powers of Eden, H. C. Sill of Washington, and William Wilworth of Clinton, county physicians, who were allowed $2 per visit and $1 per mile traveling expenses, and in July following the first requisition was made for the amount of hospital fund due. The first bill allowed on this fund was to W. J. Wentworth for medical attendance, etc., on Frederick Campbell, $183.

        The board of physicians was continued, with various changes and one removal, until January 1, 1856, at which time they were all discharged, the supervisors probably feeling that the bills resulting from their former order might prove a serious matter. The care of indigent sick was delegated to citizens. The matter continued in this condition until the following August, when it was decided to procure a suitable place and care for the indigent sick; accordingly a contract was made with Orrin Hamlin to that end, at the per capita allowance of $12 a week. This arrangement continued but a short time, and on April 4, 1857, an order abolished the county hospital from date and again committed to the care of the supervisors the sick of their respective districts. In February, 1860, a proposition was received from St. Mary's hospital, San Francisco, offering to take charge of the indigent sick of the county at a per diem charge of $1.25 per capita. Without hesitation the offer was accepted, and presumably all who could be safely moved were at once transferred thither, and yet among the allowances shortly afterward made was one of $146.25 to the hospital, and an aggregate to others for the same purpose of $488.30, from which it may be inferred that either the hospital was unable to attend to all the indigent sick in Alameda county or that the private citizens found county nursing far too profitable a source of revenue to be tamely surrendered.

        From the establishment of the hospital in Oakland, August 16, 1864, to December 31, 1882, there were 3,778 admissions, of whom 466 died and 3,197 were discharged, cured, improved or left voluntarily. The new county infirmary was occupied about August 15, 1870, this being the date from which Dr. Coleman, the first attending physician, was paid. In 1874 the number admitted was 191 and the total 227. Number discharged, 162; total amount of warrants drawn, $16,117.01. On April 12, 1875, the board of supervisors ordered the erection f four new wards at a cost not to exceed $1,000. On December 27, 1877, a corporation named the Oakland Homeopathic Hospital and Dispensary Association, founded by the ladies of the county, petitioned the board of supervisors for the use of two rooms in the city of Oakland wherein to establish their institution and afford free medical aid to the poor. The petition was denied at the time, but afterwards, on February 11, 1878, an allowance of $40 per month was voted with the understanding that the supervisors should have the privilege of sending patients to their establishment.

        The following report of the infirmary for the year ending December 31, 1882, was presented to the board of supervisors: "The Alameda County Hospital was located in Oakland August 16, 1864. From that date to 1869, a period of five years, there were 356 patients admitted for treatment; 200 were discharged cured, 91 improved or left voluntarily, and 54 died. In 1868 the board of supervisors purchased 123½ acres of land near the foothills, 2½ miles from San Leandro and 10½ miles (not 14 or 16 miles as often stated) from Oakland, for an infirmary, paying therefor $5,535. In 1869 a building was erected and the hospital closed in Oakland and the Infirmary established at its present location. Other buildings were erected in the years 1875, 1877, 1879 and 1882. At present there is room for nearly two hundred patients."

        In July, 1868, smallpox became epidemic in Oakland. The council at once passed an ordinance creating a board of health and vested the same with full powers to do everything possible to prevent its spread. Under an arrangement with the county the cost of procuring a pesthouse was equally divided between the city and the county, and the expense of maintaining the same was paid in proportion to the number of patients, the pesthouse being purchased and maintained for city and county purposes.

        In 1869 the Alameda County Medical Association was reorganized and a year later the State Medical Society was founded. In 1871 the American Medical Association assembled in Oakland, which fact drew wide attention to this locality. Dr. J. S. Adams began the practice here about this time.

        In 1870 the first board of health was established in Oakland and Dr. T. H. Pinkerton was appointed first health officer, occupied the position for four years and was succeeded by Dr. Sherman. Dr. J. B. Tremley died here early in December, 1890. He came here about 1870, was a member of the Alameda County Medical Society and at one time was its president and secretary. Orran P. Warren and Charles J. Draper, doctors of Oakland, were elected trustees of the Eclectic Medical Society of California in November, 1874. In January, 1875, the Alameda County Medical Society elected the following officers: E. Trevor, president; E. L. Jones, vice president; C. S. Kittridge, secretary; H. P. Babcock, treasurer and librarian; W. Allen, H. P. Babcock and T. H. Pinkerton, board of censors. At this date the society numbered twenty-six members and held monthly meetings at the health office. In February and March there were scores of cases of typhoid fever or typhoid pneumonia in Oakland and it seemed almost epidemic. There were three cases in one house. The physicians were puzzled and reticent. Many persons contended that the city water was the cause—was impure. This view was no doubt correct, though the cause of that disease at this time was so little known that even yet many presumed it was due to the miasma arising from the flats in the southern part of the city. The disease was probably due to the excessive dry spell in the winter of 1874-75 when little or no rain fell for many weeks. There were six weeks of dry weather which included the whole month of December and during that period there was far more sickness than ordinary in that month. Then came a big rain and complaints ceased, but again dry weather came and with it a deadly return of various diseases. The board of health warned people to avoid the water of wells throughout the city. Doctor Sherman was health officer, he laid the source of the epidemic to the wells.

        The California Eclectic Medical College was organized in 1878, under the auspices of the board of trustees and faculty of the California Medical College, with the following officers: J. P. Webb, president; Doctor McRae, secretary; C. C. Mason, first vice president; M. F. Clayton, second vice president; J. H. Bundy, treasurer. The College building was located on Clay street, between Tenth and Eleventh streets.

        Of the 76 zymotic cases in 1880, 20 were from typhoid and typho-malarial fevers; 13 from diphtheria and croup and 14 from cholera infantum. The total number of deaths from zymotic diseases was only 2.16 per cent of the whole. The mortality per cent from all causes was as follows: 1875, 13; 1876, 14.19; 1877, 14.17; 1878, 13.32; 1879, 10.64; 1880, 12.91. The highest mortality from zymotic diseases from 1875 to 1880 inclusive was 4.14 per thousand in 1877. At this time health reports of children in the public schools were made. During 1880 the greatest fight was made against privy vaults and cesspools. It was formally announced that filth was the cause of the increase in the death rate. Smallpox was epidemic this year—an importation from China; a total of 21 cases resulted, of which 4 died. Quarantine prevented its spread. E. H. Woolsey, M. D., was health officer and city physician at this time. This year the total number of deaths in the city of Oakland was 452, less than 13 in each 1,000 of population. The number of deaths from zymotic diseases was 76. The health department called attention to the importance of constructing intercepting sewers at the earliest practicable moment in order to check the ravages of zymotic diseases, also to the importance of connecting home closets with street sewers and the danger of using ordinary water from city wells. This death rate was a marked decrease from the two previous years. At this time a sanitary survey of the city was made.

        The July report of the health department showed a marked increase in the number of deaths from zymotic diseases. Five died of diphtheria, 5 of typhoid fever, 4 of cholera infantum—in all 23 died of zymotic diseases. The annual death rate at this time was 17.05. In August, with the population of Oakland estimated at 38,000, the death rate was 15.78 per 1,000; in September it was only 13.26. The city was one of the healthiest in the country.

        The steamer Newbern, Captain Rogers, arrived here late in September, 1883, with five cases of yellow fever on board. The vessel came from Guaymas and Mazatlan. Health Officer McAllister immediately placed the vessel in quarantine. The Pacific mail steamer San Blas arrived in port late in October with three cases of yellow fever on board and failed to notify the health officers of that fact. About half a dozen officers boarded the vessel without knowing that such was the case. There were 65 persons in the cabin, 37 in the steerage, 69 in the crew and 2 customs officers. The sick were placed in a barge and the well passengers were boarded on the old hulk China until danger was past.

        In November, 1883, Mr. Hayes of the city council offered a resolution to the effect that as the city water was muddy, dirty and otherwise unfit for domestic use, the city should not be required to pay for it, in accordance with the terms of the contract with the Contra Costa Water Company. It was referred to the committee of the whole.

        The medical and dental department of the State University graduated seven dentists and eleven physicians in November. Among the former was Miss Maria A. Burch, the first lady dentist on the coast. The Homeopathic Hospital Association in November passed a resolution asking the superior court for permission to mortgage its property for $3,500 with which to pay the debts of the concern.

        In 1887 smallpox spread over the city and thousands were vaccinated. Eight persons died of the epidemic. Late in February, 1888, there were here a few cases of diphtheria, scarlet fever, measles, smallpox. At this time Oakland barely escaped an epidemic of the latter disease, which came later. From December 1, 1887, to April 1, 1888, the smallpox scare cost Oakland $4,759. The 50 cent vaccination ordinance of 1880 was still in force and this item was the largest on the cost list. Dr. D. D. Crowley and his assistants vaccinated about 4,000 patients during this scare period. Dr. Crowley refused to make his claim or the cost would have been much greater. During the smallpox epidemic of 1888 vaccination was made compulsory and physicians were paid a fee of 50 cents for each person vaccinated. The smallpox hospital was called the Pesthouse. When this was full the surplus unfortunates were housed in the annex called The Farm. Mrs. La Ford was the nurse in charge; she slept in her chair ready for any sudden call.

        During one month in July and August, 1888, the board of health reported 34 cases of diphtheria, 17 cases of typhoid fever and 1 case of scarlet fever. Twenty-nine of the cases of diphtheria were traced directly to improper sewerage. Many spots in the city were declared nuisances, including Lake Merritt, which for many years had been used more or less as a cesspool and had a coating of filth around its border. Health Officer Crowley said: "A nuisance which is now manifesting itself to a considerable degree and will hereafter be followed by zymotic diseases, is that of Lake Merritt." At this time the board of health was doing heroic work to improve sanitary conditions.

        Oakland thus had a timely warning. The death rate had been for some time steadily increasing with exceptions. No longer could the city point to its low mortuary list and claim to be the most healthful city of the country—not until it was such in fact, made so by an efficient sewer system. Neither diphtheria nor typhoid fever was raging here, but both were alarmingly prevalent.

        There were twenty-two cases of diphtheria in Oakland in July, 1888, and the health department gave warning that the disease might soon become epidemic unless checked at once. They stated that the disease was more deadly than smallpox, but less understood. The board recommended a marginal sewer along the edge of Lake Merritt and several main sewers to be connected with it so that sewage could be carried to deep water and the pipes could be flushed. The doctors agreed that filth was the cause and bad sewerage a correlative one—that unsanitary conditions prevailed in many portions of the city. At this time zymotic diseases were better classified here than ever before and the health department was better fitted to wage a successful war against disease. On July 11-12 there were reported twenty new cases of diphtheria in forty-eight hours. No doubt there were many other cases not reported. Doctors Woolsey, Crowley, Agnew, Todd, Adams, Pinkerton, Liliencrantz, Bradley, Agard, Burchard and others were busy during this crisis. Doctor Woolsey remarked at this time, in view of the carelessness of the people generally in regard to health measures, that "some day the city would wake up rotten and do something." The sanitary inspector reported that "Complaints have come into the office from all quarters, and especially from East Oakland, the water front and Watt's tract. It is a common thing to find sewage running into the street. The Watt's tract district is in a bad condition. Hundreds of houses are not supplied with city water and as a consequence there is not proper flushing. Harlan street is still without a sewer and the people continue to sewer into the street. Abatements of such nuisances in East Oakland are only temporary owing to the lack of satisfactory public sewers. The Twelfth street sewer empties into the estuary and the sewage is washed into Lake Merritt on every flood tide and forms a deposit there. The dumps are disease breeders. The plumbing law is unsatisfactory." Doctor Crowley said: "These localities (named in his report) owing to their unsanitary conditions are breeding sickness and death. We have for over a year shown the necessity of completing the Main Lake sewer and preventing the oozing of sewage into the marsh. We have asked for a Commerce Street sewer, but the property owners object and they are dying off one by one." Dozens of locations in the city made serious complaints to the same dreadful effect. The board of health finally recommended to the council a survey for a marginal sewer along the east boundary of Lake Merritt.

        In January, 1889, the board of health found fault with their treatment by the city council; their recommendations were neglected. Dr. Crowley asked, "Why does not the council show its disposition to do what the board of health, which has given the subject a thorough study, considers essential. The cause is in Lake Merritt. For years people were allowed to drain their sewers into the lake until it was gradually filled up with a mass of sewage that has covered the bottom of the lake. Instead of a lake of pure water intended to flush the Main Lake sewer, it has become a big cesspool 180 acres in extent. Many other places are equally bad. The city is completely surrounded by those death traps. There is nothing to prevent an epidemic." (Dr. Crowley, June 17, 1889.) "We are surrounded by disease breeders on three sides and on part of the fourth. On the east there are Lake Merritt (polluted with sewage) and the bare mud flats of the north arm of the estuary; on the south there are the water front marshes on which the sewers discharge; on the west there are more marshes with sewers and dumps, and the same thing is true of the northwest. Therefore there is diphtheria all over the city. We do not desire to be classed as alarmists, but must make plain our sanitary condition. Last year there were a great many cases of diphtheria in Oakland. There will be a great many more this summer and fall. It is only a question of time when the disease will reach the proportions of an epidemic. An epidemic of diphtheria would give Oakland a black eye from which it would not recover for a quarter of a century. An issue of bonds is necessary to carry on the proper sanitary improvements." (Local paper, June 18, 1889.) The council took immediate action at this critical time, under the threatening prospect. There came appeals for proper sanitation from all parts of the city. Never before had the city been so thoroughly frightened and aroused as at this time. An ordinance ordering the construction of a "complete and effective system of sewerage for Oakland" was promptly and unanimously passed on June 17, 1889. At this time Dr. Crowley recommended the adoption of the crematory system for city garbage. The board of health asked for $30,000 for immediate use.

        In December, 1889, Dr. George C. Pardee made an elaborate report on the quality of the water furnished by the Contra Costa Company. Doctor Woolsey did not agree with the report and said that it was exaggerated and injurious. Doctor Pardee said that the water was vile, that it was swarming with the rotting remains of animal and vegetable life, that when it was made less vile the zymotic death rate decreased, that when it was viler the death rate from zymotic diseases increased, that zymotic deaths were more frequent where there was the least precaution to free the water from impurities, that perfecting the sewerage did not reduce the zymotic death rate, that a poorly-sewered, well-filtered ward was not as unhealthy as a well-sewered, poorly-filtered ward, that the water was worse where the zymotic deaths were most frequent, and that over one-third of all the zymotic deaths in this city occurred around the dead ends in about one-twentieth of the territory of the city. The board of health passed a resolution requesting the council and the board of public works to take such steps as they deemed best to compel the water company to properly purify the water it delivered to consumers in Oakland.

        A special committee of the board of trade, early in December, 1889, made formal report of its investigations of the sanitary conditions of Oakland. It made the following findings : (1) It may be safely declared that few cities are better situated for effective natural drainage than Oakland; (2) it may therefore be safely asserted that the sewer system of Oakland is an exceptionally good one and requires no sweeping modifications; (3) the city has an exceedingly low death rate from zymotic diseases; (4) the chief source of zymotic diseases wherever it exists will be found to be imperfect house sewerage. The committee therefore recommended a bond issue to be limited to actual public needs as set forth in the report; also the deepening of Lake Merritt, the reclamation of West Oakland marsh, the omission of the north arm of the estuary pending the Government's decision thereon, the correction of existing sewer defects and the use of the new ship channel to convey city sewage to deep water. The report further said, "The city having thus disposed of this vexed problem, adjusting the burden of sewer construction equitably upon the districts benefitted and bonding the city for general improvements only, in which all territory now or to be incorporated has an interest, the board of trade could properly suggest a hearty invitation to the adjacent territory to come into the city." This report was so different in plans from that of the board of health, that elaborate public discussion of the whole subject was renewed and continued for some time.

                        Oakland population

        In July, 1890, all the physicians of Oakland petitioned the city council to drain Lake Merritt immediately as a sanitary measure and said "The increasing deposit of mud in the lake is already a source of danger to the health of the surrounding inhabitants and by limiting its flushing capacity is a menace of danger to the residents of the large district drained by the main lake sewer." This petition was signed by the following doctors: F. L. Adams, W. H. Blood, M. M. Fish, George C. Pardee, E. W. Bradley, N. K. Foster, Mary Whitney, G. H. Aiken, John P. Reiley, J. B. Trembley, E. H. Woolsey, A. H. Pratt, O. B. Adams, S. I. Shields, William M. Brown, John Fearn, O. B. Metcalf, Gray Smith, N. W. Knox, S. J. Kellogg, J. R. Bradway, B. A. Rabe, G. H. Stockholm, E. J. Sharp, A. J. Russell, R. S. Clason, A. M. Taylor, J. H. Wythe, W. J. Wilcox, T. H. Pinkerton, I. E. Nicholson, A. Fine, L. S. Burchard, W. F. Southard, George A. Lathrop, F. Kirckein, R. L. Hill, E. J. Overland, L. P. Hess, H. P. Van Kirk, J. H. Todd, Richard Cannon, E. M. Patterson, G. E. Brinkerhoff, George J. Augur, J. C. S. Akerly; J. P. H. Dunn, A. H. Agard, W. E. Hook, L. Webster, J. M. Young, A. Liliencrantz, A. G. Anthony, R. Harmon. It was estimated that 300,000 cubic yards of mud would have to be removed, probably at a cost of not less than 14 cents a cubic yard, or perhaps as low as 10 cents.

        At the meeting of the State Medical Society at Los Angeles in April, 1890, Dr. J. H. Wythe, of Oakland, read a paper on "The Structure of the Blood Corpuscles and its Relation to the Practice of Medicine," and Dr. E. H. Woolsey read three papers on "Treatment of Synovitis of the Knee Joint," "Treatment of Fraction and Dislocation of the Wrist," and "Resection of the Elbow Joint."

        The Oakland General Hospital was established early in 1890 and was practically under the management of the Alameda County Medical Association. It was intended for the care of persons afflicted with all ills except those of a contagious character.

        About the year 1890 Dr. F. E. Price began the practice of veterinary science in Oakland. In 1893 he was appointed by the board of health to inspect the dairies, meats, markets, milk and animal products generally in an effort to discover the cause of the typhoid from epidemics. Soon he established the Oakland Veterinary Hospital and secured Dr. R. A. Archibald as assistant. The latter had been connected with the United States Bureau of Animal Industry and with several veterinary institutions. In 1890 about seventy-five thousand dollars was spent on the sewers of Oakland. In 1889-90 the number of sewers built was forty-two, and in 1890-91 the number was fifty-six.

        Late in May, 1891, the mayor appointed Dr. H. L. Bradley, a homeopathist, on the board of health. This act was opposed by the allopathic members of the board, who declared the step was a dangerous innovation that would disorganize the department when eclectics, hydropaths, scientists and all other so-called medical schools should likewise be represented on that body. The mayor favored the appointment of a homeopath on the board, but encountered such opposition that he relinquished the attempt. Previous to this time Doctor Selfridge, a homeopath, had been appointed on the board, whereupon all the allopathic members resigned, but were reinstated, when Doctor Selfridge withdrew. In May, there were reported to the board of health twenty-one cases of diphtheria, four of measles, six of scarlet fever, four of typhoid and typhoid malarial fevers, four of whooping cough. Doctor Bradley, the newly appointed health officer was completely ignored by the allopathic members of the board. In June an election was ordered by the county board to determine the question of a sanitary district for the town of Lorin. Oakland Free Clinic Association met in Doctor Woolsey's hospital in August, at this time, after an existence of about two months. In June fifty-seven patients were treated and in July 101 were treated. Ladies were managers of this association. Mrs. M. W. Kales was treasurer and Mrs. J. M. Driscoll, president. The staff of physicians was as follows: Surgery—E. H. Woolsey, J. P. Dunn and E. R. Sill  medicine—H. E. Muller, C. M. Fisher and W. P. Mauzy; diseases of women—J. H. Wythe, J. J. McCullom and M. L. Johnson; eye, ear, nose and throat—G. C. Pardee and H. G. Thomas; dental surgery—T. W. Hall, W. E. Brooks and J. M. Dunn.

        In August, 1891, the board of health stated that action was needed at once to improve the sanitary condition of the city. Doctor Woolsey said the water was good, but the air was bad, especially near the sewer outlets. Doctor Wythe said the odor arising from the sewers had been a standing menace of corruption and disease for many months and that if the city were broadly awakened to the evil wrought it would not hesitate at the expense of a remedy. A motion was carried requesting the board of public works to take immediate action for the improvement of the sewer system and for the disposal of garbage. The annual death rate for July was 14.4. The public schools were declared to be in sound sanitary condition, though ventilation was not what it should be. The board resolved that the passage of garbage through the streets between 6 o'clock a. m. and 6 o'clock p. m. was a public nuisance. In response to a petition to that effect the county board late in August, ordered an election to be held in the district between Oakland and Berkeley on September 12th, to determine the question of the formation of a sanitary district within the county of Alameda to be known as "sanitary district No. 1." At the election it was ordered that a sanitary assessor and a sanitary board of five members should also be voted for.

        "The greatest menace to the public health is the sewage draining into and the garbage dumped upon the West Oakland marsh. The next greatest fault of our sanitary condition is the sewage deposited along the marshes and shores of our southern water front. Another evil which threatens the welfare of the vast population within our borders is the filling up of Lake Merritt which ere long will be incapable of flushing the main lake sewer without which this conduit would become in its entire length a festing cesspool."—(Health report [Dunn], February, 1892.) Doctor Pardee denied the conclusions of Doctor Dunn and, said the marsh was covered twice daily with salt water and the filth there if there was any from the dumpings could be prevented. He declared that the board of health had repeatedly requested the council to prevent the dumping and to improve the sewers, which they had not done of the several years of urgent entreaty. "We are making a fight for health and against the hearse," said Colonel Irish in 1892. It is probably true that Colonel Irish did more for the improvement of the sewers and the health conditions in the 80's and 90's than any other man. He took the position at all times, as did the board of health, that the sewers were the cause of the epidemics of zymotic diseases and thundered his opinions through the newspapers and from the rostrum on all occasions.

        A case of leprosy was discovered here in May, 1892, by Health Officer Dunn. The victim was sent to the San Francisco hospital. A little later another case was found.

        At a meeting of the board of health on November l0th, there were present Doctors Woolsey, Anthony, Muller, Bradley, Wythe, President Anthony and Health Officer Dunn. The latter reported cases of smallpox and Doctor Wythe declared that the only opposition in regard to the cases came from the physicians who were attending the patients, and that he did not care to be a member of the board and be hampered in his work by the medical fraternity. He then read the following statement addressed to the citizens of Oakland, which was adopted and ordered printed for circulation: "The Oakland board of health sees with regret a disposition manifest by newspaper articles and in other ways, to criticize unfavorably the efforts of the health officer of the board to protect the community against infectious disease. Whether from professional antagonism and jealousy or other motives, it especially deprecates the interference of physicians who ought to be guardians of public health. The duties of the health officer are onerous and delicate enough without being rendered more difficult by the opposition of physicians themselves. A majority of the members of this board have satisfied themselves by personal inspection of the existence of a mild case of smallpox in Oakland, and of the occurrence of an eruption resembling varioloid in certain persons exposed to the disease. The health officer with the concurrence of a majority of members of the board, and in performance of his duty, proclaimed a quarantine, which certain medical men of Oakland invoked the legal authorities to remove. Under these circumstances we submit to an intelligent public the question: What need is there for a board of health officers ? Why not let contagion have full play with the doctors ? Clearly, if there be a doubtful case the public should have the benefit of the doubt." The doctor then noticed the differences between chickenpox, varioloid and smallpox. The board finally resolved that the city attorney be directed to prepare an ordinance that would enable the board of health to effectually guard the premises and people where contagious diseases existed, to vaccinate where necessary, etc.

        In June and July, 1893, Oakland suffered from a serious epidemic of typhoid fever. The Times and Tribune declared it was due to the defective sewers from which the city had so long suffered, but this was denied by Mayor Pardee who traced at least a portion of the cases to the milk of a dairy where the conditions were filthy in the extreme. From June 1st to July 4th there were reported 341 cases of typhoid. This condition roused the city like an earthquake. Both milk and sewers were thoroughly inspected and improved. One of the worst features of the case was the studied attempt to conceal the truth and to misrepresent and deceive so that outsiders would not be prevented from coming here by reason of the dangerous sanitary conditions.

        In September there was an epidemic of diphtheria at San Leandro and in spite of physicians it extended out into Eden township and finally reached Haywards. About this time San Leandro voted $15,000 in bonds to build a sewer system. By November the Oakland Clinic had been in existence three years, during which time it had treated free 2,943 patients at a claimed cost of about $100 per month for medicines. Doctor Woolsey asked for an appropriation to cover this amount. The county board granted $50, The Oakland Free Clinic in 1894, treated monthly 600 persons free of charge; they asked for a monthly appropriation from the county board of $100 to pay for medicines, etc. The following physicians made this request: Doctors Woolsey, Muller, Thomas, Sill, Kuckein, Lynch, Fisher, Dunn and Legault. The board granted only $25. At the same time the Oakland Homeopathic Free Clinic, for the same reasons, asked for $50 per month; the board had previously assisted this clinic with $40 per month, and were now asked to renew the appropriation. This clinic claimed that the so-called Oakland Free Clinic was a new concern, but that theirs had been in existence several years and its good services were known to everybody. They were likewise given $25 per month.

        At the meeting of the Oakland Dental Club in January, the following officers were elected: Russell H. Cool, president; H. W. Meek, vice president; H. D. Boyes, secretary; Cecil Corwin, treasurer; Lewis Merriman, Sr., and Hackett, executive committee.

        In the spring the board of health of Alameda was the first to begin a systematic and persistent attack on tuberculosis in cattle—particularly in cows, applying the Koch tubercular test. Dr. Thomas Carpenter was employed and examined in nine months over 1,100 head of cattle, of which 330 were within the corporate limits of Alameda. Every cow found infected was condemned. Twelve cases of tuberculosis and four of actinomycosis were found within the city; all animals were killed and a post mortem examination showed the unmistakable evidence of the disease. In close touch with this important movement was D. R. Caldwell, member of the Alameda Board of Health.

        In July, 1895, the board of health recommended a crematory but met no encouragement to their requests. They investigated the milk supply and reported present too large a number of harmful bacteria. They condemned a considerable quantity of tuberculous meat and warned all to be careful. They flushed the sewers, and directed the sprinkling of the streets and cleaned up the city generally.

        The Alameda County Medical Association held a banquet at Hotel Metropole on March 10, 1896. Over forty physicians were present and a merry time was enjoyed with music, toasts, speeches, etc. Doctors Eastman and Buteau were toastmasters. Speeches were made by Doctors Overend, Adams, Melvin, Fitzgerald, Bradway, Rosborough and others. Among those present in addition to the above were J. S. Adams, D. D. Crowley, L. S. Adams, J. C. Akerly, E. J. Boyes, A. M. Taylor, J. H. Todd, H. J. Thomas, Myra Knox, N. K. Foster, F. R. Musser, T. L. Wheeler, H. N. Rucker, J. J. Medrios, N. L. Johnson, J. P. Kitchings, J. Moher, F. W. Morris, J. L. Mayon, E. N. Patterson, F. H. Panie, A. H. Pratt, S. J. Russell, S. J. Shuey and W. F. Southerland. Oakland was supplied with milk from the following dairies: Morrell's Sunset Dairy in the Piedmont hills; Scandinavian Dairy; Oakland Jersey Farm at the head of Lake Merritt; Barker's Dairy at the head of Claremont avenue; Mountain View Dairy; Cordico's Ranch in Hays canyon; Carr's Dairy in Fruitvale at Twenty-third avenue; Swiss Dairy on the Redwoods road; Oakland Cream Depot; and Sweet Briar Ranch.

        The attempt of the board of health to have the council pass an ordinance requiring that consumption should be one of the diseases to be officially reported by attending physicians, was defeated by that body after a sharp contest. In July the county board refused to appropriate $25 per month for the Double Cross Free Clinic because the county was then contributing to the support of three other clinics, besides the Receiving hospital and the county infirmary. The application for help was denied by a unanimous vote. This act was criticised as penurious and small-souled. It was not because the county lacked money, nor because the clinic did not merit help, but because the county board had grown tired of doing well. Late in January, 1897, the county board passed unanimously a resolution discontinuing the allowance of $25 made monthly to each of three clinics.

        In the fall a resident of Alameda was arrested twice on the charge of selling impure milk in that town. His permit was revoked by the board of health, but he continued to sell. His cows were examined by experts and several of the animals, it was publicly announced, had tuberculosis and their milk contained the germs of that disease. One or more of the experts had given the dairy a clean bill of health, which fact caused the owner to disregard the revocation of the permit and to continue the sale. The case was taken into court and although there was some difference in the opinions of the experts he was required to get rid of the suspected animals. The Alameda County Medical Association notified local lodges that the practice of serving all the members for a fixed annual sum should cease after January 1, 1898. They also opposed free clinics as against the best services of the profession. This was an emphatic and distinct movement against the so-called "contract system." At this time the president of the association was Dr. H. G. Thomas. Early in December the board of health adopted recommendations condemning Contra Costa water and advising the discontinuance of its use in the public schools and elsewhere. The board ascribed the prevailing typhoid fever and kindred ills to its use. This action followed the reading of the report of the Pure Food and Water Committee and the report of Dr. Douglas Montgomery, bacteria specialist. The reports showed conclusively the unsanitary condition of the water of that company.

        In June, 1899, Health Officer H. W. Emerson quarantined thirty-two new cases of scarlet fever in Mission San Jose and reported that measles was prevalent in that vicinity. Scarlet fever broke out in the Mission first, and then spread to outer districts.

        In the spring of 1898 the greatly increased death rate was ascribed to the newly annexed territory which had not had the sanitary advantages which had wrought such an improvement in health conditions in Oakland. In December, 1899, when it was proposed to quarantine California against consumptives, Dr. D. D. Crowley favored the measure and said it was certain to come soon.

        In 1900 the death rate in Oakland was less than it had been in any year since 1884; there were 896 deaths in a population of 66,560. Yet there were cesspool districts. The annexed territory needed better drainage and demanded it as their right under the conditions of amalgamation. More zymotic diseases were reported from that district than from any other. The health officer gave due warning. The board of health of Alameda prepared to renew its war on tuberculosis on a more extensive and more effective scale. It passed resolutions calling upon all medical boards and institutions in the state to request the passage of a law to establish tuberculosis sanitariums for the care of patients and control of the disease which was declared to be contagious. Members of the Legislature from this county promised to help the movement.

        In the fall of 1900 the incorporators of Oakland College of Physicians and Surgeons met at the office of Dr. Frank L. Adams and among other doings subscribed to the by-laws. The signers were Doctors Frank L. Adams, S. H. Buteau, D. D. Crowley, J. S. Eastman, E. N. Ewer, C. R. Krone, J. L. Milton, W. S. Porter, R. T. Stratton, H. G. Thomas, C. D. Hamlin and W. F. B. Wakefield. At this meeting the faculty was selected and included the above physicians and a few others. It was provided that a surgical and gynaecological college clinic would be carried on by Doctors Hamlin, Milton and Porter. Nearly $8,000 was subscribed by the incorporators for the running expenses of the college. It was planned to be in active operation by September, 1901, and to buy a site for the college buildings as soon as practicable. The institution was of the regular or allopathic school. A four years' course was decided upon. The trustees of the medical college secured an option on the land at the corner of Thirty-fourth and Grove streets and made preparations at once to erect a suitable structure.

        In November, R. A. Archibald, city bacteriologist, made serious disclosures concerning the milk supplies of this city. In specimens examined the bacterial contents were far beyond what healthful milk should show. He said the revelations were not only sufficient to condemn the milk for food, but for all other useful purposes as well. The health department prepared to inspect and improve the product of all the dairies.

        In January, 1902,   Health Officer Von Adelung called the attention of the board of health to the importance of considering such diseases as tuberculosis, typhoid fever, diphtheria and scarlet fever in their relation to the home. The communication was in the form of circulars addressed to the public and pointing out the dangers and warning all people how to assist in preventing the spread particularly of tuberculosis.

        Apoplexy caused 50 deaths in 1902-3, diphtheria, 53, valvular diseases of the heart, 93, tuberculosis, 132 and pneumonia, 118. It was recognized at this time that tuberculosis was the most formidable enemy the health department had to encounter. Every possible measure of prevention was adopted; all cases were reported and free examinations of sputum made after October 10, 1902. The physicians generally aided in this movement for extermination. Premises were not placarded, but were fumigated upon the death or removal of the patient. The physicians of the city were almost a unit in the opinion that sputum aided greatly to spread the disease. Hence there were circulated 10,000 circulars throughout the city calling attention to the danger from this medium. An anti-expectoration ordinance was procured and its enforcement was turned over to the police department. Steps to destroy all street and alley waste were taken with greater rigidity than ever before. Signs were put up in public places and on local trains. Pneumonia was likewise attacked through the sputum. In all 374 cases of diphtheria were reported. The source of this spread was not wholly learned, but was believed to be largely due to the use of a common drinking cup at schools, etc. With $150 from the city council the health board introduced diphtheria antitoxin with good results. Scarlet fever, typhoid fever and smallpox were kept down. Lectures on sanitation in the schools were commenced. The erection of a garbage crematory aided the department. Monthly bulletins began to be issued. Improvements in plumbing and sewerage were introduced. In 1900-01 there were 24 cases of smallpox; in 1901-2, 52; and in 1902-3, 70. Dr. Edward von Adelung was health officer in 1902-3. Pauline S. Nusbaumer, M. D., was city bacteriologist. She made hundreds of examinations, with both positive and negative results. The city chemist, Charles H. Rowe, M. D., conducted many examinations of water, milk, etc. R. A. Archibald, D. V. S., was meat, market and milk inspector. Health measures were far better than ever before.

        In 1903-4 154 persons died of heart diseases; tubercular diseases, 124; pneumonia, 106; apoplexy, 61; consumption alone caused 101 deaths. Diphtheria, scarlet fever, measles and whooping cough were kept under subjection. Ninety cases of smallpox were reported, but there were no cases from recently vaccinated persons. At this time, while the city expended $5,000 annually to control smallpox, it spent comparatively nothing to control diphtheria and scarlet fever though during the past three years smallpox caused but one death while the other two caused 101 deaths. This year there were ninety-three cases of typhoid fever and twenty-nine deaths—an unusually high percentage. Sanitary lectures, medical inspection of schools, vaccination, antitoxin, pure milk crematory, better plumbing—all aided in conserving health.

        DEATH IN 1,000, ALL DISEASES

        In 1905-6 heart diseases caused 169 deaths; pneumonia, 149, and tuberculosis, 125. Typhoid caused only 10 deaths. There were 29 cases of smallpox. The care of refugees from San Francisco was a feature of this year's work. Every department was active, efficient and resourceful. Sanitary conditions were better than ever before. It should be noted that the death rate was higher than reported owing to an over estimate in city population. After 1906 the reports were made monthly, and hence afford no basis for comparison.

        In January, 1909, the new Merritt hospital was opened to the public. It was the first endowed institution of the kind in the county. It was strictly modern in every particular. For many years the county maintained on Franklin street a medical and surgical station for emergency cases. By 1909 it had become wholly inadequate to meet the demands, whereupon the county board decided to reconstruct the Receiving hospital. It was made large enough to meet the enormous growth of this community. In the fall of 1910 the county board took steps to give modern and systematic care to consumptive patients in the county infirmary by providing them with a separate pavilion and other conveniences. An inspection of the county infirmary early in 1911 disclosed a state of affairs not at all creditable to the county. The congestion there was appalling. Long ago the buildings had become too small, but still others were added until all constituted a small village of ramshackle structures inconvenient; unsanitary and discreditable to a county so wealthy and so prosperous. Adequate buildings were imperatively demanded. In March, 1911, over 3,000 persons—members of the various women's clubs—addressed a communication to the county board reciting the deplorable condition of the county infirmary and asking that body "to take steps toward the erection of a permanent building to accommodate the unfortunate sick who are dependent on the county." Neither the board nor the hospital management was blamed. This communication was signed by over twenty-five presidents of women's organizations in this county. The board at once took steps to secure a site for such a new building. Previous to this date $60,000 had been set aside for the purchase of a hospital site and a surplus of $200,000 in the treasury could at once be drawn upon for the proposed structure.

        Berkeley has had a board of health for many years, but it is only during the last four years that sanitation and inspection has been almost perfect. The emergency hospital, the bacteriological laboratory and the food examinations are excellent and up-to-date. For the year 1912-13 there were in that city 428 cases of infectious diseases reported, among which were: Chicken-pox, 69; diphtheria, 32; measles, 40; mumps, 80; scarlet fever, 38 (also 35 at the Deaf and Dumb Institute); smallpox, 13; typhoid fever, 17; pulmonary tuberculosis, 36; whooping cough, 16. The death rate was 9.28. Causes of deaths were as follows: Apoplexy, 42; cancer and tumor, 40; heart disease, 65; pneumonia, 21; broncho­pneumonia, 24; smallpox, 5; suicides, 13; typhoid fever, 5; tuberculosis of the lungs, 32.

        From July 1st to November 30, 1913, 8,468 different food establishments in Oakland were inspected. The bottled milk ordinance was rigidly enforced. The prevalence of rabies among dogs was studied and controlled. In January, 1914, the county board passed a resolution authorizing Charles P. Weeks, architect, to prepare plans for the following structures: (1) For a complete county infirmary hospital on the present site; (2) plans for a county infirmary and an infirmary hospital.

Transcribed by Kathy Sedler.