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Full text of "The rise and fall of disease in Illinois"

THE UNIVERSITY 

OF ILLINOIS 

LIBRARY 

fc 14.09 
PiQr 

llUNOtS niSTORICAl SURYn 



-.^lv.:^J^:| . 




IJLLJNOJS HISTORICAL 8UBVET 



The Rise and Fall 
of Disease 

in 

Illinois 



voi.i >ii: li 



Local Health Conditions antl Public llenlth >Vork 




ISAAC 1). KA\VLIiN(;S. M.I).. Director of I'ublic lloaltli 



The Rise and Fall 

of 

Disease in Illinois 



ISAAC D. RAWLlXiS. M.S., M. D. 

in oollnhorHtion with 

WILLIAM A. EVANS. M. D., D. 1*. H.. 
GOTTKKIED KOEHLER. M. D., and 
HAXTER K. RKHAHDSON. A.I!. 



PUBLISHED BY 

THE STATE DEPARTMENT OF PUBLIC HEALTH 

IN COMMEMORATION OF ITS FIFTIETH ANNIVERSARY 
1927 



ILLUSTRATED WITH C.HAPHS DEVELOPED AND DRAWN 

BY A. F. DAPPERT. AND WITH PICTURE REPRODUCTIONS 

OF MANY PERSONS ASSOCIATED IN ONE WAV 

OR ANOTHER WITH THE STORY 



INDEXED BY CLARA BREEN 



PHILLIPS BROS. PRIST 
SPHIXGKIELD, ILLINOIS 



6 19-. 2 



ACKNOWLEDGMENTS. 

The author and collaborators are indebted to local 
health officers, physicians and others for the collection 
of much of the material upon which the stories in this 
volume are based. For the many courtesies and ser- 
vices extended in that \va}', grateful appreciation is 
herewith expressed. 



66474G 



CONTENTS 

Introduction 9 

History of Local Health Service 12 

Down-State ^iunicipalilies 

Alton 15 

Aurora 26 

llelleville 37 

rSlooniinqton 48 

Cairo 62 

Carbondale and Jackson County 71 

Champaign- L'rbana 82 

Cicero 95 

Danville 101 

Decatur 107 

East St. Louis 118 

Elgin 132 

Evanston 143 

Freeport 159 

Galesbvirg 166 

Jacksonville 173 

jolict 188 

Kankakee 199 

Kewanee 207 

LaSalle. Ogleshy and Peru 216 

:\foline 228 

Oak Lark 238 

Peoria 247 

Ouincy 262 

Rockford 280 

Rock Lsland 303 

Springfield 314 

Chicago 326 

The Sanitary 13istrict ^^lovenient 394 

The Chicago Sanitary District 595 

The North Shore Sanitary District 409 

Other Sanitary Districts 409 

(7) 



The Tiilicrculosis Sanilariuni Movement 413 

Rural Ilealtli Service 421 

Sanitarv Supervision of Milk 426 

A]>])endi.\ 433 

Annals of Health, Sanitation and Public Health Service 435 

index 455 



INTRODUCTION 

By IT'. A. Evans 

In this \ Illume there hns lieen gathered as much of tlie histories of 
local departments of health as could be found. The nmre general histor\- 
of health in the State should be supplemented by the health histories of the 
larger ami more important communities. This has been done insofar as 
was possible. The history of local health departments has been more uneven 
than that nf the State health department. The curves of those histories 
run parallel to a surprising degree and in doing so illustrate some of the 
moti\es which originate health department work. 

The Chicago health department was organized after a fashion about 
as soon as that of any local government. This organization came about 
as a measure of protection against some form of contagion. As the years 
went by the type of organization, the degree of organization and the support 
rose and fell with prevalence of contagion. In most cases the health de- 
partment was little more than a paper organization during times of com- 
parative safet}- and was either revamped and electrified into life or discarded 
and replaced once the town woke up to the presence of contagion. These 
sporadic outbreaks of health work were sometimes governmental exclusively, 
sometimes they were wholly voluntary, a resumption of the basic rights of 
a people to protect themselves, and sometimes they were combinations of the 
two in \arying proportions. 

As a rule these outbreaks of interest in health followed the spread of 
epidemics. However, in the case of cholera and smallpox in a few instances 
the community recognized the danger before it arrived and organized in 
ruhance of the coming of the epidemic. Such sanitation as was done was 
usually closel_\- related to the prevention of the disease that then threatened, 
according to the ideas of causation of disease which then pre\ailed. 

This is a brief statement of the health work done in Chicago and the 
philosophical basis thereof between 183.i and 18(i6. one-third of a century. 

It is the basis of such other local health department work as was done 
in the ."-^tate during that period. The State had no health department but 
many cities, towns and villages did have — albeit such departments alternately 
sle|)t and worked. The work periods were principally the result of epidemic 
disease waxes such as cholera waves and smallpo.\ wa\es. There was some- 
thing of a revival of local health work subsequent to the Civil War. The 
returning army surgeons and e\en soldiers of the line had learned something 

(9) 



10 INTRODUCTION 

of sanilalion from their army experiences and they were inthiential to y>nie 
extent in c^alvanizinj,'^ tlicir local heallh ilepartments into work. 

Fortunately the great pliilanthropic agency which had functioned a-- a 
civilian aid in Illinois during war time had incorporated the word sanitary 
into its name. This had a marked effect in creating a suhstitution for lualth 
work. 

Chicago at this time came under two strong influences, one was the 
personal and professional influence of Dr. John IT. Ranch, a returned army 
surgeon and other ex-army surgeons. The other was the example set by 
New York City where Dr. Stephen Smith, ex-army surgeon, and his asso- 
ciates had persuaded the people to scrap their existing heallh department 
and form a metropolitan board of health. 

The Chicago health department report of 1869 remains an outstanding 
public document. Few if an}-, equalling it are found in the field of public 
health of the period. 

From that time until the early eighties local public health work in the 
State, when there was any, followed the Chicago lead. About 1880 Dr. John 
H. Rauch transferred his services from Chicago health department to the 
Illinois Board of Health. Soon thereafter he made a health survey of 
Illinois. This survey was in part, by way of preparation for an epidemic. 
It followed the lines of the periodic health surveys made in the face of 
epidemics in Chicago several decades previousl)'. However, it had great 
merit of its own and was no inconsiderable measure since never before 
nor since has a health survey comparable in magnitude to it been made in 
Illinois. The State Department of Public Health survey made in 1926 was 
far more complete and detailed, in so far as it provided data upon which to 
appraise local public health facilities, but it related to only fifteen cities. 
The 1882-1883 survey of housing was much more complete so far as it went, 
liut it related to housing only and it extended to but few communities. Other 
surve\ s, such as the Springfield and Chicago sur\eys, have been limited each 
to one community. 

Thus followed a period of revival of local health work in the State 
partly ;is a result of stimulation from the State Board of Health. By the 
early nineties the movement for local health work had begun to wane. Some 
revival after the World's Fair of 1893 is noticeable. This was partly a 
result of an epidemic of smallpox in that year. It was also partly the result 
of the awakening in many lines which resulted from the \\'orld's Fair. 

iMom the waning of that wave until 1908 local public health work in 
the State did not prosper. Some local health departments were abandoned 
and some were starved into innocuous desuetude. Smallpox, malaria and 
cholera had decreased to the point where the people were no longer afraid 



INTRODUCTION 11 

and therefore vinwilling to pay for protection. At the same time the new 
standards and new concepts out of which present day health departments 
grow had not been born. 

Soon after the revival of the Chicago health department in 1907 the 
influence of that department on local health departments elsewhere in the 
State was noticeable. The year 1908 inaugurated the third era of domina- 
tion of the Chicago influence in local health work in Illinois. Throughout 
the State a noticeable tendency to reorganize health departments, to build 
contagious disease hospitals, to fight consumption and other contagion and 
to protect the milk supply is recognizable. 

This third Chicago era lasted until about 1922 or 1923. About this 
time was begun the second period of State intluence — the first having been 
the Rauch era of the early eighties. 

For about five years now the tendency toward the growth of local 
health departments along fairly uniform lines can be seen. These depart- 
ments are establishing divisions of vital statistics, securing laboratory facil- 
ities, having work of sanitary engineering done, building contagious disease 
and tuberculosis hospitals, doing infant welfare work, promoting school 
inspection and in other ways building up health departments along lines 
proven to be right by large experience. The formation of county health 
departments has begun. 

Without in any way belittling the courage, lirains and initiative of the 
local communities in these matters the fact remains that this is a period in 
which the leadership is at Springfield, rather than in Chicago. The State 
Department of Public Health finds its source of strength in well-developed 
local health departments. It will not stop until every city and every county 
separately or in effective combinations will have efficient local health work. 
When that day arrives the State Department will be a coordinating agency, 
but as matters now stand it must function as a local health department over 
most of the State and for most of the people. 

This is true at least in times of emergencx . For a State agenc\- to 
function as a local agency and often as the only local agency is unscientific 
and makes for inefificiency and waste. 

The incompleteness of this treatise as a series of local histories of 
health and public health service in the State is recognized. It is hoped that 
one good effect of the publication will be the stimulation of local interest 
in local health histor\- and conditions to an extent that will make available 
many facts that are not now available and a splendid improvement in health 
conditions. 



GENERAL VIEW 

Public health service is fuuml in e\ery (k-i;i-L-e nf efiiciency in Illinois. 
Chicatjo. I'lvnnston, Rockford and a district (.-inljiTiciny LaSalle, (Jglesby 
and Pern liaw health departnimls thai ciini|iarr faxorahU' in organization, 
personnel and activities with the best municipal health departments in the 
wdrld. A few communities elsewhere in the State provide too meagerly 
for health protection to escape the other extreme in efficiency and adequac)'. 
Most of the incorporated municipalities maintain official public health organ- 
izations strong ehough to function with reasonable satisfaction under stress 
of emergency but not many are provided with health departments commen- 
surate with the constant public needs and qualified to apply modern sanitary 
and h_\gienic principles on a scale that approaches the maximum for profit- 
able retiu'ns. 

There are several types of municipal he;dth departments in the State. 
Some cities have boards of health authorized under the general laws. Usually 
these boards function only as technically legal agents leaving administrative 
matters largely in the hands of an executive officer employed for that pur- 
pose. Other cities have the commission form of government where the 
city council has supreme authority in all municipal matters and public health 
service comes under the jurisdiction of one of the commissioners. In still 
other places, Berwyn and Quincy at present, public health districts embracing 
the township have been erected by popular vote and while the districts are 
coextensive with the city boundaries they are managed independently of the 
municipal government. There is one privately endowed health department, 
the Hygienic Institute, which serves LaSalle, Oglesby and Peru. In Jack- 
sonville the city public health service is provided by an organization jointly 
supported b\' the cit\' and the countx'. a single health officer directing activi- 
ties for both. 

Um-al health service is not so well developed as the municipal. .\t this 
particular time three counties, Cook, Morgan and Pulaski, are maintaining 
full time, well manned health departments capalile of serving to a satisfactory 
degree all of the rural population in each. Three or four other counties 
have underfaken to do likewise but Iia\c abandoned the project after Iirief 
periods. .\ lack of legal authority to appropiiale funds for whole time 
permanent public health organizations seems to be one of the main reasons 
wh\- rural Illinois is backward in providing a reasonably adequate public 
health service for itself. 

(12) 



GENERAL VIEW 13 

There is, ho\ve\er, legally established pulilic health machinery in every 
rural political unit in the State. A law enacted in 1901 prescribes that the 
board of county commissioners in counties not under township organization, 
and the supervisor, assessor and town clerk of every town in counties under 
township organization, constitute boards of health for all territory outside 
the corporate limits of incorporated cities and villages. This system, mani- 
festly weak in that the personnel is subject to frequent changes and depend 
for office upon political success rather than upon technical knowledge of 
sanitation, hygiene and public health practices, does nevertheless provide a 
definite means of contact between the State Department of Public Health 
and the rural population. This contact makes notification of communicable 
diseases from rural districts possible. It permits State officials to render 
timely service in emergencies. It provides a local organization that can be 
brought into useful action under medical supervision in times of stress. 

The 1,107 cities and villages in the State are all authorized by law to 
maintain either boards of health or commissioners of public health and 
safety where the commission form of government prevails. When the local 
officials fail to appoint a board of health then the duties and responsibilities 
thereof fall upon the ma}or or village president. Out of the 1.107 cities 
and villages only 300 or 400 have medical health officers. Health officers 
in all the others are non-medical. 

There are 16 counties which have the commission form of government. 
In these the 3 count\- commissioners constitute the board of health and under 
them are designated certain other officials like the overseer of the poor to 
act as precinct health officer. In the 16 counties there are 175 precincts. 

In the other 86 counties there are 1.448 local officials who constitute the 
legal health machinery for the unincorporated territory. Practically all of 
these are non-medical. 

Thus we find that Illinois has 2,720 local health officers, less than 400 
of whom are trained in medical or sanitary science. This volume is con- 
cerned chiefly with the story of how the municipal health organizations of 
today came into being. 

There are, of course, a number of other important organizations, both 
official and voluntary, at work in the State in the field of public health. 
Among the officials are the municipal and county tuberculosis sanitariums 
and the sanitary districts. There are now two municipal and 17 county 
tuberculosis sanitariums operating in the State at public expense and several 
other counties that collect taxes under the sanitarium law but use it to rent 
sanitarium space as needed. These sanitariums have had a ver_\- important 
influence over local health conditions. 

In nearly every municipality there are voluntary organizations of various 
character which contribute to the local public health service. Indeed these 



14 GENERAL VIi:\V 

agencies are usually responsible for a larger volume of work than that done 
b\' the official organization. Often the voluntary agency has initiated activi- 
ties that later were turned over to the local government for continuity. 

The municipal histories iiKlu(k-il in this volume are presented in two 
groups. Those concerned with communities of less than 100,000 and those 
with larger communities. Each group appears in alphabetical order, the 
smaller commimities coming first. 



DOWN-STATE MUNICIPALITIES 

Alton 

One of the oldest communities in Illinois, Alton is located in Madison 
County (in the eastern bank of the Mississippi River just above the junction 
with the Alissouri. It stretches from the water's edge back across the 
bluffs that skirt the river. It was organized as a city in 1821, although 
settlers arrived there much earlier, and it has lived through many experiences 
of rich historical and romantic interest to the State. It was there that the 
Lovejoy tragedy was perpetrated. There Lincoln and Douglas held one 
of their famous debates. It was across the river from Alton that Lincoln 
made a hoax of a duel in which he was involved to the great relief and satis- 
faction of all concerned. 

E\en so Alton ne\er grew to be a very large city. It lies within one of 
the most densely populated counties in the State, excepting Cook, but its 
own municipal boundaries encompass something less than 30,000 people. 
Beginning with 1890 the decennial census returns showed the population to 
be 10,294, 14,210, 17,528, 24,682 respectively, the last figure being that for 
1920. Of the 1920 population 21,302 were native born whites, 1,670 or 
something over 5 per cent were foreign born whites while 1,707 or nearly 
7 per cent were negroes. There were 5,695, a little more than 23 per cent, 
in the age group of 45 years and over, suggesting a longer average span of 
life than prevails in many other municipalities of Illinois. 

Hi'ALTii Machinery. 
Official attempts to control and prevent sickness in Alton began as a 
result of emergency epidemic conditions that provoked sufficient public 
concern to stimulate action on the part of local officials. The situation was 
first met, at some early date in the city's history, 
by creating from the membership of the city 
Council a committee on health. This committee 
was given power to perform work and to order 
activities ordinarily vested in a board of health 
but its range of service was limited by lack of 
funds, which could be secured only upon action 
by the council since there were no appropriations 
for health work, by lack of popular interest ex- 
cept during epidemic outbreaks or rumors of out- 
breaks and withal by a lack of the fundamental 
knowledge of preventive medicine. From time 




A. P. Robertson, M. D. 
Health Officer, 1917-1920 



(15) 



16 



1)0\V N-STATE M V N I C I I'M. I Tl KS 




Mrs. Daisy C. Rice 

Inspector of Hygiene 

Alton Public Schools 

lOlO to date 



to time the cdinmittee e.xerted its intluence through quarantine powers and 
by ordering the abatement of nuisances and the cleaning of streets but these 
activities were hmited largely to times of epidemic stress when ])ul)lic alarm 
demanded something as a palliative. 

Later an nrdinaiice was adopted which created 
a board of lieaUh. 1 1 consisted of a numl)cr (if 
aldermen. app(jinlcd by the ma\or, and of the 
chief of police and the pcjlice nialron who were 
made e.x-oflTcio inemhers. The health (jfficer, 
designated by the ordinance to lie a regularly 
licensed physician, is not a member of the hoard. 
^^1 '/'T^^^B -"^ peculiar feature of the health machinery in 

^m^^ 11 jl '^ x'Mton is the part played b\- the police. .\ number 
^1 utm^ °^ ordinances, purely public health in character, 

^tL. t mitm I are placed under the jurisdiction of the police 
department. An ordinance provides for a milk 
and food inspector, for example, and makes him 
a part of the police department. The board of 
health ordin:ince itself makes two of the police 
department members and leaves the health commissioner off. .V more under- 
standable practice would be to make a part of the police dep.'irtnient respon- 
sible to the health commissioner. 

Vokmtary agencies and such public agencies 
as the school board and the county tuberculosis 
board have provided Alton with a larger volume 
of health service than the city government itself. 
The facilities for doing health work in Alton, as 
they existed at the close of 1925, and very little 
change has since occurred, are summed up very 
well in a report of a survey made by the State 
Department of Public Health in the earl\' part 
of 1926. It reads, in part, as follows: 

"With the score of only 420 or 42 per 
cent of what is regarded as standard, it is 
manifestly apparent that according to the 

findings of the survey, Alton provides less than one-half of the puljlic 
health services which might be reasonably expected from that city. 

■'The health department normally consists of a part time physician. 
Tinder pressure of epidemic conditions, it is permitted to employ tenipor;- 
arily professional and untrained assistants. In addition to this the city 
pays $1,200 a year toward the support of a social hygiene clinic. No 
public health laboratory work is done in the city at all, the State furnish- 
ing the only services of this sort to be utilized. 




Mrs. Anna Most 
School Nurse, 1919 to date 



IS 



DOWN-STATI': .M i;.\ Kl PALITIKS 




Mrs. Oscar Becker 
(nee Frances Robertson) 
School Nurse, 1916-1919 



"The Ixiard of education employs two fuil time nurses aiul a part 
time dentist. The State, county and city jointly employ a part time phy- 
sician for the social hygiene clinic. The associated charities employ two 
full time nurses hut their function is more 
largely bedsirle than public health nursing. 
Two full time nurses on the staff of the 
county tuberculosis board spend part of 
their time in Alton. The only clinical ser- 
vice of any character consists of a general 
(■lluic al the local hospital where indigent 
l)atients of all kinds are admitted, and a 
dental clinic for indigent school children. 
The county operates a tuberculosis clinic 
in Kdwardsville to which patients from 
Alton are admitted. 

"The city normally spends directly 
alxnit $:!,iiiiO i er year for public health 
service. All other agencies including the 
board of education, the county and State 
and the Visiting Nurse Association spend 
about $12 000 a year. Last year (1925) the city actually expended about 
$5,800 for public health work, a matter of 21 cents per capita, while the 
combined e.xpenditures of all the other agencies lirought the total to some 
$1S,500 or a little more than 68 cents per capita. 

"The city clerk acts as the local regis- 
trar of vital statistics. While he does his 
work with great care and thoroughness, he 
attempts nothing more than the law re- 
(jv.nes — the collection and recording of re- 
ports and their transmission to the county 
and State officials. 

"The total personnel in the city em- 
ployed in any way directly with the public 
health activities, consists of 12 persons, s 
of whom are part time and 4 full time. 
Two of the four, however, are nurses of 
the associated charities and spend only part 
of their time in actual public health work." 




Mrs. Geo. D. Pfeiffenberger 

(nee Charlotte Todd) 

Director, Visiting Nurse 

Association 1915 



This quotation comes from a report of sur- 
\cy of lieatth service facilities made in \92U. 
More detailed surveys that embraced sanitary inspections in considerable 
■detail were made on two former occasions, once in 1886 and again in 1919. 
Moth were supervised by the State health officials. Thq first was undertaken 
with a view of educating the public in the importance of sanitary matters of 
supplying the State officials with data valuable in efforts to combat threatened 
invasions of cholera. The 1919 project which involved a house-to-house 
inspection and a very careful inquiry into every health feature of the city was 
a preliminary effort toward improving the local health service. Its purpose 




Public Si;hool Dental Clinic at (larlii-ld S.liuol, Alton 



20 



DOWN'-STATK MUNICIPALITIES 




D. F. Duggan, M D. 
Health Officer, 1920 to date 



was to provide accurate data on the sanitary problems of the city and thereby 
supply tangible grounds for a program and for creating a service commen- 
surate with the needs. Local economic conditions prevented the carr\ ing out 
of the recommendations based upon the 1919 survey. 

One unusual feature of the voluntarv public health activities in Alton 
has been the interest manifested and the service rendered by the medical 
profession. This is particularly true of the Madi- 
son County tuberculosis program. The county 
medical society has from the beginning taken a 
very active part in the anti-tuberculosis work and 
has been in a large measure responsible for the 
splendid success of the movement in the county. 
Alton, of course, has profited by the county work 
against this disease. The great interest and activ- 
ity of the medical profession in tuberculosis work 
was largely inspired and cultivated by Dr. 
Edward W. Fiegenbaum, of Edwardsville, long 
time secretary of the Madison County Medical 
Society. 

The list of health officers who have served Alton include : 
1885-1887 Dr. Robert Gibson 1903-1917 Mrs. Sophia Demuth 

1893-1895 Dr. J. H. Fiegenbaum 1917-1920 Dr. A. P. Robertson 

1901-1903 Dr. W. R. Smith 1920 to date Dr. D. F. Duggan 

\\ati;r Supply. 

The Alton public water supplx' has always been obtained from the 
Mississippi River and the waterworks s_\stem has alwa\s been privately 
owned. The Alton Water Company was formed and the original water- 
works built in 1898. In 1906 the franchi.se of the company was extended 
for 25 years and provided simply that the water must be filtered and sufficient 
pressure maintained at the highest point in the city. Because of the con- 
siderable range in elevation in different portions of Alton the pressures in 
the lower portion are higher than normal if adequate usuable pressures are 
maintained in the higher portions of the city. The Alton Water Company 
is now controlled by the American Water & Electric Company with head- 
quarters in New York City. 

The original plant, which included tub filters and appurtenances, was 
not very efficient and improvements to the plant have been made from time 
to time. .\t the close of the period covered by this history there are still 
some further improvements necesary if the plant is to be made equal to 
modern water-purification plants. The pumping station and filter plant are 
located in a narrow strip between the river and the limestone bluffs and the 
restricted site has made additions and improvements to the plant difficult. 



ALTON 21 

The waterworks now comprises two intakes extenclint; a little over 200 
feet from the shore, mixing and settling basins, filters, chlorination equip- 
ment, clear-water basin, low- and high-lift pumping equipment and appur- 
tenances, and a distribution system which extends to practically all the built- 
up portions of the city. At different times difficulty has been experienced 
with the intakes because of the formation of sand bars or ice. 

There is no municipal sewer outlet into ^Mississippi River for a con- 
siderable distance above the intakes. During the past decade land outside 
city limits on the bluffs upstream from the waterworks has been developed 
for residential purposes and private sewers from these properties discharge 
into limestone sink holes, which on the basis of geological studies, it is known 
connect or discharge into the river above the waterworks intake. This is an 
important item of possible local pollution which at the close of this period 
was still being studied. 

Lime and iron were originall\' used as a coagulant and later a change 
was made to alum and lime. Local lalioratorx- control was established during 
the last decade. 

Because of the location of the clear-water basin immediately adjoining 
Mississippi River and the non-water type construction, the water has always 
been considered as subject to possible contamination after filtration and, 
therefore, the chlorine used as a sterilizing agent is applied to the water as 
it is drawn from the clear well and pumped to the distribution system. 

Although the water-purification plant has never been a good example 
of a well planned, efficient purification plant and there have been periods 
when the water supply has been of questionable qualit}', there has never 
been any definite record of any illness caused b\' the public water supply, and 
the waterworks system has been an important factor toward better sanitary 
and health conditions in the city. 

Sewer.\ge. 

The city is served with a combined system of sewers, additions and 
changes to which have been made from time to time so that public sewers 
were available at the close of the period in most of the built-up portions of 
the city. Many of the city sewers were installed to provide for immediate 
needs without full regard of future needs and the growth of the cit\'. Con- 
sequently some of the sewers have from time to time proved inadequate 
and in addition to the need of public sewers in the remaining areas not now 
sewered there is need of other sewers to relieve some of the existing over- 
loaded sewers. 

Through the city Piasa Creek flows to Mississippi River, portions of 
which creek have been covered. This creek receives sewage at several points 
and has for many years been more or less polluted and the subject of con- 



22 



DOW N -STATI-; M t ■ N 1 1 I I'A LI T I ES 



Table 1. 
AlokTALi'iY I-"k()m C':-.kt\in Causes. 



VKAll 




■X 






1 




1 


'X 
•> 




a 




^ 

^ 




] 




II 

1= 




= 


11)07 
1908 
190!) 
1910 
1911 
1912 
1 9 1 :i 
1914 
191.-> 
191(i 
1917 
191S 
1919 
19.i0 
1921 
1922 
1923 
1924 
192:-. 
1926 


194 
194 
217 
248 
248 
239 
222 

499 
371 
301 
2«0 
308 
367 
38:-) 
390 
397 


6 

7 

4 

2 
1 

4 

i 

4 


" 




'. 




2 

."! 

's 

i 

1 

i 




i 
i 

3 
2 

2 

1 

3 


4 

v. 

■7 

i-i 

i 

1 


1 
'3 

'8 
3 
9 
6 

4 
4 
3 


86 
22 

"s. 

13 
13 

24 
9 
29 


• 


i 


27 

26 
29 
28 
33 
41 
49 
39 
23 
11 
23 
14 
13 
13 
20 


11 

59 
36 
40 
17 
IS 
21 
26 
18 
25 



Table 2. 
Mortality Rates From Certain Causes. 



1907 
1908 

190:) 

1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 



11.7 


36. 


11.5 




12.6 




14.1 




13.6 




12.6 




11.3 


35. 


26.7 


Hi. 


1.5.1 


8. 


14.1 


4. 


10.3 


15. 


12.0 




14.1 


7. 


14.6 


3. 


14.5 


U. 


14.6 


■ 



33.3 
16.0 
36.0 
23.8 



358 . 3 
89.0 
88.0 
31.7 
50.7 
.lO.O 
92.3 
33.5 



132 

142.2 
132 . 7 
151.2 
182.7 
204.1 
137.8 
100.0 



245.8 
145.7 
160.0 
67.3 
58.5 
80.7 
100.0 
67.1 
91.9 



per I.OIIO iiopuluticm; all other.';, per 100.000 pnpuhi 



23 



siderable complaint. Projects for enclosing" the creek llirou,i;h practically 
the entire city so as to make it a larj^'e comliined sewer have been proposed 
and discussed several times, hut without any definite action having' been 
taken. 

The sewage is discharged into Mississippi River, below the waterworks 
intake, through two main outlets and several smaller outlets. At the close 
of the period there was need at Alton of an inventory of all existing sewers 
and the development of a comprehensive plan for additional sewers to relieve 
some existing sewers and to serve unsewered areas so as to abate local 
nuisances, especially along Piasa Creek. Because of the large dilution 
available by the river, treatment of the sewage at Alton has not been neces- 
sary and priihably will not be necessary at least for a great many \'ears. 

Table 3. 
Births and Infant Dkath-s. 



Infant Deaths 



YE.Mi 






[ 






Number 


Rate" 


Number | 

I 


Rate* 


1917 






1 


95 . 3 


li)ls 






58 1 


96.2 


una 






34 1 




1!)20 


583 


23.3 


47 1 


80.6 


in-21 


ri9.5 


25.6 


30 1 


45 . 5 


wn 


fi05 


23.. 8 


36 


59.5 


1<I23 


(!4-i 


25.1 


55 


84.1 


1H24 


Ii80 


25.7 


62 


91.2 


192:i 


r,;-,r, 


24.5 


60 1 


91.6 


]<)2G 


72S 


26.8 


00 1 


82.4 



•Deaths of infants undi 
••Per 1000 ijopulation. 



of age per 1000 births reported. 



Hkai.tii Conditions 



The earliest references to health conditions in Alton center ar( imd tlic 
"pest house." That implies smallpox. For some reason not e:isily understood 
people in Alton, like those who inhabit the rest of North America, calmly 
accepted as more or less a part of normal life such costly diseases as typhoid 
fever, tuberculosis and diphtheria but shrank in mortal fear from smallpox 
and doubtless cholera too. Of course, smallpox is dramatic and sudden in 
its action. Folks knew positively that it spread by contact. Accordingly 
patients and those who had been exposed were regardcil with the utmost 
apprehension. 

Thus we tind the "pest house" in .service as late as 190,^. In that year 
several hundred cases of smallpox occurred in the city. Tbiis, it seems, was 
not ])articularly unusual ho\\f\cr. In I'HIl a malignant oulbre.ik so al'irmecl 



24 



DOWN-STATE MUN ICI I'AI.ITIES 



the [)iil)lic that it was ami still is referred tn as the "hlack-siiiallpox epidemic." 
Again in l')()3 the disease reached epidemic proportions and then the big 
outbreak of 1905 followed. This has been the history of smallpox since 
that time and doubtless was prior to 1900. As late as the winter of 1918- 
1919 there were some four or five hundred cases in the city and again in 
1925 there were one hundretl and seventy-two cases rejjorted. 

Typhoid fever has been anoiliei' nt the chrcmic problems and it remains 
til be banished from the cnninninity. I'ricjr [n I'KlO the disease reached epi- 
demic proportions almost annually and since that time the prevalence and 
mortality has been high until 1926. Periodicallx' 

epidemics occurred. The \ear of 1901 and 1905 
are designated as dates of typhoid epidemics of 
[tarticular se\erity. 
The ])robleni of tuberculosis was attacked on 
a county basis and carried out with success 
enough to culminate in the building of a sani- 
tarium at I'.dw ar(ls\ille. Results appear to have 
fully justitie<l the effort. The work got well 
underway about 1920. ."^ince then the number of 
deaths from tuberculosis, down to 1927, has 

averaged 17 per year. For seven years prior to 
1920, the average number per }ear was 35. Sta- 
tistics for earlier years are available but it seems 
probable that tuberculosis was one of the major causes of death and sickness 
over a long period. 

The sanitarium was opened en May (>. 1926, under the able supervision 
of Dr. D. D. Monroe who is not only carrying forward the fight against 
tuberculosis with the same spirit and sound judgment that animated Dr. 
Fiegenbaum in starting it but he follows Dr. Fieg- 
enbaum also as .secretary of the Madison Count\- 
Medical Society. Prior to the opening of their 
own sanitarium the county secured for its tuber- 
culous citizens sanitarium care which it p.iiil for 
at prescribed rates. 

The inlluetiza-imeumonia epiilemic of 1918 
was moderately severe in Alton, relatively speak- 
ing. Mortality from both diseases amounted to 
145, of which 86 were attributed to influenza, 
giving a rate of 6[)4 per 100,000 population. 
About 15 municipalities of the State had higher 
rates and a dozen experienced less loss. 



D. D. Monroe, M. D. 
Director Madison County 
Tulierculosis Sanitarium 




E. W. Fiegenbaum, M. D. 



25 



Infant mortality in A!t(in runs higher than in many other places and 

higher than for the State at lart;e. In 1''26 the rate was 82.4 per 1.000 

births reported in Alton and only h'll in the State. The rate in Alton was 

higher than that in 28 of the 44 cities of Illinois 

with 10.000 or more inhabitants. 

The general mortality rate is somewhat higher 
in -\lton than in some of the other communities. 
This is due partl\- to the fact that Alton is an 
uld city with a larger percentage of old people 
than a lot of mid-western municipalities. Young, 
rapidly growing communities are populated with 
yi.ung, active people among whom the death rate 
is very naturall\- l(.iw. Alton is old. compared 
with most communities of Illinois, and has ex- 
perienced a slow growth. Consequently, the city 
has a relati\ely large number of people who have 
passed middle age and therefore contribute to a 
higher mortalit\- rate than prevails in younger, more rapidly growing 




Helen Heighway, R. N. 
Tuberculosis Nurse. Madi- 
son County, 1919 to date 



municipalities. 



Table 4. 
Cases of Certain Diseases Reported. 



1 191fi 

1 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


T.\iihoi(I Fever 


13 


4 


3 







13 


8 


6 


9 


22 


3 


8 


Jfalaria 








1 




1 


4 










2 


Smallp.ix 


18 


70 


720 


18 


4 


Vi 


3 


1 


82 


172 


2 


1 


Mea,>ile:i 


283 


99 


22') 


10 


109 


131 


14 


460 


14 


38 


84 


453 


Scarlet Fever 


32 


12 


20 


50 


77 


57 


79 


35 


4". 


101 


195 


86 


Whoop. Cough 


20 




19 


34 


90 


25 


5 


160 


40 


85 


14 


49 


Diphtheria 


44 


52 


72 


32 


63 


76 


135 


98 


88 


31 




16 


Influenza 






1200 


66 


235 


3 


172 


10 


13 


10 


23 


8 


ruIinniVHlili, 




1 


3 


1 




6 


1 


1 




1 


- 




M.-niii-iti. 




1 




3 


















'iiilnTi nlii-i^' 






10 


12 


3S 


75 


47 


39 


49 


35 


42 


42 


I'lii-iiiH.iiiia- 


20 


12 


18 


15 


69 


3') 


45 


36 


38 


3fi 


47 


31 


.S.vjihilis 






4 


87 


123 


106 


201 


218 


69 


79 


132 


92 


Gonorrhea 






20 


110 


209 


229 


197 


203 


165 


135 


175 


123 


Chancroid 








9 


16 


18 


10 


12 


9 


11 


14 


7 



•All forms. 
Note : Case reports 



Reference: 



Data furnished b.v Dr. A. P. Robertson, Alton, Illinois. 

Annual Reports, State Department of Public Health, SprinijflcM, Illinois, v 
Dr. Thomas H. Leonard, data furnished through personal interviews v.-ith ju-i 
U. S. Census Reports, Washington, D. C, various dates. 



ous dates, 
inent citize 



Aurora 

Settlfiiiciit first slartfd at Aurora in IS.^4. A \ear later the tirst ph\s- 
ician to permanently locate in the new comniunitv arrived in the person of 
Dr. Daniel Eastman. He found the rolling terrane watered by the beautiful 
Fox I\i\-er a pleasant place for a home and lie felt that the fertile alluvial 
sciil well drained by the river and its trilnitarics would furnish an am])le 
basis for prosperity through agricnUural and industrial development. 

Doubtless he discovered also that the underlying strata of rock overlaid 
with gravel would make a solid foundation for the thrifty city that now 
spreads itself upon both banks of the river. 

Aurora like all of the towns on the Fox River in that vicinits suffered 
severely from the cholera epidemic of 1849-52. Public concern that grew 
into alarm and culminated in panic followed the first appearance of the 
disease which prevailed more or less until 1854. It is "estimated that 
from 300 to 350 victims yielded to the cold embrace of the destroyer in that 
period of time." This was the opinion of a Kane County historian who adds 
that "it seemed to be much more fatal to foreign immigrants among whom 
two-thirds of the cases occurred." 

Dr. Nicholas Hard, who located in Aurora in 1845 delivered an address 
on cholera at the meeting of the Fox River Medical Association at Elgin, 
F'ebruary 1st, 1850. He emphasized the contagious character it manifested 
in the Aurora epidemic of 1849, pointed out the fallacy of specific cures 
and described the unusual symptoms that characterized many patients whom 
he saw. 

In the summer of 1851, he contracted cholera and with impaired health, 
an attack of dysentery caused his death on October 16, 1851. A colleague 
wrote of him : "Professor Hard maintained a good character as a pleasing 
and instructive lecturer during his connection with the medical schools at 
LaPorte, Indiana, and Keokuk, Iowa, and enjoyed a high reputation as a 
practitioner in Aurora. He has been cut down in the prime of life and in 
the nndsi of usefulness." 

( )llicr pin sicians who served the conimunitx' of that time were Doctors 
S. c;. llui.liard, r. D. H. Coff and .\. R. Cilman. 

Aurora was incorporated as a city on I'ebruary 11. 1857 and on March 
7th, 1887 was reorganized under the general incorporation law governing 
cities and \ illages. 

(26) 



AURORA 27 

During the ten years beginning with 1830. the population of iVurora 
jumped from 1,895 to 6,011 and by the end of the next decade (1870) it had 
ri.sen to 11,162. The 1920 U. S. census gave it a population of 36,397 of 
which 29,289 were native born whites and 6,476 foreign born whites. 

Health AIaciiinery. 

Any organized public efforts at sanitation and hygiene during the early 
life of the community is either shrouded in oblivion or buried in the dusty 
council records of that period. We may surmise that the cholera epidemic 
in the middle of the nineteenth century inspired an almost religious zealous- 
ness for clean streets and premises, the usual precautionary methods em- 
ployed in those days, and that some sort of an organization, probably official, 
was created and functioned during the emergency. It is altogether probable 
that a board or committee of health was appointed. 

However that may be, the best records availaljle show that the first reg- 
ularly established board of health which became a permanent part of the 
city government was appointed on March 2, 1863. It consisted of three 
members, L. W. Gray, E. R. Allen and Charles Earle. From that time for- 
ward until 1894 there was constantly maintained a board of health, usually 
with three members, sometimes including a physician. Then came a lapse 
of 12 years during which there apparently was no board of health, the health 
officer performing the functions of tlie hoard as well as those of his own 
position. 

In 1906 the board of health was revived witli K. J. Fenton, John P. 
Kartheiser and J. H. Pompa as members. From tliat }ear until 1920 the 
board never lacked a full membership of three. 

With a change from the aldermanic to the commission form of govern- 
ment in 1920 the board of health went out of existence and its duties, func- 
tions and responsibilities fell automaticall)' upon the city council and upon 
the department of pulilic health and safety. Lender this ch.mge \\^ E. I'ar- 
clay was elected to a commissioner's place on the city council and was as- 
signed to the department of public health and safety. He was re-elected in 
1927 and assigned again to the same department. 

During the early period of its existence the board of health spent aliout 
$.^00 annually. $100 of which went to the chairman who. Ijy \'irtue of his 
capacity as chairman, was also health officer. Like most boards of health 
this one was endowed with the broad if vaguely expressed power "to do 
what it ma\- deem necesary to preserve the public health." Likewise in 
conunon with similar boards elsewhere the great possibilities implied in that 
blanket authority so unreservedly thrust upon it was practic.illy vetoed by 
a carefully inserted pursj-string clause. No budget was provided and all 
expenses incurred had to Jiave the api)ro\al of liie council. 



28 



DOWN -STATIC Ml'N ICIPALITIES 



Tin- (iriliiiance umltr wliicli tin- l)i);iiil functioned at that time rcquireil 
it to investigate alleged nuisances that were reported, to quarantine or remove 
to the "pest house" every case of smallpox, to retiuire the registration of 
births and deaths in the office nf the ciu clerk, who was also the clerk of 
the board, and to prevent the ]i(illutinn (if tlir ii\er. Apparently nntilication 
for no disease except smallpox was rei|uired because no other one was men- 
tioned in the ordinance. 

Ai)parently the fortmies of the boanl i>f health provoked very little 
public thought until rather recently. There is no evidence that it did. ( )r(li- 
nances relating to it and its duties are few. Detailed history of activities is 
wanting. Expenditures were meagre. As late as 1913. for example, in the 
course of a year the health department spent $8,715 of which $7,488 went 
for garbage removal, $408 to the health officer, $6..S0 for laboratory service 
and the remainder to two part-time inspectors and for such ordinary mis- 
cellaneous matters as fumigation, quarantine, etc. 

The next year, 1914, a laboratory was established, however, with C. R. 
Hixson in charge and an automobile was provided for the use of the de- 
partment. 



AURORA 



[%i- 



VITAL STATISTICS § 

conn. DI5. comROM 

VEh. DI5. COhTROLH 
TUB. COMTROL l^'j 
HEALTH CHILD.- 
HEALTH 5CH.CHILD=*' 
SAMITATIOH "?--[= 
MILK COMTROL 
LABORATORY 
POP. HEALTH IHST 




PfRCEtlT OF STAMDARD SCORE 
FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 

I9Z3 



Figr. 1. This graph illustrate.s the strong and weak points in Aurora's 
public health service, official and voluntary, as it existed in 1925. It is 
based upon a personal survey and rated upon the standards evolved by the 
American Public Health Association. The total efiiciency rating in Aurora 
was 52 per cent of the standard perfection requirement. 



Al'RORA 29 

A se\ere oiitlireak uf scarlet fe\er in the winter of V>\7. coming as it 
dill upon the heels of an epidemic of whooping cough, and accompanied by 
an unusual amount of pneumonia led to the employment of a school nurse. 
The personnel of the health department was also strengthened at the same 
time b)- the addition of a full time meat inspector. The same influences 
operating to strengthen the health department at this time were doubtless 
responsible for the building of an isolation hospital that was started in 1917 
and opened the following year. 

By 1926 the health department had grown into an organization involving 
the full time services of a nurse, a laboratory technician and an inspector 
and the part time service of a director (the medical health officer), a veter- 
inarian and a clerk. In addition to the activities provided by this staff the 
city was at that time enjoying the services of two nurses employed by the 
two school boards and four nurses supported bv the Visiting Nvirse Asso- 
ciation. 

-\t the beginning of the pulilic health mo\ement in Aurora, the idea of 
making the community disease proof or rather epidemic proof v\-as com- 
pletely divorced from the idea of practicing medicine. .Sanitation was re- 
garded as a matter of physical and environmental cleanliness in the most 
superficial meaning of that word and the functions of the health officer 
were principally concerned with clean streets, garbage removal and the like. 
Consequent!}' health officers were not chosen because of any knowledge 
of medicine or hygiene. Once in a while a physician happened to be selected 
for the office but his professional equipment was coincidental and not the 
cause of his appointment. 

This continued to be the situation in Aurora until 1888. liy that time 
sufficient knowledge of bacteria and disease germs had been discovered and 
disseminated and medical knowledge had progressed far enough to give 
leading citizens the notion that disease prevention 
depended upon the application of technical know- 
ledge. This created popular distrust in the 
capacity of laymen to render effective service as 
health officers and led to a demand for physicians 
to fill that post. As a result Dr. G. F. Allen 
was appointed health officer of Aurora in 1888 
and since that time the position has always been 
filled by a meml)er of the medical profession. 
Dr. George W. Haan, present incumbent, has 
the distinction of having served the city as health 

officer over a longer period than any other person 
George W. Haan, M. D. , ,,,,-.• 

Health Officer, 191S to date wlio ever held the position. 




30 



DOW .\ -STATE MUNICIPALITIES 



The list of healtli oflicers of Aurora, toijctlu-r with the dates when each 
tilled the nt'lice, follows: 



March 2, 1863 to 1S65 A. A. Dexter 



1865-1866 

18G6-1S71 
1S71-1S72 
1872-1873 
1873-1874 
1874-1878 
1878-1881 
1881-1884 
1884-1888 
1888-1889 



Dr. W. Young 
Geo. 0. Fish 
E. S. Day 
Geo. 0. Fish 
J. D. Andnis 
J. D. Andrus 
A. C. Graves 
Dr. C. Smith 
H. G. Gable 
Dr. G. F. Allen 



l.ss!i-lS!il Dr. H. Reder 

1S91-1S!I4 Dr. W. S. Johnson 

1894-1902 Dr. J. W. MacDonald 

1902-190G Dr. F. J. Coughlin 

190(;-1908 Dr. C. W. Geyer 

1908-1909 Dr. A. L. Anderson 

1909-1910 Dr. A. R. Reder 

1910-1914 Dr. W. H. Uehren 

1914-1918 Dr. G. B. Schwachtgen 
1918 to date Dr. Geo. W. Haan 



The loeal dental soeiet_\- has established the practice of making gratui- 
tuush an annual dental examination of all school chiklren while a group of 
local physicians give their services in diagnostic conferences of infants and 
preschool children. The city also benefits by clinical services and sanitarium 
care provided by the Kane County Tuberculosis Sanitarium Board which 
was established by popular vote under the Glackin law. 

A clear picture of present facilities for doing public health work is 
found in a report of a survey made in l')26 by the State Department of 
Public Health. In it, we read: 

"Earning 521 points out of a possible 1,000, Aurora takes ninth place 
among the fifteen cities on the health service score sheet. Operating 
under the commission form of government, the mayor and commis- 
missioners constitute the municipal board of health. The part time 
health officers get $1,000.00 per year plus an allowance on about the 
same scale toward clerk hire. He provides official quarters in his own 
office where vital statistics and morbidity records are handled. A 
diagnostic laboratory with a full time technician is maintained. There 
is a full time nurse employed who works in the private school and a 
part time veterinarian who inspects food handling establishments. 

"Each of the two school boards employs a school nurse. Tuber- 
culosis diagnostic clinics are held by the staff of the county sanitarium. 
The Public Health Nursing Association is responsible for infant health 
clinic, tuberculosis, prenatal, infant and preschool age field nursing 
service. There is no public clinic for indigent venereal disease patients. 

"The official expenditures amount to 26 cents and the total, includ- 
ing those of voluntary agencies, to 60 cents per capita per year. 

"Complete tabulations of vital statistics data are not made, although 
some rates are determined and published in the local papers. 

"No communicable disease nurse is employed. A policeman, who is 
detailed as a quarantine officer, placards premises and releases all 
cases. Complete epidemiological information is not collected. When an 
unusual prevalence of disease occurs the health officer himself visits 
cases in an effort to determine the source. Only a small proportion of 



AURORA 31 

diphtheria and scarlet fever cases are hospitalized. The health officer 
estimates that about 500 children received toxin-antitoxin, g;iven by 
private physicians, last year (1925). Only about 33 per cent of the 
grade school children are vaccinated against smallpox. 

"Two new cases of tuberculosis were reported last year for each 
death. The personnel of the Public Health Association is insufficient to 
render as much field nursing service as is desirable. Tuberculosis 
clinics are held twice each month, total attendance for the year bein? 
225, which is much less than the standard. Hospitalization of tuber- 
culous patients is up to standard and approximately one-half of the cases 
admitted were in the incipient stage. This is a much higher percent- 
age than the average in similar institutions. One open air classroom 
with an attendance of about sixteen children is in operation. 

"There are two school boards in town. The grade school popula- 
tion is about equally divided between the private schcols and each of 
the two public school districts; one nurse works in each of these 
groups. The nurses weigh, measure, test vision and make physical 
inspections. Each of the nurses operates independently of the other 
with no uniformity of records or reports. The public school nurses 
cooperate with the health department in the control of contagion, but 
more satisfactory routine procedures should be worked out. Local den- 
tists made a complete dental inspection in the public schools last year. 
There is no medical supervision of school children. 

"It was estimated that about 94 per cent of the dwellings are con- 
nected with the city sewers. A sanitary district has been voted, which 
will provide treatment of the city's sewage. 

"Food handling establishments are not licensed, but are inspected 
by a part time veterinarian. 

"The health officer who personally inspects the milk depots esti- 
mates that 98.5 per cent of the milk supply is pasteurized. No lab- 
oratory examinations are made of milk before pasteurization and the 
bacterial counts after pasteurization are high. Only one producing 
farm is regularly inspected. 

"A very good laboratory is maintained by the health department 
with a full time technician. The examinations made approximated or 
exceeded the standard quotas except for tuberculosis and venereal 
diseases. 

"The health officer has done a considerable amount of educational 
work." 

Water Supply. 

The public water supply, in-stalled in 1886 at a cost of $137,0(10, com- 
prised an intiltration gallery on an island in Fox River about 1>^ miles north 
of the center of the city. The original pumping station constructed on the 
east bank of the river, although substantially enlarged, is still in service. 

In 1902, due to repeated contamination, the infiltration gallery was 
abandoned and four deep wells bored in the vicinity of the main pumping 
station, penetrating Potsdain sandstone at a depth of 2,250 feel. These wells 



32 nowN'-STATi-: MrMcii'Ai.rriES 

are all operated b_\' air-lift. A colleclinj,' reservoir was also constructed, into 
which the output of the wells was discharged. 

In l')ll a fifth well but of somewhat larger l)ore was constructed at the 
same site. 

In l'J14 the increased demand for water made it necesary to develop the 
abandoned Esser quarry pit, located in the south part of the city, as an aux- 
iliary source of supjjly. A hypochlorite treatment plant was installed to 
treat the water thus secured. In the meantime, the city had adopted an 
isolated deep-well system to meet the ever-increasing water demands, and 
during 1915 two wells were completed, one in the southeast and the other 
in the southwest part of the city. A third well located on an island in the 
river near the central part of the cit\ was placed in service in 1917. 

Since the three additional wells were placed in service the quarry supply 
was entirely abandoned. An additional well was constructed in 1923 and 
another in 1925. 

In 1913 the waterworks were investigated and attention called to several 
possible sources of contamination, namel)', in the open shallow discharge 
basins of the several wells and in the leak\- and open collecting reservoir. 
Due to the close proximity of the collecting reservoir to Fox River, there 
was danger of seepage into the reser\'oir. The open condition of the reser- 
voir further made it possible for the supply to be accidentally or maliciously 
contaminated. 

On later investigations attention was called to the existence of several 
dangerous cross connections between the city and river supplies. 

The present supply comprises the first five drilled wells constructed 
near the main pumping station and the five drilled wells that have been pro- 
gressively constructed between 1915 and 1925. In 1*^19 a concrete covered 
collecting reservoir was constructed to supplant the old open and leaky 
reservoir. An emergency chlorinator is kept available. One cross connec- 
tion is still in existence, but the cross connection involves an artesian well 
and is not regarded as particularly dangerous although such cross connections 
are regarded as objectionable. The w^ater supply is regarded as being of a 
safe sanitary quality. 

In 1921 there were 84 miles of 4- to 16-inch mains. 8,325 services, and 
the average daily water consumption was 71 gallons per capita. 

Sewer.'^ge. 

In 1880 there were no sewers and liquid sink wastes were discharged 
through cesspools. The houses depended on privies, with but few exceptions. 

Prior to 1893 some sewers were installetl and from time to time addi- 
tional areas were sewered. 



33 



The present system is of the combined type carryinij lioth sanitan- sew- 
age, industrial wastes and storm water. There are four major outlets 
. sei-ving about 85 per cent of the population and nine minor outlets which 
serve the remaining 15 per cent. These outlets are located along Fox River. 

The discharge of the present sewers, particularly during low-water 
periods creates a nuisance in Fox Riser which has been the occasion for 
several complaints. 

In 1926 the Aurora .Sanitary District was organized, embracing the 
city of Aurora, and with boundaries following in general the boundaries of 
the city. Thorough investigation and study of the sewerage needs of the 
city were made in 1927 and recommendations made for the construction of 
an intercepting sewer to carry the dry-weather flow to a point well below the 
city and the construction of sewage-treatment works comprising grit cham- 
bers, sedimentation tanks, separate sludge-digestion tanks, pumping station. 
sludge beds, sprinkling filters and secondary sedimentation tanks. .\ bond 
issue was recently passed which assures that the improvement will lie in- 
stalled in the immediate future. 

Table 1. 

Mortality From Certain Causes. 







^ 








S 


= 














c 


£■ 








> 





£. 




i 


II 


■2? 


VKAll 


= 


~ 


_, 


^ 


_^ 






■ Jo 




>. 


3 5 


= i; 
















(i 






































~ 


>i 


■ffl 


1 


i 


5 


1 


&£ 


c 


1 


1= 


1 = 




< 


P 


S 


a: 


a 


cc 


& 


Zi 


— 


1. 


H^ 


z~ -^ 


189.5 


28.5 


19 




8 


12 


9 




12 






IS 




1896 


... 


















'.'.'. 




'.'.'. 


1897 


280 


'io 






6 


"■3 




13 






io 




1898 


272 


5 








2 


' '4 


23 






33 




1899 


















::: 








1900 


384 


17 


' i 










"e 


6 




'32 


'39 


1901 


370 


12 


1 




3 




5 


5 


.5 




42 


36 


1902 


319 


10 










2 


2 






28 


27 


1903 


322 


4 


"i 








1 


1 






29 


33 


1904 


353 


12 












13 


"2 




33 


29 


190o 


























1906 


368 


' 4 






i 




" i 


' '4 


" '2 




'3.5 


'29 


1907 


410 


5 








11 


1 


5 


4 




23 


44 


1908 , 


379 


4 1 ... 










9 


12 




45 


20 


1909 ' 


422 


6 






' 3 




1 


6 


1 




37 


34 


1910 


433 


5 










5 


2 


1 




36 


36 


1911 


413 


7 












7 


3 




32 


32 


1913 


462 


1 






3 




5 


7 


2 




35 


43 


19U 


461 


7 






4 




7 


3 


4 




40 


39 


1911 


466 


11 










1 


5 


... 




37 


45 


1915 


471 


7 






' 3 









3 




41 


63 


1916 


471 


4 










' i 


1 


8 




45 


36 


1917 


.516 


3 






i 




11 


5 


8 




37 


60 


1918 


740 


3 






4 




5 


2 


125 




55 


138 


1919 


.563 


1 












5 


32 




43 


58 


1H20 


.576 


3 






' -2 




' i 


2 


38 




35 


04 


1921 


493 


6 










1 


14 


4 




25 


31 


1922 


529 








4 




3 


12 


7 




22 


34 


1923 


521 


1 






1 






9 


5 




22 


44 


1924 


499 


1 






1 






5 


-' 




22 


43 


1923 


527 


3 






1 




. "i 


4 


4 


"i 


25 


39 


1926 


594 


1 






10 




1 


2 


' 




16 


50 



34 



DOW N -STATE M L' M CI PA L 1 TIES 



Tabic 2. 
MoKTAi.iTv Rati-.s 1"ki>m C'irtain Causes. 



YEAR 


i 


s. 

a. 


= 
S 


1 

F 


i 

s 


b 


1 


it 


g 


>, 


1 = 


ll 


1893 


11.4 


86.7 




36.4 


54 . 7 


41.0 




54.7 




82.0 




189(i 
























18H7 


16.6 


43.7 






26.3 


13.1 




56 is 




43!7 




isys 


9.7 


21.4 








8.0 


17!2 


98.9 




141.9 




189!) 
























1900 


ih.i) 


70 '.4 


i'.i 






'i'.i 




siis 


24.'8 ".'.'. 


132!. 5 


leiis 


1901 


14.9 


48.8 


4.0 




12!2 


24.4 


26 '.3 


20.3 


20.3 


170.7 


146.4 


1902 


12.7 


39.9 








3.9 


7.9 


7.9 






111.8 


107.8 


1903 


12.6 


15.7 


■y.9 








3.9 


3.9 




'.'.'. 


113.8 


129.3 


1904 


13. G 


46.3 




3.9 








50.1 


7.'7 




134.9 


111.8 


1905 


11.. "i 


7.4 










liis 


14.8 


7.4 




125.7 


77.6 


1906 


13.7 


14.9 






3". 7 


14.9 


3.7 


14.9 


7.5 




130.6 


108.1 


1907 


14.5 


17.7 








39.0 


3.5 


17.7 


14.2 




88.6 


156.0 


1908 


13.7 


14.4 










7.2 


32 . 5 


43.3 




162.3 


72.2 


1909 


14.4 


20.4 






10.2 


l6!2 


3.4 


20.4 


3.4 




126.1 


115.8 


1910 


14.5 


16.7 








3.3 


16.7 


6.7 






120.2 


120.3 


1911 


13.2 


22.4 








3.2 




22.4 


9!6 




102 . 4 


102.4 


1912 


14.5 


3.1 






i'.i 


3.1 


1.5 .'7 


22.0 


6.3 




110.0 


135.1 


1913 


14.2 


21.6 


3!i 




12.. S 


6.2 


21.6 


9.3 


12.3 




123.3 


120.3 


1914 


14.1 


33.3 








3.0 


3.0 


15.1 






112.0 


136.3 


1915 


14.0 


20.8 






8.'9 


3.0 




17.9 


8.'9 




122.0 


157.7 


1916 


13.7 


11.7 








2.9 


•i!* 


2.9 


23.4 




131.5 


105.3 


1917 


14.8 


8.6 






2!9 


8.6 


31.6 


14.4 


23.0 




106.3 


172.4 


1918 


20.8 


8.5 






11.1 




13.8 


5.3 


347.2 




152.7 


383.3 


1919 


15.6 


2.7 




i'.i 








13.8 


88.8 




119.4 


161.1 


1920 


15.7 


8.1 






.5.' 4 




2.7 


5.4 


102.7 




94.5 


172.9 


1921 


13.2 


16.1 








.5.4 


2.7 


37.5 


10.7 




67.0 


83.1 


1922 


13.9 


13.2 






16.' 5 


5.3 


7.9 


31.4 


18.4 


58.0 


89.6 


1923 


13.5 


2.0 






2. ,5 






23.3 


12 . 9 


57.1 


144.3 


1924 


12.6 


2.5 








.5.6 




12.5 


12.5 


55.0 


107.3 


192f> 


13.0 


7.5 






2.5 


2.5 


2.5 


9.9 


9.9 2.5 


62.1 


96.7 


1926 


12.9 


2.1 






21.0 


8.4 


i'.l 


4.3 


14.7 


34.8 


108.9 



Health Conditions. 

Of prevailing' health condition.^ in Aurora subsecjuent to the devastating 
cholera epidemic of 1849-50 there is little or no record until 1881, In that 
}ear a severe wave of smallpox crossed the State but Aurora escaped with 
only eleven cases and two deaths. Dr. Courtney Smith, president of the 
board of health at the time, had vigorously enforced the regulation of the 
State Board of Health that required all school chihlren to be successfully 
vaccinated. This work provided the whole community with a degree of 
immunity sufficient to almost escape the deadly epidemic entirely although 
the infection was introduced into the population on seven different occasions. 

At the opening of the twentieth centur\' t\[)hoid fever was endemic in 
the community on a scale that gave Aurora one of the highest mortality 
rates in the State from that cause. Typhoid fever was charged with 17 
deaths in 1900, giving the unusually high rate of 70.4 per 100,000 population. 
There were probabl}' about 170 cases that year (this estimate being calculated 
upon the usual experience of 10 cases per death), a severe and costly volume 



35 



of illness for a city of 24,000 people. That one season of typhoid probably 
cost the community at least $1,000 per capita in economic losses without 
regard to the expense of life itself. 

This is a fair sample of what the people in Aurora doubtless went 
through with from year to year for a decade or so prior to 1900 and for 
five years afterward. Typhoid came and went like the seasons and was re- 
garded as almost inevitable. Shallow wells furnished a large percentage of 
the local water supply and the absence of extensive sewer facilities made an 
ideal situation for the perpetuation of the infection. After 1905 the number 
of deaths in the city from t_\'phoid never reached 10 in any one year except 
1911 when an epidemic carried off 11 souls, and in 1926 only one fatality 
was recorded, giving a rate of 2.1 per 100,000 population. 

Few places in the State have had more happy results from efforts 
directed against tuberculosis. Only six out of the 44 municipalities of 
10,000 or more population had a lower mortality rate from tuberculosis in 
1926 whereas Aurora suffered one of the highest rates in 1900. During that 
period the rate in Aurora fell from 132.5 to 34.8 per 100,000 population and 
the actual number of deaths went down from 32 to 16. In 1927 the number 
of deaths climbed back up to 26 but even so the rate was only 55.8, a figure 
far below that for earlier years and equalled but twice before. 

With the other ordinary infectious diseases, Aurora has had her ups and 
downs like other communities. Epidemics have come and gone in the mys- 

Table 3. 
Births and Infant Dkath.s. 



YEAR 












Niililber 


Rate** 


Number 


Rate* 


1906 






51 




1907 






73 




1908 










1909 










1910 






77 




1911 






83 




1912 










1913 






84 




1914 






72 




1915 






M 




1916 






5.5 




1917 






82 




1918 






97 




1919 






75 




1920 


827 


22..') 


68 


70.1 


1921 


894 


23.9 


68 


76.1 


1922 


881 


23.1 


64 


72.6 


1923 


928 


24.1 


67 


61.4 


1924 


1002 


•25.3 


55 


54.9 


192:-) 


1025 


25.5 


73 


71.2 


1926 


1091 


23.8 


62 


56.8 



"Deaths of infants under 1 
"I'er 1000 population. 



of age per 1000 live births reported. 



36 



l)()\V\-STATi-. Mr.VUirAI.ITIES 



'I'al.lr 4. 
Cases OF Cer'iaix 1)isi:asi:s Ki i'orted. 





1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


24 




5 


3« 


in 


24 


22 


5 


10 


9» 


4 


3 


Smallpox 


9 




Ifi 


19 


ir> 


9 


6 


3 


6 


3 


13 


103 


Measles 




gr. 


51.-I 


52 


i.ii 


187 


367 


374 


68 


342 


995 


93 


Scarlet Fever 


101 


231 


22 


90 


no 


43 


53 


110 


281 


93 


124 


62 


Whoop. Cough 












101 


44 


164 


42 


107 


142 


86 


Diphtheria 


iry 


43 


31 


31 


17 


263 


287 


287 


95 


53 


29 


15 


Inthienza 






2500 


268 


26(5 


1 


20 


16 


3 


3 


16 


7 


Poliomyelitis 


4 


2 


4 




1 




2 


1 


5 


4 




1 


Meiiinjjitis 






10 




S 


2 


1 


2 


2 




1 


3 


Tuberoiilosis* 


2 




4 


44 




88 


94 


83 


109 


112 


118 


105 


l*nevimonia* 










162 


6fl 


92 


100 


125 


109 


189 


141 


Syphilis 






1 






30 






30 


60 


38 


126 


Gonorrhea 






4 






112 






50 


60 


48 


85 


Chancroid 












4 












1 



*A11 forms. 
Note: Case reports are never complete, but they have been niuch more so since l!t20 than before in 
Illinois. This table indicates improvement ili notification moie tlian aiiytlling el^^e. 

terious cvclcs peculiar {<> ihenLseKcs, iinw fiL-rce and dcadh. now mild and 
harmless. The general trend of diphtheria has been down although the mor- 
tality rates in 1921, 1922 and 1923 soared to 37.5, 31,4 and 23.3 respectively, 
figures far in excess of the State rates for those years. Lately, a rathei 
determined campaign against the disease has been conducted in the cit\- 
with the end in view of preventing the recurrence of such heavy fatalities. 
Apparently the efforts are hearing fruit. The number of deaths in 1926 was 
only two and the same for 1927. 

The great influenza epidemic of I'US hit .Viirora hard. Only seven 
others of the 44 chief cities in the State suffered losses so heavy. Influenza 
and pneumonia together accounted for 263 deaths in that year, giving a rate 
of 730 per 100,000 poiiulation. a fiyure that stood from 200 to 300 points 
higher than the rates in niaii\- other conimuiiities. It is estimated that 5,000 
people had the disease during the e]iideniic which hovered over the citv 
from September to Decembr. 

The general mortality rate of the city suggests distinct improvement in 
the prevailing health during recent years but the average is still above that 
of the State and somewhat higher than .i number of other comparable 
municipalities. 

Refkrexces. 



dates. 



ual Deports .if the Oity 
.\nimal Reports of the State 



>f Aurora, various dates. 

Bi.anl of lleallh, .I.ihn H. Hauch, .M. 11.. Secveta 



History of Medical Practice in Illinois, Vol. 1, Lucius H. Zeuch, II. IJ., Cliicago 
Report on an Appraisal of Health Senice for the Year 1925 in Fifteen llli 
Kawlings, M. 0., Director of Public Health, State of Illinois, Springfield. 
Illinois Health News, May-.hme, 1926. 
U. S. Census Reports, Washington, D. C, various dales. 



, Sprint-fleld, 
1927. 



Belleville 

Belleville owes its very existence to the unfortunate location of another 
community. If Cahokia had escaped the frequent inundations that periodi- 
cally flooded the American Bottoms, leaving marshes, boggs, mosquitoes and 
malaria to make life miserable for the hardy settlers, and if choice of space 
for a house or a city had not been almost as free as the air that bathed the 
lungs of the pioneers, a commission would liket\ never have been appointed 
bv the court of common pleas to select a more advantageous and satisfac- 
tory piece of ground upon which to build the county seat of St. Clair Count) . 
Having made a mistake, however, in choosing a site for a town and a seat 
of their county government the people now corrected tlieir error by choosing 
a piece of rolling territory, known as Compton Hill and l\ing midway be- 
tween the Kaskaskia and Mississippi Rivers, for a new home and city. The 
transaction took place in 1813, five years before Illinois became a state, and 
the new community was christened Belleville. 

But even the new location was not spared from ponds and boggs. Occa- 
sional overflows of Richland Creek, which cuts through the southwestern 
part of the city, left low places filled with water and the wells generously 
diluted with seepage. The terrane could he drained, however, and this sub- 
sequently took place, leaving the community less apt to sufl^er from the 
vagaries of the weather. 

A court house wa> built in 1S14 and the ccjnimunity was incorporated 
as the town of Belleville in ISl'i. 

When the community was incorporated as a city in 1850 the population 
was 2,941. The end of the next decade found the municipality with 7,320 
people and this number grew to 8,146 in the next ten years and mse to 
10,683 by the time of the census in 1880. During the next forty years the 
population increased to 24,823 and was made up in 1920 of 22,250 native 
born whites, 2.393 foreign born whites and ISO negroes. 

Hkaltu Service Machinery. 

Just when !'ielle\ille first passed an ordinance creating a board of lu-alth 
is not clear from available records. It is pmhablc that steps to that end 
were taken at an early date. If so. no particular vigor was attached to the 
health service organization for there is practically no record of its activities. 
If a board was actually organizerl it doubtless fell promptly into a dormant 
paper institution, a common custom at the time. 

(37) 



38 DOWN-STATE MUNICIPALITIES 

There is evidence of a Ixiard of health existing in the place about the 
time of the Civil War. It appears to have had seven members, plent\' of 
power, no money and no executive officer except its chairman. Its chief 
function seems to have been the investigation of nuisances, findings being 
referred to the mayor when action was deemed necessary. 

According to Dr. Charles H. Starkel,* who made a careful sanitary 
survey of the community under the supervision of the State Board of Health 
in 1885, there were practically no facilities for carrying on public health 
service at that time. In his description of the situation we read: 

"There is no special board of health: the alder- 
men in each ward act as health officers. The Ijounds 
of their authority are confined to the city limits. The 
:ildernien receive no pay for such service. There are 
no physicians among them, and they have no execu- 
tive health officer. The police act also as inspectors. 
All of them have police powers. Inspections are 
seldom made unless complaint is tiled. No meetings 
of the aldermen are held as a health body. Their 
powers are not specifically defined or limited by law 
and have no authority independent of the city council. 
They can only define a nuisance, but have no author- 
ity to abate. No notice is taken of defective house 

TT^'^if^ r\ai ''■'"I'on'o inir' drainage unless complaint is made, and so of all in- 
Health Officer, 1892-1915 

sanitary conditions. 

■In cases of contagious diseases, especially smallpox, patients are isolated, 
more, however, through the influence of the attending physician than that of the 
e.\-officio health board. It has power to remove persons sick with contagious 
diseases to a special hospital. Vaccination is not compulsory. Births, marriages 
and deaths become matters of record only through reports to county clerk's office." 

A few years later things began to mend, however, for in the autumn of 
1892 an ordinance creating a board of health was passed and Mayor Herman 
A. Weber appointed Louis Kemp and John Green to serve as members of 
the board until May 1, 1893 and Casimir Audel and M. W. Wier to serve 
until May 4, 1894. These gentlemen constituted what is now regarded by 
local officials as Belleville's first board of health. 

From that date f)n to the present Belleville has had a definitely organized 
board of lieahh but the practice of appointing members to overlapping terms 
gave wa\- to the custom of annual appointments in all cases and the city 
council now e.xercises the appointive privilege instead of the mayor. 

Soon after the organization of the board of health in 1892 Dr. C. H. 
Starkel became health officer and continued in the capacity until 191, r He 
was succeeded in office by Dr. B. H. Portuondo who has filled the place 




Ninth All. R|.t. INSd- HI. SI. r.il. 11. , page 28-41, bv Dr. Charles 



BELr.EVILLE 



39 




B. H. Portuouclo, M. D. 
Health Officer, 1915 to date 



continuously to date. Xo other municipality in Illinois has allowed tlic health 
officer to remain in office over so long a period Even in those places wdiere 
the power of the office is not particularly attractive and the remuneration 
small there have been more frequent changes, 
jierhaps for that very reason. 

The very fact that the health officers tenure 
has escaped the whims of political spoilsmen 
suggests that neither the remuneration nor the 
duties of that position are such as to excite envy 
or heciime liunlen^ome. Indeed there is little 
done in the way nf public health service, the only 
extragovernmental activity being a nurse who 
works in the public schools. 

Subsequent to the board of health ordinance 
in 1892 there appears no further legal references 
relating to health until 1923 when an ordinance 
regulating the sale and sanitary quality of milk supplies vk^as adopted. At 
the same time there was some sort of executive interest manifested in the 
general health affairs because we find Belleville listed in the United States 
registration area for deaths in 1900. Few cities in the State were keeping 
vital statistic records carefully enough at the time to share this distinction. 
Consequent!)-, we have carefully compiled mortality records for Belleville 
over a longer period than for most of the other cities in Illinois. 

Another factor of influence over the health machinery in Belleville is 
that this cit}- was made the headquarters for State public health activities in 
the southern section of the State. Here a district health superintendent on 
the field medical staff of the State Board and later the State Department of 
Public Health, has been located. Dr. Henry Reis was active as a State 
district health superintendent from 1920 to 1925, 
inclusive. Dr. E. P. Stiehl was appointed in 
1926 and still holds the position. 



Water Supply. 

.\ waterworks was established about 1873. 
The supply was obtained from Richland Creek, 
which is supplied by springs and surface water. 
The water was first delivered into a large pond, 
where it was allowed to settle. From the reser- 
voir, the water passed through a large fitter com- 
posed of drain tiling and gravel, into a smaller 
pond from which it was conducted about one- 
quarter of a mile to the distributing pond. Here 




Henry Reis, M. D. 
District Health Superin- 
tendent, 1920-1925 



40 



DOVVX-STATK .MUXICirAI.lTIKS 



it was iJiiniped into a stone tower 125 feet high from which it passed througli 
two Hyott pressure filters and then to the distributing; system. These filters 
were installuil in 18S6 and constituted the first water-purification plant in 
the State. 

A majority of the inhabitants continued the use of well or cistern water. 
These private wells were from 20 to 60 feet in deptli. 

The waterworks installed in ISOO were dependent upon Christine Lake, 
a small body of water east of tlie cit\ , for its source of supply. This proving 
unsatisfactory, a number of tubular wells 400 feet deep were sunk at the 
south edge of the city. These wells supplemented 
1 \ tile lake constituted the source of supply until 
I'lOS, l)nt the yield was always more or less 
ina(lri|natc. 

.\])oin this time, tile waterworks was taken 
over hv the American Water Works & (juarantee 
Coiiipanx . which company owned and operated 
the waterworks in the near-by cities of East St. 
Louis and Granite City. The company sank five 
wells in the Mississip])i River bottoms at Edge- 
mont, about seven miles northwest of the city. 
'i'lie water from these wells was harder and con- 
tained coiisidera];le iron, consequently it did not 
[jrove very popular. 
In 1912, the supply became inadecjuate and a L) inch ])i]ie was laid fr( in 
East St. Louis to Edgemont, a distance of about li\e miles. After this the 
pumps at Edgemont pumped filtered Mississippi River water from the P^ast 
St. Louis supplv. .Since that time the suppl\- has been adequate and safe for 
drinking purposes. 




E. P. Stiehl. M. D. 
District Health Superin- 
tendent, lii2H to date 



Sewicrage. 

There was no general system of sewerage in 1880. Small drains were 
laid in a few streets in the lower part of the city to drain the cellars. These 
emptied into Richland Creek and its branches. The\- were built and paiil 
for bv the owners of propert\- (jn the streets in which tlie\ were laid. 

In 1886 underground drains constructed by the owners drained about 
one-fourth of the city's area. There was one outlet sewer discharging into 
Richardson Creek below the waterworks. Main Street had the only under- 
ground .sewer, and the surface drainage passed into it. 

Ninetv per cent of the houses depended win illy nn privy vaults. Thev 
were required to.be water-tight and cleaned ai the linuseholder's expense. 
About 25 per cent of the houses had cesspools into which kitchen and laundry 
waste water was drained. 



BELLEVILLE 41 

In the fall of 1916. the State Water Survey made an investigation of 
Richland Creek. At the time of inspection, pollution by sewage was notice- 
able for six- miles below the city. Septic tanks installed at the main sewer 
outlets removed only a part of the suspended solids. It was also found that 
industrial wa.^tes played only a minor part in the pollution of the creek. 

Since that time the septic tanks have been abandoned, and many nuis- 
ances have been reported downstream from the cit}'. 

In a report on sewerage by Pearse, Greeley & Hansen in 1924. complete 
treatment of the sewage was recommended. 

Health Conditions. 

As may be surmised, malaria was an important health problem in Belle- 
ville during its early history and continued to be a source of considerable 
annoyance and economic loss in that community long after it had ceased to 
be a problem in most of the places further north. This, of course, was due 
to the n-.ore salubrious climate that prexails in that section, the low, flat 
terrane that favors stagnant pools which encourage mosquito breeding and 
the lack of adequate drainage facilities. Malaria was noticeable enough in 
the early days to bring from Governor Reynolds, in his Pioneer History of 
Illinois, this statement: 

"The disease (bilious- fever with the ague) attacked the people in 
the latter part of the summer and in the fall, and was very common hvit 
not often fatal." 

As late as 1923 we find malaria pre\^ailing in Belleville to an extent 
sufficient to impel local civic organizations to join in a voluntary mosquito 
abatement project which has practically cleared the communit\- of both a 
nuisance and an expensive disease. 

Cholera managed to complicate health matters in Belleville as it did in 
so many other places during the nineteenth century. It introduced itself to 
the community in 1832 through the agency of a traveller who was attacked 
while camping near the town and who was compelled to find refuge and 
shelter in the court house after being refused accommodations at local inns 
and hotels. 

The incident brought out the fine spirit of the medical profession which 
has for so long a time made that calling one of the noblest and most admir- 
able of the human family. While the public generally shunned the poor 
stranger like a leper. Dr. William H. Mitchell of \'irginia, who had settled in 
Belleville, gave to him every care and comfort that his training and skill per- 
mitted. The patient died, however. 



Jf^ 



Willi;iiii Henry Mitchell, M. D. 



BELLEVILLE 



43 



Thus the uinvclconied stranger soon vexed them no more but tlie disease 
lingered to plague the people for many months. Indeed the epidemic lasted 
until late in 1833, carrying off, among others. Governor Ninian Edwards. 
Here again we find a vivid description of conditions from the pen of an eye 
witness. Governor Reynolds, whose personal knowledge of Belleville and 
Governor Edwards led him to say : 

"While the cholera was raging at Belleville he (Governor Edwards) 
was out attending night and day to the afflicted with the scourge. With 
his knowledge of medicine and his -true benevolence, he was a kind and 
efficient friend to the sick. It was his great anxiety and exertions in 
time of the cholera to save the disti'essed that caused him to take the 
disease. He was aged and his constitution some shattered, so he fell 
a victim to the disease a few hours after it seized him. He died in 
Belleville, July 20. 1833." 

Table 1. 
Mortality From Certain Causes. 







S 










_ 
















t 








> 


if 






s 


M^ 


^ 


YEAR 


i 


fa 


.2 


1 


1 


U-, 




i 


.2& 


i 


g 


Is 


.2 - 

1'^ 




< 


£■ 


S 


T. 


■^ 


1 


5 


5 " 


= 


i. 


S-z 


Is 


1877 






1 










1 




.. 




3 


1S78 




5 


4 






'3 




38 






■ii 


7 


1879 




4 


4 










11 






18 


13 


1880 




3 


6 










10 






11 


7 


1881 




9 


3 










9 






8 





1882 




1 


4 










1 








5 


1883 




8 


1 










8 






23 


7 


1884 




7 


2 










2 






8 


4 


188:> 




2 


4 
















7 


2 


1894 


209 
























1895 


187 


'9 




'■'. 














is 




1896 


269 


12 












i2 






26 




1897 


204 


7 












1 






19 




1898 


248 


27 




'■'. 








13 










1899 


























1900 


267 


i-i 


'4 










16 


1 




27 


17 


1901 


270 


10 


1 










8 


2 




24 


12 


190-2 


284 


7 












10 


4 




31 


16 


1903 


318 


14 


'3 


h 








2 


2 




29 


24 


1904 


377 


9 


2 


46 








1 


2 




36 


22 


19Dr) 








.. 


















190S 


342 




2 










'4 


"1 


w 


28 


i.5 


1907 


334 


8 




■ ■ 








7 


2 




32 


15 


1908 


333 


10 












1 


4 




39 


19 


1909 


272 


13 












3 


2 




33 


14 


1910 


312 


4 








3 




1 


3 




33 


16 


1911 


310 


6 








2 




1 


4 




34 


14 


1912 


276 


12 










3 


1 




26 


8 


1913 


326 


10 












3 


1 




32 


16 


1914 


304 


8 








13 




4 


2 




26 


14 


1915 


260 


2 












8 


1 




30 


16 


1916 


312 


4 












8 


.^, 




29 


29 


1917 


3.51 


9 












10 


2 




35 


29 


1918 


481 














R 


lis 




25 


70 


1919 


317 


b 












12 


12 




28 


22 


1920 


321 


2 










:: 


7 


20 




29 


23 


1921 


317 


3 




.. 






n 


3 


1 




21 


23 


1922 


317 


4 




.. 








3 






18 


21 


1923 


373 


2 












5 


20 




15 


27 


19S4 


332 


1 












2 


2 




22 


15 


192.5 


345 


1 














10 




10 


16 


1926 


372 


1 




" 




' 


" 


■ 


1 




10 


15 



44 



DOVVN-STATK MUNICI I'AI.ITIKS 



Table 2. 
Mortality Katf.s I'"rom Ckktain Causes. 







5 








s 


■& 














'£ 


Ce. 








s 


3 


- 2* 




'^ 


■^'7 


a'i 


YEAR 


= 






g 




b 


6 


P 


5 


'i. 


3 


§ c 




o 


'3 


■^ 


^ 


_* 


X 


a 


g 


s 


a- 


s-^ 






.c 




B 








J3-0 






S" 


3^ 




^ 


p. 


S 


S 






3 " 


c 


c 


^l 


H 


1877 






10.0 










10.0 








30.0 


1878 




50.0 


10.0 








30.0 


16. '6 


380.0 






aioio 


70.0 


1879 




36.3 


63.6 












100.0 






163.6 


118.1 


1880 




27.2 


.54.5 












90.0 






100.0 


63.6 


1881 




81.8 


27.2 






9!o 


isii 




81.8 






72.7 


34 . 3 


1882 




9.0 


36.3 












9.0 






200.0 


45.4 


1883 




72.7 


9.0 






<).0 


g^o 




72.7 






209.0 


63.6 


1884 




63.6 


16.6 








9.0 




18.1 






72.7 


36.3 


IK.S.-) 




16.6 


33.3 


















58.3 


16.6 


1894 


12.8 


























189r> 


11.8 


57]6 












h.h 








82.3 




1896 


16.6 


74.4 








1».B 




24.8 


74.4 






161.2 




1897 


12.3 


42.5 














6.0 






115.4 




1898 


14.7 


163.1 














77.3 






148.7 




1899 




























1900 


15. '2 


68 .'7 


22.9 








.5 .'7 


5. '7 


o7i2 


5.7 




1.54.5 


97.2 


1901 


13.3 


57.0 


5.6 






5.6 


11.3 




45.2 


11.3 




135.6 


67.8 


1902 


15.9 


39.1 










28.0 


h'.6 


55.9 


22.3 




173.1 


89.3 


1903 


17.6 


77.3 


16.6 


sl'.s 


leie 


22.1 


5.5 


11.0 


11.0 




160.1 


132.3 


1904 


20.1 


49.1 


10.9 


262.9 


10.9 




21.8 


5.5 


10.9 




196.4 


120.0 


190r> 


16.9 


51.4 




11.4 






5.7 


28.6 


11.4 




125.7 


57.1 


1906 


18.2 


26.7 


i6!7 






'.'.'. 


26.7 


21.3 


10.7 




149.3 


85.7 


1907 


15.8 


37.9 






i'.i 


4.7 


4.7 


33.2 


9.5 




151.5 


71.1 


190S 


14.0 


43.8 






30.7 


4.4 


13.1 


4.4 


17.5 




170.8 


83.2 


190H 


12.9 


61.6 












14.2 


9.5 




156.3 


66.3 


1910 


14.7 


18.9 






14^2 


14!2 


is] 9 


4.7 


14.2 




156.2 


75.7 


11)11 


14.4 


28.4 


9^5 




4.7 


9.5 


0.5 


4.7 


18.9 




160.9 


66.3 


lill.; 


12.6 


56 . 8 










4.7 


14.2 


4.7 




122.0 


37.9 


11113 


14.6 


47.3 






37^9 




9.5 


14.2 


4.7 




151.4 


75.7 


1914 


13.4 


37.8 


4!7 


'.'.'. 4.7 


61! 5 




18.9 


9.5 




123.0 


66.2 


19i:> 


11.3 


9.5 








9. 5 


4!7 


37.8 


4.7 




141.9 


75.7 


1911; 


13.3 


19.0 






4.7 






38.0 


23.6 




137.2 


137.1 


1917 


14.7 


42.5 






4.7 


14! 2 




47.3 


9.5 




165.5 


137.1 


1918 


19.8 


23.8 






4.7 




14.2 


28.5 


561.9 




119.0 


333.3 


1919 


12.9 




12. i 










48.0 


48.0 




113.3 


89.0 


1920 


12.8 


8.'6 


4.0 




24.0 






28.0 


80.0 




116.0 


92.0 


1921 


12.5 


11.8 










sio 


11.8 


3.9 




82.7 


90.6 


1922 


12.2 


15.5 








3.h 




11.6 


27.2 




69.9 


81.5 


1923 


14.3 


7.6 


k'.i 




3.8 




15.3 


10.2 


76.9 




57.6 


103.8 


1924 


12.3 


3.7 








3.7 


7.3 


7.5 


7.5 




81.4 


55 . 5 


1925 


12.8 


3.7 








7.4 






37.0 




37.0 


59.2 


1926 


13.6 


3.6 






s.'c, 


7.2 




7!2 


3.6 




58.4 


54.7 



rate from .\11 C:i 



per 1.000 i)cM>ulatii 



all others per 100,000 population. 



Cholera invaded the city again (luiin.i;- the epidemic \va\e that swept 
over the country during the middle years of the nineteenth century. This 
outbreak was im less severe than the mie twenty years earlier, causin.i; tnll\ 
fifty deaths and niakint; so IiarrnwiiiL; an impressidii uimn the puimlar mind 
that the idea of [nihlic health ser\iee became synonymous with the idea of 
chdleia pre\ention for main- \ears in that community That outbreak, which 
occurred during- the jieriod of 184')-52 was the last disastrous experience 
of the community with cholera and it is probable that this deadly infection 
will never again sadden the households of that or any other American city 
so long as the present standard of civilization remains. 



BELLF.VILLE 



45 




A. L. Reiiss, M. D. 



While tlie re>t of the State was distressed from time to time by loath- 
some and deadly epidemics from smallpox Belleville enjoyed a rather distinct 
freedom from that disease up to 1900. Intelligent foresight led the local 
school board to adopt a ruling in 1858 which required all childret: to present 
a certificate of successful \accination before being admitted to the class 
rooms. This regulation remained in force for more than thirty years and 
while it did not prevent smallpox from gaining entrance into the community 
it did establish a degree of public immunity suffi- 
cient to prevent an outbreak of the serious magni- 
tude common elsewhere, especially during the 
eighties. 

In spite of this early immunity, however, a 
lapse in the practice of vaccination made possible 
the advent of a most fatal and alarming outbreak 
of smallpox in 1903. The outbreak raged for 
three years. There were 6 fatalities during the 
first }ear and 46 the second, the mortality rate 
from smallpox climbing from 34.3 per 100.000 
in 1903 to the extraordinarily high point of 262.9 
in 1904. The next year the rate fell to 11.4, 
marking the last fatality from smallpox in that cit_\- to date. 

Belleville was one of the cities in Illinois where the influenza-pneumonia 
epidemic of 1918 pla\ed grim and deadly havoc on a grand scale. IMortality 
from the two causes combined amounted to 895 per 100,000 population, a 
figure surpassed in only three other cities of the State. Influenza was 
charged with 118 deaths and pneumonia with 7(). Never before nor since 
has any other communicable disease approached such fatal proportions in 
that niunicipalit}' as did influenza in 1918. 

With regard to other diseases, Belleville has gone through no particu- 
larly unusual experiences. Tuberculosis was bad enough up to about 1920, 
since which time it has steadily declined. Typhoid fever has been and still 
remains an endemic problem although the annual mortality rate has declined 
from a maximum of 81.8 per 100,000 population to an average of about 3.5. 
Scarlet fever and diphtheria have visited the city in epidemic cycles peculiar 
to those diseases, sometimes virulent and fatal, sometimes mild and less 
mortal. Both infections exacted a considerably heavier toll of life in Belle- 
\ille in 1926. in proportion to the population, than they did in the State at 
large. 

The general mortality rate in Belleville now averages considerably 
higher than that for the State at large and for many of the comparable cities 
luU it must be remembered that Belleville is one of the oldest communities 
in Illinois. This gives it a higher ratio of elderly people than the .State liut 



46 



DOWN-STATE MUNICIPALITIES 



Table 3. 
BiKTiis AND Infant Deaths. 





Bir 


ths 


Infant Deaths 


YEAR 










Number 


Rate** 


Number Rate* 


18Y7 






2 20.0 


1878 






41 410.0 


1879 






61 


554.5 


1880 






31 


463.6 


1881 






52 


472.7 


1882 






48 


436.3 


1883 






42 


381.8 


1884 






2.) 


208.3 


1906 






So 




1907 






51 




1908 










1909 










1910 






47 




1911 






58 




1912 










1913 






56 




1914 






35 




1915 






22 




1916 






39 




1917 






28 




1918 






45 




1919 






33 




1920 


479 


19.1 


31 


64.7 


1921 


540 


21.3 


38 


70.4 


1922 


493 


19.1 


20 


40.6 


1923 


501 


19.2 


46 


91.8 


1924 


466 


17.5 


37 


79.6 


1925 


504 


18.7 


22 


43.6 


1926 


501 


18.3 


31 


61.9 



per 1000 live births 



Table 4. 

Cases of Certain Diseases Reported. 





1921 


1922 


1923 


1924 


1923 


1926 


1927 


Typhoid Fever 


6 




fi 


3 


10 


6 


- 


Snmllpo.x 


26 


1 




1 


3 


3 




Measles 


2 


1 


30 




1 


30 


28 


Scarlet Fever 


46 


2.) 


6 


45 


153 


127 


35 


Whooping Cough 


10 






2 




9 


35 


Diphtheria 


39 


63 


OS 


38 


30 




24 


Influenza 




13 


10 


1 


7 


2 


4 


Poliomyelitis 








1 








Tuberculosis* 


7 


10 


11 


18 


21 


23 


20 


Pneumonia* 


4 


9 


27 


9 


21 


19 


14 


Syphilis 


12 






14 


7 


9 


13 


Gonorrhea 


31 






98 


31 


22 


10 


Chancroid 














1 



*AU forms. 
Note: Oiise reports are never complete, but they hnve been muth m 
Illinois. This table indicates improvement in notification more tha 



BELLEVILLE 47 

the difference in age distribution is not as great as the difference in the 
mortahty rate. According to the 1920 United States census report, 21.5 per 
cent of the population in Ilhnois was over 45 years old, while in Belleville 
23.2 per cent fell into that age group. In 1926, the general mortality rate in 
Illinois was 11.8 while that for Belleville was 13.6. About the same differ- 
ence has prevailed for several years. 

References. 

Annual reports of the State Board of Health, Springfeld, Illinois, various dates. 
Bulletins of the State Water Survey, Urbana, Illinois, various dates. 
Pioneer Histoo' of Illinois. John Refolds. Belleville, Illinois, 1852. 
U. S. Census Reports, Washington, D. C, various dates. 



Bloomington 

One of the largest and finest of the isolated groves in the great prairie 
region of the Sangamon basin adorned the hills of what later became McLean 
County. Early settlers called it Blooming Grove. It covered between 40 
and 50 square miles of land area, making the locality very attractive. As 
the settlers pushed back from the vicinity of the navigable rivers, the_\- very 
naturally gravitated to this beautiful spot and made their abode in its vicinity. 
The community grew into the thriving municipalities of what are now called 
Bloomington and Normal. 

One of these early settlers was Dr. Isaac Baker, a veteran of the War 
of 1812, who came to McLean County in 1827. This versatile physician, 
who was doctor, architect and civil engineer by turns, helped to lay out the 
town of Bloomington on July 4. 1831, locating it on the north edge of the 
Blooming Grove. 

Dr. Baker was clerk of the county commissioner's court for fifteen 
\ears. During this time a young man wished to secure a marriage license 
and having no money offered to pay for it in maple sugar the following year. 
A historian who says that the doctor accepted the proposition adds the com- 
ment that it was a "sweet transaction for all concerned." This incident sug- 
gests the scarcit}- of cash during the days when Bloomington \va^ in the 
making. 

The communit}- was organized into the town of Bloomington in 184o 
and incorporated as a city in 1850. To show their temper and disposition 
to manage public affairs the board of trustees at its first meeting in 1843 
passed an ordinance requiring a license fee of $25.00 each from grocer \- 
stores doing business within the town limits. 

During the twenty years between 1850 and 1870 the iHi]iulati(in grew 
from 1,594 to 14,590, an average increase of 650 per annum. That was the 
period of most rapid growth. In 1880 the number of people was 17,180 and 
in 1890 it was 20,484. The 1920 United States census report shows a total 
population of 28,725 which was made up of 25,053 native born whites, 2,831 
foreign born whites, 799 negroes and 42 persons of other races. Persons 
45 \ears of age and over constituted 27. ii per cent of the population in l')20. 

Health M.actiinery. 
It is probable that the people in I'locimington were among the first in 
the State to realize in a significant way. the possibilities of what we under- 
stand today as public health service. Dr. Llias ^^'. Gray lived there during 
the seventies and he was exceptionally active as an advocate of sanitation 

(48) 



r.LOOMI.NC.TON 



49 



and hvgiene. His efforts (see volume 1 of this history) were an important 
factor in causing the legislature to establish the first permanent State Boani 
of Health in Illinois. Doubtless his influence was felt in Bloomington. It 
may even be that his conceptions and activities were inspired by citizens of 
Bloomington and that his championship of the 
public health cause was but a reflection of mature 
sentiment among thinking citizens there. 

In either event there must necessarily have 
been mi inconsiderable sentiment there in favor 
of organized public health service of a high 
order for that day. This attitude was manifested 
in 1885 when the Mayor Benjamin F. Funk of 
Bloomington exercised a pronounced personal 
interest in the house to house sanitary survey 
inaugurated by the State Board of Health, taking 
time enough to visit Springfield for a conference 
on the subject with Dr. John H. Rauch, secre- 




Benjamin F. Funk, 
Mayor 



BLOOniMGTOM 



(St 




VITAL STATISTICS 

conn. DI5 coriTROL 
VEM discohtrol: 

TUB. COMTROL 
HEALTH CHILD-i'' 
HEALTH 5CH. CHILD ^ 
5ArilTATI0M^^5.r^" 
MILK CONTROL 
LABORATORY 
POP HEALTH mSTZ 



PERCEMT OF STANDARD SCORE 
FOR EACH OF TEH MAJOR HEALTH ACTIVITIES 




Fig. 1. This graph illustrates the strong and weak points in Blooming- 
ton's public health service, official and voluntary, as it existed in 1925. It 
is based upon a personal survey and rated upon the standards evolved by 
the American Public Health Association. The total efficiency rating in 
Bloomington was 46 per cent of the standard perfection requirement. 



50 



DOWN-STATIC .MUXICIPALITll-.S 



tary of ihc hoard, and causing tlie project to l)c carried nut with great 
thoroughness in his city. 

Again, in later years we find a legislator from lilooniingtun, leading a 
successful movement in the General Assembly to enact a law permitting 
counties to establish and maintain tuberculosis sanitariums and that McLean 
(."ount\-. with the help of Bloomington, took 
ad\antage of this law rather promptly. 

Furthermore, there was, in 1880. a health 

committee of the city council. It consisted of 

three aldermen and the mayor and functioned as 

a board of health. It employed a health officer 

at $40.00 per month whose chief duties were the 

j'^K k abatement of nuisances and the enforcement of 

.^^^M J^^^L^ garbage removal regulations. He had police 

^^^^W ^KgyBAk powers and he was responsible for removing to 

^^^* ^B^^^BS fi^ie "pesthouse" persons found in the community 

with smallpox. It is interesting to observe that 
the medical profession was not represented on 
the committee nor did it participate officially in the sanitarx' efforts of the 
public. 

The list of health commissioners who have served Bloomington include : 




Hiram Greenwood 
Health Officer, 1885 



188.-.. 


Hiram firecinvood 




1898-1801 


Dr. Dwight 0. Moore 




1901- 


Dr. F. J. Welcli 




1901. 1906 






1912 


Dr. A. W. Mever 




1902-1904 


Dr. J. E. Kundler 




1913-191.1 


Dr. H. H. Griffin 




1915- 


Dr. J. J. Coniion 




1915- 


VV. T. Williams 




1915-1919 


Dr. F. C. Vandervoort ) 






Dr. H. H. Griffin ^ Serve. 


together 




Dr. F. H. Godfrey ) 




1919- 


.Jacob Meeth 




1919-1921 


Dr. James M. Fiirstman 




1922-1923 


Dr. Harold B. Wood 




1923-1927 


Dr. Charles E. Schultz 





By 1898 the board of health had grown to 
include fourteen aldermen in its membership and 
the influence of the medical profession had 
caused the appointment of Dr. Dwight O. Moore 
to the position of health commissioner, the title 
of the board's executive officer. Under Dr. 
Moore was a sanitary policeman in the person of 
John F. .\nderson. The expenditures of the 
board of health in 1898 amounted to $11,991.55 
but $10,473.81 went for scavenger service. 

Dr. Moore died in 1901 and was succeeded 
by Dr. F. J. Welch who remained in office for a 
short time only but he appears to have been re- 




Dwight 0. Moore, M. D. 

Health Commissioner 

1898-1901 



BLOOMINGTOX 



51 




sponsible for inaugurating the keeping of vital 
statistics in tlie city. Prior to that time report? 
of births and deaths had been recorded by th^ 
county clerk only. The city clerk now began 
to exercise that function and continued to 
ilo so under Dr. A. W. ^Ie\-er who became 
health commissioner before the end of 1901. 
])r. J. E. Kundler followed Dr. i\leyer as health 
commissioner and drew a salary of $600.00 per 
\ear for his services in that capacit}'. 

In 1915, when the city adoptetl the commis- 
sion form of government, an important and 
unique change was made in the administrative 
organization of the health department. By ordi- 
nance the public health activities were placed in 
the hands of three men, known as health com- 
missioners, under the commissioner of public 
health and safety. Three physicians, Doctors 
F. H. Godfrey, H. H. Griffin and F. C. Vander- 
voort, were appointed to these positions and they, 
in turn, employed two inspectors, one for foods 
and one for sanitation. 



John F. Anderson 
Sanitary Policeman, 1S9S 




F. H. Godfrey, M. D. 

Health Commissioner 

1915-1919 



The commissioner of public health and safety 
and the three health commissioners constituted a 
board of health while the food inspector acted as 
its secretary. Three men on one job apparently 
worked out but little better than the proverbial eft'ort of one man to serve two 
masters for we find the triumvirate abandoned by 1919 when arrangements 
were completed for reverting to the one man 
s\'stem and he was placed on a full time basis. 

Public confidence in the potential benefits of 
public health service had grown too, so that ap- 
propriations to the health department had soared 
to $12,600.00 for the fiscal year ending April 30, 
^pf^ i^w. '^''"^ ^""^ *-'^^ matter of garbage disposal had been 

^•■^^^HBfcH transferred to another department. At that time 
^^^^^^^^M l^r. J. JNI. Furstman was the full time health com- 
^^^I^^^^^H missioner, one of the first to be employed in 
Illinois outside Chicago, and he was assisted by 
three nurses and one or two inspectors. 



k'^iLfe. 



H. H. Griffin, M. n. 

Health Commissioner 

1915-1919 



DOW N -STATK M L' N ICl PALITI 1 




James M. Furstman, M. D. 

Health Commissioner 

19191921 



In 1922 the city abandoned the commission 
form of government but the full time health com- 
missioner was retained, Dr. Harold B. Wood suc- 
ceeding Dr. Furstman in that capacity. His 
budget amounted to 810,830.00 per year and his 
staff included one food and one sanitary inspector 
and one public health nurse. He maintained a 
-small amount of laboraton- equipment which 
enabled him to make tests for diphtheria and 
examine samples of water and milk. 

The strength of the health department staff 
in 1925 had changed but little, embracing the 
commissioner. Dr. C. E. Shultz, three nurses and 
two inspectors, all on a full time basis. A clear 
picture of public health administrative machin- 
ery in the cit_\- at that time, which still prevails in 
much the same character, is found in the report 
of a survey and appraisal made by the State 
Department of Public Health. 

It reads, in part, as follows : 

"The public health services carried out in 
Bloomington during 1925 were evaluated at 461 
points, giving to that city fsvelfth place among the 
fifteen included in the appraisal study. 

It so happened that the position of full-time 
health officer was vacant during several months last 
year (1925). causing a lower score than might other- 
wise have been the ease. All of the health department personnel, consisting of the 
health officer, three nurses, two inspectors, and a clerk are appointive by the mayor 
except for one nurse who is employed by the school board. The county tuberculosis 
board employs a nurse whose travel expenses are paid by the county tuberculosis 
association. Volunteer agencies do less in Bloomington than in any of the other 
fifteen cities. Last year (1925) a board of health was organized, an emergency 
measure brought on by a smallpox outbreak. 

'The city spends thirty cents per capita per year for public health work, 
funds from other sources raising this figure to 47 cents. 

'■Notification of contagious diseases measure up satisfactorily to the standard 
required. A good system of eiiidemiological record keeping is in use although the 
cards are not completely executed and no spot maps or charts of contagion are 
kept. No communicable disease nursing service is provided. The sanitary inspec- 
tor quarantines and releases all cases not seen by the health officer. The health 
officer himself devotes much of his time to visiting cases of contagion. There are 
no communicable disease hospital facilities in the city or county. Very little has 
been done to stimulate the immunization of children against diphtheria. Due to 
an epidemic of smallpox last year, however, it is estimated that more than one- 




Harold B. Wood, M. D. 

Health Commissioner 

1922-1923 



BLoo>riN'c;To.\' 53 

half of the population, including 98 percent of the school children of the city was 
vaccinated against that disease. 

"There is no venereal disease clinic. Case reports are not up to standard 
appraisal requirements. 

"Cases of tuberculosis are well reported. The tuberculosis clinics are well at- 
tended although the total number of visits is slightly less than the quota. A county 
tuberculosis sanatorium is maintained. At this institution a total of nearly 
14,000 patient days treatments were given. About 14 percent of the cases were in 
the incipient stage of the disease on admission. There are no open-air classrooms 
or prevenforia. 

"There are no prenatal, infant or preschool clinics. Only about 300 home 
visits were made by nurses in behalf of this age group. There is a very active 
Day Nursery with a trained public health nurse as director. She has done a con- 
siderable amount of educational work in prenatal and infant hygiene through 
mothers clubs. Tonsil clinics are held occasionally at the Day Nursery. 

"There is no medical inspection of school children. The nurses weigh and 
measure all children and test the vision and hearing of some. The only correc- 
tion of defects of which there is a record is the tonsil and adenoid operations at 
the Day Nursery. The nurses made a large number of home visits in behalf of 
school children, the numbers being about double the standard appraisal require- 
ment. Considerable attention is given to the teaching of hygiene in the schools, 
fifty minutes per week being devoted to it in all grades. Health classes are also 
held at the Day Nursery. 

"A good sanitary and food inspection service is maintained although food 
establishments are not licensed. The city water supply is of good quality and is 
distributed, it was estimated, to S5 per cent of the homes. It was estimated also 
that 80 per cent of dwellings are connected with sewers. An accurate survey of 
the privies in the city was made three years ago. 

"Ninety per cent of the milk supply is pasturized, one plant supplying 80 per- 
cent and the two others 10 per cent of the total. No inspections are made of dairy 
farms except of 13 which are located close to the city. Periodic inspections of 
distributing plants, and a large number of sediment tests are made of both raw 
and pasteurized milk. Shipments of dirty milk when discovered are excluded from 
the market. These tests give a fair index as to the sanitary quality of raw milk 
but are of little use in determining the quality of pasteurized milk. Bacterial 
counts are not made. 

"A small laboratory is maintained by the health department, the city health 
officer himself making the examinations. About the only tests made last year 
were for diphtheria and gonorrhea, the remainder of the laboratory credit being 
due to the examinations made at the Springfield State Laboratory." 

Water Supply. 

The public water supply was installed in 1875 and comprised one dug 
well 40 feet in diameter and 38 feet deep, located on the banks of Sugar 
Creek within the city of Normal, which adjoins Bloomington. The main 
water supply has ever since been derived from wells penetrating the glacial- 
drift deposits in that vicinity, but different wells have been installed from 
time to time. 



54 DOWN-STATE MUNICIPALITIES 

111 1885 the dug well was enlarged and deepened by installing an ellip- 
licii pit 26 by 32 by 16 feet deep below the bottom of the original well, 
making the total depth 56 feet. The yield became inadequate to meet in- 
creased demands and in 1894 twelve 10-inch tubular wells were installed 
and the water pumped from them by air lift into the original well, which 
then served as a receiving reservoir until the installation of the present 
10-million-gallon reservoir about 1905. 

The supply again proved inadequate and in I'JlO the former tubular 
wells were replaced by three shafts about 42 feet deep in the bottom of each 
of which several tubular wells with strainers were extended 30 feet deeper 
into water-bearing glacial drift. At the same time the pumping station was 
rebuilt, electric pumps replaced air-lift equipment for the wells and direct 
pumping pressure in the distribution system was established. 

During warm weather when the use of water increased and the yield 
of the wells decreased the supply continued to be inadequate to meet the 
growing needs of the city and the inadequacy of the supply has continued 
to be a topic of discussion and consideration up to the close of the period 
covered by this history. In 1915, one of the 1910 wells was abandoned, the 
others were improved, and one additional well and unit was developed by 
installing in the bottom of the original dug well eight tubular wells and a 
pumping unit. 

In 1920, after a study of possible ground-water resources by the local 
officials, it was decided to install additional wells at some distance from the 
main pumping station in the vicinity of which all the previous wells were 
located. One tubular well with strainer was sunk into the glacial drift 
about l'/2 miles southwest of the main station and a pump house and 
188,000-gallon concrete collecting reservoir built. This well was also along 
Sugar Creek which flows westerly through the northern portion of the city. 
In 1921 two more tubular wells were sunk at the western station where ten 
acres of land had been secured for water-works purposes and another high- 
service pumping unit installed. 

About 1921, consulting engineers were engaged to make a study of water 
resources, possible impounding reservoir sites, the mineral and sanitary 
quality of the various possible supplies and the costs of development. The 
engineers recommended the development of a surface-water supply by means 
of a dam on the lower portion of Money Creek. There had already been 
local differences as to whether the future supply should come from wells 
or a stream, and following the consulting engineer's report this controversy 
among the residents of the city continued. Some contended an adequate well 
supply covdd be developed ; others that a well supply would always be inade- 
quate as it had been most of the time since the original waterworks was 
installed ; still others that even though an adequate well supply could be de- 



BLOOM INGTON 55 

veloped the water \\oul(J continue to be very hard and of unsuitable mineral 
quality for domestic as well as for industrial purposes, as in the past, and, 
therefore, an adequate softer filtered surface-water supply was the best pro- 
ject for the cit\-. 

The supply, continuing to be inadequate and of unsatisfactory mineral 
qualit}', in 1926 a group of men and their consulting engineers favoring an 
impounding reservoir on Mackinaw River submitted a project to the city 
which included the development of such a supply and the wholesaling of the 
water to the city. Another group and its consulting engineers made a some- 
what similar proposition to the city, hut the source proposed was an im- 
pounding reservoir on Money Creek. A citizen's Water Committee was 
organized to make a comprehensive stud_\' of the development of an adequate 
satisfactory water supply for Bloomington and Normal, which committee 
comprised officials of both cities, representatives of the chambers of com- 
merce, civic organizations, etc. This committee held many hearings, reviewed 
the two projects submitted, studied the question of softening a well-water 
supply and studied the possibility of other impounding reservoirs. 

The work of the Citizen's Committee convinced practically everybody 
that the softening of the well-water supply was impracticable because the 
water would still be highly mineralized after it was softened even though it 
could be made adequate, which was very doubtful. About everyone was 
agreed that the only suitable sites for an impounding reservoir were either 
on Mackinaw River or Money Creek, but an agreement as to which was the 
better could not be reached, and the Citizen's Committee closed its activities 
by submitting the facts gathered to the city councils of Bloomington and 
Normal but without recommendations as to impounding reservoir sites. At 
the close of the period covered by this report, a water company to develop 
an impounding reservoir had been formed by local persons subscribing stock, 
and the officials of this Citizen's Water Company had undertaken the task 
of deciding whether to develop the Mackinaw River or Money Creek pro- 
jects and then to make plans to develop and finance the project decided upon. 

The original distribution s\stem comprised about ^y2 miles of mains 
which were put in by bond issue. Since then additional mains have been 
laid from time to time by special assessment, and at the close of this histori- 
cal period practically all the property in the city has access to the public 
water supply. 

The water obtained from the wells has been of varying quality and after 
drawn from the wells it is subject to contamination in the open storage 
reservoir. No epidemic has been caused by the public water supply, but the 
State Department of Health has for the last several years at least regarded 
it as of doubtful quality, especially because of possible contamination in the 
reservoir. ,\nah ses have at times shown conlaniinalinn. 



56 DOWN-STATIi MUNICirAl.ITIES 

A watcr-bonie epidemic did occur in 1920 when a conlaminalcd indus- 
trial supply maintained by the Chicago iV Ahon railroad entered through a 
cross connection the piping carrying the cit\ water within the Chicago & 
Alton railroad yards. Fortunately the consumjjtinn witliin the railroad 
yards was sufficient to take care of the polluted water that was passing 
through the cross connection, and thus the polluted industrial supply did not 
get out into the street main and cause an\- primary typhoid cases among 
those not working and drinking water at the railroad shops. This epidemic 
comprised many hundred cases of diarrhea, about 200 cases of typhoid fever 
and at least 24 deaths although some of the mortality was returned as due 
to other causes. This epidemic, in one sense, was the indirect result of the 
inadequacy and unsuitable mineral quality of the public water supply, be- 
cause if the public supply had been adequate and suitable for the railroad 
shops the polluted industrial suppl\ probably would not ha\e been estab- 
lished or at least maintained. 

At the close of this historical period the liloomington supph' was being 
derived from the two groups of glacial drift wells, and storage of the well 
water until i)umping into the mains was furnished by the open 10-million- 
gallon reservoir and the covered 188,000-gallon reservoir. The water supply 
was the hardest and one of the most highly mineralized public water supplies 
in the State, which has tended to keep the consumption low because it is not 
even satisfactory for general domestic purposes. 

Sewerage. 

Sewers, principally eif the enmbined t\pe. have been installed from year 
to }-ear in accordance with the immediate demands. Many of the sewers have 
been built with open joints, resulting in excessive ground-water infiltration. 
The sewers all drain north and westward into Sugar Creek, there being in 
1920 seven such sewers ranging from 15 to 96 inches in diameter. A small 
section of Bloomington known as the Miller Park district was sewered on 
the separate plan and discharges through an Imhoff tank constructed in 1915. 

In 1919 the Bloomington and Normal Sanitary District was organized, 
including all of the corporate area of Normal and most of the city of Bloom- 
ington and some adjoining territory. The Miller Park district was not in- 
cluded. An intercepting sewer w-as constructed to carry the ordinarx- dry- 
weather sewage flow and a portion of the storm flow from the area to a 
point southwest of Bloomington. A sewage-treatment plant designed to 
serve 54,000 people is under construction, comprising bar screens, grit cham- 
bers, pumping station, Imhoff tanks, sludge-drying beds, dosing tanks, 
sprinkling filters and secondary settling tank. This jilaiit will be placed in 
operation in the immediate futiu'e. 



BLOOM INGTON 



57 



Health Conditions. 




Charles E. Schultz, M. D. 

Health Commissioner 

1923-1927 



\\ liat seems to be the very earliest reference concerning health matters 
among- the settlers of Bloomington relates the story of how Dr. John F. 
Henry, a local physician, took into his own house an eight year old girl 
•who was suffering from smallpox to save her from being exiled by a terrified 
public. The girl's mother also came down with 
the disease and shared in the benevolent care of 
Dr. Henry just as otherwise she would have 
shared the helpless exile of her daughter, a con- 
summation fraught with the gravest dangers to 
life itself. 

Another glimpse at health conditions in and 
around Bloomington during these early days 
Comes down to us through Dr. Daniel Drake, 
medical observer, author and traveler, who visited 
the town in 1844. From Dr. Henry he learned 
that autumnal fever was both infrequent, rela- 
tively and mild in that vicinity. This opinion was 
shared by a brother practitioner. Dr. Colburn. 
These same two physicians described to Dr. Drake an extensive epidemic 
of er\si]X'las that occurred during the winter of 1843-44. Strangely enough 
both (locti)is stiiutly maintained the opinion that this disease was not con- 
tagious. 

Apparently erysipelas caused no particular alarm, although it swept the 
community in a rather thorough-going fashion, while smallpox, which could 
be prevented by vaccination, created such violent fear that a helpless girl 
and her mother whose only fault was illness, would have been summarily 
exiled upon the desolate prairie with a sanction of the public that touched 
upon religious fervor. 

Thus we see already in the infant municipality the manifestation of 
fears and prejudices that will lead Bloomington straight into the "pesthouse" 
period when smallpox was less welcome than leprosy in the popular imagina- 
ti<in while typhoid fever, tuberculosis, scarlet fever, diphtheria and other 
deadly infections were condoned as unhappy visitations of an angry provi- 
dence. Accordingly we are not surprised to find a vi\ id report of a smallpox 
outbreak that occurred in 1882. Tramps, immigrants antl new-comers came 
under the ban of epidemiological scrutiny at this time and. as usually hap- 
pened, local officials pinned the blame of starting the epidemic upon a couple 
of tramps, an immigrant and a family of new-comers who Jiappcned to be 
still within the limits of the hone_\moon period of their matrimonial exjjcri- 
ence. The bride and groom escaped the "iiesthouse" because of their ad- 



58 



DOWX-STATi: MUNICIPALITIES 



Table 1. 
Mortality From Certain Causes. 







;_ 


















































sc 
















































5 








'S ^ 




YEAU 


1 


1 ' 


g 




^ 





'^ 


= 


i> 


•=£ 


i 1 










c 


S 


■g 


c. 








£~ 


c*< 




O 






























■i 


1 


s 


g 


I 


|- 


1 


'•~ 


I5 


S^ 






E- 


s 


X 


s 




>■ 












1900 


340 


._ 












2 










1901 


333 














'.'. 


2 










!! 


1907 


425 


's 








'2 




'3 


"2 








35 


28 


1908 


395 




























1909 


399 














] * 














1910 


425 




























1911 


408 




























1912 


445 




























1913 


41S 


9 








6 




4 


5 








27 




1918 


527 


'2 














■5 


83 






38 


57 


1919 


407 


1 








i 






1 


27 






24 


24 


1920 


460 


10 















2 


31 






24 


42 


1921 


430 


1 








5 






3 








24 


28 


1922 


412 


1 














6 


11 






20 


35 


1923 


403 











'i 








7 






19 


24 


1924 


406 


1 














i 








15 


26 


1925 


434 


1 






i 


3 






4 


9 






16 


31 


1926 


432 


1 












^ 


1 


11 






10 


24 



Table 2. 
Mortality Rates From Certain Causes. 







t. 


























> 








a; 


1 






5 


■, ^ 


^ 




'i 


^£4 





















.S s 


YEAR 


•s. 


"2 




g 




'" 





i 


N 


\ 


- fc 


'= Z. 




6 




.g 


^ 


1 


■^ 


d 


■~ 




E i"" 


= *- 




< 


i 


S 


1 


j 


2 

■r. 


1 


1 


1 


■^ "=5 


= < 


1900 


14.5 










1 
. 1 17.2 




8.6 










1901 


14.2 












. 17.0 






8.5 


' 










1907 


16.9 


31 '.9 








8 


6 4!n 


12 


6 


sio 


14^2 






139!6 


iii.'i 


1908 


15.4 






























1909 


15.6 






























1910 


16.4 






























1911 


15.6 












; 


















1912 


1G.8 






























1913 


13.6 


33!7 








22 




15 


6 


18!7 








loiii 




1918 


18.'o 


7.'i 










'. 3.5 






17.' 8 


296.' 4 






13.5.7 


203^2 


1919 


14.2 


3.4 








3 


4 3.4 






3.4 


94.4 






83.9 


83.9 


1920 


16.0 


34.1 












20 


li 


6.8 


106. S 






82.0 


144. S 


1921 


14.8 


3.4 








17 


•i 3^4 


3 


4 


10.3 


24.0 






82.3 


96.1 


1922 


14.0 


3.4 






3.4 










20.4 


37.4 






68.0 


118.9 


1923 


13.6 










3 


3 '.'. 








23.5 






63.9 


80.8 


1924 


13.5 


3.3 
















sis 


13.2 






50.0 


86.6 


1925 


14.3 


3.3 






sis 


9 


8 3^3 


6 


6 


13.1 


29.5 






.52.5 


101.9 


1926 


14.0 














16 





3.2 


35.2 




; , 32.1 


78.1 



iite from All C.nises is per 1,000 populatit 



uU others per 100,000 populatic 



BLOOMINGTON 59 

vanced convalescence but the unhappy vagabonds paid for their indiscretion 
by a solitary residence in that isolated institution which probablv woukl have 
welcomed a thief or burglar as an honored guest. 

From the date of that experience down to the present time Bloomington 
has elected to treat smallpox as an emergency matter rather than as 
a constant danger that could be averted through the practice of systematic 
vaccination during quiet }ears. Consequently the infection has visited the 
city from time to time, now mild and inconsequential, now loathsome and 
costly. About 1900 an epidemic cost the municipality about $400.00 for 
specific control measures. Another outbreak smouldered in the community 
during 1921 and 1922. Again in 1925 an epidemic of some 109 cases em- 
barrassed the commercial and business interests of the city bv creating a 
disturbance on the very eve of the holiday shopping season. This led to the 
vigorous application of control measures, wholesale vaccination, and the 
happy suppression of the outbreak before irreparable damage had been done 
to holiday merchandizing. Ordinarily these periodic epidemics result in such 
general vaccination that smallpox is of no consequence again for several 
years. 

Toward the end of the nineteenth centvny, in common with forward 
looking citizens all over the country, the people in Bloomington began to 
regard scarlet fever, diphtheria, typhoid fever and other infections as com- 
municable from person to person and therefore subject to prevention by 
quarantine. Accordingly the practice of case notification and the placarding 
of infected premises came into vogue about that time. More and more fre- 
quently do reports of outbreaks appear in the records and doubtless the\- are 
more and more complete. 

In 1898, for example, 18 cases of scarlet fever and 15 cases of diph- 
theria were recorded with a notation that all cases had been quarantined and 
the premises fumigated after termination of the illness. Again, in 1900 seven 
cases of diphtheria and 20 of scarlet fever were reported. This is about 
the way these diseases behaved from year to year with but few exceptions, 
the mortality tending downward with the wider use of antitoxin, the con- 
stantly growing improvement in the qualitv of medical practice and the in- 
creasing efficiency of local health service. One outbreak of diphtheria in 
1925 is noteworthy because of its extensive proportions, involving 374 cases. 
It was fortunately of a mild character and the efficiency with which physi- 
cians and health officials handled the situation saved all but one of the 
patients. In an orphanage 14 out of 61 people got the disease hut none 
were lost although the institution went through the inconvenience of a con- 
tinuous quarantine for three months. 



60 DOWN-STATE M U N I CIPAr.TTIES 

llloomington. like so many other communities of the State, has had 
a long and unpleasant experience with typhoid fever but mortality statistics 
arc too meagre to furnish any clear notion of whether the disease has been 
relative!}- more severe there than elsewhere. It appears that the city escaped 
with a loss of from two or three to ten or twelve lives a year without going 
through any particularly widespread or disastrous outbreak until 1920. In 
that year a valve that separated the safe public water supply from a contami- 
nated private supply in the Chicago and Alton railway shops sprang a leak 
and because the water pressure on the private supply side was greater, pollu- 
tion was driven into the drinking water that quenched the thirst of hundreds 
of workmen. An epidemic involving about 1,000 cases of severe diarrhea 
and some 200 or 300 cases of typhoid fever resulted. Public resentment ran 
high, expressing itself in a belligerent mob attitude that threatened the life 
of the 'local health officer. This was a manifestation of radical change in 
popular sentiment concerning typhoid fever from that which had prevailed 
twenty-five years earlier. Subsequent to 1920 Bloomington went through 
one year. 1923, without a fatality from typhoid but lost one person to that 
infection in each of the others down through 1926. 

Influenza struck Bloomington with moderate severity during the pan- 
demic of 1918. The mortality rate per 100,000 population from influenza 
])r(iper was 296 and that from pneumonia 203, the latter being a trifle more 
than twice the ordinary per annum. One-half dozen of the other communi- 
ties embraced in this volume esca|ieii with losses as light as those experienced 
in Bloomington. Mortality rate.-i from influenza and pneumonia higher than 
the usual prevailed during the next two years but this was common through- 
out the State. 

Tuberculosis appears to have been the captain of the forces of mortality 
during the earlier years in Bloomington, ordinarily accounting for more 
fatalities than any other disease. In 1907 tuberculosis was credited witli 
35 out of 425 deaths from all causes, a matter of eight per cent. From that 
time down to 1920 the mortality \acillated between 20 and 40 but subse- 
quently the death rate has declined with splendid continuity. For the three 
years ended with 1926 the average annual mortality rate was less than 40 
per cent of what it was in 1918 while the number of deaths, 47, in three years 
combined was scarcely 25 per cent higher than that, 38, for 1918 alone. The 
community appears to be well on the road toward the complete eradication 
of tuberculosis as a particularly dangerous health hazard. 

The general mortalit_\- rate in Bloomington has persistentl\' been some- 
what higher than that for the State and higher than those for some of the 
other municipalities. It must be remembered, however, that Bloomington 
is an old residential community in the center of an agricultural district and 
that the age distribution of the population is different from that in many of 



BLOOMINGTON 



61 



the younger places and those devoted more to industries which attract young 
people. A population with a considerable group of elderly people experi- 
ences a higher mortality than one with few old people although health condi- 
tions may be unusually good. 



Table 3. 
Births and Infant Deaths. 





Births 


Infant Deaths 


YK.XR 










Number 


Hate** 


Number Rate* 


1918 






38 


1919 






33 




1920 


448 


15.5 


36 


80.4 


1921 


495 


17.0 


45 


90j-9 


1922 


530 


18.2 


45 


84.9 


1923 


578 


19.5 


40 


69.2 


1924 


545 


18.1 


40 


73.4 


1925 


597 


19.6 


4S 


80.4 


1926 


553 


18.0 


42 


75.9 



^Deaths of infants under 1 ye 
*Per 1000 population. 



of age per 1000 births reported. 



Table 4. 
Cases of Certain Diseases Reported. 





1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


7* 


17 


2 


6 


3 


8 


^ 


7 


Smallpox 


139 


105 




1 


4 


140 


2 


11 


Measles 


522 


751 


7 


224 


428 


771 


84 


383 


Scarlet Fever 


181 


135 


75 


99 


62 


64 


46 


38 


Whoop. Cough 




48 


135 


39 


68 


155 


168 


139 


Diphtheria 


18 


89 


38 


20 


24 


34 


10 


7 


Influenza 






31 


3 


2 


4 


8 


4 


Poliomyelitis 




1 




1 




3 




12 


Tuberculosis*' 


100 


111 


10.1 


131 


93 


82 


202 


199 


Pneumonia"* 






10 


38 


40 


72 


53 


55 


Syphilis 




18 






13 


52 


105 


58 


Gonorrhea 


1 


9.5 




35 


26 


43 


68 


35 



*An outbreak of 130-150 cases of intestinal disturbance which it was possible was typhoid fever, was 
reported to the city health department. 

**A1I forms. 
Note: Case reports are never complete, but ihey have been much more so since 1920 than before in 
Illinois. This table indicates improvemnt in notification more than anything else. 

References. 



.\nnual Reports of the City of Bloomington, various dates. 

Annual Reports of the State Board of Health, John H. Rauch, M. D., Secretar; 



Springfield, variou.s 



History of Medical Practice in Illinois, Vol. 1, Lucius fl. Zeuch, M. D., Chicago, 1927. 
Report on an Appraisal of Health .Service for the Year 1925 in Fifteen Illinois Citii 
vlings, M. D., Director of Public Health, State of Hlinois, Springfield. 
Illinois Health News, JIay-June, 1926. 
U. S. Census Reports, Washington, D. C, various dates. 



Cairo 

Located on the most southern point of land and the lowest above sea 
level in the State, Cairo faces the Ohio River where her front yard is lined 
with docks that furnish anchorage for river vessels while her back yard is 
walled off from the Mississippi by a levee upon which a railroad enters the 
city. Cairo was incorporated as a cit\- on January 9, 1818, several months 
before Illinois was admitted to the Union, and was chartered as a city second 
only to Shawneetown among municipalities within what are now the bound- 
aries of Illinois. 

To the south of the community a few acres of swampy marsh land sink 
down into the waters of the two great rivers. To the north a considerable 
acreage of reclaimed land protected from Cash Creek and the Ohio River 
by levees, lends itself splendidly to the cultivation of cotton. 

Where Cairo got its name is a matter of some dispute. One theory is 
that the community was christened for Louis F. Cairo, a man who settled 
there in 1780 and became the father of the first white person born in that 
localit\'. M. B. Harrell, a local historian, contends that the name was taken 
from the ancient and widely famed city of the Nile delta. At any rate, that 
whole vicinity is vulgarly known as "Egypt", a term that has gradually come 
to embrace the whole southern end of Illinois. 

Sharing whatever advantages may have accrued from being near the 
center of population of the State, during the early days, Cairo likewise 
suffered later, in common with neighboring communities, from a shift in 
population density that carried with it the great industrial and agricultural 
interests of the State to the north, centering in Chicago. From 1850 to 1870 
Cairo experienced the greatest period of growth in her history. During 
that time the population increased from some 150 souls to about 10,000. 
Subsequently, growth has been exceedingly slow and the rate has declined 
in recent years. For the census years of 1900, 1910 and 1920, the number 
of inhabitants was 12,566, 14,548 and 15,203 respectively. Of the 1920 
population 9,779 were native born whites, 411 foreign born whites and 5,000 
negroes. Few, if any, other places in Illinois have such a heavy negro popu- 
lation. There were 3,280 or about 2\yi per cent in tlie age group of 45 years 
or more. This suggests a relatively short average life span since Cairo is 
an old community and the percentage of people 45 years of age and over 
is scarcely greater than that for the State at large. 

(62) 



63 



Health AIaciiinery. 



Frightened into action b_\- an epidemic of smallpox, Cairo passed an 
ordinance creating a board of health in 1857. The board membership con- 
sisted of the mayor and a committee of aldermen. A little later, provision 
was made for the employment of a health officer, whose qualifications and 
duties were those of a sanitary policeman, but this office was abolished in 
1869 and the duties were transferred to a policeman. 

A revival of interest in health matters took place in 1866 when rumors 
of an impending outbreak of cholera alarmed the public. Again a board of 
health was organized, this time composed of three physicians headed by 
Dr. Horace Wardner, and a health officer in the person of Dr. James 
Summerwell was appointed. With the subsidence of the outbreak, which 
arrived on anticipated schedule time, and the return of tranquilit\- in public 
thought the board of health fell again into a more or less dormant state 
only to be aroused again in 1869 by another visitation of the smallpox. 

These experiences together with the increase in river traffic from the 
south which opened the community to danger from imported diseases 
prompted the city to adopt what might be called a sanitary code in 1871. 
The text of this ordinance or code reads as follows: 

"If any person in charge of a boat shall permit any person suffering 
with a communicable disease to land or come ashore in Cairo or within 
five miles of the city in Illinois without a permit he shall pay a fine of 
$50 to $500. Such permit shall be passed upon by a physician of respect 
and standing of city of Cairo. Any captain or master of a boat con- 
cealing a passenger subject to same fine. 

"Any person having a communicable disease leaving their premises 
or place of abode without permit shall be subject to a fine of from $10 
to $100. The city marshal shall post quarantine signs on houses during 
illness of any person or pay a similar line. 

"The mayor of city and one member of the city council from each 
ward shall constitute a board of health which shall exercise general 
supervision of the public health of the city and they may report to the 
city council from time to time such sanitary rules as may be necessary to 
promote health and prevent contagious disease. It shall be the duty of 
the householder or occupant of any house to report any communicable 
disease to the mayor or city marshal or be liable to a fine of $25 to 
$100. Any medical doctor who shall have any patient within the city 
of Cairo shall forthwith make report to the mayor or city marshal of all 
communicable diseases subject to a fine of $20. 

"It is lawful for the board of health to establish a hospital for con- 
tagious diseases and to remove patients thereto when necessary in 
their opinion. Approved Nov. 25, 1871, John M. Lansden, Mayor, M. J. 
Hawley, City Clerk." 



64 DOWN-STATK M I'.X I( I PAMTIl-.S 

It ina\' be observed from the ordinaiu'c tliat another chan.t,fe was made 
in the provisions governing membership on the Imard and that it again be- 
came Ia\' in cliaracter. For the next year or two we find tlie Ijoard exer- 
cising its authoritx in a number of ways, employing physicians to vaccinate 
against smallpox all non-immune citizens, hiring special policemen to exe- 
cute quarantine regulations, constructing a "pest house" for isolating the 
unfortunate victims of smallpox and participating in many other activities 
calculated U> control diseases, especially smallpox. 

From 1871 on there seems to have been no further change in the legal 
provisions for maintaining an official public health organization until 1913 
when the commission form of government was adopted. During that period 
there were, however, many and at times violent changes in the character, 
size and activities of the board of health and its employes. The fact that 
Cairo was an important transportation point in those days, receiving and 
passing on heavy tonnage by rail and water, brought constantly to the city 
the hazard of smallpox and this disease was an almost perpetual source of 
annoyance and even alarm to the inhabitants. Then there was the matter 
of yellow fever which actually invaded the cit}- once and caused no end of 
anxiety and apprehension among the natives whenever it prevailed in the 
South. These factors made busy seasons for the health officials who some- 
times dropped out of the public picture for a few months only to come back 
into action as the most important agency in the city. At one time there were 
no less than eight mounted guards besides a staff of medical and sanitary 
inspectors supplemented by medical and sanitary officers of the State Board 
of Health at work while the mayor closed his business in order to devote 
his full time to matters of public health. Sometimes appropriations amounted 
to several thousand dollars and again they fell to a negligible sum. Some- 
times a health officer was employed and clothed with arbitrary powers and 
again there were times when nobody was emploAed in health work. Some- 
times the board of health was made up of physicians and at other times its 
membership was entirely la\-. Now a doctor would serve as health officer 
and again a sanitary inspector would till the job. 

The barometer that governed health activities was the presence in the 
city of some dreaded disease — smallpox, yellow fever or cholera — or the 
fear that one of these diseases might be introduced from areas where it did 
prevail and with which Cairo maintained commercial communications. This 
continued to be the case until about 1900 when smallpox, yellow fever and 
cholera began rapidly to lose their place as alarming diseases and ceased to 



CAIRO 



65 



give health officials more than casual interest. The men who served Cairo 
as health officers during this period include tiie following: 

Dr. James Summerwell, 1S66 — during cholera epidemic 

W. W. Wooten— April 22, 1S73. also 1S79 

William Brown 

Dr. W. R. Smith, medical quarantine officer — Aug. 1S80 

January, 1SS5 — board of health employed five assistant health officers 

S. M. Orr, 190.3, 1905, 1907 

George E. Atcher, 1S97-1S99 

Dr. F. J. Fitzgerald, 1911-1912 

In 1013 Cairo adopted the commission form of government and that 
automatically dissolved the board of health, transferring its responsibilities 
and duties to the commissioner of public health and safetx". I'rom that date 
forward to the present time no further adminis- 
trative change has been made. A medical health 
officer on a part time basis has been in office con- 
tinuall}' during that period while several ordi- 
nances relating to sanitation, milk, contagious 
disease and the like have been adopted. Regular 
appropriations, ranging from $5,000 to $9,000 
per year have been made to the health department 
but these sums included funds for garbage col- 
lection and disposal. Charles Fentcher was the 
first commissioner of public health and safety 
and the physicians who have filled the position of 
health officer include : 




B. S. Hutcheson, M. D. 
Health Officer, 1921-1927 



Dr. W. C. Clark. 1913 to May, 1921 

Dr. B. S. Hutcheson, 1921 to May 1927 

Dr. Charles Webber, May 1927 to date. 

Other public health service facilities that have developed in the city 
include a venereal disease clinic established in 1920, financed jointly b}- the 
State and the city and operated by the local medical society ; a school nursing 
service established in 1917 and financed by the school board; a county tuber- 
culosis association organized in 1918; a general clinic for children supported 
by the Kiwanis Club and a clinic for crippled children maintained by the 
Rotarians through the Illinois Society for Crijjplcd Children. 



Water Supply. 

The public water supply was first installed by the Cairo Water Com- 
pany in 1886. The supply was obtained from the Ohio River and provision 
was made for filtering the water. The plant was improved from time to time 
until the present purification plant was installed aliout 190,3. 



66 DOWN-STATE MUMCIPALITIKS 

The original franchise expired in 1915 an<l a new one was not granted 
until 1925. During that period few improvements were made. Since 1925 
plans have been made to improve and enlarge the plant which will practi- 
cally amount to the construction of a new purification plant. 

Analyses of samples of water have been made in the laboratory of the 
State Health Department since 1917 and with few exceptions, these indicate 
that the water has been safe, although the supply has until recently been 
classed as doubtful because of cross connections at the waterworks and in 
industrial plants which cross-connections have now been removed. 

Sewerai;e. 
The city is served by a combined system of sewers discharging into Ohio 
River. Becau.se of the large dilution furnished by the Ohio and Mississippi 
Rivers which join at Cairo no treatment of the sewage is necessary. 

Health Conditions. 

Nowhere in Illinois have health conditions created greater public excite- 
ment, alarm and agitation than in Cairo. Nowhere have more drastic and 
arbitrarv measures been employed to deal with emergency situations. 
Nowhere have these things been more fully justified by prevailing circum- 
stances. 

Subject to inundation and surrounded by swampy territory, Cairo is 
located in the midst of an area ideal for mosquito breeding. This condition 
introduced the malaria problem at the time when the very first settlers 
arrived and was later responsible for a harrowing experience with yellow 
fever. As early as 1700 Father Jaccjues Gravier observed that two members 
of his exploring party came down with "tertian fever" while stopping on 
the delta at the junction of the Ohio and Mississippi Rivers. Doubtless from 
that time onward the travellers and settlers who stopped or remained at 
Cairo was harassed by malarial infections that soon became endemic in 
that part of the State and remain so to this day. Records on that matter 
are exceedingly meagre, however, for the reason, perhaps, that malaria was 
too common a subject to inspire written comment. It was more or less like 
the weather — a thing to be talked and joked about but never reduced to 
historical manuscript. 

During the middle Aears of the nineteenth century, Cairo was one of 
the most important transportation points in the Mississippi Valley. River 
traffic from the Gulf and intermediate points found Cairo a convenient ter- 
minal and transfer station. Railroad facilities were inadequate to handle 
the freight business and the Mississippi steamboat interests were at the peak 
of their prosperity. Both passenger and freight service used Cairo as a 
terminal and transfer point for destinations north and east. Thus the in- 
habitants of this thriving little port were open to all the hazards of health 



67 



that constant contact with the travelhng' pubhc and with steamboat and rail- 
road crews could provide. 

We are not surprised, therefore, to learn that the cholera epidemic that 
swept the country during 1848-1852 spared not its fatal fury upon the 
citizens of Cairo. Commercial activities were practically paralyzed while 
the outbreak prevailed. Even the local newspaper, the Cairo Delta, sus- 
pended publication although a half sheet edition, carrying President Taylor's 
proclamation exhorting the public to pray for rehef from the awful cholera 
plague, was printed and circulated. Just how severe mortality was in Cairo 
is a matter for conjecture, however, since no statistics relating thereto have 
been preserved. 

Another wave of cholera swept over our country during the sixties and 
a mild epidemic frightened the people in Cairo and vicinity into strenuous 
preventive efforts. This experience was followed in 1873 by another out- 
break of the disease which carried off a number of persons and resulted in 
the usual feverish sanitary activities. There is no evidence that cholera 

Table 1. 
]\loRT.\LiTY From Certain C.\usi:s. 







fc. 


























> 








1 


= 






.S 


M^ 






s 


&. 








'X 


r°. 


C3 




•;S 


il 


.2 = 




- 


— 




§ 








s 


« 


>, 




- 1- 




o 


c 


■^ 






■s 


s 


5 


S 


£ 


f -S 


5*- 




< 




a 


1 


S 




1 


3 
S 


= 


II 




1918 


396 


4 


6 








., 




76 




62 


44 


1919 . 


299 


6 


3 








1 


3 


19 




.-)S 


12 


1920 


321 


6 


1 




3 




1 


1 


19 




.-.2 


28 


1921 


23.5 


1 


4 








1 


1 


5 




37 


15 


1922 


262 


3 










9 




5 




31 


24 


1923 


262 


3 






4 




2 




17 




32 


16 


1924 


275 


4 


1 




1 


i 


3 


1 


11 




29 


29 


192.-. 


301 


6 


3 




1 








6 




31 


13 


1926 


297 


4 


1 








2 


1 


11 




2.T 


29 



Table 2. 
Mortality Rates From Certain Causes. 







'I 








S 


■S 






































YEAR 


s 






>< 




" 


^ 


s 


g 


■3 




S c 




6 




•p 




S 


"oj 




^ 


g 


£ 




E° 




< 


a. 


1 


j: 


1 


1 


s 


fi. 
5 




S, 


St 




1918 


26.2 


24.6 


37.0 








12.3 




469.1 




382.7 


271.6 


1919 


19.7 


40.0 


20.0 








6.6 


20.6 


126.6 




386.6 


80.0 


1920 


21.1 


39.3 


6.5 




19. C 




6.5 


6.5 


124.6 




341.2 


183.7 


1921 


15.4 


6.5 


26.1 








6.5 


6.5 


32.7 




241.8 


98.0 


1922 


17.0 


19.5 










13.0 




52.0 




201.7 


156.1 


1923 


17.0 


19.4 






25.9 




12.9 




110.3 




207.7 


103 . 8 


1924 


17.7 


25.7 


6.4 




6.4 


6.4 


19.2 


6.4 


70.9 




187.0 


187.0 


192.5 


19.3 


38.5 


19.2 




6.4 








38.5 




199.1 


83.3 


1926 


19.0 




6.4 








12.8 


6.4 


70.4 




160.2 


185.2 



Note: The rate from All Causes is per 1,000 populate 



all others per 100.000 population. 



68 DOWN-STATE iMUXICIPALlTIKS 

ever again letunied lo plague and terrorize the citizens of Cairo but a 
smouldering fear of it, ready to flare up into frank alarm at the slightest 
rumor, never ceased to repose in the public mind until the generation which 
had witnessed the disastrous outbreaks had passed on beyond the vale of 
mortal existence. 

Smallpox was another prolific source of jjublic iiv'xei in Cairo. It is 
probable that no other city in the Middle West went through a more exas- 
perating e.xperience with that disease. Year after year the infection was 
brought to the gates of the community by steamboat and railway crews, by 
passengers en route to more distant terminals and by new or temporary 
settlers. Of what occurred during preceding years there is no authentic 
record but in 1857 an epidemic burst upon the community with fury enough 
to send local officials scurrxing awa_\- to the task of organizing and putting 
into operation a board of health. How fatal or disastrous the outbreak 
proved to be can only be surmised. It is probable that wholesale vaccina- 
tion was resorted to and this protected the permanent population, so far as 
that applied in those early days, for the time being. Rapid growth, an extra- 
ordinary temporar}' character of residents and the rising generation soon 
built up a heavy unvaccinated element, however, so that in 1869 the disease 
returned in a virulent character and the scenes of 1857 were again enacted 
although apparently less extensive and complete. 

At any rate we find malignant smallpox again present in 1872 and the 
city officials, evidently at their wits end to control the disease and calm the 
public alarm, built a "pest house", employed a special corps of police to 
maintain rigid rjuarantine of premises where patients were housed, ordered 
the disinfection of houses where patients had been and the burning of clothes 
and bedding, and passed, withal, an ordinance, requiring all susceptible per- 
sons to be vaccinated. .V year later when the epidemic had subsided a 
report showed that 71 patients had been sent to the "pest house", 29 of whom 
died; that 55 were non-residents and 56 colored; that 75 patients had been 
quarantined in their homes and that 23 of these died ; that operating the 
"pest house" had cost $2,508.77 and that the city had spent $1,034.00 in 
other wa\s incidental to handling the outbreak. No wonder the citizens 
were sensitive about epidemics and felt strongly- concerning quarantine and 
immigrant inspection ! 

Even that experience did n(jt end their troubles with smallpox. Three 
years later, 1875. a new and malignant epidemic broke out. Two pupils at 
Loretta Academy died. Judge Baker moved his court into the fire engine 
house to escape exposure from prisoners among whom the disease had 
started. What to do again agitated the unhappy minds of mayor and alder- 
men. ( )nce more they tried everything. An ordinance forbidding anyone 
to house a patient sick of contagious disease without a permit so to do 



69 



was adopted, arrangements were made with St. Alary's Hospital to care 
for the sick, general vaccination was ordered, the city paying the bills where 
necessary, and a full time health officer in the person of William Brown was 
employed. \\'hat more could they do? Surely that was enough had the 
population been stable but the constant shifting and the coming and going 
made sporadic control measures effective for only temporary periods and 
soon the disease was up to its mischief making again. Another outbreak 
occurred in the early eighties, a rather severe epidemic in 1885 and re- 
current epidemics more or less .severe from year to year down to the present 
time. Never has the municipality succeeded in ridding itself of this loath- 
some disease. In 1927 there were 47 cases reported. 

But yellow fever was the disea.se that overshadowed every other human 
affliction in the public mind. A kind of morbid romance enshrouded the 
disease. It not only breathed fear, alarm and dread into the hearts of men 
but it drove them from their homes. Citizens of Cairo lived in constant 

Table 3. 
Births and Ixf.-^xt Deaths. 











Births 




1 
I 




nfant Deatl 


' 




YE.iR 


Number 








Rate** 




Number 


1 

I 
1 


Rate* 




1920 
1921 
1922 
1923 
1924 
192S 
1926 




233 
247 
229 
219 
262 
225 
251 




1 


1.5.3 
16.1 
14.9 
14.2 
16.9 
14.4 
16.0 


1 
1 
1 

1 


26 
34 
34 

37 
29 
29 


1 

I 
I 
1 


107.3 
10.5.3 

148.5 
1.55.3 
141.2 

128.9 
115.5 




•Deaths of 
♦♦Per 1000 


infants 
populati 


under 1 year 


of 


ag 


B per 


1000 births 


report e< 


. 









Table 4. 
Cases of Certain Diseases Reported. 





1916 


1917 


1918 


1919 


1920 1921 


1922 


1923 


1924 


1925 


1926 


1927 


Ti-phoiil Fever 


2 








6 


10 


7 


16 


30 


8 


27 


Malaria 




19 




37 




5 






3 




2 


Smallpox 




35 


8 


6 


41 




2 


IS 


88 


1 


47 


Measles 


45 


665 


34 


21 


1 


2 


63 


4 


1 


51 


17 


Scarlet Fever 


3 


6 


5 


32 


1 


5 


]0 


14 


4 


4 


11 


AVTloop. Cough 










B 


3 


2 


4 




17 


8 


Diphtheria 


9 


12 


20 


35 


24 


24 


15 


21 


13 


8 


11 


Influenza 






1443 


64 


1 


5 


13 


7 


4 


12 


. 2 


I'olioinvelitis 










1 












1 


Menirr-ilK 






2 




t 


1 


1 


1 








Tubcn iil-.i.- 


46 








1 ^ 


36 


35 


16 


2S 


36 


34 


PneuHiMM.- 






242 


80 




15 


9 


24 


25 


52 


18 


Svpliili- 


42 




4 




1 181 






45 


83 


8.5 


43 


Gonorrhea 






5 




56 






13 


14 


17 


2 


Chancroid 










2 















•AH forms. 
Note: Case reports are never complete, but they have been much mon 
Illinois. By comparing the figTires in this "Uible with those showi 
specific causes it is manifo.st the notification is even now far from c 
ticularly noticeable in the case of n.alaria and tuberculosis, 
No figures for 1920 available. 



1!>20 than before in 

iniber of deaths from 
I C-Aira. ThU is par- 



70 DOWN-STATIC MUNICIPALITIES 

(Ireail of yellow fever. Outbreaks that often grew into harrowing epidemics 
occurred during the late summer and early autumn almost annually in the 
lower valley. Communications were very close between Cairo and points 
as far south as New Orleans, the very heart of the yellow fever area. 

In 1878 the thing that Cairo greatly feared actually happened. Yellow 
fever came to town. Death and disaster stalked through the empty streets. 
F-verybody who could deserted the city. Over 100 cases and some 62 deaths 
were enough to justify the public panic which prevailed. This outbreak, one 
of the ver}' few if not the only one that ever occurred in Illinois, is decribed 
at length in volume I of this history, beginning on page ^^IT . 

Other health problems and experiences have cast their lugubrious 
shadows across the public life of Cairo but those of cholera, smallpox and 
yellow fever have submerged them into relative insignificance so far as 
thought anil action were concerned. At the same time some of the other 
diseases cost the people more dearly in health and life than did these three 
more notorious ones. This is manifested in the general mortality rate which 
rarely descends below 17 per 1,000 people and frequently rises to 20 or more. 
Tuberculosis has always been widely prevalent there, causing a mortality 
rate considerably in excess of what prevails in most communities of Illinois. 
It was 160.2 per 100,000 in 1926 and 382.7 in 1918. T\phoid fever, likewise, 
has been endemic in Cairo throughout the years, rarely falling in prevalence 
to a point even remotely comparable with that in the State at large and that 
found in municipalities generally. The influenza epidemic of 1918 hit Cairo 
hard, causing one of the highest mortality rates registered anywhere in the 
State. Other diseases such as diphtheria, scarlet fever, pneumonia and the 
like have not overlooked the place but have varied in intensity from time to 
time. 

The fact that Cairo has a heavy negro population explains some of the 
unfavorable features of health conditions here. It has a bad influence over 
the infant mortality rate, always high, and it adds a marked increase to the 
death rate from tuberculosis. In 1924, for example, the 5,000 negroes lost 
118 of their number by death, 17 of which were due to tuberculosis, while 
the 10.000 white people lost only 157 by death and only 12 of these were due 
to tuberculosis. Even then the mortality rates among the white population 
appear to be somewhat more unfavorable than that generally found in 
Illinois. This, however, might be expected in view of the fact that Cairo 
has grown slowly in recent years, thus causing an age distribution among 
the whites that wdiild result in a higher death rate than would ordinariU 
be found in a rapidly growing city of reasonable healthfulness. 

Rf.ferences. 

I.:m,i;J..i|-- lllstorv. 

lii.i.n "I s. Hllic"m Illinois—George Washirifrton Smith — 1912. 

Ill tMt\ -if M.xander, Pulaski and Union Counties. 

Ill, lli.>tiias II. Leonard's personal interviews with various citizens of Cairo. 



Carhondale 

Lying close to the foot of the Ozarks, Carbondale shares with Murphys- 
boro, the county seat, the municipal honors of Jackson County. The rail- 
road shops of the Illinois Central and a State teachers' training college are 
two of the principal factors in the industrial, commercial and social life of 
the place. The density of the population is moderate, about 65 per square 
mile, being less than some of the neighboring coal mining counties and con- 
siderably more than the strictly agricultural regions in that vicinity. Coal 
mining is of no consequence in the immediate vicinity of Carliondale although 
there are 26 active mines in Jackson County. 

Carbondale itself is a small community with about 7,000 inhabitants. 
It grew up around the railroad station which was located there in 1852 be- 
cause of the easy access to coal and it owes its name to the terrane which 
suggested a dale on the one hand and was underlaid with coal on the other. 

There is nothing particularly eventful about the health history of either 
Carbondale or the county except the prevalence of malaria which was re- 
sponsible for a vigorous anti-mosquito project that started in 1922 and the 
occurrence of a devasting cyclone in 1925 which resulted in the establishment 
there of a State public health laboratory. About 1885 the municipality 
adopted an ordinance creating a board of health and this continued in force 
until 1911 when the commission form of government replaced the alder- 
manic, automatically dissolving the board of health and transferring its 
duties and responsibilities to the commissioner of public health and safety. 

Health officers have alwa}'s been employed on a part time basis. At 
first a physician was chosen to act in this capacity but later, upon the death 
of Dr. H. E. Lightfoot while holding the office in 1917. his wife was ap- 
pointed to fill the place and she was later succeeded by another non-pro- 
fessional woman. A nurse to work in the public schools of the county was 
employed in 1919, being paid by the county board and the tuberculosis asso- 
ciation and later by the Red Cross only and .she spends some of her time in 
Carbondale. 

With the exceptions mentioned above, there has been little of an un- 
usual character in the health conditions which have prevailed at Carbondale. 
Available information centers around outbreaks of smallpox that alarmed 
the public from time to time. Occasionally somebody has started the rumor 
that trachoma is rampant there and that a general epidemic of blindness is 
consequentl\- imminent l)ut careful investigations have never substantiated 
these alleged facts. T\]ihoid fever has been endemic for \ears, providing 

(71) 



72 



DOWN -STATE MUNICIPAl.ITIKS 



one of the most expensise health problems of the community and county. 
'ruheiculnsis has run a lillle higher than for the State but that is perhaps due 
to the inxsiMice nf a cmisiderable negrci population. Other diseases have 
Clime and gone in e|ii(Iemic cycles uf more or less ordinar\ experience. 

Due to the unusual nature of the malaria-mosi|uito eradication project 
and the destructisc character of tin- cyclone which led to a concentration of 
a considerable amount of public health work in the area, the stor_\' of these 
events will be delineated in some detail. An account of the development of 
a ])ublic water suppl\ and sewage disposal system is also included in what 



Mosquito Control. 



In November I'd.s. 
before the Southern lllin 




H. C. Mitchell, M. D. 



)r. H. C. Mitchell of Carbondale, read a paper 
. Medical .Society at Mt. \'ernon, entitled "Malaria 
;md Mosquito Control in Illinois". 

In lOU) attention w.as called b\ the State 
I 'epartment of Public Health to the heavy eco- 
nomic losses from malaria in southern Illinois. 
In I'd/, the Southern Illinois State Medical So- 
ciety, aflt-r reflecting upon a paper presented by 
Dr. 1. W. Harrow of Carbondale, adopted a 
resolution asking that studies of malaria and 
m(Jst|uitoes in southern Illinois be made. In 
I'dS. I'd'' and 1920 investigations were carried 
on by b'.ntomologist S. C. Chandler of the State 
Natural History Survey and the findings were 
publisheil. 
Simu'lrmeously and following the southern Illinois malarial investiga- 
tions, the ([uestion of systematic malaria-mosciuito eradication was presented 
on several dilVerent occasions, as opportunity offered, by the division of sani- 
tary engineering of the State Department of Public Health to the cit\' 
officials and interested civic organizations and citizens at Carbondale. It was 
considered that Carbondale presented, for various reasons, the best place to 
demonstrate what could be done in the \va\- of mosquito eradication and 
that other cities would lienefit by such work. 

As a result the Lion's Club of Carbondale went on record on January 
27, 1922, guaranteeing to raise a fund of $2,000 in order to carry on syste- 
matic malari.i-mosquito control during l')22. The International Health 
Board had pre\iously tentatively agreed to furnish $1,000 and the Illinois 
Central Rriilroad had given f.iMirahle consideration to the project of drain- 
ing m;my ;icres of sw<amp land adjoining the city on the north. The State 
Ue]>artmenl of Public Health had agreed to provide the services of a sani- 



74 DOWN-STATK MUNICIPALITIES 

tary engineer to supervise the work, and the assistance of the State Natural 
History Survey and the I'nited States PubUc Health Service was also 
assured. 

Proposed and recommended by the Stale Department of I'ublic Health, 
sponsored by the Lion's Club of Carbondale and receiving financial assist- 
ance from that club, the International Health P)oard, and the Illinois Central 
Railroad, and directed by the sanitary engineering division of the State 
Department of Public Health, Carbondale carried on systematic mosquito- 
control work for the season of 1922, and for the first time in the history 
of the city enjoyed practically complete relief from that pestiferous insect. 
The results from the standpoint of reduction in malaria cases were equally 
gratifying. Vital statistics and house-to-house canvasses had shown that 
prior to 1922 the city suffered an average of over 250 cases of malaria a year 
(267 during 1921'). Following the close of the mosquito-control work for 
1922 it was fdund Iiy a house-to-house canvass that only 19 cases of malaria 
had occurred (hiring tliat year in the entire city. It is quite probable that 
some of those few cases were recurrent (ir may have recei\e(l their infections 
elsewhere. 

The results were so satisfactory to the city officials and ci\ic organiza- 
tions that had participated in the work, and the economic saving to the 
community was so apparent that arrangements were made to carry on similar 
control work in 1923. During 1923 the city was again practically free from 
mosquitoes and only 11 cases of malaria were found by a house-to-house 
canvass. 

The work at Carbondale lias comprised major and minor drainage, 
stream clearing, utilization of top minnows, oiling control of rain barrels. 
open wells and cisterns, house inspections, paris-green treatment, and edu- 
cational measures. The control work in Carbondale, by reason of its tre- 
mendous success has been repeated annually with profitable results. 1927 
marked the sixth year of continuous malaria mosquito control in Carbondale. 

The 1927 legislature passed an act jtermitting the creation of "mos- 
quito-abatement districts" and Carbondale in the fall of 1927 voted by a 10 
to 1 majority to create such a district. In the future malaria-mosquito 
control in Carbondale will be financed by funds collected by tax ]ev\- against 
the properties within the district. 

In addition to the Carbondale malaria-control project, campaigns were 
conductt'd at Alurphysboro and (mrham following the tornado of \'>2S. 
These projects were financed jointly li\ the .State of Illinois and Interna- 
tional Health Boanl. and resulted in reduction of 220 cases of n:alaria at 
Murphysboro and 33 cases in (iorham. according to estimates based u]ion 
cases prevailing in those two cities prior to the introduction of control work. 



CARBON DALE 



75 



Table 1. 

Mortality From Certain Causes in Carbondale. 

From Local Records. 







aj 










a 


























bj 








































i 


^ 








& 


U 


a 




iH 


'i s 


ci 


YEAR 


^ 


"3 







^ 






S 


g 


>. 


3 i 






D 


■3 


•^ 


a 


^ 


'SJ 


C. 


j= 





H 


^■M 


i~ 




< 


>^ 


s 


rt 


1 


1 


1 
IS 


S 


C 


L 


Is 


3_ 


1902 


43 


2 








... 










- 


5 


1903 


29 


1 




'3 














2 


5 


1904 


64 










"3 










15 




190ri 


60 


3 










2 








IS 




1606 


51 


3 










1 








8 




1907 


63 


2 






' 












9 


6 


1908 


60 


5 


















6 


4 






F 


ecords des 


troyed 


r. 


11 l!l09-191(i, inclusive. 










1917 


:>7 


2 








i .. . 1 


... 






12 


10 


1918 


103 












1 




"5 




8 


32 


1919 


54 


i 


















9 


8 


1920 


61 


2 














i 




7 


7 


1921 


























1922 


125 


"3 














6 




ii 


"s 


1923 


127 


1 














2 




11 


13 


1924 


139 


2 








' i 






2 




10 


16 


1926 


148 


2 


















6 


20 


1926 


114 


2 








i 






(i 




10 


14 



Table 2. 

Mortality Rates From Certain Causes in C.vrbondale. 







t. 










„ 
















> 








^ 


•5 






.2 


^„ 


^ 






^ 








," 












■- S 














^ 


u 








6 £ 


YE.\R 


rt 


— 













V 


S 


>i 


Is. 










'3 


■^ 


^ 


S 


"S 


g. 


^ 




£ 




E- 






D. 


.2 


S 


1 


"^ 


_g 


J= 


= 


~ 


•s^ 


S = 






^>.. 










S 








=>■< 


^< 




"f. 




S 


c/: 


s 


T. 


d 


.r 


£. 


!--^ 


0.^ 


1902 


11.5 


53.5 


















133 . 8 


133.8 


1903 


7.3 


25.3 




76!6 














50.6 


126.7 


1904 


15.4 








48 .'i 


72^2 










361.0 


120.3 


1905 


13.7 


68 .'7 


22^9 








4.5.8 








297.9 


114.6 


1906 


11.1 


65.6 










21.8 








174.9 


109.3 


1907 


13.1 


41.8 








26 .'9 










188.2 


125.4 


1908 


12.0 


100.2 


46!6 
Recon 


s de.strr 


26;6 

ycd fro 


n 1909 


191(i] 


liclusivi 






120.2 


80.0 


1917 


9.4 


33.3 


... 


... 


... 




10.6 








199.8 


166.5 


1918 


16.9 
















16.4 




82! 6 




131.3 


525.3 


1919 


8.7 


li'.i 






















143.7 


129.5 


1920 


9.7 


31.9 














1.5!!) 


is! 9 


liiig 




105.3 


105.3 


1921 






























1922 


17.5 


42.6 
















14 '.6 


84.6 




1.54! i 


ii2!i 


1923 


16.7 


13.2 


















26.4 




145.3 


171.7 


1924 


17.3 


24.9 


12 '.4 










12^4 




12!4 


24.9 




124.9 


199.9 


1925 


17.5 


23.7 






















71.1 


237.0 


1920 


12.8 


22.5 












li.'i 






67." 6 




112.7 


157.8 



Note: The rate from All Cau 



per 1.000 population; all others per 100,000 population. 



76 DOWN-STATE MUNICIPALITIES 

Recapitulating, the combined expenditures for malaria and mosquito 
control in Jackson County during 1922-1927 inclusive have been $12,150, 
exclusive of the supervisory service of a State sanitary engineer. The ex- 
penditure of this sum of money has resulted directly in the prevention of 
1,273 cases of malaria according to what appears to be reasonable estimates. 
If an economic loss of $100 per case is assumed, the return upon the invest- 
ment for the county has been $11.%150 or an average of $19,190 per vear. 

Storm Disaster Brings Laboratory. 

Thv c\cl(inic storm that spent its wrath mainly in Jackson County on 
iNlarch 18th, 1925, was one of the most devastating weather phenomena that 
ever occurred in Illinois. Homes, barns, school houses, store buildings, 
automobiles, everything were swept before it, leaving ruin, death and de- 
struction in its path. The death toll reached 850. About 3,000 persons 
were more or less severel}' wounded. Twent\- thousand were made homeless. 
The wreckage played ha\-oc with water snppl\- and sewage disposal systems 
both public and private. 

These conditions introduced a very grave public health situation as 
well as emergenc}' relief problems. A\"ith temporary living quarters neces- 
sary for the comfort of those made homeless, and with all ordinary means 
of handling food supplies, securing water and disposing of wastes completely 
disorganized a condition favorable to disastrous epidemic outbreaks was 
created. Not only so but the rehabilitation of the homeless presented health 
problems requiring for solution considerable time and professional skill. 

For these reasons the State Department of Public Health promptly 
joined forces with the relief agencies that established headquarters in 
Carbondale on the morning following the stoiTn and participated in the 
relief work, taking particular notice of sanitary and public health conditions 
and utilizing ever}- possible resource to prevent epidemic outbreaks. Among 
other things the department established a laboratory for making all the 
tests ordinarily performed in jnililic health laboratories. 

The laboratory proved to be so beneficial to the local medical profession 
and indirectly to the public that a strong demand for its permanent location 
there was manifested. Accordingl\', arrangements were made for maintain- 
ing in Carbondale, in quarters supplied by the Holden Hospital, a branch of 
the State diagnostic laboratory. A full-time technician is assigned for duty 
there and the laboratory serves all of southern Illinois, offering facilities for 
doing all tests ordinarily done in a ])ublic health laboratory. The report for 



CARBONDALE 



77 



the month of September 1927, given below, suggests the character and 
volume of the work done at the Carbondale laboratory. 

Positive Negative Doubtful Total 

Diphtheria 3 70 73 

Tuberculosis 1 15 16 

Gonorrhea ^ 12 17 

Widals (typhoid) 12 78 7 97 

Widals (paratyphoid) 7 86 4 97 

Kahns 85 245 6 336 

Malaria 10 10 

Rabies 6 2 8 

Typhoid cultures 28 28 

Miscellaneous 9 9 

691 

Daily average 23 plus 

Urines 38 

Miscellaneous blood counts 2 

Complete blood count 1 

X-Ray examinations 7 

Containers sent out : 

Wasserniann 276 

Microslides 18 

Diphtheria 48 

Widals 126 

Sputum IS 

Fecals 20 



Tlie list of health officers who have served Carbondale include : 



1891 Dr. A. M. Lee 

1891-1893 Dr. John Keesee, member anil health officer 

1893 Dr. .T. T. McAnally 

1892-191G Dr. T. C. McKinney 

1906-1912 Dr. M. Etherton 

1912 Dr. W. A. Brandon 

1912-191G F. M. Hewitt, commissioner of piililic health and safety 

1917-1919 Dr. A. S. Caldwell 

1917-1920 Dr. H. E. Lightfoot 

1919-1921 Rev. J. S. Merrill 

1920-1924 Mrs, H. E. Lightfoot 

1924 



to date Mrs. Cora Black 



Table 3. 

Casi:s of Certain Diseases Reported in Carbondale 

From Local Records. 





1923 


1924 


1923 


1920 


1927 


Tvphoid Fever 


15 


6 


11 


8 


9 


Smallpox 





13 





1 





Measles 


5 


1 







1 


Whooping Cough 





8 


5 


3 


6 


Scarlet Fever 


5 


19 


9 


34 


36 


Diphtheria 


7 


10 


3 


4 


3 


PoIiom\elitis 


1 





1 





2 


Tuberculosis* 


3 


4 


3 


5 


11 


Pneumonia* 





9 


5 


3 


4 


Syphilis 





1 


3 


1 


5 



*A11 forms. 

Note : Manifestly diseases have been more prevalent in Carbondale than figures in this table suggest. 
T.vphoid fever, scarlet" fever and diphtheria are more completely reported than any others. 



78 



DOWN-STATE M UN ICIPAI-ITIES 




1st row, left to right: General D. H. Brush, plotted the town of Carbondale; Dr. 

J. Ezra Blanchard; Dr. John Keesee, health officer and member of board of 

health, 1891-1893; 
2nd row: Dr. A. M. Lee, health officer, 1891; Dr. J. T. McAnally, health officer, 

1893; Dr. T. C. McKinney, health officer, 1892, 1916. 



Table 4. 
Mortality From Certain Causes in Jackson County. 









u 








._^ 


fr 














































fc. 








S 


6 


.2 




~ 


V,^ 


.2 « 




YKAH 


3 




« 


o 






V 




>i 


3e 


§1 




































j: 


•| 




i 


■s 




^ 


1 




^< 
































1919 


454 


























1920 


342 


























1921 


40S 


10 


2 








12 


1(5 






■ 41 


23 




1922 


431 


12 


3 








3 


11 


32 




42 


1.-. 




192.'! 


471 


3 








1 


9 


4 


9 




41 


27 




1924 


423 


2 


2 






2 


10 


3 


S 




44 


34 




•192,"; 


707 


9 


4 






1 


3 


1 


13 




29 


44 




1926 


472 


4 


1 




13 


3 


■' 




20 




38 


31 



rtality due to cyclone storm. 



CARDOXUALE 



79 




1st row, left to right: Dr. M. Etherton, health officer, 1906-1912, and member 
present board of health; Dr. W. A. Brandon, health officer, 1912; Prank 
N. Hewitt. Commissioner of public health and safety, 1912-1916. 

2nd row: Mrs. Cora Black, health officer, 1924 to date; Major Robert W. Davis, 
president, present board of health; Joseph K. McGuire. member city council, 
1920-1923 and publicity director of campaign that made Carbondale the first 
mosquito abatement district in Illinois. 



Table 5. 
^loRTALiTY Rates From Certain Causes in Jackson County. 

































5 








L. 


jj. 






M 






YEAR 


i 


fe 


.d 


« 




> 
& 


8 


■3 


„ 






'ii 




a 


"3 


o. 


<u 


■s 


O. 




c 


£ 


£^ 






< 


a. 


1 


1 


a 


1 


1 


1 


3 


Cu 


Tube 
(All 


B 


1919 


12.3 
























1920 


9.2 
























1921 


10.8 


26.7 


5.3 








32.1 


42.7 




2.6 


109.fi 


6i..5 


1922 


11. .5 


31.9 


7.9 








7.9 


29.2 


85 . 1 




111.7 


39.9 


192:! 


12.5 


7.9 








2.6 


23.8 


10.5 


23.8 




108.4 


71.4 


1924 


11.1 


5.2 


5.2 






5.2 


26.3 


7.9 


21.1 


2.6 


115,1 


89.4 


1925 


18.5 


23.5 


10.4 






2.6 


7.8 


2.6 


34.2 




75.9 


114.2 


1926 


12.3 


10.4 


2.6 




33. S 


7.8 


13.0 




52.0 




99.0 


80.7 



Note: The rate from All Causes is per 1,000 pnpulation ; all others per 100,000 popul.iticn. 



80 



IX)\V.\ -STATE MUNICIPALITIES 




Delia Caldwell, M. D. 
Merllcal Advisor. Southern 
Illinois Normal Univer- 
sity. 1920 to date 



A public liealth service is maintained for the benefit of the students in 

the Southern IlHnois State Normal University located in Carbondale. The 

activities connected therewith, which are and have been under the direction 

of Dr. Delia Caldwell since 1920, doubtless have 

an iinportant influence over comnutnity health in 
(."arbcindale. 

Water Supply. 

The waterworks were first installed in 1898 
1)\ a private corporation which obtained a fran- 
chise in 1902 for a period of thirty years. Water 
was secured, first from two wells, later from 
three, four, five and still later six wells. These 
ranged in depth from 200 to 650 feet, two of 
which were 410 and 416 feet respectivel}-. The 
estimated maximum yield of all wells was about 
135,000 gallons per day with a reservoir capacity 
of about 260,000 gallons. The demand for water 
during the dry season was usually greater than the supply. The supply was 
considered by the State Department of Public Health to be periodicall\- con- 
taminated. The water had a strong saline taste and on account of the peri- 
odic contaminatiiin had been chlorinated. There are about ten miles of 
cast iron pipe ranging in size from ten to four inches. 

In 1924, a new water system was proposed and plans for the same were 
approved by the State Department of Public Health. In 1925. the people 
of Carbondale voted to install the new system, construction of which was 
completed in 1026. The present supply consists of the following: — An im- 
pounding reservoir of 400,000 gallons capacity, with a drainage area of 
2,400 acres, located about one mile south of the city limits, covering an area 
of sixty acres and ranging in depth from ten to twenty feet, a gravity pipe 
line to the city, and a modern water-purification plant. The water is treated 
by coagulatiuti and sedimentation, filtration and chlorination and is distri- 
buted through the former water mains. At the present time the water is 
regarded as of safe sanitary quality and suitable for all domestic and indus- 
trial purposes. 



Sewerage. 

Carbondale sewerage s\-stem, about twelve miles in length, has been 
built a portion at a time without any definite plan and mostly for sanitary 
purposes with only a few storm sewers. The s}'stem discharges without 
treatment northeast of the city into Crab Orchard Creek, a tributary of Big 



CAKIiONDALE 



81 



Aluilih River. Sewerage is available for alioul four-fifths of the population, 
but not more than one-half of the population are using the system. Improve- 
ments to the sewer s\stem are necessary if proper sanitary conditions are to 
be maintained. 

Table 6. 
DiKTiis AND Infant Deaths in Jackson Countv. 



VK\i; 


1 












1 Number 
1 


Rate** 


Number 


Rate* 




1919 


] 




71 






1920 


«14 


21.1 


88 


lOS.l 




1921 


783 


20.9 


63 


80. fl 




1922 


772 


20.-1 


69 


89.4 




1923 


819 


21.7 


62 


7.i.7 




1924 


810 


21.3 


64 


79.0 




1925 


804 


21.0 


89 


112.2 




1926 


830 


21.6 


81 


97.6 





•Deaths nf infants under 1 , 
•Per 1000 population. 



of age per 1000 births reported. 



References. 



.\nnunl Reports of the State Board of Health, Springfield, 
History of Jackson County, Newsonie. 

Bulletins of the State Water Survey, Urbana, various dates. 
U. S. Census Reports, Washington, D. 0., various dates. 



Charnpaigri'lJrbana 

The twin cities, I'rbana and Chamiiaign. are officially two separate cor- 
porations but in realit}- they are one communitx'. They are in Champaign 
Countv, the third richest agricultural county in the United States (census 
1920) and are 126 miles south of Chicago and 187 miles northeast of St. 
Louis. In Urbana is located the great State university which accommodates 
more than 10.000 students, a distinguished seat of learning that lends to the 
community a distinct collegiate atmosphere. 

Champaign County was formed from the western part of Vermilion 
County in 1833. Urbana became the county seat and was organized under 
a charter in 1855. 

The city of Champaign began in the earl\- fifties when the Illinois 
Central I\ailwa\- laid a track through that section and built a station about 
two miles west of Urbana. calling it West L'rbana. In 1860 the name was 
changed to Champaign and a community government set up under the city 
plan. 

The fact that the main line of the Illinois Central ran through Cham- 
paign gave that part of the future community a tremendous advantage in 
potential growing power. Then in 1867 Urbana managed to balance thing 
up somewhat when it succeeded in getting itself chosen as the site for the 
State university. Urbana has remained under the aldermanic form of gov- 
ernment but Champaign changed over to the commission form in 1917. 

Both together the two incorporations include a population that compares 
favorably in size with the leading cities of the State. The census figures for 
the three most recent decennial periods are: 



Champaign 102.511 12421 909S 

Urbana 10244 8245 o72S 



Eighty-eight per cent of the population are native whites, 5 per cent 
foreign born and about 7 per cent negroes. So the community is made up 
principally of a well-to-do middle class American people. 

The University has an enrollment of 10,700 students and a faculty 
of 1.200. '^Tfi 

(82) 



CHAMPAIGN-URBAN A 



83 



Health IMachinery. 

The first niovenient toward providing official public health service in 
the community got under way when Champaign adopted in 1864 an ordi- 
nance relating to the abatement of nuisances and to general sanitary condi- 
tions. A somewhat similar but more all-inclusive 
ordinance was adopted by Urbana in 1880. 

Since city ordinances like amendments to the 
Constitution of the United States refuse to en- 
force themselves, both municipal governments 
soon found themselves facing the necessity for 
creating machinery with which to carry into ef- 
fect the mandates of the city fathers. Thus we 
find a new ordinance, adopted by Urbana in 
1882, creating a board of health made up of the 
mayor and one alderman from each ward. Cham- 
paign followed in 1884 with an ordinance creat- 
ing a committee of the city council, known as the 
health and sanitation committee and made up of 
three members. 




W. E. Schowengerdt, M. D. 

Health Officer, Champaign. 

1S99-1900: various times 

since and present 

Health Officer 



Apparently the committee in Champaign was created simply to provide 
a means for handling sanitary and health problems with greater dispatch 
and ease whereas the board in Urbana was endowed with all the powers 
and authority that it might deem necessary for 
controlling disease and to it was assigned for 
duty the city marshal as quarantine officer. It 
even had authority to establish an isolation hos- 
pital during emergencies. 

In 1888 Champaign went a step further. An 
ordinance adopted then created a board of health 
and the position of city health officer. The board 
was formed by simply transforming the commit- 
tee into a new legal status and adding to its mem- 
bership the mayor, the health officer and the city 
clerk. The ordinance required the health officer to 
be a licensed physician. These changes came to 
pass under the influence of Dr. L. S. Wilcox, 
mayor at the time, and Dr. Chas. B. John- 
son, a public spirited physician of the community, 
with the usual broad powers and authorit\- that have alwa\s characterized 
such official agencies and the police department was made subject to its 




H. A. Sim.s. 

Commissioner of Public 

Health and Safety, 

Champaign. 1927 

to date 

The board was endowed 



84 



IX)\V.\-STATI-: MrNIClI'Al.ITIKS 




command so far as ciuarantine, abatement of 
nuisances and similar activities misjht require. 

The trend toward medical influence in pub- 
lic healtli matters in Champaign really began with 
tlic arrival of Dr. Chas. B. Johnson, still living 
and active at the age of 84, who located in that 
cniiinniniiy in 1879. In 1888 he was a member 
(if ilu- hoard of education when reports started 
cuniini,' in about children being absent from 
school with a rash, .^ome reports were confus- 
ing so Dr. Johnson was appointed by the school 
hoard to take the matter up with the mayor, at 
that time Dr. L. S. Wilcox. He did this and 
Dr. Wilcox called his attention to the fact that 
this came under the duties of the health commit- 
tee of the council. 
After Dr. Johnson had talked to the mayor regarding the importance 
of having a medical man as the health officer, the mayor consented. A few 
days later Dr. Johnson was n<itified of his appointment as health officer and 
instructed to confer with the city attorney on an appropriate health ordi- 
nance. {Sec "Sixty )'t'i}rs in Medical Harness'' pp. 188-189). 

Dr. John.son is still carrying on as president of the county tuberculosis 
sanitarium board and an officer of the Champaign County Anti-Tuberculosis 
and Public Health Association. 



Charles B. .Johnson, M. D. 
First Health Officer. Cham- 
paign. ISSS Chairman, 
County Tuberculosis 
Sanitarium Board, 
1921 to date 




Chnmjiaisn County Tuberculosis Sanitarium, "The Outlook" 



CHAMPAIGN -URBAN" A 



85 



Somewhat later Urbana gave up the cumbersome board of health made 
up of an alderman from each district and put in its stead a board of three 
members, one a physician or sanitarian who. by virtue of that fact, is chair- 
man of the board and city health officer. The section of the ordinance relat- 
ing to the personnel of the board reads : 



"Section 2. Appointment. The Board of Health shun be appointed by the 
Mayor ot said City by and with the advice and consent of the City Council m 
the same manner and at the sinie time as other officers are appointed. At the 
time of the appointment tlie Mayor sliall designate one of said members to be 
Chairman of said Board, who shall also be Health Officer and said Chairman 
shall be a legally licensed rractiiioner of medicine or trained in sanitary 
science. All of said members shall ho'.d their office from the date of appoint- 
ment to the end of the municipal year and until their successors are duly ap- 
pointed and qualified." 

The present board in Urbana is made up of Dr. D. T. Cole, chairman 
and health officer, ]\Irs. Blanche Gladding and Mrs. Doris Carpenter. 

A final change came in Champaign when the commission form of gov- 
ernment replaced the aldermanic in 1917. This dissolved the board of health 
leaving its duties and responsibilities in the hands of George B. Franks, first 
commissioner of public health and safety. The 
health department continued to be in medical 
hands, however, with Dr. W. E. Schowengerdt 
as health officer. 

In the meantime there developed public de- 
mands for various specific types of public health 
service that were not being supplied by the city 
government. Consequenth' we find the board of 
education in 1010 feeling its way into a new ven- 
ture by employing a nurse to work among the 
school children during a month or two. Evi- 
dently the experiment was popular for 1911 
found ^liss Frances North at work as a full time 
nurse in the schools under a board of education 
presided over by Dr. W. L. Gray. The immediate 
inciting^ cause which led to the full time nursing 
activities was an outbreak of diphtheria in one of 
the schools. A doctor at the helm — an epidemic 
— sick children — a nurse. Nothing could have developed with more logical 
sequence. A second nur.se was employed for full time service in 1918 and 
both continue in the work to date. 




Mayor George B. Franks 

Commi.ssioner of Public 

Health and Safety, 

Champaisn, 

1917-1927 



86 



DOWN-STATIC M U X I CI PALITIES 




P. W. Wright 
President, Urbana-Cham- 
paigu Sanitary District 



Urbana subsequent!}- provided medical su- 
[jervision over children in the public schools Mvhcu 
Dr. .Mnucl E. Nichols was employed in 1918 to 
il(i lliat work. She is still active in that capacity. 

N'oluntary agencies got busy also in the early 
part of the second decade of the twentieth cen- 
tury. Thus the Family Welfare Society of 
t'hampaign-Urbana was organized in 1911. It 
did little that could be classed as public health 
service during its early existence but beginning 
in 1918 it has participated in such activities as 
public health nursing, infant hygiene etc. It 
sponsored an orthopedic clinic for the after-care 
of infantile paralysis victims. It established an 



infant welfare clinic in 1921 with Dr. C. George 
Appelle in charge and a child guidance clinic, 
under the direction of the Institute of Juvenile 
Research, in 1923. 

The Champaign County Anti-Tuberculosis 
League was organized in 1912 and carried on a 
ver\- active campaign with its field service en- 
trusted first to Dr. Carrie Noble White and later 
to Dr. Maude E. Nichols. Still later two nurses 
were employed to do the field work, the construc- 
tion of the county tuberculosis sanitarium in 1920 
and the employment of a medical staff in 1921 
making it unnecessary for a voluntary organiza- 
tion t(j maintain such professional talent. The 
^.'iiiilarinni 1i:in m r:iii;i( 




C. George Appelle. M. D. 

Director. Infant Welfare 

Clinic, Champaign, 

1921 to date 




Robert G. Bell, M. D. 
Medical Director and Sup- 
erintendent, County Tub- 
erculosis Sanitarium, 
1927 to date 



f 48 patients. 

A \ery important factor in the health ma- 
cliincr\- of the communitx' is the Cniversity 
1 lealth .'service. This was organized in 1916 
iin<lfr the able supervision of Dr. J. Howard 
Heard. This service not only uses every facility 
pnixided by modern knowledge of .sanitation, hy- 
j^ieiK- ami medicine for the suppression, control 
and jjrevention of communicable diseases, but it 
undertakes to promote positive health by giving 
to every pupil enrolled a thorough physical exam- 
ination. It also teaches subjects of importance in 
personal hygiene and preventive medicine. This 
it is able to do in a very satisfactory manner be- 
cause of the happy arrangx'mcnts which make the 



CHAMPAIGX-URBANA 



87 



first doctor to settle there. 




A. M. Lindley. M. D. 

First Health Officer, Ur- 

bana, 1S91-1922 



Staff of the health service faculty members as well. \'aluable data of import- 
ance in research have been collected by the health service. 

^ledical influence was first introduced into the twin-city community 
with the arrival of Dr. J. G. Saddler who located in Urbana in 1839, the 
He was followed the next year b}- Dr. Winston 
Somers and Dr. William D. Somers. From that 
time on the medical profession increased in num- 
bers until 1859 found a dozen doctors there, or- 
ganizing themselves into the Champaign Count}" 
Medical Society. W'hile guests of this society in 
1876, the Illinois State Medical Society passed a 
resolution favoring the establishment in Illinois 
of a State Board of Health. As a consequence the 
first permanent public health legislation was writ- 
ten into the laws of the State. 

The parent-teacher association movement, 
which involves considerable health activities, was 
organized in 1914. 

The most recent movement took place in 
1926 when the various voluntary and official agencies participating in public 
health activities were brought together into a cooperati\e organization known 
as the Champaign County Public Health Association. At first this organiza- 
tion showed signs of inanition but lately it has gained a splendid degree' of 
vigor and under the chairmanship of Dr. W. E. Schowengerdt, Champaign 
health officer, gives promise of leading to pro- 
nounced improvement in the public health affairs 
of the county. 

\\-ATER Supply. 

Waterworks were first installed in 1885 by 
the ^NIcKinley interests and operated by them 
until 1893 when it was taken over b>- the Union 
Manufacturing Company. On June 27, 1899 the 
present compan}-, known as the Champaign & 
Urbana Water Company, bought the property 
and was granted a franchise. This franchise 
called for the installation of filters to remove at 
least 50 per cent of the iron. 

The supply is obtained from a number of wells, all of which are about 
150 feet deep. The well water is rather high in iron, but part of it is re- 
moved b\- aeration, chlorination and filtration. 




T. C. Sullivan, 

Treasurer, Urbana-Cham- 

paign Sanitary District 



88 



DOWN-STATE MUNICIPALITI KS 




J. C. Dodds. M. D. 

Vice-President. Urbana- 

Champaign Sanitary 

District, 1921 to 

date 



The University of Illinois campus is about 
midway between the two business districts and 
the public supply is available, but it has its own 
private supply. Water is obtained from wells 
similar to those of the water company and 
|l immpcd inlii llie mains witlnnit treatment. 

Si:\\EKA(;i;. 

The iirst system of sewers was installed in 
both cities about 1895. The sewers were designed 
on the separate plan. Each cit\- had a septic tank 
and its own outlet into Salt Fork. 

The systems soon became inadequate and the 
llow through the septic tanks exceeded that for 
which they were designed. 
In 1921 the L'rbana & Champaign Sanitary District was ort;ani/.ed and a 
new sewage-treatment plant was constructed in 1*'24. At that time new 
sewers and interceptors were constructed and at present buth cities are ade- 
quately sewered. 

Health Conditions. 
Like the pioneers in general those who settled in Champaign County 
took the ordinary hardships of life as they came, accepting common diseases 
as a necessary evil that deserved little discussion 
and less notice in the record of important events. 
Perhaps epidemics of common infections were 
the temporary subject of neighborhood gossip 
but it took an outbreak of cholera to stir up pub- 
lic 'fear and alarm sufficient to get the story re- 
corded in the traditions and history of the com- 
munity. 

Thus the earliest reference to unusual health 
conditions in Champaign-Urbana relate to a chol- 
era epidemic brought back from Chicago by trad- 
ers who had visited that outpost of civilizatimi. 
Soldiers garrisoned at Ft. Dearborn had started 
the disease there. How disastrous the epidemic 
in Champaign proved to be can be surmised only. 

The very fact that the story has been preserved ^^ | 

suggests that it was bad enough. j.,>, |^ 

Cholera was again the unwelcome visitor in 

the community in 1854 when introduced by ,^^ ' i'i^''*-\'„'^' '^ 

■' , .^,1- • ^ 1 T^ -1 J Health Officer, Clianipamn, 

laliorers workmg on the Illmois Central Railroad 1S97-1899; 1911-1913 




CIIA.MPAIGX-URl'.AXA 



Table 1. 
Mortality From Certain Causes in Champaign. 





























is 








s 


p 






./. 




































fc^ 










O 


.5 




'^ 


/. ^ 


"5 ^ 


YEAE 




r^ 








■^ 




s 




^ 


'- r 






6 


o 


a 


X 




1 


1 


s 


^ 


1 


It 


Is 


1913 


168 


S 








1 








10 




1918 












1 


2 


.57 




14 


36 


1919 


192 


2 






1 1 






3 


15 




17 


9 


1920 


224 










1 


2 


1 


15 




13 


16 


1921 


203 


1 










2 


1 




2 




7 


17 


1922 


227 










1 




r, 











15 


1923 


202 


2 








1 




1 


4 


7 




.( 


9 


1924 


216 














3 




3 




12 


8 


1925 


236 


2 








2 






1 


2 




11 


15 


1926 


217 




... 










1 


... 


4 


... 


11 


14 



Table 2. 
AIoRT.M.iTY Rates From Cert.\in C.\uses in Champaign. 



YEAR 


i 

O 


^ 


1 




1 


! 




1 




1 


11 

1? 


li 


I'.na 

1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 


12.4 

17.4 
12.3 
13.9 
12.3 
13.2 
11.5 
12.1 
12.9 
11.7 


liis 

6.1 

ii!4 
i6!9 


y. 








6.4 

5^8 
5.7 

l6!9 


12.8 
6.2 
12.1 


7.4 
0.5 

n'.i 

6.1 
29.1 

16!7 


13 
19 
6 

22 


1 

3 

8 
4 


375.4 
96.6 
93.4 
12.1 

39!9 
16.7 
10.9 
21.6 






J 


74.3 

92.2 
109.4 
80.9 
42.6 
34.9 
28.5 
67.4 
60.4 
59.4 


237.1 
57.9 
99.6 

103.6 
87.2 
51.3 
44.4 
82.4 
75.6 



Note: The rate from All Causes is per 1,000 population; all ulliers pei- 100,000 populatii 

Table 3. 
Mortality From Certain Causes in Urbana. 

















„ 
















S 








qJ 


l" 








tf' 




YEAR 


1: 


fe 


1 


X 




S, 


o 


1 


„ 




Is 

"3 'C 


^'7 

1e 




o 


>. 


? 




1 


a 
o 


1 


! 


1 


^5 


ll 


1913 


so 






1 


















1920 


120 












2 


2 


7 




7 


.5 


1921 


79 












1 


1 


1 


i 


9 


3 


1922 


85 












1 




2 








1923 


108 








1 








3 




6 


11 


1924 


147 












... 


1 


9 




10 


13 


1925 


147 












2 


1 


o 




6 


7 


1926 


133 
















2 




10 


■' 



90 



DOWX-STATE MUNICIPALITIES 



Table 4. 
Mortality Rates From Certain Causes in Urbana. 

















.=: 
















1 








o 


^ 






£ 


■^ 






























YEAR 


1 




cj 


g 




&; 


O 


1 


S 


>i 


11 


'- = 




cd 


1 






£ 






^ 


c 


1 


u o 






D 


1 


"S 




1 


1 


S 




1? 


5^ 




< 


K 


5? 


r^ 


^ 


X 


2 


^ 


Oh 


H^ 


£- O 


1913 


1 9.0 








11.3 












56.4 




1920 


11.7 












19.5 


19.5 


68.3 




68.3 


48.8 


1931 


7.5 


i'.i 










9.4 


9.4 


9.4 


9^4 


85.2 


28.4 


1922 


7.9 


IS. 6 










9.3 




18.6 




37.2 


37.2 


1923 


9.8 








9!i 








27.4 




54.8 


100.4 


1924 


13.2 














9!6 


80.3 




90.0 


116.8 


1925 


12.9 


s'.s 






!;; 




irc 


8.8 


44.1 




32.7 


61.7 


192G 


11.6 
















17.4 




87.0 


43.4 


1927 




s'.h 






8.5 


... 


... 




17.0 


sis 


76.8 


42.7 



Note: Tlie rate from All Causes is per 1,000 poi™l;itiuii ; M others per 100,000 population. 

which was under crjiistniction at the time. I'ulilic alarm and panic prevailed 

until the disease burned itself out. 

Strangely enough the people generally gave little heed to more common 

disease, less dramatic but far more costl\' in suffering and life than cholera 

in the long run. It took a medical observer to remark that : 

"The permanent scourge of the people ot Champaign County which 
mowed down its victims, young and old for a period ot fifty years was 
represented by the miasmatic diseases caused largely by undrained 
sloughs and swamp lands. These troubles largely disappeared with 
systematic drainage." 

Later typhdid fc\-er came under the ban of "suspicious character" as 
the public learned to believe it a preventable 
disease. Consequently more and more notice of it 
found space in tradition and recorded history. 
Di". Johnson loves to tell of an outbreak that 
disturbed Ihe traiK|uilit}- of health conditions in 
Champaign in 1884. A young man came home 
sick- from Kansas and presumably infected his 
relatives and friends. Shortly thereafter the di- 
sease had attacked 17 persons, leaving 6 dead. 
The absurd notions that even the medical profes- 
si(}n entertained alxiut the disease during those 
days is set forth in a quotation that appears in 
Johnson's Sixt\' ]'cars in Medical Harness. It 

neoif,( Ua\ M 1) reads: 

He 1 1th Oiruei I rbin i, 
1'i.';-1<)2j 

"Typhoid fever is never communicated from person to person. 
"The disease never comes up spontaneously; no amount of filth and 
no de.ijree of docompcsition can originate the disease. 




CHAMPAIGN-URBANA 



91 



"Typhoid fever is a miasmiatic infectious disease. The poison from 
within the body of a person suffering with typhoid must pass through, 
in the process of development, a nidus outside of the body before it be- 
comes capable of propagating the disease. 

"The discharges from the bowels of a patient affected with typhoid 
in a few hours after they are voided pass through some process by 
which they become infectious and when allowed to enter wells or 
cisterns cause those who drink the water to have the disease. 

"The susceptibility to typhoid deiiends largely upon the age of the 
person exposed, those under thirty being most liable to contract it." 



The last two paragraphs expressed ideas that proved to be true under 
scientific observation. 

Another illustration of how disastrous typhoid fever was prior to 1900 
took place near Urbana in 1890 when every member of a fatnily of 11 came 
down with the disease and nine never recovered. In another family of 9, 
seven cases developed with two fatalities. 

Twenty-fiye years later, in 1915, medical and bacteriological knowledge 
had progressed far enough to enable the chief sanitary engineer of the State 
Department of Public Health, Paul Hansen, to trace an outbreak of typhoid 
fever in Champaign to the consumption of con- 
taminated raw oysters. This outbreak, involving 
some 25 cases, is apparently the first instance on 
recoid when typhoid was traced to contaminated 
oxsleis and it led to investigations which uncov- 
ered three more epidemics at widely scattered 
points, all of which originated with oysters 
shipped out of Baltimore. 

Alore recently typhoid has practically di.sap- 
peared from the community. No death was 
registered in Champaign in either 1926 or 1927 
Professor Stephen A. Forbes, and onlv one in Urbana. 

'Tut-^tUor/r'^SuSunf- statistics Of all n.ortality are meagre but it 

Board. Ut2i to date is safe to presume that tuberculosis inflicted 

heavy losses upon the population in days before 
modern methods of control came into vogue. At any rate the citizens saw 
fit to organize a campaign against it and under the splendid leadership of 
Professor Stephen A. Forbes and Dr. Johnson erected a sanitarium in 1920. 
The disease continues to be a problem of no insignificant magnitude, as may 
be observed from Tables 1 and 3, but the campaign against it is progressing 
in the right direction and perserverance will surely result in ultimate success. 
The mortality rate in the whole conimimity is no less favorable than that for 
the State at large. 

Diphtheria has carried many children to an untimely grave in 
Champaign-Urbana but liai)pily it is now yiekling to preventive measures 




92 



DOWN-STATE MUNICIPAI.ITI F.-S 



Table 5. 
Cases of Certaix Diseases Reported in Champaign. 





1021 


1!I22 


1!I23 


1024 


102:-. 


1926 


1927 


Tvplioiil Fever 




3 


4 


13 




1 


4 


Sniallprix 


11 


4 


3 


1 




21 


23 


M(<:islrs 


134 


10 


223 


20 


1S2 


52 


115 


s,iil.-t Fever 


63 


42 


41 


10 


22 


31 


29 


«h K Cc.ush 


29 


r,e 




27 


40 


41 


34 


l>i|>litli.'iin 


R 


30 


3 3 


12 


5 


3 


4 


hillii.-ii/.i 


4 


14 


5 




2 


1 




l'..li..r„velilis 


2 








1 




2 


Mfiiiiiuitis 








1 








'rulM'Mtllo^is* 


45 


34 


28 


SO 


41 


100 


56 




9 


28 


4C 


30 


31 


22 


31 


S\l.llilis 


21 


48 




32 


40 


50 




Conorilie t 


r.o 


16 




26 


8 


3 


50 


ChalK-n.i.l 


4 












1 



•AH forms. 
Xote: Case reports are never complete, but notification in Champaign and Urbana i>; 
give a fairly good index to prevailing health conditions. 

Table 6. 

Cases of Certain Diseases Reported ik Urrana. 





1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fe^er 


16 


7 




6 


1 




4 


Smallpox 


17 


1 


1 


1 


1 


35 


2 


Measles 


14 


;■) 


269 


17 


178 


75 


15 


Scarlet. Fe\ev 


47 


20 


9 




38 


12 


12 


WhoniiiiiK Cough 


21 


24 


12 


87 


22 


22 


35 


l)iphll,..,in 


9 


4 


15 


21 


9 


1 


5 


Iiillil.Mi/a 


9 


1 


20 


8 


13 


1 


1 


McniiiKilis 




1 


" 








1 


Tubcroiilosis* 


1 


10 


16 


57 


37 


63 


23 


Pneumonia* 




9 


7 


45 


24 


S 


14 


Svphilis 





10 


20 





4 


2 


1 


(iouorrhea 


17 


4 


26 


26 




3 


4 

• 



Table 7. 

Births and Infant Deaths. 

City of Champaign. 



Infant Ueatli! 



1919 






23 




1920 


291 


18.1 


32 


109.9 


1921 


368 


22.4 


26 


70.6 


1922 


331 


19.3 


25 


75.5 


1923 


356 


20.3 


21 


58.9 


1924 


390 


21.8 


36 


92.3 


1925 


409 


22 4 


236 


92.9 


1926 


407 


22.0 


23 


56.5 



•Deaths of infant* 
MVr innn pnpulati 



of age per 1000 births reported. 



CHAJIPAIGN-URBANA 



93 




which have been puslied lately in the coniniiinit}' 
and county. The whole county escaped without 
a sinijle fatality in l'J26 and lost but one citizen 
to diphtheria in 1''27. 

Smallpox seems to have avoided this univer- 
sity community in general. At least there are no 
traditions or written accounts tilled with vivid 
stories and conunents about "pest houses" an<l 
heroic re.t;ulations that make up the principal 
early health history of other municipalities in the 
Judge J. O. Cunningham, '^^ate. Recently the disease has ventured to put 
President, Champaign Coun- in its appearance once or tw'ice but the university 
'^ llagTie'^Tft™'"^'^ ^"•' municipal health machinery went into action 

with such prompt thoroughness that the out- 
breaks amounted to little except a general vac- 
cination of susceptible people. 

The influenza epidemic of 1918 was severe 
in the community. Mortality from this cause 
alone rose to 375 per 100,000 population while 
combined with pneumonia it soared to 631. These 
losses stood well up toward the top of the list of 
municipal rates. 

The general mortality rate of Champaign 
County was among the most favorable in the 
State in 1927. It was a trifle higher for Urbana 
than Chamjiaign. The rate in neither place was ^- -^. Earnest 

high for the combined community it was unusu- Ser.-Treas. Champaign Coun- 




ally favorable, 
palities. 



comjiared with other numici- 



tv Tuberculosis Le:igue, 
]912-]927 




Mayor W. F, Burres, M. D. 
Acting Healtli Officer, Ur- 
bana, 1925-1927 



Infant mortality, considered by many sani- 
tarians as a sensitive index to health conditions 
in general, suggests favorable public health con- 
ditions in the community. For the county, the 
rate was 57.4 infant deaths per 1,000 live births 
in 1926, a figure nearly 18 per cent below that 
for the State. The rate in Champaign was even 
lower than that for the county, but in Urbana it 
w;is considerably higher. Of course the loss of 
one infant more or less makes a very pronounced 
difference in the rate of a community where the 
total number of births is 165. It appears, furth- 
ernujre, from the rather high birth rate attributed 



94 



DOWN-STATE MUNICII'AI.ITIKS 



to Champaign that a good many babies of Urbana parents are born in 
Champaign. This would give Champaign the advantage in calculating rates. 
At all events the combined rate for the two municipalities was but little more 
than 62, relatively quite favoralile. 

Table 8. 

Births and Infant Deaths. 

City of Urbana. 





YEAR 


Birtlls 


Infant Deaths 




Number 


Rate** 


Number 1 Rate* 

1 




1920 


Not 


ivaibble, prior to 192 


1 
1. Included in county. 




1921 


162 


15.4 


10 


61.7 




1922 


126 


11.7 


7 


55.6 






162 


14.8 


9 






1924 


210 


IS. 8 


14 


66.6 






207 


18.2 


147 


12.9 




1926 


165 


14.3 


13 


78.7 



•Deaths of 
•Per 1000 



infants under 1 y( 
population. 



of age per lUUU births reported. 



References. 



Ordinances and Reports, City of Urbana, various date.s. 
Ordinances and Reports, City of Champaign, various dates. 

History of Champaign County— J. R. Stewart (Lewis Pub. Co., N. Y. & Cliicago, 1918). 
Medicine of Champaign Count.v — Chas. B. Johnson, M. D., 
Si.\tv Years in Medical Harness — Chas, B. Johnson, M. D., 

Reports of Trustees & Officers of Urbana and Champaign Sanitary District, various dates. 
Reports of Board of Education, various dates. 
U. S. Census Reports, various dates. 

Personal interviews by Mr. Thomas J. Brophy, wlio collected the data, with various officials, 
dty faculty members, physicians and others in Champaign-Urbana. 



Cicero 

Cicero is one of the largest coninumities in Illinois, except Chicago, 
but technically it is not a city. It has retained the township form of gov- 
ernment, never having been incorporated under the Cities and Villages Act. 
In 1920 the census returns showed a population of 44,995 but there is evi- 
dence of very rapid growth since that time so that current estimates vary 
from 70,000 to 100,000. The estimate for 1927 made by the federal bureau 
of the census is 68,500. It is one of the newer communities, suburban to 
Chicago. There were only 1,272 inhabitants in 1860 and only 16,310 in 1900. 

Even in 1920 the character of the population was distinctly that of a 
rapidly growing community and it was unique in other ways. There were, 
for example, only 5,770 persons or a little more than 12 per cent, in the 45 
years and over age group. This is scarcel_y more than one-half the i^atio in 
other municipalities of the State. Then the number of men was greater 
than the number of women by a wider margin than prevails in the State at 
large. There were but four negroes listed in the 1920 census but the foreign 
born whites accounted for 34.4 per cent of the whole population. 

Furthermore, Cicero is really a part of the great metropolitan area of 
Cook County, enjoying and utilizing many of the municipal facilities of 
Chicago so that the mortality and morbidity rates returned for Cicero do 
not reflect actual conditions as accurately as might be desired. 



He.'vlth Machinery. 

The story of public health service in Cicero is simple and complete. One 
day in August, 1904 Dr. J. J. Hood, the only resident practicing ph\sician in 
the communit\- at the time, happened to be walking down the main street. 
In front of the old Weare building he met George 
Comerford, town president, and George Engel, 
police magistrate. They greeted each other and 
fell into conversation. Somebody remarked tliat 
Cicero needed a health officer. Comerford rather 
banteringly put in : "Dr. Hood is our health offi- 
cer from now on". And he was. 

The matter was no more complicated than 
that because no salary was attached to the job 
and the work required and done was about equal 
to the emoluments of the office. When for any 
reason it was necessary to call upon the health 
officer for service he was paid a fee on time basis. 



1 





J. J. Hood, M. D. 
Health Commissioner 
1904-1912; 1924 to date. 



(95) 



96 DOWX-STATK ML-NKIl'ALITIKS 

This CDiUinued to be the pohc\ until V>\Z wlien Dr. B. Shulek was 
appointed to succeed Dr. Hood hut the fornirv ([uit after a year in office 
on the plea that the health officer's (kitics interfered w ith his practice. Then 
followed a couple of years where Cicero managed to get along without a 
health officer but in 1916 the officials decided that the coinmunit>- needed 
a health officer badly enough to make some contribution toward the livelihood 
of the one chosen for that position and, attracted by the small remuneration, 
if not by the honor. Dr. James Shinglmen accepted the place. For two years 
he exercised some active interest in efforts at controlling communicable 
diseases. 

Then came a radical change. A new town administration headed by 
Joseph Z. Klenha came into office in 1918. It made a substantial appro- 
priation for public health work, appointed Dr. Bert L. Vilna as health officer 
and instructed him to organize an effective health department. He did so 
and gave to the communit}- its first health service of consequence. 

The administration went further. It adopted an ordinance creating a 
board of health made up of the health officer or commissioner of health as 
he was now called, town president, supervisor, attorney and captain of police. 
This board was clothed with all the power and authority ordinarily vested in 
such bodies and with the health commissioner as ex-officio chairman it con- 
centrated the official public health service in a very workable shape. 

Dr. Vilna kept things growing and expanding until his death in 1924 
when he was succeeded as health commissioner by Dr. J. J. Hood who has 
continued to date the splendid work inaugurated by Dr. \llna. 

Ordinances relating to sanitation, h_\giene and other matters of health 
interest were adopted from time to time so that the board and commissioner 
of health have been able to execute such policies and plans as their tinancial 
resources and initiative have permitted. 

Shortly after the reorganization of the municipal health department that 
inaugurated a new day in health service for Cicero, voluntary agencies 
became active. On January 28th, 1919, the Cicero Welfare Center was or- 
ganized. Its prime object was to afford emergency relief to the distressed 
and to hold weekly clinics where mothers might receive proper instructions 
as to the diet and care of their babies. 

Through and with the cooperation of the health department this work 
has steadily increased until today it ranks with the best services of that type 
found in Illinois. With the added cooperation of the Chicago Tuberculosis 
Institute, the anti-tuberculosis program has developed in a no less satisfac- 
tory way. 

The scope of work covered by the Center, including its social service 
department and baby clinics both at the Center and in the Hawthorne sec- 
tion, has necessitated the employment of two full time nurses, a clerk and 



CICERO 97 

an executive secretarx- besides the services of the physicians in attendance 
at the cHnics. Over one hundred babies a week attend these clinics. 

The Cicero day nursery was ordinarily for the purpose of affording to 
the children of wage earning mothers the proper environment and care dur- 
ing the absence of their mothers. An average of twenty-seven children are 
taken care of dail}-. 

These efforts gave to Cicero in 1925, a public health service that occu- 
pied a commendable place among the fifteen leading communities of the 



CICERO 



VITAL 5TATI5TIC5 "^l 
COm.DISCOhTROL^^I 
VEri. DI5. COMTROLo" 
TUB. CONTROL S 
HEALTH CHILDs."-.. 
HEALTH 5CH. CHILD 
SAMITATIOh -"«" 
MILK COMTROL M 
LABORATORY 
POP HEALTH iri5T>^^ 

PERCEMT OF STAMDABD SCORE 
FOR tACH OF TEN MAJOR HEALTH ACTIVITIES 
1925 



This graph illustrates the strong and weak points in Cicero's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in Cicero was 53 per 
cent of the standard perfection requirement. 

State. This fact was determined by a study of the municipal facilities pres- 
ent in these places which was carried out by the State Department of Public 
Health. The report on Cicero, which gives a good conception of facilities 
then, reads, in part, as follows : 

■A total of 526 points gives Cicero eighth place on the health service 
apijraisal schedule of the fifteen cities ranging from 30,000 to 100,000 
in population. 

"With a part-time health commissioner this city enjoys a coordina- 
tion of public health activities that is rare in Illinois. Practically all 



98 DOWN-STATE MUNICIPAI.ITIES 

sucli worli attemiited is direfletl ;inti supervised liy tlie licallli depart- 
ment, to wliich. for oxaniple. the boai-d of education pays $>i.O(iO per year 
for application on the costs of school hygiene service. A clinic at the 
infant welfare center maintained by the Infant Welfare League is under 
the direction of a physician paid by the city. One half of the salaries 
of two nurses engaged in tuberculosis work is also paid by the city, the 
remainder coming from the Chicago Tuberculosis Institute. These 
'financial connections give the municipality a directing influence in all 
the public health affairs which results in harmonious coordination. 

"There are no contagious disease hospital facilities nor public clinics 
for treating venereally infected indigents. Nor is there a iiublic health 
laboratory. Proximity to Chicago, with an abundance of all sorts of 
medical and public health advantages, seems to make less acute the need 
for some services indispensable elsewhere. 

"Expenditures in the city for public health work amount to .51 cents 
per capita per year, 3.5 cents of which comes out of the niunicipal 
treasury. 

"The health commissioner acts as local registrar. Records are 
checked for completeness and a brief statistical report is pul)lished. 

"A comprehensive system of epidemiological record keeping is main- 
tained, cards of different color being used for each disease on which are 
entered all essential data. An up to date siJot map is kept of the major 
contagions but there are no chronological charts showing the current 
prevalence. Communicable disease control practices are excellent. All 
cases of contagion are placarded by an inspector. A physician from the 
health department visits all doubtful and all other cases of contagion 
except measles, whooping cough and mumps in order to establish defi- 
nitely the correctness of diagnosis. A communicable disease nurse also 
visits each reported case as a matter of routine, the record of each visit 
being entered on the case card. There are no local facilities for the 
hospitalization of cases, altliough some patients are sent to Cook County 
Hospital. No immunizations a.gainst diphtheria are performed by the 
health department. A survey of the school children shows SO per cent 
vaccinated against small pox. 

"Three cases of tuberculosis were reported for each annual death 
from that cause in Cicero. This ratio would be lower if cases of tuber- 
culosis from Cicero who die in outside sanatoria could be computed. 
The two nurses made a total of nearly 4.700 visits to tuberculous pa- 
tients and contacts. The attendance at clinics both as regards number 
of patients and number of visits made is satisfactory. Information as 
to the number of hospital days of Cicero iiatients could not be accurately 
determined, although 40 cases were sent to various nearby sanatoria. 
There are no open-air classrooms or preventoria. 

"The Infant Welfare League sponsors the hygiene pro.gram for 
these age groups. The infant clinics are well attended, 370 babies mail- 
ing a total of 2,257 visits last year. There is practically no field nursing 
visits to prenatal, infant or preschool cases and there are no prenatal 
or preschool clinics. Many births are attended by midwives, it being 
estimated at 60 per cent of the total occuring within the city. The mid 
wives are not supervised locally. 

"Routine weighing and measuring of all children is done by the 
nurse once each year. Four part-time school physicians are employed 
to examine all grade school children every year. No records of this 
work, however, are assembled. Each physician uses his own standards 
as to what constitutes a defect, and in general, there is no uniformity 
of iirocedure. 

"The regular staff of sanitary and food inspectors is supplemented 
by the school nurses during summer months. Food establishments are 
visited and scored on their sanitary conditions. The city water supply 
is secured from Chicago and is distributed to 100 per cent of the homes. 
It was stated, also that all of the dwellings in the city are connected 
with the sewer system. 



99 



"The health officer states that 100 per cent of the milk supply Is 
pasteurized although no inspection records of any kind are available to 
verify this assumption. Most of the milk comes through the Chicago 
market. 

"No local laboratory service is maintained, although many diph- 
theria cultures are examined at the State branch laboratory in Chicago." 

Water Supply. 
Cicero owns and operates the distribution system and booster pumping 
stations, but water is obtained from the city of Chicago. A description of 
the supply will be found under Chicago. 

Sewerage. 
The town is in the Chicago Sanitary District. Sewers are built on the 
combined plan and discharge into an interceptor which will take the sewage 
to the ^^'est Side sewage-treatment plant, now under construction. 

Health Conditions. 

Health conditions in Cicero are difficult to appraise. The general death 
rate is very low. Doubtless the very low percentage of old pecjple in the 
population is one important factor in this situation. 

The infant mortality, on the other hand is rather high. Deaths among 
children less than one year of age averaged about 87 per 1,000 births reported 
during the seven years ended with 1926. This is a higher figure than that 
for the State during the same period and considerably higher than that of 
several other suburban communities in Cook County. A good many sani- 
tarians regard infant mortality as a more sensitive and accurate index to 
health conditions than the general death rate. 

It is probable that Cicero enjoys good average health for a _\oung, 
rapidly growing community. It is doubtful that health there is as superior 
as the exceedingly low mortality rate might suggest. 

Table 1. 
]\IoRTALiTY From Certain Causes. 

















_ 






































YEAR 


i 


1 




y. 




U 


3 

6 


1 


S 


i 


li 


II 




6 


J 


'^ 


^ 


J 


1 


1 


f 




= 


»- 


3^ 




< 


3. 


g 


1 


^ 


1 




f 


or 


? 


Is 


IS 


191S 


412 












., 


7 


."ifi 




38 


S3 


1919 


307 








2 


2 




18 


17 




14 


38 


1920 


331 








*> 






13 


2."i 




30 


36 


1921 


321 








2 


2 




23 


1 




22 


35 


1922 


32S 


' i 








1 




14 


.') 




22 


32 


1923 


295 










2 




4 


9 




33 


29 


1924 


282 










1 


2 


6 


3 




20 


35 


192.5 


349 










.5 


2 


8 


11 




23 




1926 


360 










" 




1 


11 




2.-> 


'28 



100 



DOVVN-STATK .MUMCIPAI.ITIES 



Table 2. 
Mortality Ratics From Certain Causes. 



YEAR 


1 


^ 


1 


'?. 


M ■ 

1 




1 

1 




i 


1 


"5 £ 


la 

3^ 


111! 8 
1SI19 
19-20 
1921 
1922 
1923 
1924 
1925 
1928 


10.5 
7.3 
6.2 
6.5 
6.2 
5.3 
4.8 
5.6 
5.5 


i'.i 








... 

4.7 
4.4 
4.0 

12.5 
1.6 

i'Ji 


... 

4.7 

... 

4.0 
1.9 
3.5 
1.6 
8.0 
3.0 


5.1 

sis 

8.0 
1.9 
5.3 
3.3 
3.2 


17.9 
42.9 
28.8 
46.3 
26.5 

7.1 
10.1 
12.8 

1.5 


143.9 
40.5 

"i.'o 

9.5 
16.1 

5.1 
17.6 
16.5 






97.6 
33.3 
66.6 
47.1 
41.0 
58.9 
33.8 
36.9 
38.2 


213.3 
90.5 
80.0 
70.4 
60.6 
51.8 
59.2 

42. 'S 



im All Causes is per 1,000 populnt 

Table 3. 

Cases of Certain Diseases Reported, 



11 others per 100,000 populatic 





1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


5 


1 


2 


3 


2 






Smallpox 






8 


1 








Measles 


333 


102 


798 


62 


267 


289 


423 


Scarlet Fever 


117 


67 


04 


95 


158 


95 


120 


Whoop. Cough 


173 


103 


90 


164 


79 


45 


53 


Diphtheria 


257 


185 


lO.-i 


61 


69 


35 


78 


Influenza 


4 


41 


71 


3 


14 


59 


4 


Poliomyelitis 


2 




1 








1 


Meningitis 


1 




2 






1 




Tuberculosis* 


62 


113 


Rfi 


99 


69 


77 




Pneumonia* 


70 


95 


97 


93 


87 


105 


73 


Syphilis 


5 


11 


1 


1 


3 




4 


Gonorrhea 


8 


3 


;) 


IS 


3 


5 


3 


Chancroid 




1 




1 









*AU forms. 

Xote : Case reports are never complete, but those shown 
I of how prevalent the diseases listerl were during the per 

Table 4. 
Births ano Infant Deatfis. 



Infant Deaths 



YEAR 












Number 


Rate** 


Number 


Rate* 


1918 






100 




1919 






89 




1920 






76 




1921 






73 




1922 


681 


12.9 


68 


100.0 


1923 


095 


12.4 


63 


90.6 


1924 


615 


10.4 


54 


87.8 


1925 


608 


9.8 


50 


84.0 


1926 


522 


8.0 


39 


74.7 



of ase per 1000 births reported. 
Rl-ZFKRENCES. 



Municipal Records of Cicero. 

Health Survey of Fifteen Illinois Cities in 192.'). Health News. May-Ju 
Annual Reports of the State Department of Health, various dates. 
U. S. Census Reports, various dates. 



Danville 

Danville was incorporated as a city in 1839 and the United States census 
returns listed 503 inhabitants in the community the next year. During the 
ensuing decade that number increased to 736 and grew to 1,632 by 1860. 
Between that date and 1870 the population nearly doubled, reaching 4.751, 
and then the community settled down to a gradual, substantial growth that 
brought to the city 33,776 inhabitants b\' 1920. Of this number 29,471 or 
87 per cent were native born whites, 1.916 or nearly 6 per cent were foreign 
born whites and 2,366 or about 7 per cent were negroes. There were 8,192 
or about 24 per cent whose age was 45 years or more. 

Health M.-xciiinery. 




The development of a pulilic health organization to combat epidemic 
diseases has been very gradual in Danville. Emergency situations like epi- 
demic waves of cholera and smallpox, made im- 
perative some sort of official agency to require 
cjuarantine, sanitation and vaccination. This need 
was met at first by giving to a committee or 
board iif health power to perform whatever func- 
tions a given situation seemed to require. Often 
it was necessary at such times to employ profes- 
sional and non-professional persons to carry out 
plans regarded as necessary in the control and 
prevention of epidemic infections. 

This practice continued until rather recently 
when the size of the city and the tremendous ad- 
vancement of the possibilities of preventive medi- 
cine made it necessary as well as desirable to 
secure the services of a qualified physician to act as health officer and as such 
to be subject to duty at any time. 

The list of medical health officers who have served Danville include: 
1895-1900 Dr. S. W. .Jones 191G-191S Dr. George Cass 

1918-1922 Dr. William C. Di.xon 
1922-1924 Dr. J. B. Hundley 
1924 to date Dr. William C. Dixon 

In the meantime public demands for health service outran the official 
facilities for supp]\ing it so that \oluntary organizations sprang up and 
began to function. Indeed, tliev soon overshadowed, in volume of work 
accomplished, the cit\ health di-ii.artment. Accordingly, we find, at the close 

(101) 



William C. Dixon. M. D. 

Health Commissioner. 191S 

1922; 1924 to date 



1900-1906 Dr. F. A. Baumgart 
1906-1910 Dr. H. F. Becker 
1910-1916 Dr. S. L. Laundfr 



102 



nOWN-STATE ML".\U;iPALITIES 



of 1925 a siluation described in the quotations below taken from a report 
of a survey made by the State Department of Public Health in 1926: 

"With a score of 44S points, corresiiondins to an efficiency rating of 
44. S per cent, Danville ranks tliirteenth among the 15 cities in whicli 
public health activities were appraised. 

"In some respects the health work in Danville is unusually well 
organized although many important activities have either not been un- 
dertaken at all or are incompletely developed. 



DANVILLE 




VITAL STATISTICS @ 
COnM.DIS.COnTROLko 
VEin. DI5. COMTROL N 
TUB. COriTROL M 
HEALTH CHILD 
HEALTH 5CH. CHILD ra 
SAniTATIOn 
niLK COhTROL 
LABORATORY 
POP. HEALTH iriST 

PERCEMT OF STAMDARD SCORE 
FOR EACH OF TEN MAJOR HEALTH ACTIVITIES 

1925 




This graph illustrates the strong and weak points in Danville's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in ]I)anville was 45 
per cent of the standard iierfectiou requirement. 

"The health officer is on a part-time schedule, drawing $1,200 per 
year as salary. He is assisted by two sanitary inspectors, appointed by 
the mayor, and a part-time clerk. It is necessary for him to provide 
quarters for the health department in his own office. He acts as reg- 
istrar of vital statistics, handles quarantine and sanitary problems 
through the inspectors and exercises some supervision over pasteuriza- 
tion plants. The Vermilion County Tuberculosis Association is sup- 
ported partly by the city. It does field nursing service, prenatal and 
infant hygiene work iind bedside nursing. The board of education em- 
ploys two nurses. 

"Last year (1925) the city government contributed 15 cents per 
capita toward the expenditures for public health work, funds from other 



DANVILLE 103 

sources making a total of 3G cents per capita tor sucli purposes. Dan- 
ville and one other city were the only two out of the fifteen that spent 
so little for public health service." 

Water .Supply. 

Waterworks were first installed at Danville in 1883 by the Danville 
Water Co. The original plant consisted merely of a pumping station, dis- 
tribution system and elevated tank. Raw water from the North Fork of 
\'ermilion River was used. 

As the river water was found to be very turbid at times, a 6,000,000 
gallon settling pond was excavated near the station, and the water stored 
in this pond was used only when the river was very muddy. 

In 1902 ver\- extensive changes were matle including new mains, con- 
struction of a concrete dam to replace the wood dam, increase in pumping 
capacit}- and the installation of a rapid sand filtration plant. The filtration 
plant comprised 8 units only 4 of which were equipped at the start but in 
1915 all 8 filters were in service. 

In 1912 a laboratory was provided and treatment with calcium hypo- 
chlorite was begun. In 1913 the name of the company owning the plant was 
changed to the "Inter-State Water Co." 

The impounding capacity of the dam was found to be inadequate even 
with flash-boards raised to the maximum height and a ground-water supply 
was investigated. In 1913 six wells were drilled but the water was not con- 
sidered satisfactory and a new dam was constructed about four miles above 
the old dam. The new reservoir was put in service in 1915. 

In 1916 chlorine replaced hypochlorite as a sterilizing agent. 

In 1920 another shortage of water caused the company to use the wells 
previously drilled. A new^ and much larger dam was constructed in 1925 
forming Lake \'ermilion which now furnishes an ample supply of water. 

Sewerace. 

The sewerage system of Danville is built part on the comliined plan and 
part on the separate plan. The first sewers w^ere installed in 1885, and have 
been extensively added to since. At present there are 5 outlets, varying from 
36 to 84 inches in size, discharging along creeks and into the \'ermilion River. 

Healtit Conditions. 

Cholera arrived in Dansille before the comnumitx' was organized into 
an incorporated municipalit}-. It appeared in epidemic form in 1832 when 
there were fewer than 500 people in the village and again during the great 
national wave in the late forties. \'er\' likely it struck the city again during 
the sixties. 



104 



DOWN-STATE M UNICIPAI.JTIES 



"Milk sickness" appears to have made a more vivid impression upon the 
minds of early settlers than any other disease. Old inhabitants still talk of 
it and refer to it as a disease greatlx' feared. 

.Mal.iri.i mthis to h.'ive heen \er\ common in 
the early (la\s, nid residents still recalling that 
in llie years cif llieir yciuth everybody expected to 
ha\f chills and fever. Epidemics of meningitis 
locally known as "spotted fever" or "spinal 
fe\er" also left unpleasant memories upon the 
minds of some citizens who are still alive. 

Like every other city in the State smallpox 
ajipeared at intervals sometimes frequent, some- 
times less often, depending upon the vaccinal 
status of the population and the exposure to the 
disease from outside sources. Diphtheria, scarlet 
fever, whooping cough, measles and other com- 
mon infections have run a course similar to that elsewhere in the State. 
Each came and went in epidemic cycles peculiar to itself and varying in 
\irulencv with factors that even now are no less mx'sterious than formerh'. 




E. B. Cooley. M. D. 

Active in promotiiis lor:il 

lioiltli service 



Table 1. 
Mortality Erom Certain Causes. 







> 








> 


3 








■B 


■„ 




YE.\R 


i 


& 




g 




fe 


Q 


■2 


g 


1 


1! 


'c S 












V 


















6 












































s— 


3_ 




=: 


p. 


a 


£ 


s 


S 


r; 


.§■ 


TZ 


■5 


?< 


c< 










v: 








— ir"-' 




1300 


2ii:i 


10 


3 




1 


1 




7 


... 




42 


10 


1901 


400 


9 






1 


2 


2 


3 


. . . 




40 


15 


1902 


366 


2 








3 


2 


1 


2 






38 


18 


1903 


36S 


1 








2 


2 


2 


1 


. 




37 


20 


1904 


370 


1 








1 


1 


1 


1 





35 


22 


1905 


563 










1 


2 


2 


2 






35 


24 


1906 


574 


' i 








2 


3 


3 


1 






30 


25 


1907 


541 


16 








1 


I 


2 


9 


"e 




70 


23 


1908 


552 


4 








2 


3 


2 


3 






40 


27 


1909 


4S9 


2 






::; i 2 


3 


3 


2 


4 




42 


30 


1910 


487 


1 








1 


2 


2 


2 


6 




40 


2S 


1911 


469 










2 


3 


3 


1 


8 




37 


29 


1912 


480 


"i 








2 


1 


2 


4 


10 




35 




1913 


492 


11 




■' 




4 


2 


1 


12 






47 




1914 


443 


4 








2 


1 


2 


7 


' 4 




43 


31 


1915 


450 


2 








2 


3 


3 


3 


6 




35 


33 


1916 


524 


2 








3 


2 


2 


2 


18fi 




34 


30 


1917 


512 


1 








1 


2 


1 


2 


250 




28 


43 


1918 


710 


9 1 




2 




7 


4 


147 




45 


59 


1919 


545 


4 


1 










1 


71 




40 


36 


1920 


583 


7 


1 




(i 


2 


' 's 




38 




30 


53 


1921 


531 


(i 








1 


8 


"3 


6 




34 


24 


1922 


498 


2 










1 




4 


11 


51 


39 


1923 


607 


7 








i 


2 




8 


49 


28 


46 


1924 


.519 


9 








1 


2 


5 




10 


26 


20 


1925 


571 


2 








3 


1 


2 


i 


15 


36 


31 


1926 


620 


8 










- 


" 


1 


26 


28 
1 


56 



105 



Table 2. 
Mortality Rates From Certain Causes. 



YEAR 


3 
< 




3 




s 

2 
B 
S 


> 

n 


3 

.a 




s 

c 


Tuberculosis 
(All forms) 




1900 
lilOl 
1902 
1903 
1904 
190.", 
1906 
1907 
1908 
1909 
1910 
1911 
1912 
1913 
1914 
1915 
1910 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
192.-> 
1921! 


17.9 
22.8 
19.6 
18.5 
17.6 
2.5.4 
24.6 
22.1 
21.6 
18.3 
17.4 
16.4 
16.5 
16.5 
14.6 
14.6 
16.6 
15.9 
21.6 
16.3 
17.2 
15.4 
14.1 
17.0 
14.3 
15.4 
16.5 


61.2 
51.4 
10.9 
6.0 
4.7 

•i.-i 

65 . 5 
15.6 
7.4 
3.5 

sis 

37.1 
13.2 
6.4 
6.S 
3.1 
27.2 
11.8 
20.6 
17.3 
5.7 
19.5 
24.7 
5.4 
20.8 


18.3 

s.'s 

2.9 
2.9 


'.:: 
'.'.'. 

'.'.'. 


6.1 
5.7 
16.0 
10.1 
4.7 
4.5 
8.4 
4.1 
7.8 
7.4 
3.5 
7.0 
6.8 
13.4 
6.6 
6.4 
9.5 
S.l 
6.6 

li'.e 
i'A 

2.7 

8.1 


6.1 
11.4 
10.7 
10.1 
4.7 
9.0 
12.8 
4.1 
11.7 
11.2 
7.0 
10.5 
3.3 
6.7 
3.3 
9.7 
6.3 
6.2 

.5.' 8 
2.9 
2.8 
5.5 
5.4 
2.7 
5.2 


ii!4 

5.3 

10.1 
4.7 
9.0 

12.8 
8.1 
7.8 

11.2 
7.0 

10.5 
6.8 
3.3 
6.6 
9.7 
6.3 
3.1 

21.2 

23! 5 
23.1 

isis 

5.4 
18.2 


42.8 
17.1 
10.7 
5.0 
4.7 
9.0 
4.2 
36.8 
11.7 
7.4 
7.0 
3.5 
13.7 
40.0 
23.1 
9.7 
6.3 
6.2 
12.1 
2.9 

sii 
11.4 
22.3 

2. '7 
2.6 


24!5 

29.' 6 
21.5 
28.1 
34.4 

13!2 
19.4 
592.0 
781.1 
445.4 
210.6 
111.7 
17.3 
31.3 
134.0 
27.4 
40.6 
67.6 


2!6 


256.8 
228.5 
203.6 
186.7 
167.0 
158.3 
128.9 
286.7 
156.4 
157.2 
147.1 
130.0 
120.4 
158.5 
142.2 
113.5 
108. 2 
87.4 
136. S 
118.6 
88.2 
98.3 
144.9 
78.2 
71.4 
97.2 
74.4 


61.2 
85.6 
96.4 
100.9 
104.9 
108.5 
107.4 
94.2 
105.6 
112.3 
100.4 
101.8 

1021.5 
107.0 

95.4 
134.3 
178.7 
106.8 
155.8 

69.4 
110.8 
128.4 

54.9 

83.7 
148.9 



is j.er l.Ono poi.uhitioii ; ;ill oth< 



1110.0(10 popiiliiti^ 



Typh(.)i(l fever has l)een a more stubborn health problem in l^aiiville 
than in many other places. As late as 1926 there were eight deaths from the 
disease there, yielding a mortality rate of 20.8 per 100,000, a figure far in 
excess of that for the State at large. ( )nly twice since 1918 has the rate 
dropped below 10 and it stood above 20 in four of the years of that period. 

Tuberculosis, on the other hand, has yielded ground in the face of an 
aggressive program at a \ery satisfactory rate. In 1900 the community 
lost 42 inhabitants to tuberculosis, making a mortality rate of 256.8 per 
100,000 from that cause. The number of deaths in 1926 was 28 and the 
rate 74.4. a remarkable improvement. 

Influenza struck Danville moderately in 1918. It caused 147 deaths, 
yielding a rate of 445.4 per 100.000. This was heavier than the rate attri- 
buted to influenza in most other municipalities of Illinois but there were 
only 5') tlcaths charged against pneumonia that year, bringing the combined 
mortal! t\ rate to 624 which stood about midway between the high and low 
rates in the State. 

The general death rate in Danxillc has averaged considerably higher 
than that for the State. 



106 



DOW N-ST ATI-: M U M CI PALITI ES 



Table 3. 
Cases of Certain Diseases Reported. 



1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


T^i)hoid Fever 


43 




36 






7 


10 


5 


10 


19 


13 


4 




173 


168 


29 




12 


47 


116 


6 


2 


9 


16 




Measles 


2211 


361 


694 


,2 


83 


31 


12 


121 


21 


226 


62 


33 


Scavlet Fever 


40 


41 


10 


•^ 


23 


324 


125 


47 


49 


55 


92 


109 


Whnop. Cough 








'rt 




128 


32 


20 


85 


51 


101 


14 


Diphtheria 




15 


47 


> 


8 


144 


64 


33 


17 


14 






Influenza 


1500 




1121 


^ 


2 


150 


437 


28 


9 


12 


2-> 


8 


Poliomyelitis 


2 


1 




■r 


1 


9 




2 






1 




Meningitis 






1 


z 


2 




1 








1 




Tuberculosis* 


70 




99 


!U 




44 


38 


95 


52 


31 


172 


38 


Pneumonia* 






250 






11 


39 


40 


23 


33 


73 


46 


Syphilis 






1 






38 






77 


82 


157 


189 


Gonorrhea 












57 






51 


72 


117 


199 


Chancroid 

























3 



*A11 forms. 
Note : Case reports are never complete, but they have been much more so since 1920 than before In 
Illinois. This table indicates improvement in notification more than anything else. In 1926, lor 
example, there were S deaths reported from tvphoid fever and only 13 cases. The average is 10 cases 
per death. 

Table 4. 
Births and Infant Deaths. 





Births 


Infant Deaths 


YEAR 












Number 


Rate** 


Number 


Rate* 


1916 


651 


20.7 






1917 


634 


19.8 






1918 


715 


21.9 


80 


111.8 


1919 


808 


24.3 


68 


84.1 


1920 


771 


22.0 


70 


90.8 


1921 


787 


22.7 


78 


99.1 


1922 


810 


22.9 


63 


77.8 


1923 


855 


23.9 


69 




1924 


768 


21.1 


58 




1925 


837 


22.0 


88 


105.1 


1926 


870 


23.1 


81 


93.1 



♦Deaths of infants unde 
♦Per 1000 population. 



1 year of age per 1000 births reported. 



References. 



Miniifiiial Records of Danville. Illinois. 

r.-is,.ii:il Interviews with Dr. William C. Dixon, Health Commis 
Il.iillli Survev of Fifteen Illinois Cities in 1925, Rawlings, Isaac 
of Illinois. Health News, May-June, 1926. 

.\nnual Reports of the State Department of Public Health, varin 
U. S. Census Reports, various dates. 



D.. Director of Public Health, State 



Decatur 

A namesake of the famous American naval officer, the cit}- of Decatur, 
seat of justice in Alacon County, is one of the }oungest of the more import- 
ant municipahties in IlHnois. Laid out about 1825 the communitx' became 
the county seat in 1829 by an act of the General Assembly and was organized 
into a village in 1836. 

Mingled with the early history of this prairie settlement are stories of 
romance and leadership involving the immortal Lincoln and such well known 
names as Oglesby, Hanks, Love, Crissey and Chenoweth. Lincoln is said 
to have nursed a pair of frozen feet which detained him for several days 
at the Warnick home where he went a courting, thus connecting him with 
the health history of the place. Richard Oglesby, uncle of the war gover- 
nor, was the first village president, while Andrew Love, who later became 
a bishop in the Mormon Church at Salt Lake City was the first town clerk. 
Dr. William Crissey, one of the first physicians to locate in the vicinit)-, 
was a member of the first board of trustees. The character of these men 
who accepted the responsibilities of leadership in the infant city doubtless 
gave birth to the principle or policy of denying license to liquor dealers. At 
any rate Decatur never in its history permitted saloons to operate within 
her limits and this fact had a profound influence over health conditions there. 

Decatur is located near the banks of the Sangamon River in the very 
heart of the great prairie region of Illinois. Slightly rolling in the immediate 
vicinity of the city the terrane is characteristically fiat and fertile. 

The city has never experienced a phenomenal growth but the rich agri- 
cultural resources of the surrounding country and the substantial character 
of the industries that have been established there have provided a solid 
foundation for the community that might well be the object of envy in less 
favored places. Thus the population which numbered about 1,000 in 1854 
when Dr. J. W. Chenoweth, latel_\- graduated from the L'niversity of 
Louisville, settled there has increased steadily. It had grown to 3,839 by 
1860 and went up to 7,161 during the next decade. In 1880 it was 9,547 
and reached 16,841 by 1890. The new century found 20,754 souls residing 
in Decatur and these had increased to 31,140 ten years later. In 1920 the 
population returns of the United States bureau of the census showed 43,818 
people in the city and of these 40,041 or 91 per cent were native born whites. 
There were 2,590 or about 6 per cent, foreign born whites and 1,178 or a 
little less than 3 per cent negroes. About 23}^ per cent, a total of 10,309, 
were listed as being 45 }ears old or over. In Illinois 21^ per cent of the 
population was in the 45 and over age .group. 

(107) 



108 DOWN-STATE .MUNICIPALITIES 



Hi:ai.tii Maciiineky. 



Alllnniyli licit a pulilic liealtli (irLjanizalion, the Alacim County Mcclical 
Socifly. organized in 1S53. (liiulitle>s had an influence over jinhhc heahh 
in that it afforded the medical jirofession a niechum through whicli in ex- 
change experiences and information concerning successful therapeutic and 
preventive practice and the nature and prevalence of disease. It also pro- 
\ ided an official mouthpiece for the medical profession, giving a legitimate 
outlet to the expression of their professional influence. 

The lirst legislative step taken liy the city government toward creating 
a pui)hc health organization came on Jul\ 9, 1886, when an ordinance creat- 
ing a board of health was adopted. Prior to that time a committee of the 
board of aldermen managed the public health affairs which consisted chiefly 
of investigating and abating nuisances. Evidently the committee had been 
called upon to face a number of complicated problems associated with epi- 
demic outbrealcs for the ordinance reads like an instrument concei\ed b\' 
gr;i\'e experiences. The new board, for instance, was clothed with the broad 
powers implied in the term "general supervision over the health and welfare 
of the people." Specifically, the board was invested with authority to abate 
nuisances; to establish hospitals for the prevention of commimicable 
diseases ; to employ nurses to work in such hospitals ; to require all citizens 
to be vaccinated against smallpox under penalty of fines ranging from $5 to 
$25 ; to require reports of all communicable diseases ; to require the quar- 
antine of patients sufl:"ering from contagious diseases; to exercise sanita\'y 
control over food, milk, slaughter houses, soap factories and the city 
generally. 

The first board, which began at once to e.xercise vigorously its sanitary 
regulatory powers, was made up of the mayor, the town clerk and three com- 
missioners including Dr. C. Chenoweth, Ira N. Barnes and B. F. Lilley. 
It was, however, like so many similar organizations elsewhere, reduced to 
tlie necessity of doing its work principally through the force of moral 
suasion because of the paralyzing complex always introduced by an empty 
exchequer. In times of emergency the board could and did get monev by 
special acts of the city council and thus it employed inspectors and technical 
talent from time to time as occasion required. 

This practice appears to have prevailed throughout the life of the board 
of health system, which expired in 1909 with the adoption of the commis- 
sion form of government b\' the city, and even continued until 1911 when 
\\'. J. Harding was employed as full time health ofiicer. Four years later 
a milk inspector was appointed and in 1916 a full time sanitary inspector 
was added to the staff. Then in 1919 a social hygiene clinic, financed jointly 
by the city and .'^tate, w;is established and Dr. I. H. Neece was employed 
as its medical diicctor and at the same time he was given general supervision 



DECATUR 109 

over the public health acti\ities of the city. The lav health officer and the 
two inspectors were retained but Dr. Neece was given general supervision 
over all medical and technical activities and engaged personally in such 
things as the examination of school children, the investigation of epidemio- 
logical problems and the like. 

The \ear 1''24 marked the beginning <.if distinct advancement in the 
public health organization of Decatur. In Alarch of that year arrangements 
were made by the State Department of Public Health to establish a labor- 
atory service in the local hospital for doing diphtheria tests. It was but a 
step from that point to a rather complete local laboratory service and the city 
took advantage of the opportunity in October of that year, paying the hos- 
jiital a contract price for public health work done for the local physicians. 
Earl\- in the \ear Dr. Xeece gave up the health superintendency, opening the 
way for a fidl time man in that capacit\'. 

After a lapse of several months, the public grew restive, provoking a 
pronounced sentiment in favor of a well organized modern health depart- 
ment manned and equipped in a way commensurate with the needs and 
dignity of a thriving up-to-date community. Ac- 
cordingly the officials looked about until they 
struck upon Dr. William S. Keister of Charlotts- 
ville, \'irginia, a man of superior training and 
considerable experience in public health work, 
who was tendered and accepted the position of 
lull time medical director of health on September 
first, 1924. Under him a splendid cooperative 
program unifying all public health service in the 
city, both voluntary and official, under his direc- 
tion was worked out and put into operation. A 

William S. Keister, M. D. picture of the public health machinery that was 

Medical Dn-ector of Health. ... T t^ t^ ■ , , <■ 

1924 to 1927 tunctionmg under Doctor Keister at the close of 

1925 is found in a report of a study and appraisal 

of the service conducted b}' the State Department of Public Health in 1926. 

B}- consulting that report we learn : 

"Appraised on the basis of the 192.5 records of public health service. 
Decatur, with a score of C95. ranks third among the fifteen cities sur- 
veyed. Much progress has been made in this field of community effort 
since 1924 when the municipal health department was reorganized. En- 
joying an excellent relative standing, of even greater interest is the 
spirit of progress that permeates public health activities in Decatur, a 
demonstration of which is found in the addition of new activities and 
the e.xtension of existing ones during last year. 

"The health work in this city is unique in demonstrating the ex- 
cellent coordination which is possible between the city, board of educa- 




110 DONVX-STATE MUNICIPALITIES 

tion, county tuberculosis sanatorium board and tlie volunteer lieallli 
agencies under the leadersliip of a city health officer. While many in- 
fluences may have been present to bring about this coordination, that 
of the county medical society deserves special mention. In 1924. a 
central committee of public health was formed, composed of the ines- 
ident of the county medical society, su))erintendent of Decatur-.Macon 
County Hospital, su])erintendent of schools, city commissioner of health 
and safety, the directors of the venereal, orthopedic, tuberculosis and 
other clinics, the president of the Visiting Nurse Association and other 
interested persons. One of the first results of this committee's efforts 
was the appointment of a full-time health officer by the city, part of 
whose salary is paid by the tKj;ud of education. In addition to occupy- 
ing these two positions the health officer also directs the work of the 
Visiting Nurse Association. The health department conducts com- 
municable disease control, sanitation, food and milk control activities. 
The city clerk is local registrar. A venereal clinic is held at the hos- 
pital, the expense being borne jointly by the city and the State. Tuber- 
culosis clinics are held by the medical superintendent of the county 
sanatorium, but the field work for these clinics is done by the Visiting 
Nurse Association. This same organization also renders bedside care 
and field service for prenatal and infant hygiene. 

"School health work is under the direction of the city health officer 
(as noted above), who is assisted by! three nurses and a part-time 
dentist. Laboratory work for the city is done by contract in the Decatur- 
Macon County Hospital. Two baby welfare clinics are maintained and 
one nurse divides her time between these several clinics. 

"The city itself spends $13,310 for health service or 2G cents per 
capita and expenditures by all agencies totals $29,G79 or 50 cents per 
capita. Seven cities spend more than Decatur for its health depart- 
ment and in seven the total exiienditures by all agencies exceed Deca- 
tur's total. 

"Facilities for the hospitalization of contagious disease patients are 
not present. 

"A special tax for anti-tuberculosis work has been voted by the 
county under the tuberculosis sanitarium law. A sanitorium has 
been built and is operated under contract with the Decatur-Macon 
County Hospital. The sanitarium board pays the Visiting Nurse Asso- 
ciation for field tuberculosis service throughout the county. Decatur 
takes first place among the fifteen cities in its field nursing service for 
tuberculosis. The amount of hospital service provided is adequate. 

"No prenatal clinic was in operation in 1925 although one has been 
started recently at the Decatur-Macon County Hospital. Two infant 
clinics were operated but the total attendance in these was low. 

"School hygiene work Is financed by the board of education, which 
employs three nurses and a part-time dentist and pays one thousand 
dollars per year to the city health officer who acts as director of 
hygiene. Decatur is surpassed only by Peoria in its school health work. 

"The sanitary inspection service is conducted by two full-time in- 
spectors. 



Ill 



"Prior to October iy:i5. there was no free public healtli laboratory 
service except that furnished by the State Laboratory at Springfield and 
facilities for the diagnosis of diphtheria at the Decatur-Macon County 
Hospital. Since that date, however, the city is paying .$100 per month 
to the hospital for laboratory service." 



VITAL 5TATI5TIC5 m 
C0nn.DI5. COhTROL^^ 



DECATUR 

' i ° ' i ° ^f -^^f— 



VEn. DI5. COriTROL^ 
TUB. COMTROL m 
HEALTH CHILD--"^«^ 



HEALTH 5CH. CHILD WM 
SAMITATIOM 
MILK CONTROL 
LABORATORY ^ 



POP HEALTH in5T.^ 



PERCEMT OF STAMDARD SCORE 
EACH OF TEM MAJOR HEALTH ACTIVITIES 
1923 



Fig. 1. This graph illustrates the strong and weak points in Decatur's 
public health service, official and voluntary, as it existed in 1925. It is 
based upon a personal survey and rated ni)on the standards evolved by 
the American Public Health Association. The total efficiency rating in 
Decatur was 70 per cent of the standard jierfection requirement. 

With a change in the political fortunes of the municipality that took 
place in 1927, Dr. Keister resigned and Dr. Geo. W. Haan, Jr., was ap- 
pointed in his place. The official personnel of the health department re- 
mained the same in strength but some of the voluntary agencies as well as 
the school board withdrew froiii the cooperative agreement that previously 
prevailed and began again to plan and direct their activities independent of 
the health department. 

Voluntary and Other Agencies. 
Public health nursing, which began in 1908 through resources provided 
by the Civic League and the Woman's Club, has been an important factor 
in the health services of Decatur. During the second year of this work the 



112 DOWX-STATK MUNICIPALITIES 

school board paid one-half of the salary of the one nurse emplo}ed because a 
considerable amount of her time was spent in the schools. Later the school 
board undertook to pay all of the nurse's salary and in 1911 employed two 
nurses. This beginning ultiniately led to the employment by the school 
Ixiard (if three full time nurses, a part time dentist and a contribution toward 
the salarx of the health officer during the tenure of Doctor Keister and gave 
Dt'catur one of the linest school health services in Illinois. 

In I'M 7 tile Macon l'ount\- Tuberculosis and Visiting Xurse Associ- 
ation was organized and began at once to function. It participated in the 
health activities of the city and county in a large way, exercising a predomi- 
nating influence in the successful campaign that resulted, through popular 
vote, in the opening of a splendid tuberculosis sanitarium during the summer 
of 1923. This sanitarium proved to he the nucleus about which has sprung 
up that remarkable institution known as the Decatur and Macon County 
Hospital which concentrates under one administrative head a very large per- 
centage of the medical and public health facilities of the city and county. 
All of the dispensary and clinic activities of a public character, except those 
carried on in the schools, are conducted in the institution and supervised 
by it. 

A clinic for crippled chihh'en was started in the city in 1919 b_\' Dr. 
George LVon. Later it was affiliated with the hospital and upon the death 
of the orthopedic surgeon in charge it was turned over to the Illinois Society 
for Crippled Children in 1926. 

W.A.TER Supply. 

The first water supply for Decatur was placed in service in December 
1870, drawn from a well in the city. Scarcely a month later it proved to be 
inadequate. In 1871, therefore, a pumping station was built on the banic of 
Sangamon River. 

It was soon found that the river water was too turbid for use during 
high water and in 1874 an infiltration gallery was constructed. 

In 1877 the suppi}' again became inadequate. The gallery was enlarged 
and a dam constructed to raise the water level at the gallery. 

Later it became necessary to pump water directly from the river to meet 
the demand and the supply was again unsatisfactory. In 1894 a filter plant 
was constructed. 

In 1910 and 1911 a new pumping station was built and the wooden dam 
was replaced b}" one of concrete. In 1914 a new and modern filter plant 
was built. This plant is still in use. 

In 1920 and 1921 another dam was constructed which formed what is 
now called Lake Decatur. This lake will supply ample water to meet the 
needs of the citv for manv rears. 



DECATUR 113 

The Sanitary District has adopted an ordinance for the sanitar\' control 
of the lake. The outline for the ordinance was prepared by the State Depart- 
ment of Public Health, and it was the first ordinance of its kind to be adopted 
in Illinois. .\n inspector is maintained to police the lake and its tributaries. 
With this control of the lake and proper operation of the treatment plant the 
water should be of excellent quality. 

SEWi:R.\r,E. 

Sewers were constructed as needed until by l'J12 the cit\- was rather 
completely sewered on the separate plan. There were four outlets, all of 
which were below the water-supply intake on Sangamon River. 

Soon after the Sanitary District was organized in 1917. an interceptor 
was constructed to collect the sanitary and storm sewage. 

In 1922 a modern sewage-treatment plant was constructed. The plant 
receives wastes from the Staley starch works. After the plant was finished 
the wastes from the starch works increased enough to overload the plant. 
An agreement was reached whereby the starch works would decrease its flow 
and the city would enlarge the treatment plant. 

He.^ltit Conditions. 

References to prevailing health conditions and even to epidemics in 
Decatur prior to 1900 are particularly meagre. If the community suflfered 
extensively from cholera during the outbreaks of 1833 or 1849 it kept the 
matter to itself. If smallpox ever alarmed the public or carried off any 
considerable number of citizens, those facts were likewise regarded as private 
affairs. If these two notorious diseases escaped historical mention we are 
not surprised to find no records of other and less spectacular factors in the 
community health. 

(^n the other hand the city introduced an effective vital statistics system 
at an early date, the city clerk being the local registrar. The system was 
working well enough in 1900 to justify the United States bureau of the 
census in admitting Decatur along with one-half a dozen other Illinois cities 
into the United States registration area for deaths which was established at 
that time. Requirements for admission into that area include an effective 
law or ordinance and proof that at least 90 per cent of all deaths are being 
reported and recorded. 

just wlien the ordinance was passed in Decatur is not clear from ma- 
terial available. The mortality statistics for these early years are doubtless 
preserved somewhere but they were never analyzed and compiled and they 
are not accessible for a study of the kind herewith attempted. Accordingly 
we must be contented here to surmise that conditions prevailing after 1900 



114 



DOWN-STATK M U .\ Ul PAI.ITILS 



were but a continuation of those that existed before that time and thus con- 
clude that the city experienced its full share of epidemic visitations which 
came and went in periodic waves peculiar to infectious disorders. The con- 
stantly- high niortalit_v rates from tuberculosis, typhoid fever and diphtheria 
during the first decade of the twentieth century leads to the reasonable pre- 
sumption that these diseases as well as diarrheal and other communicable 
disorders were severely endemic for some considerable time before 1900. 

Scanning the mortality sheets we observe an unmistakable evidence of 
(lisiinct iniprovcnient in the public health measured by the impeccable terms 
of declining fatalit\- rates from specific causes. Deaths from typhoid fever, 
for instance, fell from 48.2 per 100,000 population in 1900 to 1.8 in 1926. 
The progi-ess of this descent was not unbroken but rather it was interrupted 
by fluctuations which varied in intensity with the changing combination of 
the innumerable factors invohed in the spread of this disease. At the same 
time the downward trend was pronounced, the marked increases grew more 
infrequent and the public conscience became more and more sensitive to 
outbreaks of typhoid fever. 



Table 1. 
Mortality From Certain Causes. 







£ 








s 


1 

o 






■B 


« 




YE.\ll 


i 


■3 




g 




& 


O 


P 


s 


>^ 


If 


■|i 




1 




•^ 


p. 


s 


■g 


d 


s 




fcitS 


£•2 








1 








ArS 






S~ 






-^ 


> 


"ea 


s 


1 


^ 


■2*5 


cs 


■3 


P< 


G? 




-^ 


H 


a 


X 


a 




I^ 


a 


.5 


i. 




t,--:- 


1897 


30 


3 












2 






2 




1898 


245 


5 










2 


1 


'. . . 






41 




1S99 


332 


4 






' i 




1 


1 


10 






37 


36 


1900 


351 


10 




. '. '. 


4 






9 








40 


28 


1901 


303 


9 


"■2 








7 


1 


8 






33 


23 


1902 


331 


3 






2 


11 


2 


10 


2 






37 


21 


1903 


280 


4 






8 




2 


10 


5 






28 


13 


1904 


323 


9 


' 2 




1 




5 


1 


3 






43 


18 


1905 


271 


3 










3 


2 


7 1 .. 




29 


26 


1900 


300 


3 


"i 




5 




5 


7 


4 






37 


20 


1907 


344 


3 










1 


8 


4 






30 


23 


1908 


345 


3 








' i 


5 




3 






28 


23 


1909 


327 


7 






"i 






"0 


2 






36 


l.-> 


1910 


412 


.5 






7 




"3 


7 


4 






45 


32 


1911 


400 


3 










4 


12 


4 






32 


14 


1912 


433 


10 










2 


5 


."> 






39 


25 


1913 


476 


8 






' i 




4 


1 


3 






45 


33 


1914 


400 


7 










4 


4 


... 1 .. 




47 


29 


191."> 


458 


3 






1 


8 


8 


3 


1 






31 


4:! 


1910 


509 


4 






13 


T 





2 


2 






35 


37 


1917 


581 


17 










3 


4 


3 






46 


57 


1918 


686 


3 










4 


7 


103 






42 


73 


1919 


556 


4 






"i 




4 


11 


29 






43 


22 


1920 


649 


i 






6 


' 2 


4 


7 


47 






52 


50 


1921 


601 


9 










3 


20 


9 






33 


44 


1922 


594 


2 








".3 




3 


13 






38 


45 


1923 


647 


2 






' i 


3 


4 


7 


26 






32 


38 


1924 


609 


2 






2 


2 


2 


3 


5 






38 


40 


1925 


660 


6 






2 


2 




1 


9 




36 


55 


1928 


755 


1 








1 


"9 


1 


14 1 


35 


40 



Table 2. 
Mortality Rates From Certain Causes. 



115 



YEAR 


3 

6 


1 

i .3 




1 


1 


i 

o 

a. 




i 




it 


.33 

g £ 

ft. ^ 


1897 


1.5 


15.3 








5.1 




10.2 






20.4 




1898 


12.3 


25.0 








10.0 


lO.'o 


5.0 










205.2 




1899 


16.3 


19.6 






iig 


4.9 


4.9 


4.9 


49!i 








181.7 


176 ! 8 


1900 


16.9 


48.2 






19.3 


9.G 




43.4 


24.1 








192.7 


134.9 


1901 


14.4 


42.8 


9.5 






23.8 


33!2 


4.7 


38. 








156.7 


109.2 


1902 


15.4 


14.0 






913 


51.2 


9.3 


46.6 


9.3 








172-.3 


97.8 


1903 


12.8 


18.4 






36.7 




9.2 


45.9 


23.0 








128 . 6 


59.7 


1904 


14.6 


40.8 


9!6 




4.5 




22.6 


4.5 


13.6 








194.6 


81.5 


1905 


10.8 


18.5 










11.1 


11.1 


29. G 








111.0 


74.0 


1906 


12.1 


12.1 






20.2 




20.2 


28.3 


16.2 








149.7 


80.9 


1907 


12.0 


10.5 










3.5 


27.9 


14.0 








104.7 


80.3 


1908 


13.6 


11.8 








3.!> 


19.7 




11.8 








110.3 


90 . 5 


1909 


10.7 


23.0 






3.3 


6.6 




19.'7 


6.6 








118.1 


49.2 


1910 


13.1 


16.0 






22.4 


12.8 


gie 


22.4 


12.8 








143.8 


102.2 


1911 


12.4 


9.3 








12.3 


12.3 


37.0 


12.3 








98.8 


43.2 


1912 


12.3 


28.1 








2.8 


5.6 


14.1 


14.1 








109.7 


70.4 


1913 


13.1 


21.9 






2!7 


2.7 


11.0 


2.7 


8.2 








123.2 


90.3 


1914 


12.4 


18.7 








2.7 


10.7 


10.7 










125.2 


77.3 


1913 


12.0 


7.8 






2^6 


20.8 


20.8 


7.8 


2!6 








80.5 


111.0 


1910 


13.0 


10.1 


5!6 




32.8 


2 . 5 


15.1 


5.0 


5.0 








88.3 


93.4 


1917 


14.2 


41.0 




2.4 




2.4 


7.2 


9.6 


7.2 








110.8 


137.4 


1918 


16.3 


6.8 


2.2 








9.0 


15.9 


234.0 








95 . 4 


165.9 


1919 


12.8 


9.1 






2 .2 




9.1 


25.1 


66.2 








98.1 


60.2 


1920 


14.6 


8.8 






13.6 


i.i 


8.8 


15.8 


1C6.8 








118.1 


122.7 


1921 


12.9 


19.3 


2!l 








6.4 


43.0 


19.3 








70.9 


94.6 


1922 


12.5 


4.2 








e'.i 




6.3 


27.4 








80.0 


94.8 


1923 


13.4 


4.1 






20^6 


(S.l 


8!2 


14.4 


63.7 








66.1 


78.5 


1924 


11.5 


3.7 






3.7 


3.7 


S.7 


5.6 


9.4 








71.7 


75.4 


1925 


13.1 


11.9 






3.9 


4.0 




2.0 


17.8 








71.6 


102.0 


1926 


13.7 


1.8 








l.S 


16.2 


1.8 


25.2 


i.8 


63.6 


72.7 



The r.ite fro 



.\11 Causes is per 1.000 population; all others per 100,000 populatio 



Table 3. 
Cases of Certain Diseases Reported. 



1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Tvphoirt Fever 


27 


99 


22 


22 


12 


31 


18 


15 


18 


15 


23 


34 


Smallpox 


163 


81 


33 


33 


34 


10 


1 


31 


5 


13 


6 


12 


Measles 


9.56 


181 


183 


188 


927 


51 


13 


24 


6 


662 


242 


286 


Scarlet Fever 


57 


66 


30 


30 


33 


217 


62 


121 


204 


78 


156 


135 


Whoop. Cough 




58 


75 


133 


168 


102 


7 


2 


3 


140 


341 


174 


Diphtheria 




21 


35 


30 


132 


309 


139 


77 


60 


47 


53 


70 


Influenza 






1566 


1563 


919 




60 


77 


16 


52 


66 


24 


Poliomvelitis 


15 


1 






2 


e 




1 


1 


1 


8 


23 


Meningitis 




6 


2 






2 


1 










2 


Tuberculosis* 




96 


55 


37 


73 


61 


133 


218 


133 


110 


232 


185 


Pneumonia* 












10 


132 


179 


116 


154 


178 


123 


S.vphilis 






26 






188 




58 


136 


172 


150 


141 


Gonorrhea 






154 






248 




112 


202 


195 


188 


189 


Chancroid 
















*- 




3 




3 



*AI1 forms. 
Note: Oase reports are never complete, but they have been much more so since 1920 than before in 
Illinois and they are more complete in Decatur than in many other communities and cities of the 
State. This table indicates improvement in notification more than anything else. 



116 



IxnVN-STATK MUNICIPALITIES 



Table 4. 
Births and Infant Deaths. 



Infant Deaths 



YKAU 












Number 


Kate** 


Number 


Rate* 


1900 


206 


9.9 


57 


276.6 


1901 


250 


11.4 


57 


228.0 


1902 


502 


SI. 9 


70 


139.4 


1903 


549 


23.0 


51 


92.8 


1904 


535 


21.4 


59 


110.2 


1905 


615 


23.7 


34 


55.2 


1906 


635 


23.5 


51 


80.3 


1907 


1004 


35 . 8 


40 


45.8 


1908 


929 


31.9 


58 


62.4 


1909 


1015 


33.7 


47 


46.3 


1910 


1047 


33.6 


54 


51 . 5 


1911 


1081 


33.3 


58 


53.6 


1912 


1114 


33.1 


57 


51.1 


1913 


1115 


31.9 


61 


54.7 


1914 


1183 


32.6 


68 


57.4 


19ia 


1150 


30.6 


58 


50.4 


1916 


907 


23.4 


75 


82.6 


1917 


840 


20.9 


74 


85.2 


1918 


971 


23.5 


79 


78.1 


1919 


908 


22.7 


78 


80.5 


1920 


1089 


24.5 


71 


65.2 


1921 


1124 


24.6 


90 


80.1 


1922 


1045 


22. 2 


76 


72.7 


1923 


1068 


22.0 


91 


85.2 


1924 


1091 


22.1 


84 


77.0 


1925 


1126 


21.3 


74 


65.7 


1926 


1275 


23.2 


93 


72.9 



of age per 1000 births reported. 



Experience with tuberculosis has been no less favorable than that with 
tvphoid fever. Mortalitv declined from 192.7 in 1900 to 63.6 in l'»26. The 
resources and energy utilized in fighting- this disease appear to have produced 
results of the most satisfactory character. 

Several unhappy epidemics have marred the story of general improve- 
ment in health conditions during the first quarter of the twentieth century. 
Scarlet fever, for example, reached alarming proportions in 1915. Condi- 
tions were regarded with sufficient gravity to lead the State Board of Health 
to go into the city and by virtue of authority vested in it by law take 
complete charge of the situation. Some 300 cases and 8 deaths occurred 
during the epidemic. Never before nor since, so far as the records dis- 
close, has scarlet fever caused such disastrous havoc in the city. 

Likewise diphtheria cast its unwelcomed shadow across the community 
on more than one occasion liut its wide prevalence and fatal character in 
1921 makes it particularly noteworth\' for that year. There were 309 cases 
and 20 deaths reported. Somewhat similar outbreaks occurred in 1900, 
1902, 1903 and 1911. 

Again, 1917 marked the occurrence of the worst typhoid fever epidemic 
which the cit\- has experienced since 1904. About 120 cases, 17 of which 



DKCATUR 117 

terminated falrilK , fullowed tlie conlaniiiiation of a milk supply by a lyphoid 
carrier who was at work on a dairy farm. 

Again, Decatur felt the grievous sting of the influenza pandemic which 
spared not the State in 1918. Fatalities from that disorder jumped from 
an average of 4 or 5 per year to 103 while deaths from pneumonia went up 
from an annual average of about 25 or so to 7?i. Even so the mortality rate 
from these two causes combined was quite moderate compared with what 
it was in most of the other municipalities in Illinois. The rate in Decatur 
was 400 per 100,000 population while Elgin alone out of all the other cities 
embraced in this volume reported a lower rate. It has been suggested that 
the sobriety of Decatur may have been an important factor in the moder- 
ation of the epidemic there. 

The periodicity of these epidemics in recent years and the very fact 
that thc\- cause profound public concern which expresses itself in the appli- 
cation of sound preventive measures are evidences of substantial advance- 
ment against the communicable diseases. Public concern over the presence 
of a preventable disease and public support of preventive programs are mani- 
festations of a healthy public mind and so long as that condition continues 
the interruptions in health improvement caused by epidemic outbreaks will 
serve only to stimulate the city to more adequate and more vigorous efforts 
against the invasion of disease. 

Ri-:fi:rences. 

Reports of Commissioner of Health. Decatur, -various dates. 

Macon Coinitv History. 

History of Medical Practice in Illinois, Vol. 

U. S. Census Reports, Washington, D. C, i 



East St. Louis 

Reckoned from the date when the white man first settled in that vicin- 
ity, East St. Louis is one of the oldest communities in Illinois. French mis- 
sionaries, arriving from the north by way of Canada and the Alaumee- 
Wabash portage, established themselves there in 1700, calling the settlement 
Cahokia. After surviving many vicissitudes of fortune a plan for building 
a city was evolved in 1817 when the site was platted and given the name of 
Illinois Cit\-. Instead of adding his benediction to the project, Lewis Beck, 
a prominent citizen and sagacious observer of the day, prophesied that the 
land laid out would never be valuable except for cornfields and potato patches 
because it had no advantages. 

This gloomy forecast, notwithstanding, the community had acquired suf- 
ficient importance by 1859 to secure a charter from the General Assembly 
in which it was called Illinois Town. Two years later. April 1, 1861, the 
name was changed to East St. Louis and a new charter was granted by the 
legislature. 

The city is located almost in the very center of the "American Bot- 
toms", the extensive low-lying area that beguiled pioneers by its fertility 
but complicated its marvelous harvests of grain with great crops of mos- 
quitoes which carried malaria to rob the settlers of their blessings. East 
St. Louis is separated from ."^t. Louis by the Mississippi River from which 
both municipalities have always drawn their water supplies. 

When Illinois became a sovereign state in 1818, East St. Louis was a 
communit}' of about 500 souls and was still known as Cahokia. The com- 
munity never grew very raj^dly until late in the nineteenth centur\-, bidding 
fair for a long time to live out the doleful forcast of Lewis Beck. By 1870, 
how-ever, the population had reached 5,644 and a decade later it was 9,185. 
During the ten years between 1890 and 1900 the population grew from 
15,169 to 29,655 and then to 58,549 by 1910. Reports of the United States 
census show that there were 66,767 people in East St. Louis in 1920. Of 
this number 52,522 or 79 per cent, were native born whites while 7.437. or 
about eleven per cent, were negroes. There were 12,212 or about 18.2 per 
cent, who were 45 years old or over. 

Hr..M.Tn M.-\CMIXERY. 

If the origin;il cmnniunity of Cahokia is included in the history of East 
St. Louis. t(i that city f;dls the distinction of having had the first health 
officer and (luarantine regulations in Illinois. Strangch' enough this first 

(118) 



EAST ST. LOUIS 



119 



health officer was a woman. Madame I-]euHeu, of whom Governor Reynolds 

in The Pioneer History of Illinois, says : 

"She was the director-general In moral and medical matters (at Ca- 
hokia). This lady was educated and intelligent. She possessed a strong, 
active mind and was a pattern of morality and virtue. She was the 
doctoress in many cases and the sage femme general for many years. 
She was extremely devout and an exemplary member of the Catholic 
church. This, together with her merit generally, enabled her to fix up 
many of the male and female delinquencies of the village. She was 
sincerely entitled to the praise due a peacemaker. * * * * She lived a 
long and useful life, and died in Cahokia in 182G, eighty-four years of 
age, much lamented by all classes". 

Reference to the first quarantine regulation of which we have record 
appears in the minutes of the court of quarter sessions of Cahokia, July 2, 
1799. It reads: 

"Ordered in order to keep off the plague of the smallpox, that now 
rages on the Spanish Side, that any one crossing (the river) to be fined 
$6.00 for the first offense, $12.00 and ten days imprisonment for the 
second offense and remain in prison until he or they shall pay the final 
fine. Goods brought from the Spanish Side shall be confiscated." 



These good beginnings failed to provoke popular support, however, be- 
cause they soon fell by the wayside. At any rate the records are singularly 
free from further references to any kind of official public health activities 
until June 3, 1867, when a board of health made up of Edward Barrett, 
Alex Fekete, Patrick jMcCormick and Angus Gillis, one from each ward of 
the city, was established by ordinance. Just how the board functioned, if 
at all, is not clear since evidence of an executive officer is wanting. Not 
onl) so but in 1881 reports of smallpox cases were transmitted by the mayor 
to the State Board of Health, a fact that there 
was no health officer active at that time. 

From the annual reports of the State Board 
of Health, it appears that medical and sanitary in- 
spectors and nurses were employed from time to 
time to handle emergency situations arising in 
F.ast St. Louis as the result of epidemic outbreaks 
and floods. Frequently these inspectors were 
temporary employes of the State Board of Health 
and the State Board paid for nursing services 
rendered in the city on at least one occasion prior 
to 1900. These records suggest that the local 
public health facilities were either ijnitc unor- 
ganized or too meagre to be of particular value 
under stress of emergencies. 




JI. R. Doyle. M. D. 

Health Commissioner, 

1901-1903 



120 



DOWiN-STATK MUNICIPALITIES 




Later it became the practice to employ a health inspector who investi- 
gated nuisances, placarded premises and fumigated sick rooms. He seemed 
to have worked under the police department. Al>out 1900, however, there 
was a revival of local interest in the puljlic health re(|uirements of the city 
and it became the practice to employ a physician as health officer on a part 
time basis. The first to serve in this capacity- w-as Dr. M. R. Doyle, who filled 
the office during the period of 1901-1003. He was succeeded by Dr. A. A. 
McUrien who retained the position until l''ll when he was replaced by Dr. 
L. D. Short. In 1915 Dr. .Short was succeeded by Dr. R. X. McCracken who 
turned the office over to Dr. C W. Lillie in 1919. 
East St. Louis adopted the commission form 
of government in May 1919 so that Dr. Lillie was 
after that date responsible for his duties to the 
commissioner of public health and safety who had 
fallen heir t<i all the powers, duties and responsi- 
bilities formerly vested in the local board of 
health. Dr. Lillie continued a> health officer 
until his death in 1922 when the co.nmissioner 
of public health and safety undertook to manage 
personally the administrative functions of the 
health service. This executive custom has pre- 
vailed to date. 

Apparently the health officer made up the 
epartment in East St. Louis during the early years 
hut assistants in the capacity of inspectors were 
added from time to time until we find the personnel including the health 
officer, and assistant health officer in charge of 
garbage collection, a sanitary inspector, a hospi- 
tal matron and a bacteriologist (part time) in 
1919. 

.\bout this time a wave of enthusiasm for 
health improvement flooded the cit\". Through 
the interest manifested by the War Civics Com- 
mittee, which found itself with considerable un- 
expended funds after the Armistice had stopped 
W'orld War .hostilities, an exhaustive sanitary 
and health study involving a house to house can- 
vass and a careful analysis of the statistics, laws. 
facilities for health work, etc., was undertaken in 
1919. This task, supervised by the .State Depart- 
ment of Public Health was initiated with the view of discovering the exact 
nature and magnitude of the sanitary and h\gienic problems of the city and 
then creating a ])ublic health organization commensurate with the needs. 



L. B. Short. M. D. 

Health Commissioner. 

1911-1915 

entire staft" of the health 
of ihe twentieth centurx 




R. X. JlcCracken. M. D. 

Health Commissioner, 

li)l.i-1919 



EAST ST. LOUIS 



121 




Charles W. Lillie, M. D. 

Health Commissioner, 

1919-1922 



The project turned out to be a case of the 
"Sjjirit is wilhiig but the pocket book is empty". 
Ilxerything went fine until the question of financ- 
ing an adequate health department came up but 
for this problem their seemed no solution. The 
municipality was already taxed to the legal limit 
and no other financial resources were open to the 
oflicials. 

Although no general reorganization of the 
health work followed fast upon the heels oi the 
survey, improvements and new activities were 
added to the service from time to time. Scarcely 
before the study was completed in 1919 a social 
hygiene clinic with Dr. W. C. Wilhelmj in charge, 

was. established under the joint financial support of the State and count\-. 

Shortly afterward a medical examination system was inaugurated in the 

schools. 

I^iubscciuently two other studies of an entirely different type were made 

(jf the public health equipment in East St. Louis. (Jne was carried out in 

V)2? \i\ the American Child Health Association 

and the other in 1926 by the State Department 

of Public Health. Each was initiated by the 

agencN- that did the work. In each case the 

object was to discover how much public health 

service was actually being done in the city by all 

official and \'oluntary agencies and to relate the 

whole volume of such service to the needs of the 

numicipality as measured by the practices found 

profitable in a hundred American cities. The 

findings in each ca.se w-ere reduced to an arith- 
metical \alue based upon 1,000 possible points 

and in each case the results were much the same. 

Quotations from the report made by the State 

Department of Public Health give a clear concc])li<in of the public health 

services available in l-'.ast St. Louis at the close of \')Z5. We read : 

"As indicated by a score of onl.v 41,') out of a ijossible luMO points, 
public health activities in East St. Louis fall far short of what may be 
regarded as standard practice. Although the city commissioner under 
whose supervision the health deiiartment falls, manifests a keen in- 
terest in and devotes a considerable part of his time to this department, 
the health service is poorly organized and not well bilanced. The city 
employs no nurses. The field staff consists of one quarantine officer 
and three inspectors, the latter devoting their attention chiefly to grocery 




A. P. Lauman 

Commissioner of Public 

Health and Safety. 

1927 to (l;ite 



122 nowx-STATi-. iri'xiriPALiTiES 

and moat stores, restaurants ami nuiKance coni|)laints. A part-time 
physician does tlie laboratory work and is available for settling ques- 
tionable diagnoses although his actual field activity is negligible. Vital 
statistics are collected and tonii)iled by cause and by groups for the local 
registration area which is larger than the city but no rates are com- 
puted and no analyses made. The princiiial short-coming of the health 
department under the present iMidget is a lack of trained personnel. As 
organized it functions well. 

"Four part-time physicians employed by the school board, a medical 
director of a social hygiene clinic supported from state and county funds, 
a nurse employed by the tuberculosis association and seven nurses on 
the staff of the Visiting Xurse Association make up the remainder of 
the city's public health workers. In so far as recreation may be con- 
sidered a public health activity, the park board does a splendid service. 
The Visiting Nurse Association is easily the most vigorous and best 
organized of the health agencies. Between the various agencies there 
seems to be no close contact. 

"East St. Louis spends money enough, through official and voluntary 
agencies combined, to enjoy a much more satisfactory health service 
than it obtains. The city, however, spends directly only 16 cents per 
capita per year, other agencies contributing enough to bring the grand 
total up to about 51 cents per capita per year. A reasonably adequate 
city health department requires at least 50 cents per capita per year 
and this must be supplemented by a considerable voluntary agency 
strength in order to provide a service commensurate with minimum 
needs. 

"The records collected and compiled by the health department are 
for the local registration area, which is larger than the city and no 
analysis showing the city proper is made. None of the records are 
indexed and while tabulations by cause are made, these compilations 
are in alphabetical order without reference to the International Classifi- 
cation. 

"Activities directed toward the control of communicable diseases 
are handled by the city commissioner under whose supervision the 
health department comes. He is assisted in this by a quarantine officer 
who placards premises and fumigates at the termination of quarantine. 
No nurses are employed and the part-time physician on the staff does 
very little field work. Smallpox cases are usually isolated in a 'pest 
house' but there are no hospital facilities for isolating contagious disease 
patients. Advantage is always taken of epidemics to stimulate vaccina- 
tion against smallpox. 

"Efforts directed at combating venereal diseases constitute the most 
efficient official public health service in East St. Louis and as such stand 
out in strong contrast to the weakness in other activities. A clinic is 
operated under first class supervision and patients are kept under good 
control. 

"A county tuberculosis nurse spends a considerable part of her time 
in the city and the Visiting Nur.se Association does a limited amount 
of tuberculosis work. No tuberculosis clinics are held in the city nor 
are there any hospital facilities for tuberculous patients. 



EAST ST. LOUIS 



123 



"The Visiting Nurse Association conducts two baby welfare clinics 
per week, one for white and the other for colored. Last year the total 
number of visits to these clinics was 952. The same oi'gauization did a 
large volume of field nursing work. There is no prenatal or preschool 
clinic. With limited strength and financial resources, the Visiting 
Nurse Association is doing a splendid service in a broad field. 

"Because of intense interest in health matters on the part of the 
city superintendent of schools, some very good work is being done 
among the pupils. The good points are the systematic weighing and 
measuring and the use of this procedure to stimulate interest of the 
children, the regular use of text book instruction and the splendid 
recreational system. Four physicians devote time each school day morn- 
ing to the examination of inipils. A fairly complete examination is given 
to all children during their first year. Those with gross defects are 
kept under more or less supervision. Examinations are made of other 
pupils only when some manifestation of departure from the normal is 
observed by the teacher and reported to the physician when he pays 
his routine visits to the school. There was some evidence that these 
physical examinations result in consideralile good. 



EAST 5T. LOUIS 



[St 



VITAL 5TATI5TIC5S 
conn. DIS.COMTROL" 
VEIH. DI5. COMTROL^^ 
TUB. COMTROL 
HEALTH CHILD 
HEALTH 5CH. CHILD 
5ANITATIOM™s.^S"0 
MILK COMTROL 
LABORATORY 
POP. HEALTH IMS 



^ — I 




FOR 



PERCENT OF STAMDARD SCORE 
EACH OF TEM MAJOR HEALTH ACTIVITIES 
1925 



Fig. 1. This graph illustrates the strong and weak points in Fast i-"t. 
Louis' public health service, official and voluntary, as it existed in 1925. 
It is based upon a personal survey and rated upon the standards evolved 
by the American Public Health Association. The total efficiency rating in 
East ?t. Louis was 42 ])er cent of the standard perfection requirement. 



124 nowN-STATi-: .muxich'ai.ities 

"The water siiiiply is sood and apjiears to be on tap in most homes 
and all business houses. While no actual, up-to-date records are avail- 
able, there appear to be grounds for believing that a considerable num- 
ber of dwellings have no sewer connections. Three sanitai'y inspectors 
pay especial attention to food establishments, nuisances and the like 
so that this phase of public health w'ork is more adequately covered by 
oflicial activity than most others. 

"About 85 per cent of the milk supply is pasteurized. This is dis- 
tributed by three large (oncerns while the raw milk, none of which is 
certified, is handled by 14 small producers. License is required of all 
milk dealers and satisfactory ordinance provisions for adequate con- 
trol sui)ervision are in force. No bacterial analyses of samples are made, 
however, and no systematic inspection activities prevail. Perhaps it is 
not amiss to add that the estimated daily consumption of milk, about 
one-half pint lier capita, is the lowest of the 15 cities studied." 

While not a [)art of the heahh machinery in the narrower sense, there 
were I wo other official organizati(jns the wurk of which resulted in consider- 
able luihlic health improvement. P'irst came the organization of the sanitary 
district in l'X)n. It caused the strengthening of old levees and the building 
of new ones which have i)rotected the cit\' from periodic inundations so 
C(]mmon during earlier \ears. These improvements relieved the locality 
from marshy areas and stagnant pools which had once been the prolific 
breeding grounds of mostjuitoes. Malaria disappeared also with the passing 
of the mosquito. 

Then came the park district organization in 1''08. Including a part 
of adjacent townships under its iurisdicti(jn this organization has built niun- 
erous parks, playgrounils, one open air swimming pool and promoted in other 
ways wholesome outdoor life. Doubtless these activities have contributed 
to the health assets of the community-. 

Furthermore, there was an isi)lation hospital authorizeil antl purchased 
by the city in 1904. It was somewhat superior to what was ordinaril}- re- 
ferred to as "pest house" but it did not measure up to the modern conception 
of an i-solation hospital. At any rate, it provided a place where patients suf- 
fering from contagious diseases might be cared for in a way to prevent 
spreading the infection. 

W.\ti-;k Supply. 

The waterworks were established in 1885, when a 30-_\ear franchise was 
granted to certain St. Louis interests. The properties were later bought by 
the American Water Works &■ Ciuarantee Company (now American W'ater 
Works & Electric Co., Inc.) a holding company with headquarters in New 
York City, which also now supplies Granite City, Belleville, Venice, and 
Madison from the Ea.st St. Louis plant. The old local company name of 
East St. Louis & Interurban \\'ater ("om])any is still used. 



EAST ST. LOUIS 125 

The supply has always been from the Mississippi River. The first water- 
works included a settling basin. Later a secondary settling and coagulating 
basin was added and eighteen Jewell pressure filters installed to operate 
under a low head as gravity filters with an dutlet to a filtered-waster basin. 
The next addition was ten steel tub gra\ ity filters, and four concrete gravity 
filters were added in 1913, and eight more in I'HS. 

At present the water is taken from the riser, allowed to settle for about 
53-2 hours, then agitated to mi.x it with the coagulants, and allowed to settle 
again for Syi hours before filtration, .\fter filtration, chlorine is added as a 
sterilizing agent before it is pumped to the distribution system. 

Since filtration and chlorination of the river water was started, the 
supply has been considered as a safe sanitary qualit\ and no illness has ever 
been attributed to the water suppl\'. Improvements to assure water of good 
sanitary quality have been made from time to time and a local laboratory 
was established at the plant for bacterial and chemical analyses in 1914. 
In addition to the local analyses, check analyses have been made in the engi- 
neering laboratories of the State Department of Public Health since June 
1918. " 

In the East St. Louis industrial district there are a large number of 
private water supplies that obtain writer from the alluvial sand and gravel 
deposits in Mississippi River bottom land known as the American Bottoms. 
This water is harder than the public water supply but during warm weather 
is cooler and thus better for certain purposes, such as for condensers. 

Although at the close of the period covered by this history there were 
quite a number of private wells still in u.se in the East St. Louis district, the 
water mains are accessible to nearly all the built-up territor}-. The company 
has a total of about 325 miles of mains and distributes from the East St. 
Louis plant about 20-million gallons a day. 

During 1926-27 a new intake and supply line was established upstream 
but the old intake opposite the treatment plant is maintained for emer- 
gency use. 

Sewerage. 

The land comprising the site of East St. Louis was low and quite flat 
and land drainage was one of tlie earliest needs. The first permanent or 
public sewers were installed in 1873 and since that time numerous extensions 
and additions have been made, but without regard in any comprehensive 
plan and with limited thought of future needs. 

All of the sewers are of the combined t\pe to handle stcirm water as well 
as sanitary sewage. There is one main outlet with a pumping station south- 
west of the city, and several other smaller outlets discharging either directly 



126 DO\V.\-STATF. MUNICIPALITIES 

inid Mississippi River or indirectly to the river through Cahokia Creek, 
whieh Hows through the western portion ot' the cit)' and discharges into 
^Mississippi River at the western city limits. 

No treatment of the city sewage has been necessary because of the 
dilution afforded by the river, and because there is no water-supply intake 
for a great many miles downstream. The sewage from the public and some 
private and industrial sewers has caused very objectionable pollution of 
Cahokia Creek and Schoenberger Creek, a tributary of Cahokia Creek, which 
flows westerly through the northern portion of the city. 

In 1907 the East Side Levee & Sanitary District was established, which 
district includes not only East St. Louis but a large territory surrounding 
the city, and was formed for land drainage and not to provide sanitary 
sewerage facilities. Many projects have been planned by this district, some 
of which have been carried out, others only partly carried out, and others 
abandoned or not started. Politics have entered considerably into the func- 
tioning of the district and has somewhat hindered the development and 
carrying out of good plans based upon sound engineering and finances. The 
delays and uncertainties of the district's work have hampered somewhat the 
proper development of tnain sewers serving parts of the citw 

A report was prepared for the district by Alvord & Burdick, consulting 
engineers, giving recommendations and general plans for drainage for the 
district, and in 1924 a report on sewerage was prepared by Black & Veatch 
for the city. Since the city's consulting engineer's report the city has 
planned some rather extensive sewerage improvements for the northern 
portion of the cit}', but unfortunatelx* more or less disregarded their own 
engineer's recommendations. The project thus planned by the city was un- 
sound and was defeated in the courts. 

IMany sewers in East St. Louis are now inadequate and relief sewers, 
as well as extensions to unsewered areas, are badly needed. The city has 
been advised several times by the engineering division of the State Depart- 
ment of Public Health to adopt a sewerage plan looking toward the future, 
such as that recommended by the city's own consulting engineers, and that 
an}' relief or new sewers that are built should take into consideration the 
land adjoining the city which drains to and through the city, much of which 
is building up and will sooner or later be a part of the cit}-. 

Health Conditions. 

Writing in 1852 concerning health conditions which had prevailed in 
the American Bottoms, Governor Reynolds in The Pioneer History of 
Illinois, said : 

"Tlie I'omitry :it that day was more siclily tlian it is at present: liut 
the only disease then was the bilious fever witli tlie pleinM.sy at rare in- 



EAST ST. LOUIS 



127 



tervals. The bilious attaclvs showed themselves mostly iu the form of 
fever and ague. The fever without the ague or some chill with it was 
not frequent. These diseases attacked the people In the latter part of 
summer and in the fall, and were very common, but not often fatal. 
The sickness at this time i.s not so common, Init more malign-:int and 
dangerous. 

"Many in olden times w'cre siik in the fall, Ijut few died. By im- 
provements or by some otlier means the diseases of the country have 
changed within the last fifty years to be much fewer in the number of 
cases, but more fatal. 

"The remedies to cure the bilious fever and ague in the first settle- 
ment of the country were tartar-emetic, calomel and jalap and Peruvian 
barks. These were the uniform and universal remedies and they gen- 
erally succeeded. When the ijatient was weak after the fever, the 
doctors prescribed stimulus of wine, etc." 

While this autumnal disease, duubtless malaria, was so uncommonly 
common among early settlers that it attracted attention there were a few 
other ailments that found space for themselves upon the meagre health 
records of the time either because of public alarm which their appearance 
inspired or because of their extraordinary rarity. Milk sickness, smallpox 
and cholera were chief among these. Governor Reynolds believed that his 

Table 1. 
Mortality From Certain Causes. 















„ 










































> 








J 


g 


_, £. 




•~ 


•-^ 


„ 


YE.Ul 


i 


U^ 




g 




& 


O 


|6 


1 


>, 


3 £ 


'11 












S 




a. 






"•S 






d 


























A 










8 


J=T3 












;:: 


^ 


■« 


£ 


S 


s 






=S 


-3 


■§§ 


s^ 




< 


tH 


3 




S 


en 


5^ 


2 " 


•^ 


c 


f-w 




1894 


278 
























1895 


298 


6 








"i 


i 


is 






19 




1896 


285 


5 






' 4 






9 






13 




1S97 


276 


76 






3 




"i 


3 






26 




1!I04 








1 


















nK)7 


914 


18 






18 


7 




15 


10 




90 


101 


190S 


831 
























won 


777 










'.'.'. 














1!)10 


908 
























1!)U 


865 
























llll-i 


S5S 
























1913 


804 


19 




... 




3 




'is 






'si 




UIKi 


931 


16 


8 







1 


4 


27 






110 




1917 


965 


7 


5 




22 


3 


2 


22 






104 




191S 


1217 


14 


3 




3 


1 


13 


12 


207 




109 


173 


1919 


874 


7 


2 




."> 


2 


5 


4 


S7 




(Mi 


102 


1920 


827 


4 


3 




17 


2 


S 


8 


40 




61 


94 


1921 


753 


;j 


2 




1 


3 


17 


15 


7 




52 


66 


1922 


741 


2 


2 




1 


2 




10 


23 




59 


53 


1923 


938 


8 


1 




13 


1 


'2.3 


9 


42 


'.'.'. 


49 


99 


1924 


840 


2 


1 




7 


4 


7 


8 


18 




64 


74 


192.". 


890 


4 


1 


' i 




2 


1 


2 


38 


"i 


75 


78 


1920 


924 


1 






14 


■' 


4 


16 


35 




53 


88 



128 



DOWN-STATE MUNICII'AI.lTiES 



Table 2. 
Mortality Rates From Certain Causes. 



YEAR 


1 

s 


i 


1 


1 


i 


1 


be 

1 
d 

1 


|2 
P 

2 " 


1 


1 




II 


1894 
18!).-. 
1890 
1897 

1904 

1907 
1908 
1909 
1910 
1911 
1912 
1913 

1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
192.) 
1920 


13.1 
13.1 

11.8 
10.9 

18.3 
15.7 
13.9 
15.5 
14.5 
14.1 
14.1 

14.6 
15.0 
18.6 
13.2 
12.3 
11.1 
10.8 
13.4 
11.9 
12.5 
12.8 


26 ."i 
20.7 
300.0 

36.0 

3i!i 

25.2 
10.8 
17.9 
10.4 
5.9 
7.3 
2.9 
11.4 
2.8 
5.0 
1.3 


12 . 6 
7.7 
3.8 
2.9 
4.4 
2.9 
2.9 
1.4 
1.4 
1.4 
... 


2.4 

i!2 


10.0 
13.0 

36.0 

li.-i 

9.4 
34.2 
3.8 
7.4 
23.3 
1.5 
1.5 
18.6 
9.9 

]8!2 


i.i 
14.0 

S.l 

1.5 
4.0 
1.2 
2.9 
2.9 
4.4 
2.9 
1.4 
5.6 
2.fi 
12.4 


4^4 

s.ii 

6.3 
3.1 
16.4 
7.4 
11.9 
25.0 

32 .'9 
9.9 
1.4 
5.2 


Kh'.-i 
37.3 

13.0 

.so.o 

29! 4 

42.3 
34.2 
15.3 

5.9 
11.9 
22.0 
14.5 
12.9 
11.3 

2.8 
22.1 


20.0 

342!3 
129.8 
68.6 
10.3 
33.4 
60.2 
25.5 
33.2 
49.0 


iii 


S4!6 
53.8 
102.7 

184.3 

vii'.i 

173.2 
161.7 
139.7 
98.5 
91.0 
76.4 
85.6 
70.3 
90.6 
103.0 
73.3 


202.4 

22i;7 
152.2 
140.2 
97.0 
70.9 
142.0 
104.8 
109.2 
120.3 



per 1,000 populatit 



all others per 100,000 populatU 



.sister died of milk sickness and his historical reference to the disease sug- 
gests that it probably occurred with some frequency in the .\merican Bottoms 
where he lived during the early nineteenth century. 

Alarm and terror marked the progress of smallpox wherever it appeared 
in those days so that the suffering or escape of a communit\- from that dis- 
ease was deemed a matter worthy of record. Consequently we are not 
surprised to find Governor Reynolds observing that Cahokia escaped an 
outbreak which fell upon the community across the river in 1801. He adds, 
furthermore, that the application of preventive medicine saved the folks on 
the Illinois side at that time. Reading from his history we continue: 

"In 1801, that dreadful scourge, the smallpox, made its aijpearnnce 

in St. Louis. Many of the citizens of Cahokia, were innoculated by Dr. 

A. P. Saugrain of St. Louis and were lodged in his hospital in that city. 
"It never came to Cahokia so as to sweep entirely over the village. 

* * * * This disease did not reach the American settlements at all. The 

smallijox never raged through the country and at last was rendered 

harmless l)y proiier vaccination." 

In connection with this same worthy Doctor Saugrain, Zeuch adds: 

"In a business notice, he announced that the first vaccine had been 
brought to St. Louis and would be given gi'atuitously to indigent per- 



EAST ST. LOUIS 



129 



sons (May 2C, 1S09). We know, from the history of a contemporaneous 
writer, that he made good his word, giving vaccine not only to those 
living on his side of the river, but also to the inhabitants of the Illinois 
villages, during the smallpox epidemic." 

Thus we discover that the first clear cut piece of preventive meiHcine 
ever successfully emploxed on a community scale in Illinois and the first 
free distribution of preventive biologies were the good works of an outsider, 
truly a good Samaritan, whose concern for the health of others and whose 
love for his fellow beings recognized no political boundary lines, knew no 
religious creeds and were unhampered by economic considerations. 

East .St. Louis seems to have been no less fortunate in 1833 when cholera 
swept over the surrounding communities but apparently missed this little 
town. This is a conjecture based upon the lack of any records, however, 
rather than a clear cut statement relating the good fortune of that place. It 
seems probable though that some inention of it would be found had cholera 
visited the community at that time. For its escape only fate or happy cir- 
cumstances of chance can be credited because no method of prevention was 
known then. 

Next time East St. Louis did not fare so well. Cholera swept the 
country again about the iniddle of the nineteenth centur\-. spending its wrath 
upon this quiet little river town leaving death and sorrow in its path. Again 
in 1866 this dreaded malady visited the place alarming the people with its 
disastrous progress. How large a percentage of the population was affected 
nobody can say. Statistics were neither collected nor recorded. References 
are vague and general. We may rest assured, however, that the havoc 
wrought was bad enough. 

Table 3. 
Cases of Certain Diseases Reported. 





1918 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


20 


8 


12 


11 


13 


20 


16 


19 


12 


. 


12 


12 


Malaria 










4 


1 


12 


3 




1 




1 


Smallpox 




537 




24 


191 


398 


7 


2 


30 


129 


'io 


2 


Measles 


1S2 


5.5.') 


04 


125 


371 


77 


37 


301 


91 


6 


653 


24 


Scarlet Fever 


61 


71 


20 


25 


72 


191 


57 


34 


213 


119 


340 


62 


Whoop. Cough 


19 


3 


33 


2 




99 


1 


35 


17 


5 


36 


37 


Diphtheria 


327 


222 


88 


17 


111 


173 


111 


77 


88 


43 


135 


164 


Influenza 










629 


7 


82 


48 


11 


41 


40 


20 


Poliomyelitis 




5 




2 




9 


3 


1 


2 


1 




4 


Meningitis 




3 






4 


5 


6 


1 


3 


2 


3 




Tuberculosis* 


24 


14 


4 


5 


27 


80 


122 


47 


89 


95 


68 


69 


Pneumonia* 












33 


108 


75 


56 


119 


139 


105 


Syphilis 












214 






176 


157 


135 


139 


Gonorrhea 












282 






311 


306 


309 


189 


Chancroid 












36 












12 



*A11 forms. 
Note : Case reports 
Illinois. 



iiplete, bvit they have been 



IJt'iO than befo 



130 



DOWN-STATE MUXICIPALITIES 



Table 4. 
PjIktiis and Infant Deaths. 





Births 

- 


Infant Deaths 


YEA 11 












Number 


Hate** 


Ninnber 


Kale- 


1016 


1192 


IS. 7 


174 


145.9 


1917 


1023 


15.9 


167 


163.2 


1918 


992 


15 . 2 


201 


202.6 


1919 






155 




1920 


1374 


20.4 


157 


114.3 


1921 


1364 


20.0 


128 


93.8 


1922 


1296 


19.9 


103 


79.5 


1923 


1358 


19.5 


147 


108.2 


1924 


1457 


20.6 


154 


105.6 


1925 


1434 


20.4 


138 


94.9 


1926 


1471 


20.3 


147 


99.9 



per 1000 births reported. 



It was the same with smallpox. The immunity established by general 
vaccination in 1801 did not last forever and with the passing of immediate 
danger human nature was uj) to its time honored trick of casting precaution 
to the winds. Thus epidemics recurred from time to time, brought in from 
first one source and then another. St. Louis was a great immigration terminal 
which made it the source of constant danger. An epidemic threatened in 
1881 but prompt conti-ol activities together with the fact that many inhabi- 
tants had been vaccinated at the time of previous outbreaks, kept the disease 
down to a dozen cases and one death. 

Even as late as 1921 East St. Louis experienced one of the worst small- 
pox epidemics in her history. The outbreak got beyond control before effec- 
tive control measures were put into practice so that 461 ca.ses occurred. 
Wholesale vaccinations rendered the city practically immune to the disease 
so that it has not yet experienced any further serious difilcult\ from small- 
pox. 

The influenza pandemic of 1918 was decidedly the worst epidemic ex- 
perience of the city during the twentieth century to date. Deaths from in- 
fluenza and pneumonia combined caused the mortality rate for the year to 
rise five or six points above the annual average. At the same time East St. 
Louis escaped with less severe losses than many other municipalities in Illi- 
nois. In ratio to the population the number of deaths from influenza and 
pneumonia in 1918 ranked about midway between the highest and lowest 
mortality from those causes in Illinois communities. 

The infant mortality rate in East St. Louis has been persistently high. 
Deaths per 1.000 live births have seldom dropped below 100 and at times 
have reached twice that figure. In 1926 deaths among children less than 
one year old constituted about 16 per cent of the total mortality in East St. 



EAST ST. LOUIS 131 

Louis, whereas in the State at large it accounted for less than 11 per cent. 
Mortality among children less than five \ears old has averaged more than 
20 per cent of the total mortality in the city during recent years and about 
IS per cent in the State. A relatively large negro population has contributetl 
materially to the high child mortality. 

In other respects health conditions in East St. Louis have varied but 
little from that which has prevailed elsewhere in the State. Tuberculosis 
has been and remains a big problem but mortality from it has declined 
materially of late. Diphtheria has come and gone in epidemic cycles common 
to that disease. Scarlet fever likewise has varied in prevalence from season 
to season. Infantile paralysis seems to have struck the city a trifle more 
severely in 1917 than it did some other communities. 

With sanitary improvements, including the public water suppl\-, the 
sewage disposal system, the sanitary district, the pasteurization of milk, and 
with the hygienic work done by voluntar\' agencies, the health department 
and the park district, the mortality rate in East St. Louis has declined 
noticeably, indicating more favorable health conditions than prevailed twenty 
years ago, but the city does not enjoy facilities for combating communicable 
diseases and promoting health equivalent to those active in most munici- 
palities of its size. 

References. 

Annual Report of the Health Department of East St. Louis, East St. Louis, 1921. 

.\nnual Reports of the State Board of Health, John H. Kauoh, Secretary, Springfield, Illinois, 
various dates. 

History of East St. Louis, East St. Louis, 1875. 

Report on an Appraisal of Health Service for the vear 1925 in Fifteen niinois Cities, Isaac D. 
Rawlings, Director of Public Health, Illinois Health News— May-June, 1926. 

Hi^tcirv of Medical Practice in Illinois, Vol. I, 1927, Lucius H, Zeuch, Chicago. 

The Pioneer History of Illinois, Belleville, 1852, Gov. John Reynolds. 

U. S. Census Reports, Washington, D. C, various dates. 



Elgin 

l'"oun(le(l (luring the first half of the nineteenth century and located on 
the Ijanks of the beautiful Fox River amid a group of splendid hills Elgin 
was incorporated mi IV-hruary 28. 1854. under a special charter granted by 
the legislature. W liilc ihe region is fertile enough to make it a rich agricul- 
tural area, dairying predominates among rural activities while the city itself 
depends largely upon industry for its economic wellbeing. Elgin shares the 
municipal honors of Kane Cinmty, (ine of the most densely populated of the 
State, with Aurora. 

Elgin is a city of gradual development although the population more 
than doubled during the decade between 1880 and 1890. It was first listed 
in the United States census returns in 1870 when 5,441 people resided there. 
This number had increased to 8,787 by the end of the next decade and had 
jumped to 17,823 by 1890. An influx of foreign immigrants accounted for 
the growth at that time, less than 40 per cent of the population in 1910 being 
of native parentage. The opening of the twentieth century found Elgin with 
22,433 people and the next decade witnessed a growth that brought the count 
to 25,976 in 1910. The 1920 census returns show-ed the presence of 27.454 
souls in the city, of whom 22.278 or about 81 per cent were native born and 
5,055 or about 18 per cent, foreign born whites. There were only 116 ne- 
groes in the municipality. A total of 8.224 nearly 30 per cent of the whole 
population, were listed as being 45 or more years of age. This as well as a 
number of other unusual features of the health history of Elgin is explained 
i)y the presence in the city of a large State hospital for the insane. 

H i:.\LTII ^L\CII I XERV. 

On October 18. 1880, Elgin gave up its special charter and reorganized 
under the Cities and Milages Act. The statute authorizing the change con- 
ferred upon the municipality powers to create a board of health and to make 
such local ordinances and regulations as were deemed necessary for the 
l^rotection and preservation of the ])uljlic health. 

Advantage of this authority was taken in 1883 when an ordinance 
creating a local department of health w;is adopted. The first section of the 
ordinance reads : 

"Sec. 1. There is hereby established a department of health, which shall 
embrace the committee on health, the city marshal, the city jihysician. a 
health officer and such employees and assistants as the city council may pre- 
scribe and establish: Provided, that until otherwise prescribed by the city 
council the superintendent of streets shall be ex-officio the health officer of 
said city." 

(132) 



ELGIN 



133 




While tliis appears to l)e the first legislative action towartl providing 
the city with an ot^cial pubUc liealth organization it gives, in the section 
quoted, evidence of a pre-existing agency. "The 
committee" and "the cit}' phxsician" are clearly 
terms imjjlying tjiat the city council had been 
accustomed to exercising its powers concerning 
public health through a committee from its own 
membership and that a local doctor had habitually 
been designated as city physician. These prac- 
tices had continued over a period long enough to 
establish both as familiar agencies in the city. 
I~)oubtless the city physician was called upon 
whenever medical services were required to 

Dwight E. Burlingame, M. D. handle an emergenc\' and surely inspectors were 

City Physician, 1875- ^ ^ ,,■"'. ' , u ■ -i 

IcSSG. 188S P"t to work when occasion arose, each bemg paid 

according to the time consumed and the charac- 
ter of the cmplownent. No appropriations were made for health work but 
expenditures, which the committee were authorized by the council to incur, 
usually amounted to about $300 per year. 

The term "a health officer" certainly indicates that no ofScial had been 
so designated in the past and the council shrewdly steered clear of financial 
complications by providing that the superintendent of streets should be ex- 
oflicio health officer. This choice had a deeper 
significance, too. It manifestly betrays the close 
association in thought of environmental cleanli- 
ness with preventive medicine and it indicates 
how inferior the work of city health officer was 
considered at that time when compared with the 
practice of medicine. A doctor would have felt 
and rightly so, that he was disgracing his profes- 
sion, had he engaged in the sort of work expected 
and required of a health officer in small com- 
munities diu'ing the eighties. 

If the city council had displayed mature 
skilfulness in financial maneuvering when they 
discovered a health officer who cost them nothing, 
the newly created health department showed n 
that direction when it designated, through the council, the cit\' clerk as local 
registrar of vital statistics. He seems to have performed this work with an 
unusual degree of care and faithfulness for the death certificates were 
recorded in extension. The health department exercised an interest in the 
statistics exactly commensurate with what the clerk cost it. No compila- 
tions nor anah'ses were made. 




Alljan L. Mann. M. D. 

City Pliysician. 1889-1891; 

1912 to date 

insignificant ajititude in 



134 



DOWN-STATE M U X ICIPALITIES 



The city physician was a doctor designated by the ordinance and named 
by the mayor to be an integral part of the health department, which to all 
intents and purposes was a board of health. His function was to perform 
whatever medical duties arose in connection with public health emergencies 
and give advice on medical problems that arose. He usually was elected 
chairman of the health department and in that capacity had opportunity to 
color the public health policies of the municipality with medical influence. 
He was remunerated for actual services rendered but drew no specific salary. 
Dr. D. E. Burlingame, for instance, who was chairman of the department 
and city physician during the early eighties when a great epidemic wave of 
smallpox swept the State, was responsible for a rigid enforcement of the 
vaccination requirements of the State Board of Health and by performing 
much of the vaccination work himself and by isolating and disinfecting 
patients he was able to protect Elgin from serious invasion. The danger 
past, Dr. Burlingame dropped the roll of public official, taking up again his 
private practice of medicine and leaving the "health officer-superintendent 
of streets" and the public to take care of themselves until a new emergency 
appeared on the horizon. 

The system prescribed by the ordinance of 1883 continued in operation 
until 1907 when a new ordinance reorganizing the health department was 
adopted. It provided for a health department and created the offices of 
"city physician" and "health officer," fixing the 
salary of the city physician at $150.00 per year 
and that of the health officer at $720.00. This is 
the first evidence of anything like a regular bud- 
get for the health department. 




J. Forrest Bell, M. D. 
City Physician, 1S92-1895 



Manifestly, from the lengthy ordinance made 
up of 43 sections, the functions of the city phy- 
sician were largely advisory in character while 
those of the health officer were executive. This 
is suggested by the specified rate of pay and by 
the enumeration of duties as well. The adoption 
of the ordinance was a mark of distinct advance, 
however, for it created an independent ann of 
the cit}- government for health service onl\'. This indicates a growing respect 
for the possibilities of preventive medicine even though the character of the 
organization created betrays only juvenile notions abmit the fundamental 
principles of sanitation, hygiene and bacteriolog}'. 

A few _\ ears later, I'Ul, I'Hgin adopted the commission form of gov- 
ernment and this brouglu on ;i third change in the legal basis for the public 
health organization of the cit\ . All powers, duties and responsibilities for- 



ELGIN 



135 




O. L. Pelton, :\I. D. 
City Physician. 1S9C-1S97 



merly vested in the cit\- council, departments or 
boards of health now fell upon the shoulders of 
the commissioner of public health and safety. 
Under him the cit\' physician and the health 
officer cunlinued to be two distinct officials, the 
one CI intending to be the superior health au- 
thiirit\ in the communit}' by virtue of his medical 
trainint; and a more ancient life of the position 
while the other declared that the office of "health 
officer" carried with it superior authority in all 
save medical questions upon which he would re- 
quest aid from the city physician if and when it 
was needed or desired. 

TW]> uncertain and ctinfused arrani^ement continued to feature the 
official agenc}- for conducting public health work in hdgin until V>ZS. In 
that year the city council pas.sed another and tinal ordinance relating to the 
health department. This ordinance created a lioard of health, specifying 
the maxor, the commissioner of public health and safety, the health officer, 
the city physician and another resident physician as members of the board. 
The board was given power among other things, to make rules and regula- 
tions as it deemed wise and necessary without conflicting with State laws 
and regulations. l.'nder this provision the board adopted a set of rules, one 
section of which specified unequivocally that the city physician should be 
the executive officer of the health department and that he should have all the 
powers and authority of the board while not in session. Thus we see the 
health service finally placed firml\- in the hands of the medical profession 
where it belongs and still remains. 

By 1927 ]-"lgin had reached the point where 
adequate degree of public health service although 
a considerable part of it was supplied by volun- 
tar\- agencies. In the health department there 
were the city physician, practically a full time 
officer, a sanitary inspector, a laborator\' which 
had been established in 1912 and which had lie- 
cnme a \er\- useful and important part of the de- 
jiartmcnt and a clerk. The city clerk was doing 
the \ital statistic work. 

There were four school nurses and three 
iither public health nurses at work in the com- 
munil\. Thniugh their efforts and the support of 
the org.mizations back of them a health center 
for infants, prenatal patient> and children was 



she was enjoying a fairly 




H. .1. Gahagan, M. D. 

Citv Plivsician, 1898-1903; 

1911-1912 



136 



DOWN-STATE M I" i\ ICIPAI.ITIES 



niaiiilaiiird. 'riiese scrsiccs combined with those provided by the city proper 
and li\ tlic Kanr C'nuni\ Tuberculosis Sanitarium Board gave to Elgin a 
]nihlic hraltli |)r()i;rani that compares favoral)ly with those in other communi- 
ties of comi)arable size in t!ie State. 

The diictcir^ who have ser\ed I'd^in in the cajiacitN' of cil\' ph\sician 
inchide tiie follow int; : 

I). E. Biirlinsanie, M. I)., 
Howard L. Pratt. M. D.. 
Alban L. Mann, M. D.. 
John F. Bell, M. D.. 
O. L. Felton, M. D., 
II. .1. (Jahagan. M. D., 
A. B. Sturm, M. D., 
F. C. Schurnieier. M. I)., 
H. C. WatUlell, M. D.. 
L. W. DiKllev, M. D., 
H. J. Gahagan, M. D., 
Alban L. Mann. M. D.. 

A list of the la\nien whc 
virtue of another job, such 
appointment, include the following: 
William Rundquist 1.S97-1N!)9 



1.ST.5-1SN(.; and IsSN 

1S87 

1SS9^]891 

1S92-1S95 

lS9i;-1N97 

ISMS iiHi:; 

i:mii 190.5 

I'.iim; I9II7 
l!HI\- i:mi9 
1910-1911 
1911-1912 
1912 to date 



held the place of health officer, either by 
s su]jerinlcndent oi streets, or li\ direct 



.John W. Mink 
Georse E. Allen 
Adolph Fischer 
A. J. Volstorff 
Herman Vierke 
George Reber 



19(111 19111 

1902-19(15 and 190.S-1909 

19(l(;-19!i7 and 1910-191:1 

1914-1922 

1923 

192:3 to date 



This apparentK' strange dual system of carrying on the city's public 
health work is not unique of Elgin nor is it difficult to understand, when 
the background is examined somewhat closely. Until c[uite recently, about 
the beginning of the twentieth century, the ac- 
tivities of a health officer, according to popular 
((inception as well as in practice, were limited 
];irgely to abating nuisances, weed cutting, fumi- 
gation, alley inspection, pest house supervision, 
placarding quarantined premises and the like. 
.Such menial duties were beneath the dignity of 
the ancient and honorable profession of medicine. 
But the introduction of bacteriology into the 
world of science and the consequent potentialities 
of preventing diseases by medical processes raised 
the level of public health service to a plane equiva- 
lent and in some respects superior to that of treat- 
ing the sick. Still further developments, such as those relating to nutrition 
and hygiene, have added one dignity after another to public health wdrk until 
now it embraces a multitude of highly technical professions, such as bacteri- 




Arthur B. Stin-m. M. D. 
City Physician, 1904-1905 



137 




L. C. Volberdiug. 
Commissioner of Public 
Healtli and Safety, 
1923 to date. 



ologists, sanitai'N en,i;ineers, statisticians. piil)lici>ts, milk sanitarians, nurses, 
dentists and doctors and offers an hnnnralile and worthy calling for am- 
bitious physicians with executive al>ilit\. Indeed public health service is 
now a highly technical profession of its <.>wn, in\ol\ing scientific knowledge 
of wide scope. 

Thus the very requirements of the service, highly technical as they are, 
have eliminated untrained la\ men from executive control over reasonably 
adequate health departments while the pressure 
of long standing custom and the love of public 
office ha\e inspired the vanishing la\- health olfi- 
cer wliu in truth was a sanitary policeman to 
cling tenaciously to whatever authoritv and 
power he was able to reach. l-"or the sake of 
political peace and expediency it has often been 
necessary to beguile him with titles, leaving him 
with whatever glory the term "health officer" 
nia\ gi\c him, while clipiiing from his creden- 
tials practically all administrative authoritv and 
vesting it in medical men designated as "city 
phvsician," "director of public health," "commis- 
sioner of health," "executive ofticer," or some 
such title. 

\\".-\ti:r Supply. 

In 1887 a water supplv was installed with Fo.\ River as the source, 
fn 1888 a water-puritication pl;mt u>ing Jewell pressure filters was 
installed. This supply continued until \\>05 when, owing to popular 
adverse opinion as to the advisability of procuring water from the 
river which had become gradually more and more polluted, a series of 
artesian wells were installed. Four wells, 16 inches in diameter, were sunk 
at depths ranging from 1,300 to 2,000 feet deep on land bordering Fox River 
about two miles north of the city. The wells were interconnected by means 
of a 9-foot circular shaft 120 feet deep with 9-foot circular tunnels leading 
off to each well at the bottom. Water from the wells was pumped into two 
circular reservoirs, each having a capacity of one million gallons. To su|)- 
plement the well supply, a low dam was constructed across the river below 
the waterworks plant to impound water for emergency purposes and t<< 
maintain depths suitable for the intake. The old filters were used when any 
water was drawn from I'V)x River. 

In VU4 an addilicmiil v\ ell was sunk on the (iriginal >ile, ,uioilu-r in 
l'n8, audther in l')21, another in 1022. and another in l'i2(). It has been 
necessary- at various time> up to the present to supi)lenient the well water 
supply from Fox River. 



138 nOWX-STATK MUMCII'AI.ITIES 

At the present time, four deep wells ami three shallow wells are in 
service, all located in the vicinity of the pumping station, with the exception 
of one shallow well which is situated in the south part of the cit> . Ki\cr 
water is used only when the yield from wells becomes inadequate ainl at 
such time is coagulated, filtered and chlorinated before discharge to the dis- 
tributing reservoirs. 

Routine analyses of pul)lic waler-sui)])l\ samples have been made since 
July, 1920. 

The present w^ater consumption is ab(jut 05 gallons per cajiita daily. 
Cross connections in existence between the river water and well supply 
necessitate classification of the water as doubtful in sanitary quality. 

Sewage. 

As late as 1890 privy vaults were very common, especially in the large 
area of the city which was not sewered at that time. 

In 1894 Samuel M. Gray, consulting engineer of Proxidence, Rhode 
Island, was engaged to prepare sewerage plans for the city. The plans were 
adopted and a number of sewers built in accordance with them. Subse- 
quently, however, changes were made in the basis of design. Mr. Gray rec- 
ommended a separate system of sewers and the early installations adhered 
to this principle. Recent districts, however, have been built on the combined 
plan. 

I'^ox River at Elgin has been polluted for many years by sewage from 
l"llgin and other neighboring cities. A few years ago the Fox River Con- 
servancy District was organized and residents in the valley have been keenl\- 
interested in the matter of removing pollution from the ri\er. 

In 192,3 comprehensive studies were made of the sewerage needs of the 
cit\ for the Sanitary District of Elgin, w^hich was organized in 1922. 
Recommendations were made and plans prepared for an intercepting sewer, 
pumping station, and sewage-treatment plant, comprising oil and grit cham- 
bers, Imhofif tanks, sprinkling filters, sludge beds and secondary sedimenta- 
tion tanks. This improvement was completed in 1926 and the sewage-treat- 
ment plant placed in operation. 

The Elgin Sanitary District includes 5,320 acres. The entire citv is 
now well served with about 80 miles of sewers. The condition of Fox 
Ri\er has been \ery materially improved since the project has been com- 
pleted. 

Health CoxniTioxs, 

Information on the state of public health in Elgin prior to 1900 is 
meagre enough. A relatively new community, heavily populated with immi- 
grants not altogether homogeneous, facing economic problems at once fasci- 



139 



nating and defiant, tender with growing pains, the inhabitants had plenty to 
do besides quietly marking down every wave of sickness tliat chanced to 
befall the place. Folks had always suffered from sickness and always would 
so far as they knew. Why should they spend time and effort in laboriously 
recording things that everybody knew had existed since the beginning of 
time and would evidently continue to the end? 

At any rate people took their diseases as private affairs and tried to 
combat ill health as well as they might with the resources at hand, accepting 
the results of their efforts as matters of good or evil fortune. Consequently, 
we know but little about what transpired in this tranquil community, so far 
as health is concerned, prior to 1900. Tradition has it that Union soldiers, 
home on furlough, infested the cit\- with smallpox in 1864. Citizens still 
living declare that malaria plagued the inhabitants, frequently in epidemic 
proportions, for }ears and did not begin to decline until 1870 or thereabouts. 
Surely tuberculosis, t\'phoid fever, scarlet fever, diphtheria and the whole 
family of communicable diseases shared with one another the inglorious 
task of heaping hardship upon the local people but they soon forgot their 
sufferings and sorrows, drowning past defeats and griefs in the success of 

Table 1. 
MoRT.\LiTY From Certain Causes. 

















_ 
















> 










^ 


c 




£ 


^ 




VE-\R 


i 


^ 








&> 


o 




a 


I. 


ii 


11 






























o 




•2 




2 
s 


rt 


1 


a " 


s: 


■^ 


*= 


l< 


189.5 


207 


3 










4 


16 






., 




1896 


312 


8 




1 








10 






11 




1897 


262 














16 






13 




1898 


228 


5 












4 






3 




1901 


278 


7 








1 


1 


1 






28 


30 


1902 


219 


3 








1 




2 






16 




1903 


232 


7 












1 


1 




20 


18 


1904 


226 


4 


















30 


10 


1905 


229 


1 


















15 


22 



1906 
1907 
1908 
1909 
1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 



399 I 

376 I 

423 

476 

507 

407 

423 

231 



. • ■ - ■ 


5 


4S 


IS 






16 
1.". 


13 
16 


1 


2 


20 


21 


6 


6 




17 
11 


17 
15 


6 






40 


15 


4 








17 







... 


1 




1 


... 




22 








3 










15 








1 




i 

3 


70 
19 




47 
44 






i 


3 




4 


1" 




54 






1 


2 




4 


8 

8 




39 

50 


1 


1 


3 






4 


17 




47 


1 


1 


1 

"i 


?, 


2 


"•2 

... 


4 
7 
10 


' i 


31 

1 



14U 



DOW X-STATK -M U X I CI I'Ar.ITl KS 



Table 2. 
JMouTAi.iTY Rates From Certain Causes. 

















^ 
















o 








fc 


^ 






•A 














































O 








S2 




YEAR 


3 

6 


3 


.2 


1 


M 


s 




|5 


1 






3_ 




= 


fi 


1 


■?. 


3 


o 


■a 


'^ 3 


^ 


i, 




e.^^ 


1895 


13.2 


14.9 










19.8 


79.2 






9.9 




1896 


15.1 


38.8 




4.8 








48.5 






53.4 




1897 


12.4 








... 






7C.0 






01.7 




1898 


10.5 


23.2 












18.5 






13.9 




1901 


12.2 


30.7 








4.3 


4.3 


4.3 






122.8 


131.0 


1902 


9.4 


12.9 








4.3 




8.0 






09.1 


95.0 


1903 


9.8 


29.7 






4.2 






4.2 


4.2 




85.1 


76.6 


1904 


9.4 


10.7 


















120.2 


41.9 


190;-) 


9.4 


4.1 


















01.9 


90.8 



1900 


1 9.4 


1 








... N 


3 KecoF'^'i 










1907 


12.'0 


8.0 








4.0 


8.0 


8.0 


'2b'.b' 




192.7 


72.2 


1908 


14.8 










3.8 


3.8 








61.5 


50.0 


1909 


16.3 


i'.e 






sis 




3.8 








57.0 


61.5 


1910 


18.3 


11.5 












3.8 


7.0 




100.0 


80.7 


1911 


19.4 


19.2 








3.8 




23.0 


23.0 




05.3 


05.3 


1912 


17.7 


11.5 








3.8 


3]s 








42.3 


57.6 


1913 


10.1 


11.4 








15.2 


11.4 


22.' 8 






174.3 


58.8 


1914 


8.7 


7.5 ... 






3.7 




14.8 




::; 


94.3 


64.1 


1915 


8.1 
7.3 




N 


Reoor 


ds 






1910 


89.1 








3.7" 




3.7 






83.0 


"79!2' 


1917 


11.5 


3.5 








10.7 


3^5 








53 . 5 


07.8 


1918 


25.2 


3.4 








3.4 


17.2 


k'.i 


241!. 3 




102.0 


141.3 


1919 


19.8 


7.2 












10.9 


09.3 




160.5 


124.0 


1920 


21.1 


3.6 


'.'.'. 




sio 


lo'.k 


3 '.a 


14.5 


61.7 




196.1 


239.7 


1921 


19.2 






3.6 


7.2 




14.4 


28.9 




140.8 


104.8 


1922 


20.4 


sie ... 




... 






7.2 


28.7 




179.7 


129.3 


1923 


23.3 


3.5 


3.0 10.5 






14.2 


00.7 




107.8 


146.4 


1924 


21.5 


3.5 


3 . C 3.5 


i'.o 


i'.o 




14.2 




110.6 


121 . 4 


1925 


24.9 


7.1 




3.5 


3.5 


ri 


24.7 


s.'s 


102.5 


97.0 


1920 


22.3 


5.8 


'.'.'. 2.9 


5.8 


5.8 




29.0 




73.5 


135.2 



is per 1,000 populati. 



all others per 100,000 population. 



the present ami the luipL-s of the future, lea\ing for the historian nothiiii; hut 
the fragmentary mortality statistics lahoriously copied by the city clerk. 
These are practically worthless for one who has not the time to study and 
analyze hundreds of records in great detail. 

Likely enough cholera spared not the city in 1849-53. .Smallpox, which 
nearly always provokes a shower of publicity, seems to have been prett\' well 
averted during the great epidemic of the earl}- eighties. Evidence of other 
factors in the health conditions of the community in the earl_\- }ears is ahnost 
whdily lacking. From such data as are available it appears that typhoid 
fe\'er was ne\er the serious iiroblem in Elgin that it has been in so many 
other communities of the State, although an outbreak of 216 cases resulted 
in .some 24 deaths in 1916. Diphtheri,-i, on the cither hand, has time and 
again visited the place in severe epidemic foi'm. In 18'',\ for instance, there 
were ](> deaths charged against that disease and ten and sixteen in the ne.xt 
twd years, respectively, the wave stretching over a full triennium. Since 
1900 the number of deaths has never been so high in an\ one year but out- 
breaks of varying intensity ha\ e come and gone. 



141 



Tuberculosis became a very grave danger to public health there in the 
nineteenth century but liegan to recede during the second decade of the twen- 
tieth century in the face of a determined effort at eradication. During its 
ascendancy mortality rates from that disease climbed to a maximum of 
almost 200 per 100,000 population but the downward trend in recent }ears 
brought it to 73.5 in 1926. 

The only noteworthy epidemic of scarlet fever listed is one that occurred 
during the winter of 1925-26. It caused nearly a thousand cases of illness 
but the disease was mild and resulted in but two or three deaths altogether. 
Doubtless other epidemics have visited the city from time to time since the 
first settlements there but records of the facts are wanting. 

The intluenza outbreak of l')18 while severe encjugh. was relativeh- verv 
mild in Elgin. On!}' three other cities embraced in this volume experienced a 
lower mortalit\- from influenza proper while Elgin had the lowest rate of all 
from influenza and pneumonia combined. 

If a stranger should scan the general mortality records of lilgin he 
would surely conclude that the city is a mo.st unhealthful community. Deaths 
from all causes rarely fall below 20 per 1,000 population per year, a figure 
fully 75 per cent higher than that for most other municipalities in Illinois. 
To one familiar with local conditions, however, these otherwise alarming 
statistics indicate nothing more sinister than the location of a large State 
hospital for the insane in Elgin. Patients confined in the institution experi- 
ence a mortality high enough to make a distinctl}- unfavorable aspect on the 
general rate for the cit\-. 



Table 3. 
Cases of Certain Diseases Reported. 



1 

1 3916 

1 


1917 


1918 


1919 


1920 


1921 


1922 


1S23 


1924 


1925 


1926 


1927 


Typhoid Fever 


218 


7 


4 


12 


4 





1 


6 


7 


9 


,, 


10 


Smallpox 


4 


5 


88 


53 


7 


a 




1 




2 


49 


4 


Measles 


90 


647 


68 


57 


300 


806 


20 


405 


72 


180 


1232 


51 


Scarlet Fever 


•>9 


77 


10 


25 


77 


27 


38 


54 


50 


307 


418 


44 


Whoop. Cough 


18 


84 


250 




268 


28 


30 


83 


279 


34 


268 


200 


Diphtheria 


9 


29 


9 


19 


47 


93 


29 


17 


15 


13 


6 


2 


Influenza 






1399 


173 


314 




6 


39 


5 


6 


7 


12 


Polioniyeliti.s 


2 








1 


6 




3 


3 


1 




3 


Meningitis 








3 




1 


2 








1 


5 


Tuberculosis* 


13 


18 


22 


62 


27 


29 


51 


63 


5*? 


62 


58 


72 


Pneumonia* 










17 


27 


39 


125 


71 


73 


111 


123 


Sy-philis 




2 




25 


25 


24 


28 


29 


196 


187 


171 


185 


Gonorrhea 




2 


17 


42 


41 


47 


29 


38 


47 


48 


44 


50 


Chancroid 








- 


1 


1 


1 


2 











*A11 forms. 
Note: Case reports are never complete, but they have been much more so since 1920 than before in 
Illinois. This table indirntes improvement in notification more than anything else. Elgin is anion;? 
the cities where notification is comparatively good, practically complete repnrt.s being the rule for 
the more serious diseases. 



142 



DOWX-STATE MUNICIPALITIES 



Table 4. 
BiKTiis AM) Infant Deaths. 



Infant Deaths 



YEAR 












Number 


Kate** 


Number 


lial..." 


1913 






37 




1914 






33 




19ir, 






27 




lillli 


32:) 


12.3 


28 


86.1 


1917 


372 


13.3 


34 


91.4 


1918 


4«8 


16.7 


23 


60.1 


1919 


390 


13.9 


21 


nS.S 


1920 


472 


17.1 


36 


76.3 


1921 


646 


19.7 


24 


44.0 


1922 


553 


19.1 


23 


43.2 


1923 


539 


19.3 


26 


48.2 


1924 


621 


22.1 


30 


58.0 


1825 


636 


22.4 


31 


48.8 


1926 


619 


18.2 


44 


71.1 



•Deatiis of infants under 1 
**Per 1000 population. 



of age per 1000 births reported. 



References. 



Annuiil Reports, City of Elgin, Illinois, various dates. 

Annual Reports of the State Board of Health, John H. Ranch, M. D., Secretary, Springfield, Illinois, 
IS dates. 
Bulletin of the Illinois State Water Survey. Edward Bartow, Director, Urbana, Illinois, various 

"Elgin Today — 1904," published by Lowrie and Black, Elgin, Illinois. 
U. S. Census Reports, Washington, D. C, various dates. 



Evanston 

Settled originall}- as a residential community and built into a uni\ crsitv 
city of comfortable homes, Evanston has always enjoyed the enviable repu- 
tation of being the healthiest city in Illinois. This reputation was and is not 
without foundation on fact whether unqualifiedly true or not. 

It seems that a man named Samuel Rohrer was the first to choose what 
is now h'vanston as a place of residence. Pie left Chicago in 1839, at that 
time a communit}- of only a few hundred souls, in search of a more healthful 
and what he probably had in mind was more air lanes or rather bigger and 
wider and better air lanes on all sides of his house. The location of Evans- 
ton satisfied his requirements and he started a community that was destined 
to perpetuate his ideals of home environment although there were man\- 
factors other than his notions involved in the matter, his ideas probaliK' 
being indeed the least influence of all. 

For one thing, Chicago was by natural location destined to be the heart 
of commercial and industrial life in that vicinity. This caused a centralizing 
of business activities there, leaving the magnificient lake shore territory now 
occupied by Evanston for other purposes. Covetous eyes of successful and 
enterprising men were not slow in recognizing in this locality a splendid 
place for homes, free from the noise, smoke, turmoil and excitement of a 
rapidly growing city and with great possibilities for beauty and contentment. 
Consequently many of the more financially able were attracted to Evanston 
where the}" settled, adding a tremendous influence to the character and 
wealth of the communit\-. 

Another factor of tremendous influence in the character of Evanston 
was the founding there of Northwestern University. This great institution, 
organized in 1851 and located on a campus of 379 acres in the very heart of 
Evanston, brought to the municipality the wholesome and perpetual atmos- 
phere of dignity and learning. It did more. It secured from the legislature 
a charter which, among other provisions, prohibited the sale of intoxicating 
liquors within a radius of four miles of the university. This made Evanston 
a dry town. 

Furthermore, it will be seen hereafter that the municipality began very 
early, relatively, to spend money freely for public health service. While 
other communities contented themselves with providing boards of health 
clothed with broad powers but starved to death financially, Evanston was 
appropriating real money to the health department. No wonder this com- 
munity was reputed to be the healthiest in the State. 

(143) 



144 



DOWN-STATE MUNICIPALITIES 




Tile Old CoUese Buildins. Northwestern rniversity 

F.vanston was organized as a township in 1857 and was incorporated as 
a ti)wn in 1863. The village of South Evanston was organized in 1873 and 
annexed to Evanston on February 20, 1802. A month later, ]\larch 20tli. 
Evanston was established as a city under the Cities and \'illages Act and tlie 
first cit\- officials were duly elected on April 19th of the same \ear. 

In 1860 the population of Evanston was 831. As might be expected of 
a residential and universit\- conimunily, gruwtli was never rapid but substan- 
tial, so that by 1900 the number of inbabitanls was only 19,25' ». This figure 
rose to 24,978 in 1910 and to 37,234 in 1920. Approximately 7S per cent of 
the population in 1920 were native born whites, nearly 18 per cent were for- 
eii;n bcirn white> and something over 6 per cent were negroes. There were 
8,714 |)ers()ns, .snniething over 23 per cent, returned as being 45 or more years 
of age. 



Health Maciiine.ry. 

It seems ihat the first board of health was app(.)inted in Evanston in 
1874, three \ears befure the first State F.oard of Health was created and at 
a time when Fvanstun was still a small village. Contrarv t(j customs gen- 



EVANSTON 



145 



erally prevailing elsewhere the whole membership 
of the board was made up of physicians from the 
outset. Apparently, the chairman of the board 
acted as its executive officer during the first few 
\ears but the ordinance was amended in 1882 so 
that provision was made for the employment of a 
health officer to execute the policies and plans of 
the board. 

It is probable that a sanitary inspector was 
emplo\ed shortly after the revision of the ordi- 
nance in 1882 and that he exercised the authority 
of health officer, although the administrative head 
of the work done was a physician, the chaiimian 
of the board. At any rate John Corney was at 
work as the health officer in 1883 although Dr. O. H. Mann, a member of 
the board is shown in the records as filling the place of village health officer 
from 1882 to 1888. 

The complete list of village health officers includes the following: 




Webster, M. D. 
Board of Health, 

1SS5 



Dr. 0. H. Mann 
Dr. M. C. Bragdon 
Dr. W. A. Phillips 
Dr. E. P. Clapp 



1SS2-18SS 
188S-1S90 
1890-1891 
1891-1892 



When the village was reorganized into a city in 1892 a department of 

health was created and its executive officer, subject to appointment by the 

mayor, was called the commissioner of health. Dr. Clapp was retained 

under the new title which has continued in use 

down to the present time. The office was not 

made a full time position until 1926. Physicians 

who have filled the place of health commissioner 

in Evanston are : 

Dr. E. P. Clapp 1892-1896 

Dr. W. A. Phillips 1896 

Dr. Josiah Jones 1897 

Dr. E. E. Shutterly 1898 

Dr. A. B. Clayton 1899-1901 

Dr. William R. Parkes 1901-1909 

Dr. S. V. Balderston 1909-1914 

Dr. C. T. Roonie 1914-192.5 

Dr. John W. H. Pollard 1926 to date 

Manifestl}' the medical profession has al- William G. Alexander, M.D. 

ways exercised a predotninating influence over Dairy inspector, Board of 

^ ^ . ^ , , • Health. 1901; Mayor, 

the public health mterests in Lvanston and this igoc to date 

w;.'. doubtless a factor in establ'shing the health 
reputation enjoyed by the city. 




146 



DOWN-STATE Ml'.N ICIPAI.ITIES 



The breadth of vision, the foresight and withal the broad understanding 
of heahh service requirements displa\cd in the code of ordinances adopted 
in 1892 were sncli ihal no materird changes have since been necessary. That 
code vested a(hiiini>trati\r authority in the commissioner of health and gave 
iiini power to cnfurtx- all rules, regulations, ordinances, etc., relating to 
health. It rcciuired the reporting of contagious diseases by any person having 
knowledge of a case; it provided for quarantine; it placed the commissioner 
of health in charge of the city hospital; it gave the commissioner of health 
supervision over health in the schools ; it required the vaccination of school 
children; the keeping nf \ital statistics; the abatement of nuisances; the 
abandonment of privies where sewer facilities were available; the adequate 
ventilation of public buildings ; the sanitary supervision over milk supplies. 
In short it provided the legal machinery necessary for the operation of an 
efficient and adequate department of public health. 

Since the adoption of the code in 1892 no significant changes have taken 
place in the health organization of the city. It has simply grown and de- 
veloped, increasing its staff and expanding its services as the multiplying 
complexity of the community on the one hand and the knowledge of medi- 
cine on the other demanded. 

Of course, the official health department diil not grow in size and 
ability fast enough to meet all the demands of the city for public health 
service. No health department ever did. Voluntary agencies sprang up and 
did an enormous volume of work. The two 
school boards employ physicians, dentists and 
nurses to work among the children. But with it 
all a splendid policy of co-ordination h.as pre- 
vailed so that the commissioner of heaUh exer- 
cises the leadership and really directs the public 
health service of the municipality. 

The State Department of Public Ilcalcli con- 
ducted a survey of the public health facilities of 
I'.vanston in 1926 and compared the results of 
the study with those found in 14 other communi- 
ties of the State. The report gives a clear picture 
of the situation as it was at the close of 1925. 
Pertinent quotations read as follows : 

"Reckoned on the basis of the appraised value. Evanston, with a 
score of 812 points, enjoys the most satisfactory public health service 
maintained in any of the fifteen cities embraced in the study. 

"The best health organization was found here. Practically all work 
is centralized in the city health department which engages in compre- 
hensive activities relating to vital statistics; communicable disease con- 
trol: ]irenntal, infant and preschool and school hygiene; safety of food 




S. V. Balderston, M. D. 

Commissioner of Health, 

1909-1914 



EVANSTOX 147 

and milk supplies: sanitation; i)iirity of water supply; diagnostic lab- 
oratory service. All employes are appointed by the liealth officer, sub- 
ject to civil service regulations. 

"The Chicago Tuberculosis Institute conducts tuberculosis clinics 
and field nursing work, the nurse having her office in the health depart- 
ment. The Visiting Nurse Association, in addition to bedside care, 
does some prenatal and infant field work. The nurse so engaged also 
has her office with the health department. A very satisfactory coordi- 
nation of all social service agencies is in effect. 

"This city furnishes a good example of the efficiency in health serv- 
ice which can be secured through a part-time liealth officer, who has a 
grasp of public health ]3roblems and who devotes his energies to develop- 
ing an efficient organization. He, however, has realized that the de- 
mands on the time of a health officer have become such that full-time 
service Is needed, and has convinced the city government of this need. 
A full-time health officer will have been appointed before this report 
appears in print. 

"Based on the U. S. Census Bureau estimated population of 4:3, SS3. 
exactly one dollar per capita is being spent for health service in Evans- 
ton. Of this, the city spends $26,SO0, or sixty-one cents per capita. If 



EVAN5T0M 

[^ T " T — T — 



VITAL 5TATI5TICa9l 
conn. DI5. COHTROL^ 



vEh. DI5, cohTROL :m 

TUB. COMTROL i^M 
HEALTH CHILD ^"-^ ^ 
HEALTH 5CH. CHILD [i^M 
5AmTATI0riT^^J.T^5H 
niLK COfSTROL []«■ 
LABORATORY SB 
POP. HEALTH milM 



PERCE MT OF STAhDARD SCORE 
FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 

I9Z5 



This graph illustrates the strong and weak points in Evanston's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated uijon the standards evolved by the American 
Public Health Association. The total efficiency rating in Evanston was 81 
per cent of the standard perfection requirement. 



148 DOWX-STATi; Mr.MCII'AIJTlES 

local estimates of population are used the expenditures are forty-nine 
and seventy cents respectively. 

"Very efficient measures are carried out for the control of contagion. 
A high percentage of cases are hospitalized and the communicable 
disease control score equals the standard except that a communicable 
disease nurse does not visit all cases: only about fifty per cent of 
grade schools show a vaccination against smallpox; and immunization 
of preschool children against diphtheria is not quite up to minimum 
requirements for full credit on that item. It should be noted, how- 
ever, that Evanston's score for the immunization of children against 
diphtheria is by far the highest of any of the fifteen cities of this 
group. 

"Measures for the control of venereal disease constitute the most 
neglected phase of health service in Evanston and stand out in striking 
contrast to the efficiency of other activities. It is true that owing to the 
presence of clinics in Chicago, the need here is not so great as in some 
other towns. However, the few cases of venereal disease recorded indi- 
cate that physicians rarely report these diseases. 

"Evanston is unique among the fifteen cities surveyed in accepting 
! as a health department function all activities for the promotion of 

prenatal, infant and preschool hygiene. Evanston stands first in the 
service rendered in prenatal, infant and preschool clinics and in field 
nursing service. This is in addition to a considerable amount of work 
done at similar clinics in the Evanston Hospital, a definite record of 
which was not secured. Evanston has the honor of being the only city 
in this group to score 100 per cent on the care given to its children 
under school age. 

"The administration of school health activities in Evanston is com- 
plicated by the existence of two school boards, each representing approx- 
imately one-half of the city. This work is carried out by two school 
physicians (one in each district), who are assisted by three nurses. 
The nurses perform the work of truant officers in addition to their school 
work. A school dentist also is employed by the board of education. The 
school work is not so well organized as most other health activities. 
The two physicians do not employ uniform methods in their work or 
in their record reports. Children are weighed but parents are not 
notified. A total of more than five thousand out of a total grade school 
population of seven thousand are examined each year, but the examina- 
tion is not so thorough as is desirable. In some cases a nurse and a 
school physician each inspect a child rather than have the nurse conduct 
the vision, hearing, height and weight inspection, leaving the medical 
examination to the physician. 

"More than 95 per cent of the Evanston milk supply is pasteurized 
and practically all of the remainder is certified. Since the same milk 
plants supply both Chicago and Evanston, an intimate supervision of 
the ijlants is not possible. A higher percentage of samples of pasteurized 
milk than would be expected was shown to have a count in excess of 
fifty Ihousmd bacteria per c. c. 

"In addition to the health services recorded on the standard ap- 
praisal form and which have been discussed above, a number of addi- 



EVANSTOX 



149 



tional activities have been carried out. Prominent among these has 
been the demonstration in active immunizations against scarlet fever 
in one school. The health department secured the services ot the Doc- 
tors Dick, who tested the children and immunized 155 who were found 
to be susceptible. Since scarlet fever has been prevalent in Evanston, 
it will he interesting to observe the case incidence among this group 
of children as compared with children of same ages in other schools. 

"A mental hygiene clinic is maintained at the Northwestern Uni- 
versity, cases being referred to the clinic by the health department, 
schools and social agencies. Group and individual mental tests have 
been made in a number of the schools. In 1925, a heart clinic was 
started at the Evanston Hospital, one evening clinic every week being 
held. The city health officer was instrumental in bringing about its 
organizations. Fort.v-nine cases attended in the month of December. 
Through the social service department of the hospital, vocational read- 
justments are made for the cases whose condition makes a change of 
occupation advisable. The Evanston Hospital conducted a numlier of 
other clinics, including dental and prenatal, 

"The interest of the local medical profession, as evidenced by the 
hospital clinics, has been a considerable factor In the progress of health 
services in this city." 



."^ince the time when the report quoted above was written Evanston has 
emplo3'ed a full time commissioner of health, Dr, John W. H. Pollard, estab- 
lished a venereal disease clinic and increased the efficiency of the public 
health service at a number of points by co-ordination and co-operation be- 
tween the various official and voluntary agencies at work there. The budget 
for 1*^27 amounted to $38,6v^3.75, a respectable sum for a city of that size. 

\ Oluntary and c|uasi-public organizations have played a particularly 
active part in the health history of Evanston. The milk borne scarlet fever 
epidemic of 1907, which spread into Chicago when the contaminated milk 
sup;)ly was diverted to that market, led to the 
birth of what is known as the Chicago and Sub- 
urban Health League. The function of this non- 
official agency is to keep health officers in the 
whole metropolitan area informed about local 
conditions that may prove to be inimical to the 
health of any section or district in the absence of 
precautionar_\- activity. 

Prior to this, however, in 1906, the medical 
inspection of school children was undertaken as a 
privately supported enterprise although the school 

Clarence T. Roome, M. D authorities heartily co-operated in the project. 

Commissioner of Health. Later this work was taken over and enlarged by 

1914-1925 „, III , 

the school Ijoards. 




J^o 



IXiVVN-HTATI. MCNK fl'Af.l'f (IS 



111 I'MO the cxlicii'liliiics ()( the liciillli il(|»;iitiiiiiit aiiii)Uiil(.<l to 
$.3,141 ,62, of wliich .$7fK),(K) vvr'iil to the. I'.vaDHKin :\ni\ .St, I'l-incis llospil.-il 
AtiHoci.'ilidtm, $l,SO.(XJ to llic ViHitinj; Nurse A.SHOciation and ^l.SH,^) lo ilic 
linanl of phiiiiliinj.; cxamincis, These ileiTis betray iidt only a close s|)itit oi 
eo-opeialion lietvveeii the city oCCicials an<l the axeneies iiJmied, hut indicate 
(hat the oi>{atiizatioii» were enj{a((ed in health work jiopnlarly remarried r.s 
definitely jfuhlie in eharaeter. They show, fnrtherinore, that these agencies 
were of lon){ st.'itiditiK in the ( iMiininnily at th,'il time and enjoyed implicit 
piihlic conCideiicc. 

,'\),'ain, in 1''I2 a public spirited citizen donated limds for the constriic- 
lioii of a contajjion*! di.nease hoHpil;il. An endovvnicni fnnd of $l(X),fXX) was 
promptly siihscrihed hy citizens in the whole stihnrli.in territory of northern 
Illinois .'ind the institntion was tiM'iied over for niaii,'if,'emenl to the Isvanston 
liospil.'d Assoriation, The conditions of the ori).,'in;il donation as well as 
the source fi'oni which the endowment fimd vs-av dr;ivvii ni,'i<le the hospital a 
distinctly pnhlic insliliiiion ami Ji ha, fiim lioncd in lh,'il way. 

It was in l'M2 also tli;it the h.vanslon Woman's (Iiih nndcilook a 
speciCic piece of pnhlic health service in ihi- ii;iIhic of fo.nl .aiiii,itioii. 
Tmr lo (ill- hij,di (le^ree of inlellijjence that has niarkcl so iii.un of ilif 
lieallh projects there the clnh first ohl.iinrd ilic 
{■■^^■■^■■■■■^■l advice , and assistance of Professor lulin II 
\^^^^f^ ^^^1 "'' Northwestern I'nivrsily who idcniilicd 

^^^Hf ^^H self will) many irnport.ml health projects in the 

V^^f- ^^M tominiinily and State, tniiicnl.'irly those involving; 

^^^K' ^^^B l.il.nratory service, and . f I )i ' i Koildcr, assis- 

^^^^^ ^^^M ( oiiimissionei- of ||, .ilih ( liii ajMi, in draw- 

^^^VV^k^ ^^^M lip their pl-iiiH for :\u- A s.'ilisf.'icioi'y 

^^^^^^^Ma^^^^^H adopted, the clnh 

^^^^^^ ^^^^^^M it wa» to inspi'i I ^roi cry 

'^^m^ ^B^I^H nwirkels, oilin fcvul est,'d)lish- 

.lotiii W II. I'lilliiril. .VI. 1», iiicllls. 'I'o provide him with .mllMJiih an onli 

('olMllllnMldllcr of llollltll, I 1 ,1 ', 1 1,1., 

Ili;!(i Id (liiie nance was passeil hy trie cily rmiiH il .iml iIlii upr 

of woiiv liciamc pi'lln.'iliclit in llir coinmiimly, 
■fill- iiii.ihci -■ chill-, ill iM'ial •( honis iiiiilcilooU ihc u cij^iiiiiii; and 
meaMiiiii)/ of scjiool .Inlilim III I'd'' .11 the iiislinice of lln- 1 nilcd .Slates 
Children's I'.nreaii and m I'' 'I iln I h/.ilirili McCoiiniiL .\l( inoii;il ImiikI 
!■ l.iMi licij a nnliilioii . I.i ■ . m nnc ni ilic- pnhlic schools (Dewey). Then in 
I'l.'l ilir l.vanslon I'.i.iinli of du- Inl.nil Welfare .Society .started picnal.ii 
woi'l\ in the cil\, Their was alsn in I'.vanslon the (onncil ('ommillee un 
.Similalion, Charities and Health, an orj;ani/.alioii repres(•nlin^,' m,niy com- 
ponenl parts, which for a lon^; lime pailiripaied in a lar^e \\a\ in llie hcdili 
and sanilary pi'o^M'inn of the miniicipaliu 



EVANSTON 151 

These references, although not exhaustive, indicate how strong the pub- 
lic sentiment favors preventive medicine and they explain why Evanston has 
always enjoyed the reputation of being the healthiest city in Illinois. A bona 
fide reputation of that kind comes only as the result of steadfast determina- 
tion that inspires intelligent and persistent activitw 

Watkr Supply. 

Water supply was one of the first matters discussed after Evanston was 
incorporated as a village in 1872. An ordinance providing for a waterworks 
was passed in 1873 and in 1875 the water supply was put in service. North- 
western L'niversity donated the site for the pumping station at Lincoln Ave- 
nue and the lake. The installation consisted of an intake pipe, extending 
about one-half mile into Lake Michigan, wooden crib, and pumps which 
delivered the water direct to the distribution system. A sewer outlet was 
within one mile of the intake, but the supply was used by .some for drinking 
purposes. 

In 1884 the village of South Evanston installed a waterworks, securing its 
supply from an artesian well. When this \illage was annexed to I'.xanston 
this waterworks was abandoned. 

As the population of Evanston increased, more pumps were added and 
the intake was enlarged and extended. 

Analyses made between 1897 and 1''12 indicated that the water was 
safe for drinking purposes only a part of the time. Typhoid fever was 
prevalent. At times 10 per cent of the cases in ho.spitals were typhoid 
patients. The water was also turbid dining lake storms or dredging opera- 
tions along the lake front. 

In 1012 treatment of the water with hypochlorite of lime was started. 
The sanitary quality of the water was improved but the method of applying 
the hypochlorite was rallier crude and the supply was not considered safe 
at all times. 

Financed by a bond issue, a motlern, adequate, purification plant was 
placed in service in 1914. In 1922 the purification plant was doubled so as 
to have a capacity of 24-million gallons a day in order to meet the increased 
consumption demands. Liquid chlorine replaced "hypo" as a sterilizing 
agent in 1921. 

Since the installation of the pinification plant the supply has been con- 
sidered safe for drinking puri)oses at all times, and by 1922 the typhoid rate 
had dropped to a small percentage of the rate before purification. 

The original limited distribution system has been enlarged and extended 
so that it serves practically the entire built-up area. 



152 DOVVN-STATl-: MUNICIPALITIES 



Sewerage. 



Evansloii, like all (iIIut cities alon.y; Lake jMiclii.i;aii, originally disposed 
of its sewaije 1)\ dischari^ini;- it into the lake. By 1912 there were five separ- 
ate outlets to the lake, .\llhough in the Chicago Sanitary District, it was not 
until 1920 that an interceptor was constructed to divert the Evanston sewage 
from the lake into the north shore channel of the Sanitary District. 

-\t the close of this history period the north side sewage-treatment plant 
of the Chicago Sanitary District was nearing completion and it will treat all 
the sewage from Evanston before it is discharged into the drainage canal. 
E.xtensions of submain and lateral sewers have been made from time to time 
and good sanitary conditions maintained. 

HicALTn Conditions. 

While vital statistics are not available for the first fift\' \ears of com- 
munit\' life there, it is probable that Evanston never experienced an exces- 
sively high mortality rate. Epidemics did not spare the place, to be sure, 
but the general tone of health was good and the intelligent management of 
home and communit\ kept it so. The general mortality rate since 1900 has 
rarely amounted to as much as 12 per 1.000 population per year and was 
onh' 14 in 1918, the great influenza year. More recently, the rate has tended 
a little higher but that does not necessarily imply a decline in the general 
health. Hospital facilities there attract people from outside the city and this 
i>> liable to affect adversely the crude death rate. I'nrthermore, the city is 
gettting to l:)e of respectable age, as cities go in the Middle West, and that 
indicates an increasingly large number of people in the upper age strata. 
Over 23 per cent of the inhabitants in 1020 were 45 or more years old. 

Apparently Evanston escaped the unhappy experiences A\ith smallpox 
that colored so vividly the "pest house" period in the history of so many 
communities. They didn't even have a "pest house" in Evanston so far as 
available evidence shows. Physicians were always at the helm in health mat- 
ters and they knew a lietter way of controlling that loathsome disease than 
by casting into the exile of a barren shanty the unfortunate victims of the 
disorder. The people who lived there w-ere the sort who resort to calm 
judgment and sound advice rather than to public alarm and mob psychology 
in dealing with public problems whether of health, economy or what not. 
Thus smallpox has been a minor problem there because the inhabitants so 
willed it. Trior to I'.'UO the disease was so rare that a case discovered on 
the last day of that _\ear provoked no little comment and brought out the 
interesting fact that no other case had been observed in the city for eight 
\ears. 



EVANSTON 



153 



Siib.sequeiitly the smallpnx record has been a httle less favorable due to 
the supreme court decision that compulsory vaccination is not constitutional 
in Illinois. There was an outbreak involving 81 cases in 1902 and another 
of 3 cases in 1908. In 1920 another little flare-up took place when 17 cases 
were reported and again rarly in 1927 another epidemic was vaccinated out 
of existence when half a dozen cases endangered the community. Perhaps 
smallpox appeared within the city on other occasions but the story is the 
same. That disease nevers gains any considerable headway in a community 
where public health affairs are managed as they have been in Evanston. 

Typhoid fever was not so easily managed. Ways by which this infec- 
tion was communicated from one to another were mysterious even to the 
medical profession and specific preventive measures were unknown until 
about 1900. Consequently, outbreaks of considerable severity though not 
of the serious character frequently observed in the history of many other 
places have marred the happiness of the inhabitants from time to time. 
Furthermore, Chicago suffered from disastrous outbreaks of typhoid fever 
time and again while the infection was endemic there during the last half of 
the nineteenth century and the proximit}' of that comnumity to Evanston and 

Table 1. 
Mortality From Certain Causes. 































s 








t. 


1 






f 










£ 






















YE.\R 


i 






c 




fe 


J 


.2 ^ 
So 


s 


;. 


P 


li 




a 


1 


1 




'& 


■g 


a. 
1 


^ 




li 






< 


H 


S 


X 


s 


^ 


^ 


fi 


^ 


in 


H ^ 




1897 


200 


4 












1 

5 










1898 


191 


2 












5 










1899 


























1900 


206 


5 












"4 










1901 


173 


11 


















19 


14 


1902 


233 


7 












5 






13 


32 


1903 


212 


7 












3 






22 


28 


1904 


201 














2 






28 


10 


190.1 


209 


3 












5 






19 


20 


1906 


216 














2 






22 


30 


1907 


268 


,5 


















18 


49 


1908 


258 


8 






3 






' '4 


"4 




28 


21 


1909 


24.5 


7 












1 


1 




20 


18 


1910 


273 


6 






"i 






2 






22 


17 


1911 


281 


7 






6 






S 






18 


31 


191-2 


302 


6 






1 






7 






14 


20 


1913 


276 


4 






2 






.■-. 






12 


24 


1914 


304 


3 












4 






20 


29 


191 r> 


340 


1 






"3 






4 


' '4 




19 


35 


1910 


369 


1 






1 


'16 




7 


1 




18 


39 


1917 


38r, 


1 








10 




r> 


1 




21 


44 


1918 


496 


1 












2 


93 




20 


87 


1919 


385 














3 


19 




13 


42 


1920 


493 


"s 












I 7 


25 




31 


41 


1921 


410 














! 17 






22 


27 


1922 


495 


i 












1 4 


' '4 




19 


.39 


1923 


478 


1 












1 5 


8 




18 


29 


1924 


476 


3 












3 


3 




8 


7 


192.-, 


570 






' i 


' 'i 






2 


4 


2 


19 


32 


1926 


623 








1 


"1 




? 1 


'^ 




17 


45 



154 



DOWX-STATI-; .ML'MlIPAI.ITIKS 



Table 2. 
Mortality Rates From Certain Causes. 



VE.vi; 


a 


1 
1 


.3 


a 


S 


1 
1 


1 

1 


26 


^ 


.2 


as 
1= 


H.2 


1897 
1898 
1899 
1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
1908 
1909 
1910 
IHll 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 


11.0 
10.2 

10.6 
8.7 
11.4 
10.1 
9.3 
9.4 
9.5 
11.5 
10.8 
10.0 
10.9 
10.6 
10.9 
9.4 
10.0 
10.8 
11.2 
11.3 
14.0 
10.5 
13.0 
10.5 
12.3 
11.5 
11.2 
13.0 
13.8 


21.4 
10.7 

25.9 
55.4 
34.3 
33.3 
23.2 
13.5 

2i;4 

33.5 
28.5 
24.1 
27.3 
22.9 
14.7 
10.8 
3.6 
3.5 
3.4 
3.3 

7.'8 

2.4 

6.9 
4.6 


3'..^ 


2.3 


12!5 

4!6 

23.4 
3.8 
7.4 

ib'.i 

3.5 
6.8 

2.':i 

2.2 


h'.h 

10.0 
9.5 

i.'i 
17.1 
8.4 
8.0 
4.0 
7.8 
19.0 
18.4 
7.2 

34!8 
34.1 

2 .'7 

18.4 
2.0 
7.5 
2.4 
9.3 
2.3 
4.4 


4^2 
4.1 
15.9 
3.9 
3.8 
3.7 

3.6 

S.i 
13.3 

16 .".5 
5.1 
2.3 
4.8 
4.6 
4.6 
6.6 


26.7 
26.7 

20! 7 

24 is 
14.3 

9.2 
22.6 

8.8 

leis 
4.0 

8.0 

31.2 
26.7 
14.7 
14.4 
14.3 
24.4 
20.5 
6.0 
8.1 
18.4 
43.5 
9.9 
12.0 
6.9 
4.6 
2.2 


ih'.s 

24.5 

14. '3 
3.5 
3.4 
310.0 
51.3 
65.7 

9^9 
19.2 
6.9 
9.1 
4.4 


4. '5 


9.5! 4 

63.7 
104.8 
129.9 
85.9 
96.8 
77.4 
117.4 
80.1 
88.0 
70.1 
53.3 
44.3 
72.1 
67.8 
62.7 
71.7 
66.6 
35.1 
81.5 
56.4 
47.2 
43.4 
18.6 
43.2 
37.7 


ib'.lt 
101.7 

138.2 
46.4 
90.4 
132.2 
210.6 
88.1 
73.7 
180.9 
120.7 
76.2 
88.4 
104.6 
124.9 
135.8 
150.2 
290.0 
113.5 
107.8 
69.1 
90.9 
70.0 
16.2 
72.8 
100.0 



Note: The rate from .\ll Cau.se- is per 1.000 pcijulatioi 



per 100,000 populati 



the close social and commercial intercommunication between the two munici- 
palities exposed the citizens of Evanston constantly. There was local danger 
too because of inadequate sanitary sewer facilities, because the lake from 
which the pulilic supply was drawn was contaminated from a sewer outlet 
relatively near the water intake, because effective water sterilizing processes 
were not started until 1912, because the factors involved in the sanitation of 
milk were not full\' appreciated, because the public supply after it became 
safe was not available to all citizens and because, withal, the public had not 
learned the very close and subtle relation between sewa.sje disposal, safe water 
supplies and typhoid fever. 

Increasing knowledge on these points was reatlily appreciated and re- 
duced to practical application, however, so that typhoid began to dwindle as 
soon as preventive measures could be made operative. The year 1901 seems 
to have been the worst typhoid year in the whole history of the municipality. 
Eleven deaths occurred, giving a mortality rate of about 55 per 1(X),000 
inhabitants. This was about twice the rate for Chicago in that year but there 
is no data available to show^ the source of the outbreak. It might have been 



EVANSTON ■ 155 

from the public water supply. The population at the time was a bit short 
of 20,000 and 11 deaths from t\phoid fever suggest an epidemic of more 
than 100 cases, a rather severe experience. 

Subsequently, energetic measures toward vv'ater purification, sanitary 
sewage disposal and sanitary supervision over milk supplies began to result 
in perceptible declines in the annual typhoid fever rates but no marked de- 
creases occurred until 1912 when the practice of treating the public water 
supply with hypochlorite of lime was .started. After the modern purification 
plant was put into commission in 1914 typhoid became a negligible factor 
in the health problems of the community. The city profited also, in regard 
to danger from tvphoid, from the general practice of pasteurization of milk 
which became generally effective in Chicago in 1914 and by its own vigorous 
efforts to safeguard milk sold in the city (much of Evanston's milk is handled 
by Chicago dealers). Evanston had prexifuisly suffered from a few milk 
borne outbreaks, particularly in 1912 when twenty cases were traced to a 
single dairy. 

Another flare-up of typhoid started in 1923 and stretched out over three 
years, confining itself however to the late autumn or winter months. This 
caused no little public concern because most cases were among the best 
families and because the source of infection appeared at first to be quite 
bafifling. Careful epidemiological studies finally incriminated raw oysters 
as the offending agent, however, and after considerable agitation which 
ultimately involved the whole oyster industry of the United States and the 
local. State and federal health agencies — because outbreaks traced to the 
same source occurred elsewhere — the disease abated in Evanston and has 
continued to be a health problem of minimum >ignificance in the city. 

Diphtheria was another of the gra\e problems that presented itself for 
perennial solution and its savage assaults on the child life made it a subject 
of very active consideration from time to time. Epidemic waves carrying 
off from one to five children came and went with the seasons, sometimes 
confined to a handful of cases and again reaching alarming proportions. 
Experiences prior to 1900 were much the same as those elsewhere. Until 
the last few years before that date antitoxin was unknown so that quaran- 
tine was the only control measure applicable in a public way and this all 
too frequently was not utilized with the promptness antl uncompromising 
rigidness necessary for maximum benefits. 

After 1900 the increasingly general use of antitoxin caused a marked 
decline in the ratio of deaths to cases but that had little effect upon the 
number of cases, which sometimes grew to alarming proportions. They 
varied, of course, from year to year but 1921 seems to have been the worst 
in the history of the city. In that year 178 cases and 17 deaths were re- 
ported. That gave a mortality rate of about 43 per lOO.OOO population. 



156 I)0\V\-STATE MCNICIPAI.ITIKS 

OlluT years since I'HKl wlieii the rale has soared alxne 20 per 1(K).000 are 
1902. l''»05, l'»ll, 1012, 1016 an.l l'il7. 

Since r'21 llie possihilit} nf prexentini; diphlheria b_\- the immunization 
of children with toxin-antitoxin has come into popular favor and Evanston 
demonstrated her historic attitude of a will to be well by taking advantage 
of this opportunit\- on a large scale. Although there is in Evanston a con- 
siderable element who are opposed to the specific methods of prevention ad- 
vocated by the orthodox medical and public health professions, still the gen- 
eral ])ublic follows the lead of these scientific proponents and the result seems 
to justifx' their faith. The total number of cases of diphtheria reported in 
Evanston during the five years ended with 1927 is less than tliat for the one 
year of 1021. 

The history of scarlet fever in Plvanston has been consiilerably different 
from that of diphtheria because the milk supply has been involved in the 
spread of the former. On at least three occasions, in 1906, 1907 and 1908, 
rather conclusive evidence was secured pointing toward specific milk sup- 
plies as the source of outbreaks. The epidemic of 1907 was the worst of 
the three and the wor.st that the city ever experienced. There were 279 
cases reported and the city had less than 25,000 people at that time. Dr. 
H. B. Hemenway made a careful epidemiological study of the outbreak and 
concluded that the source was a contaminated milk supply. The fact that 
the epidemic promptly subsided when the sale of milk from that supply was 
cut off and the further fact that a severe outbreak occurred shortly after 
in Chicago among families who l)ought the milk that had been diverted from 
the l-lxanston market, \erihed the conclusions of Dr. Hemenwax' in the 
matter. 

In 1''25 there was another wave of scarlet fever that caused 260 cases 
of illness but at that time the population of the city was estimated at 43,833 . 
so that the ratio of prevalence was far less than in 1907. True to the spirit 
of keeping abreast of the times arrangements were made to promote the 
use of scarlet fever toxin as an immunizing agent against the disease. This 
procedure is very new, having been announced by the discoverers. Doctors 
George F. and Gladys H. Dick, in 1923. The Dicks themselves were secured 
to test the children in an Evanston school and to immunize the susceptibles, 
a task which was completed in 1925. Results of the demonstration are not 
a\ail;ible for use here. 

Other than the points mentioned there has been nothing unusual about 
the scarlet lexer history of Evanston. The disease appears to have grown 
milder there as it has elsewhere in the country although the incidence has 
declined but little. 

Tuberculosis is a disease particul.niy sensitive to errors in the habits of 
living and accordinglv we should exi)ect to find relativelv little of it in 



EVAXSTON 157 

Evaiiston where the public has manifested such a keen and intelligent in- 
terest in health matters. That is exactly the case. Since 1908 the annual 
mortalit}- rate from that disease has always been less than 100 per 100,000 
population, with a persistent downward trend that reached the point of i7 7 
in 1926. That is an unusually low rate, less than one-half of that which 
prevails in Chicago and scarcely more than one-half the rate for the State 
at large. 

Before 1909 the mortalitx' rate sometimes grew to a figure in the neigh- 
borhood of 150 but those were the days before the anti-tuberculosis move- 
ment with its modern effectiveness was well under w'ay. Even so the people 
in Evanston were alive to the importance of tuberculosis and were busy at 
whatever measures gave reasonable hope of prevention and control. Were 
not three herds of cattle in the vicinity tuberculin tested in 1900? 

The bulk of the anti-tuberculosis work has been done by vokmtary 
agencies, principally the Chicago Tuberculosis Institute. Splendid response 
from individuals and the public to control and preventive measures made 
possible the enviable progress that has marked the trend of the local cam- 
paign against tuberculosis. 

Influenza struck Evanston a rather severe blow in 1918 although the 
mortality rate from that infection and pneumonia was not so great as in 
many other places. Ninety-three deaths were attributed to influenza that 
year and 87 to pneumonia, giving mortality rates of 310 and 290 per 100,000 
respectively. This was disastrous enough but 12 other cities embraced in 
this volume suffered worse from influenza. The combined rate from influ- 
enza and pneumonia was greater in 11 other cities. Rut even with this un- 
happy experience the general mortality rate was only 14 per 1,000 population 
compared with 18 and 20 in man}" of the other municipalities. 

It W'ould hardly do justice to the health histor}- of Evanston to close 
the account without reference to the infant mortality rate. This, like the 
tuberculosis mortality rate is a sensitive index to the efficienc\' of public 
health service. Evanston has for a long time enjoved one of the lowest bona 
fide infant mortality rates in the State. The average number of deaths 
among children less than one year of age was 50.4 per 1,000 live births 
reported during the seven years ended with 1926. During the same period 
the average annual rate in the State at large was more than 75. The favor- 
able showing in Evanston is doubtless the result of the splendid infant and 
child hygiene and the prenatal service that has so admirably supplemented 
the general sanitary and health program of the ctiy. 

No community in the State has gone at its health problems more earn- 
estly nor more intelligently than has Evanston and none has reaped more 
enviable rewards of efforts in the shape of favorable health conditions and 
low mortality rates. 



158 



DOW X-ST ATE il U N ICIPALITIES 



Table 3. 
Cases of Certain Diseases Reported. 





1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 






5 


8 


4 


2 


2 


17 


17 


11 


3 


4 






1 


2 




17 


















53 


318 


228 


1206 




93 


141 


1169 


108 


410 


329 






17S 


150 


34 


46 


174 


83 


72 


111 


181 


260 


142 


110 


Whoop. Cough 












120 


487 


250 


204 


425 


162 


217 




38 


55 


13 


20 


137 


178 


48 


66 


49 


7 


18 


35 


Influenza 






2878 


124 


574 


4 


11 




2 


6 


32 




Polionivelitis 


8 


2 


6 


1 




5 


1 


2 


4 


2 


1 


3 


Meningitis 








1 




1 












•t 




15 




8 










oa 






















28 


104 


S8 


62 


79 


104 


119 


Sypliilis 












1 






3 


20 


85 


125 


Gonorrhea 


















1 


8 


36 


54 



•All forms. 
Note: Case reports are never complete, but they have been much more so since 1920 than before 
Illinois. Notification in Evanston now is as nearly complete as in any city of the country. 



Table 4. 
Births and Infant Deaths. 



Ml A It 












Number 


Rate** 


Number 


Rate* 


1910 






42 




1911 










1912 










1913 










1914 










1915 










1910 






44 




1917 










1918 










1919 










1920 


960 


25.4 


61 


63.5 




1136 


29.0 


02 




1922 


1203 


29.5 


62 


51.5 


1923 


1313 


31.7 


60 


45.7 




14S1 


34.7 


64 


43.2 


1925 


1528 


34.8 


06 


43.2 


1920 


1724 


38.2 


89 


51.6 



"Deatlis of infants under 1 
•Per 1000 population. 



of age per 1000 births reported. 



References. 



Data supplied by Dr. John W. H. Pollard, Health Commissioner of Evanston. 

Data by Oity Clerk's oflBee, City of Evanston. 

Annual Reports of the City of Evanston. 

Laws and ordinances of the City of Evanston, 1902 and 1904, Evanston, Illinois. 

History of Cook County, Andrews, J. I., Chicago, 1884. 

Health Survey of Fifteen Illinois Cities in 1925. Rawlings, Isaac D., Director of Public Health, 
State of Illinois. Health News, May-.Iune, 1926. , , , „ , , „ , . 

Annual Reports of State Board of Health, vols. 1-9, Ranch, John H.. Secretary state Board of 
Uealth. 

,\nnals of Health and Sanitation in Chicago, Koehler, G., Chicago, 1919. 

V. S. Census Reports, varioiis dates. 



Freeport 

The cit\ of Freeport is located in Stephenson Count}-, about 15 miles 
from the northern boundary of the State and is about 113 miles west from 
Chicago. It is served by three railway trunk lines and one interurban sys- 
tem, namely, the Illinois Central, Chicago, Milwaukee and St. Paul and 
Chicago and Northwestern railways and the Rockford and Interurban elec- 
tric line. 

The cit\' is located on the Pecatonica River, which forms a part of the 
north and east boundaries. The greater part of the city is so located that 
good natural drainage is afforded. There are certain sections, however, espe- 
cially the northeast, which become flooded during high water. The greatest 
known flood in the history of the Pecatonica River occurred in March, 1916. 
The river frequently spreads out over a whole valley north and east of the 
city limits during flood period, and there is considerable property damage 
in that part of the city located on the east side of the river due to a silting 
up of the channel. 

The rich alknial soil of the bottom lands and the good rail facilities 
encourage extensive farming and grazing, devoted largely to the raising of 
cattle and the production of dairy products. 

The city occupies an area of 4.2 square miles, the highest elevation 
being 873.5 feet above sea level and the lowest 743.5. It has a total of 10.7 
miles of alleys and 70 miles of street. There are six parks, four of medium 
size, comprising an area of about two acres each, and two large parks, one 
covering an area of 90 acres and the other 75 acres. Aside from these there 
are six small flower parks of about one-quarter acre each. The city has a 
park board operating under special State law, which has control over all 
the "breathing spaces." 

Freeport is an industrial community. Here one of the large shops of 
the Illinois Central Railway is located while thirty-odd manufacturing con- 
cerns maintain plants in the city. Hardware, engines, toys, furniture and 
medicinal products are the chief items made in the factories. 

In 1920 the population of Freeport was 19,669, a figure to which the 
number of inhabitants had grown from 17,567 in 1910 and 13,258 in 1900. 
The 1890 census returns showed a population of 10,189. Of the 1920 popu- 
lation 5,410, or nearly 28 per cent, were listed as being 45 years or more of 
age. Native whites predoniinatcnl with a jiercentage of 87.7, the remainder 

(159) 



160 



DOWN-STATE .MUNITIPALITIES 




being divided between foreign born whites and 
negroes with percentages of 10.6 and 1.7 respec- 
tivel\. Tile character of the population had 
changed hut httle during the decade that pre- 
ceded. 

Health jMacuinery. 

The orilinance creating the first otlicial 

health organization in Freeport was adopted in 

1893. It provided for a board of health under 

which a health officer performed the executive 

duties ascribed to him. From the very outset a 

physician has always filled the position of health 

officer. Under the first board of health ordinance 

the health officers who served Freeport included the following, the dates 

indicating \ear of original appointment from which time each continued in 

office until the next one Hsted : 

E. H. Best, M. D. 1S93-1S95 

J. A. Poling, M. D. 1S95-1899 

E. E. Burwell, M. D. 1899-1901 
T. .T. Holke. M. D. 1901-1903 

R. ,J. Burns, M. D. 1903-1909 



Robert J. Burns, M. D. 

Commissioner of Healtli, 

1903-1909; 1923 to date 



E. H. Best, M. D. 
J. A. Poling, M. D. 
E. E. Burwell. M. D. 
E. J. Torey, M. D. 



1909-1911 
1911-1913 
1913-1915 
1915-1917 



In 1917 the original board of health system was abandoned when a 
new orcHnance, creating a department of public health with a commissioner 
at its head and administered through a committee of the cit}- council, was 
adopted. Under this plan the mayor appoints, every two \ears, a commit- 
tee of three aldermen and a health officer or commissioner of health who, 
with himself, make up the official health organization of the city. The com- 
missioner of health is the executive officer. 

The ordinance of 1917 requires that the cit\ health commissioner shall 
be a legally qualified physician possessed of the requisite knowledge of sani- 
tary science. It specifies as a duty of the health commissioner that he shall 
assist and advise the health committee in all matters pertaining to public 
health and clothes him with the power and responsibilit\' of general super- 
vision over the health conditions of the community. The ordinance is suffi- 
ciently broad in its terms to provide ample legal authorit}' for initiating and 
carrying out every reasonable activity calculated to benefit the public health. 

I'nder the ordinance of 1917, which still constitutes the legal basis for 
the official health activities in Freeport, three physicians have served as health 
commissioner. With the date of appointment they are : 
E. H. Best, M. D. 1917-1919 

.1. A. Poling, M. D. 1919-1923 

U. .1. Burns, M. D. 1923 to date 



FREEPORT 



161 



Besides the commissioner of health the city hcahh department emplo_\s 
a sanitary inspector. 

\'oluntary agencies and such public organizations as the local school 
and count}- tuberculosis boards have done more active public health work 
in Freeport than the city government. This is not uncommon aniung muni- 
cipalities. 

In 1915 the board of education employed a nurse to do health work 
among the school children of the city and that service has continued. At 
about the same time, through the cooperation of the Stephenson County 
Dental Societ\', tlie board of education established a dental clinic in the 
schools where necessary dental work is done gratuitously fur indigent 
children. 

The Stephenson County Tuberculosis Board employs two nurses who 
spend a part of their time in Freeport. Their attention is devoted entirely 
to problems relating to tuberculosis and their efforts are directed i)riniarily 
toward preventing that disease. 

The Amity Society, oldest of Freeport's charitalile organizations, dating 
back to the seventies, is responsible for the largest volume of active public 
health work accomplished in the city. With an annual budget of about 
$4,000 this society has carried on practically all of the infant and child 
welfare work, other than that in the schools, which has been undertaken. 
It first became active in this field in 1917 when the Children's Bureau of 
the U. S. Department of Labor stimulated interest in a child health program. 
Later the Amity Society became affiliated with the American Child Health 
Association and has operated a child welfare station for many years. It 
has sponsored a crippled children's clinic, provided by the Rotarians, and 
has been responsible for much of the success of this clinic to which crippled 
children have come from a large surrounding area. 

\V..\TER .Supply. 

A waterworks was first installed in 1882 when a thirty-year franchise 
was granted the Freeport Water Company. In 1912 the franchise was re- 
newed but with some important alterations in the terms of the ordinance. 

In supplying the city with water the founders of the company first 
planned to develop a spring which issued from a bluff near the river on the 
north edge of town. A large pit was excavated and the flow from this 
spring was conveyed to this pit through a drain tile. Beside the pit was 
buill ;i pumping station which still forms a part of the present waterworks 
plant. 

It soon fjecame ap]5arent, however, that the spring suppl_\- was altogether 
inadequate to meet the demands and for a period of three or four years it 
was supplemented by water drawn direct from Pecatonica Ri\er. 



162 DOWN-STATE MUXICIl'AI.ITIES 

Next a small well was bored at the plant and it was found that the 
water rose and overflowed at the ground surface. This encouraged the 
sinking of several more wells. The static head receded, however, in a short 
time and it became necessary to pump the wells. These wells then became 
the main source of su|>])ly. In 1890 the old river intake was discontinued 
and the old pit filled up. 

In 1893 there were 14 wells in service, all confined to an area of one- 
fourth of an acre lying just north of the pumping station. 

Between 1893 and 1915, 11 drift wells and 2 wells entering St. Peter 
sandstone were added to the system. These additions extended westward a 
distance of about 300 feet. 

For a number of years the drift water was satisfactory and then diffi- 
culties began to arise due to iron and growths of crenothrix in the wells 
and pipe lines. In 1900 an effort was made to eliminate this trouble by 
seeking a new supply from St. Peter sandstone. One well was drilled and 
is said to have furnished good water until it also began to contribute iron. 

Experiments were then begun to discover a means of overcoming the 
difficulty by treating the water. Aeration alone proved inadequate while 
treatment with lime resulted in the precipitation of the iron. 

In 1903 the company added to its equipment a purification plant of 
2,000,000 gallons per day capacity, consisting of a means for treating with 
lime, two sedimentation tanks, four gravity filters, clear-water well, and 
low-lift pumping machinery. In the same year new high-service equipment 
was installed. 

In 1910 an appraisal of the company properties was made and nego- 
tiations undertaken looking toward renewal of the franchi.se in 1912. The 
city and company could not agree on the original appraisal and a commis- 
sion was appointed which made a new appraisal and submitted a report 
including recommendations for extensive improvements. 

B\- 1915 most of the recommendations of the committee had been carried 
out. In 1915 a second well was drilled to St. Peter sandstone but was not 
equipped for the reason that the metering of the city so reduced the water 
consumption that additional water was unnecessarw The capacity of the 
filter plant was doubled, an additional clear-water basin was built and new 
low-lift equipment, coal bunkers and new service mains were installed. The 
cost of these improvements was approximately $215,000. 

In 1915 the water consumption was about 1.6 million gallons per day. 
The distribution system comprised about 54 miles of service mains. 

In 1917, 25 drift wells and 2 wells into St. Peter sandstone were in use. 

In 1920 there was a threatened shortage of water and in changing pump 
connections so as to connect with the deep wells, a mistake was made which 
permitted raw river water to enter the system for several hours. 



FREEPORT 163 

In 1921 a new well entering St. Peter sandstone was constructed. Dur- 
ing this year also, attention of local officials was directed to numerous indus- 
trial cross connections between polluted river and the cit\- well-water supply. 

In 1922 to safeguard the water supply a chlorinator was installed. To 
date, however, it has been impossible to secure the removal of dangerous 
cross connections which are in existence. 

The pi'esent suppi}- comprises 25 shallow drift wells and 3 deep wells. 
The waterworks comprises a purification works and pumping equipment. 
The present water consumption is about 1.85 million gallons per day. 

Due to dangerous cross connections, the water is regarded as of doubt- 
ful sanitary quality. 

Sewerage. 

The city is served by a system of separate sewers with 8 sanitary and 
storm outlets to the river ranging from 12 to 144 inches in diameter. 

Health Conditions. 

Only present day health conditions in I'reeport can be appraised on the 
basis of statistical evidence. Reliable records date back to 1907 only. Since 
that time the general mortality rate has fluctuated between 14 and 20 per 
1,000 inhabitants. These figures are higher than the rates for the State 
generally and for some of the other municipalities. This results partly, at 
least, from the character of the age distribution in Freeport. Nearly 28 per 
cent of the population in 1920 were above 45 years of age. That suggests 
a considerable number of individuals in the upper age strata. At any rate 
the group constitutes a much larger share of the whole population than in 
the State at large and in a number of other places. 

Infant mortality and the death rate from tuberculosis are usually re- 
garded as sensitive indices to general health conditions. Since 1920 the 
infant mortality in Freeport has fluctuated between 50 and 80 per 1,000 live 
births reported with an average of 65.2. This is what may be termed a 
moderately low rate. In a few cities the infant mortality is much higher, in 
a few it is much lower. The average for the State during the same year 
was 73.0. 

Mortality from tuberculosis has consistently declined in recent \ears, 
reaching the unusually low point of 28.8 per 100,000 population in 1926. 
Most of the decline has taken place since 1918 when 24 deaths gave a rate of 
120. Prior to that time the number of deaths seldom fell below 18 per year, 
yielding rates above 100. 

In Dixon and Freeport rather aggravating situations developed in 1922 
when activity on the part of anti-vaccinationists delayed the establishment 
and carrying out of control measures in the face of a threatened epidemic 



164 



DOWX-STATl-: MUXICIPALTTIES 



Table 1. 

IMOKTALITY I'KOM CeKTAIN CaUSES. 







S 








«: 


1 






X 
































YEAR 


■£ 

3 


b 




g 




fa 


6 


'E 


g 


% 


1! 


■5 1 










3* 


M 




d 










11 




6 


p. 


S 


1 


i 


o 




£. 


^ 


1 






< 


r- 


IS 


X 


a 1 CO 


^ 


™ 


— 


b 


E-w 




1907 


248 


8 




... 




8 


^^ 


4 




23 


19 


1908 


228 






















1909 


234 






. . . 
















1910 


246 
























1911 


260 


"s 


.'.' 






"i 








•i 


22 




1912 


285 


3 












2 


"i 




18 




1913 


274 


2 




2 


' -i 


5 








22 




1914 




2 

















19 




1915 




2 









4 








16 




1916 


296 


2 














5 




18 


'23 


1917 


























1918 


366 


2 








' i 


2 




52 




'24 


'36 


1919 


296 


1 








3 






18 




21 


9 


1920 


399 










5 






40 




16 


25 


1921 


308 


' 




1 


"2 


1 


10 


3 




14 


19 


1922 


302 


... 1 






1 1 ... 


3 


7 


2 




17 


18 


1923 


330 








1 1 1 






8 




11 


25 


1924 


311 


"i 






... ... 






1 




12 


13 


192:> 


308 


5 






... f ... 






4 


i 


15 


15 


192fi 


359 






... 


4 j ... 


"4 




6 




6 


23 



Table 2. 
Mortality Rates From Certain Causes. 







% 








fe 


1 






<« 

































YEAR 


1 


fa 
3 




>< 




fa 


Q 


i 


S 


^ 


II 


ll 




5 




•j^ 


0. 


s 


tj 


0. 


j:: 


£ 


c 


U.S 


P 


















3 




S~ 






5 


H' 


3 


i 


s 


1 


5: 


s 


c 


1 


H - 


Is 


1907 


15.2 


49.1 










49.1 


12.2 


24.5 




141.3 


116.7 


1908 


14.5 




























1909 


13.8 










. . '. 




















1910 


14.0 






























1911 


14.0 


4.5! 6 










5.6 




li 


2 




ii.2 


123 .'7 






1912 


15.8 


17.0 














11 


1 






100.0 






1913 


15.0 


10.9 








16.' 9 


16.9 


27! 4 


10 


9 






120.8 






1914 




10.8 






■ \ 








21 


7 






103.2 






1915 




10.7 












2i!4 










85,9 






1916 


15.' 7 


10.6 








.5.3 










26'5 




95.6 


122.' 1 


1917 
















'.'.'. 














1918 


is'. 9 


il.i) 










5.0 


9.9 


5 


6 


260.6 




126!6 


150.6 


1919 


15.1 










16.2 


15.3 




20 


4 


91. S 




107.1 


45.9 


1920 


20.2 












25.0 




5 





200.0 




79.9 


129.9 


1921 


15.4 


soli 






,'.b 




10.0 


s'.o 


50 


1 


15.0 




70.1 


95.3 


1922 


IS.O 










h'.i) 




14.9 


34 


8 


9.9 




84.4 


89.4 


1923 


16.2 










4.9 


4.9 




30 





39.4 




54.1 


123.1 


1924 


15.2 


4.'8 














4 


8 


4.8 




58 . 5 


63.4 


1925 


14.9 


24.1 


















19.3 


iis 


72.5 


72.4 


1926 


17.2 


... 


... 






19!] 




19.' i 






28.8 




28.8 


110.0 



The rate fio 



1.000 pipuliition ; all others per 100,000 populatic 



(if sniallpiix. .\t Di.xdii the differriicc Ix'twet-n local adherents to the con- 
stituted authorities and tn the Medical Lihert\- League terminated in court 
action, and the same thin.sj; was threatened in I'reeport, althoutjjh the final 
outcome at each point resulted in the ,s,reneral \accination or quarantine of 



FRF.KPORT 



165 



all umacciiiateil contacts with active cases and the outlireaks were stamped 
out with less than 100 cases at each point. 

The influenza epidemic of 1918 was not severe in Freeport, relatively 
speakin.t;-. The death rate of 2()() per 100,000 was moderate. Pneumonia 
was also relatively light that year, the rate of 150 being much lower than 
for many municipalities. 

Table 3. 
Casf..s of Cfrtain Diseases Reported. 





1!119 


1020 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


1 


1 




2 


•2 


., 


9 


7 


4 


Smallpox 


4 


103 


4!1 


4(i 


22 


12 


4 






Me.isle.s 


61 


207 


S 


13 


572 


f)7 


112 


573 


27 


Scarlet Fever 


22 


4."i 


47 


89 


62 


71 


119 


19 


19 


Whoop. Cough 






21 


IfiO 


12 


17 


91 


84 


22 


Diphtheria 


1.") 


20 


12.-. 


123 


36 


16 


6 


4 


4 


Intlueriza 


124 


34S 


2 


12 


10 


2 


12 




5 


Poliomyelitis 










2 


1 


1 




9 


Meningitis 






1 




3 






1 


1 


Tuberculosis* 




13 


22 


C4 


2.} 


30 














8 


64 


.56 


32 


3.5 


69 


57 


Svphilis 






37 






13 


9 


30 


17 


Gonorrhea 






(iO 






16 


13 


35 


18 



*A11 forms. 
Note: Case reports are never complete, but they have been nuicli i 
Illinois. This table indicates that notification of more diseases 
there is still room for improvement in the completeness of returns 



Table 4. 
Births and Infant Deaths. 



YE.Ul 












Number 


Rate** 


Niunber 


Rate* 


1916 


407 




33 


81.0 


1917 










1918 






42 




1919 






33 




1920 


427 


21.5 


33 


77.3 


1921 


483 


24.0 


25 


.51.8 


1922 


423 


20.7 


33 


78.0 


1923 


453 


22 ..^ 


30 


66 . 2 


1924 


506 


24.7 


25 


49.4 


1925 


487 


23.5 


26 


53 . 4 


1926 


485 


23.2 


39 


80.4 



per 1000 births reported. 



References. 



Dr. Robert .1. Burns, Conunissioner of Health, personal coinnmnicatii 

niinois Health News, Ma.v 1918, Paul L. Skoog. 

Freeport Municipal Records, various dates. 

Freeport Chamber of Commerce. A Survey of Freeport, Illinois, 1925. 

U. S. Census Reports, Washington, D. C. various dates. 



Qalesburg 



Galesburg, the county seat of Knox County, is located near the divide 
between the basin of Henderson River, a tributary of the Mississippi, and 
that of the Spoon River, a tributary of the Illinois, in the west central portion 
of the county. The city occupies high level ground on the divide between 
the two drainage basins. 

Cedar Creek, a branch of Henderson River, flows westerly through the 
city, receiving practically all of the drainage with the exception of a portion 
from the southwestern part, which enters Court Creek, a tributary of the 
Spoon River. 

The soil consists of a glacial drift, varying in depth from 30 feet in 
the uplands, to as much as 120 feet in the valley of Cedar Creek. This 
drift contains water-bearing strata, which }-ield large quantities of water. 
The underlying rocks lie deep and are generally limestone with some soft 
sandstone. Bituminous coal is mined in the vicinity. There are no ponds, 
lakes or marshes in the city or within a radius of five miles. 

Settlement of Galesburg began in 1837 and the communit\' was incor- 
porated as a city in 1S41. It was reorganized under the general law of 1872 
in 1876. 

The population was 882 in 1850. In the following decade there was a 
marked growth of the city, the population reaching 4,953 in 1860. In the 
next ten years the population doubled, the inhabitants numbering 10,158 in 
1870. The end of another decade found 11,437 people there and this number 
had grown to 23,834 by 1920. Of this number 20,054 or 84.1 per cent were 
native born whites, 2,925 or 12.3 per cent were foreign born whites and 843 
or 3.6 per cent were negroes. There were 6.749 or 28.3 per cent over 45 
years of age. 



H i: A LT H M A C H I N ER Y. 

Health service in Galesburg is now provided 
vuider an ordinance, adopted in 1915, that divides 
responsibility between a commissioner of health 
and a board of health. Conflict of purpose and 
action between the two is avoided by making the 
commissioner of health a member of the board 
and by limiting to $25.00 any item of expenditure 
incurred by the health commissioner without the 
approval of the board. 




E. D. Wing. M. D. 
Health Commissioner, 

191S to date 



(166) 



GALESBURG 167 

Lnck-r the lioarcl there is an executive officer, a layman, known as the 
health officer. In matters not medical, he has authority equivalent to that 
vested in the health commissioner, who is a physician. The ordinance speci- 
fies that the city council may from time to time prescribe the duties of the 
board of health but the duties of the health commissioner are set forth in 
the ordinance. There is, furthermore, another city officer known as the city 
physician. His duties are not public in character but relate to the medical 
care of indigent sick who find themselves as city charges. The first four 
sections of the ordinance read : 

"Settion 1. The board of health shall consist of the nuiyor. commissioner 
of health, chief of police, poormaster and city physician. The city clerk shall 
be clerk of the board. 

"Section 2, The mayor shall he ex-officio the president of the board of 
health. 

"Section .''.. The city council may from time to time prescribe the duties 
of said board of health. 

"Section 4. Said commissioner of health shall have and exercise a general 
supervision over the sanitary condition of the city, shall give to the mayor 
and other city authorities all such professional advice and information as they 
may require concerning the health of the city and the preservation thereof, 
enforce all the laws of this state and ordinances of the city relating to health, 
and promptly abate all nuisances which may in any manner endanger the 
health of the city." 

The other fifteen sections enumerate various duties, responsibihties and 
powers of the health commissioner and the board of health. 

This system is the cuhnination of a long experience in official health 
activities that began when the city was \oung. The Cities and Villages Act 
under which Galesburg was reorganized in 1876, provided for a board of 
health and the city took advantage of that provision. Prior to that lime a 
board or committee of health met the emergencies that faced the nnmici- 
pality from time tn time. 

During the earlier years there was no regularity' in activities directed 
toward the control and prevention of disease and consequently there was no 
permanenc}- in the executive office of the board or committee of health. 
After 1876, it was the practice to appoint a physician as health officer. Dr. 
George W. Foote filled the office in 1881 and was succeeded by Dr. James 
E. Cowan, in 1884. Then Dr. D. W. Aldrich was appointed health olficer 
in 1885. 

Later it became the practice to let a non-medical person fill the office of 
health oflicer and Uiis has continued. Medical direction of health service 
was maintained, however, through the creation of a new office known as 
health commissioner. 

Recent incumbents have been _b>hn 1). Bartlett, M. D., 1914; F. G. Hall, 
Al. 1),, l'H5-1018; F. D. Wing. M." D. 1918, to date. 



168 nOWX-STATK MUNICII'ALITIES 

Voluntary agencies have done and are still doing a great deal of work in 
Galesburg. There are six public health nurses, supported by various organi- 
zations at work in the city and county. Among other things, the agencies 
which support the nurses participate in infant and maternity hygiene service, 
do work among the school children and maintain, through the co-operation of 
the Illinois Crippled Children's Societ\. a clinic for crippled children. 

W'.ATKR .Sltply. 

In the seventies a public water supply was provided. This was derived 
f re nil wells and cisterns. One well was located in George W. Rrown's works 
and the cither at the Frost factory. These were drift wells about 12 feet in 
diameter. 

Two reservoirs were maintained for storage purposes, one on Seminary 
Street witJi a capacity of 1,100 barrels, the other on West Street, holding 
1,500 barrels. 

Besides these reservoirs for well water, there were twenty large cisterns 
for the storage of rain water. 

In 1878 water pipes were laid only in the central part of the cit\'. 

A water supply obtained from artesian wells was established in 1887, 
supplemented hv drift wells. 

In 1890, after a private company, which received a franchise to supply 
water, had its contract revoked on account of failure to meet its obligations, 
the city took over the waterworks. The supply was derived from a series of 
driven wells about 80 feet deep, in a line parallel to Cedar Fork at the present 
site of the waterworks. These wells were connected to a common suction 
pipe from steam pumps. The methnd of pumping was unsatisfactory and 
two wells, 1,226 feet deep pumped with air, were installed. Later several 
wells about 70 feet deep were addeil. 

In 1''12 two deep wells and six shallow wells were in service. Water 
was deliveretl from the wells into a collecting cistern from whence it was 
pumped into a storage reservoir. Just prior to l')12 a large service pump to 
pump water from the storage reserxoir directly into the mains, was installed. 

In 1914 a \'enturi meter on the discharge of the high-service pump was 
installed. .\t this time three deep wells penetrating St. Peter sandstone and 
four drift wells were in service. During this year, a shallow drift well of 
large diameter with a special straining device to eliminate troubles due to 
fine sand was sunk to replace three of the old drift wells. The consumption 
in 1914 was about 30 gallons per capita daily. 

The (juestion of an adequate supply had at times been the cause of 
anxiet}' and prior to 1915 studies had been made relative to increasing the 
supply by developing of either a surface-water supply or de\elopment of an 
isolated deep-well system. 



GALESBURG 169 

Due to the continued inadequacy of the supply, private shallow dug 
wells and cisterns, open to contamination, were maintained for many years. 
In l'U5. following an epidemic of typhoid fever, investigations cast suspicion 
upon the pulilic water su])pl\' and the supph" was given hxpochlorite treat- 
ment fur a time. 

In V>1? a new deep well was started at the pumping station, but due to 
dela\s and breakdowns the well was not yet completed in 1919. In 1916 and 
I'll/ four more shallow wells were added to those already in existence. In 
l'*17 a new deep well {\.IS2 feet' deep) was constructed just back of the 
city hall. In l''l'i another deep well in the southeastern part of the city was 
Constructed, and placed in service. 

In 1''22 the supply comprised three wells entering St. Peter sandstone 
and one well entering Potsdam sandstone located near the waterworks station 
and two wells entering .^t. Peter sandstone located near the city hall and in 
the southeast part of the city, respectively. The Potsdam well, which was 
started in 1''1,t and not completed until late in l'U9, was the only well nor- 
mally pumped in 1922. 

The present supply comprises the four wells in service in 1922. The 
supjily is still subject to contamination at the open reservoir and its sanitary 
c|ualily is regarded as doulitful. 

In l'*19 there were 41 miles of service mains and .\.^(_K) services. The 
present water consumption is 65.7 gallons per capita. 

Seweragk. 

The major portion of the city has natural drainage toward Cedar Creek, 
which flows in a .southwesterly direction through the central portion of the 
city. The southeast part of the cit\- drains to Court Creek, which flows 
easterly and discharges into Spoon River. 

The first public sewer system was installed in 1870. This was on the 
combined plan and served part of the area on the south side of Cedar Fork. 

Between 1870 and 1880 four other limited systems were constructed. 
Porous tile drains laid beneath street gutters facilitated somewhat the re- 
moval of surface drainage. These early sewer projects were financed by an 
arrangement whereby two-thirds of the cost was defrayed by abutting prop- 
ert_\' owners and one-third l)y the city. 

In 1880, nearly all the private dwellings depended upon privies for 
sewerage facilities. Onl_\- hotels and other public buildings were connected. 
About this time the board of health prohibited the digging of more privy 
vaults and endeavored to bring into use the dry-earth system. This was 
done because the board had had anal\zed the water from wells on premises 
where diphtheria cases had occurred and had found it contaminated. At 
this time the board was of the opinion that \ault privies were the cause of 



170 nowN-STATi-: municip.m.ities 

diphtheria epidemics which previously had occurred. There was violent 
opposition at first, to the installation of dry-earth closets, hut the board, in 
1880, reported that the number was gradually increasing. 

Night soil was used as manure by farmers a few miles distant from the 
city, but such use was prohibited on the gathering ground of the public 
water supply. 

The sewer system, built mostl\- on the combined plan, was extended 
from time to time as local re(|uirements demanded. Many sewers, especially 
in the extreme northern and southern parts of the city were laid at such 
shallow depths that basement drainage was not afforded. 

The numerous outlets discharged into Cedar Creek, which soon became 
an open sewer ffowing through the city. In 1914 gross pollution extending 
seven miles below the city was observed in Cedar Fork. Some sewage was 
discharged into Court Creek in the southeast portion of the city, and pro- 
duced conditions concerning which many complaints arose. In 1916 the 
matter of the pollution of Cedar Creek came to a hearing before the Rivers 
and Lakes Commission, and an order was issued requiring the city to abate 
the nuisance before July, 1918, which order was never enforced. 

At the present time there are 36 combined sewer outlets discharging 
into Cedar Fork. The tributary sewers are divided into 34 sewer districts. 
Practically all streets are served and 90 per cent of the population are con- 
nected. About 50 miles of sewers are in existence. In addition there are 
some sewers discharging into Court Creek, but further development of this 
system as an outlet watercourse has been curtailed through an injunction 
granted by the court. 

Two comprehensi\e preliminary studies of the sewerage needs of Gales- 
burg have recently been made, the second study being made in 1924. The 
consulting engineers have recommended the construction of a trunk sewer 
following along Cedar Fork, channel improvement along certain portions of 
Cedar Fork, force main and pumping station to serve the Court Creek area, 
intercepting sewer for the purpose of conducting the dry-weather flow to a 
point west of the cit\', and a modern sewa.ge-treatnient plant comprising grit 
chambers, Imhoff tanks and slud,gc beds. 

Hi:ai,tii Conditions. 

The stor_\- of a "pest house" located on the outskirts of town and shunned 
like a leper by all health loving citizens, is somber evidence that Galesburg 
felt the sting of smallpox and experienced the alarm that was want to follow 
fast upon the heels of an outbreak in years gone by. Cholera doubtless paid 
its gruesome respects to the inhabitants of that college communit}-, too, but 
historians seem to have left the recording of such e\ents t(3 others and the 
others found more congenial ways to pass the time. At all events we find 



GALESBURG 



171 



very little about the coming and going of epidemic diseases even in later 
years. It is reported that the city escaped with but four cases of smallpox 
during the State-wide epidemic of the early eighties. A typhoid fever out- 
break of 20 cases occurred in 1902. With these meagre references we are 
left to surmise what other ailments may have plagued the citizens until 1918. 
What has transpired since that time is suggested in the mortality and mor- 
bidity tables hei"ewith presented. 



Table 1. 
AIoRTALiTY From Certain Causes. 



YE.\R 


6 

< 


3 
H' 


1 


Q^ 


1 


> 


t 


1 


1 


ft. 


IS 


11 


1907 
1008 
1909 
1910 
1911 
1912 
1913 

1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 


275 
283 
263 
292 
311 
304 
297 

459 
317 
376 
324 
372 
414 
344 
340 
401 




8 

6 

8 
2 
4 
1 

3 

1 
4 
1 








i 




] 




3 

2 

"i 
1 




1 

3 
3 

'e 

1 




c 

4 






65 
17 
16 

9 
10 

8 
16 








21 

29 

15 
23 
14 
15 
28 
11 
13 


21 

49 
29 
49 
23 
27 
25 
16 
17 
ol 



Table 2. 

Mortality Rates From Certain Causes. 



YE.^R 


i 

o 


1 


CJ 


i 


i 
s 




1 

i 


'5 


1 


>. 


If 

go 


.5'« 


1907 


13.0 


38.0 






19.0 


14.2 


4.7 


14.2 






99.7 


99.7 


1908 


13.2 








... 
















1909 


12.0 
























1910 


13.2 


... 






















1911 


13.9 

























1912 


13.0 


26.5 






4.4 




13.2 








110.5 


.... 


1918 


19.5 


32.0 






4.0 




12.0 


16.0 


260.0 




116.0 


196.0 


1919 


13.4 


6.3 












S.8 


70.8 




104.1 


120.8 


1920 


15.7 


16.0 






4.1 


8.2 


8.2 


4.1 


66.6 




02.0 


204.1 


1921 


13.4 


4.1 






S.3 


8.3 




4.1 


8.3 




95.3 


95.4 


1922 


15.3 




... 




4.1 






20.6 


37.1 




57.6 


111.2 


1923 


16.9 


12.2 






4.0 


4.0 


24.5 


8.1 


40.9 




61.0 


102.4 


1924 


14.0 


4.0 






24.0 


4.0 




4.0 


8.0 




112.0 


64.0 


1925 


13.7 


16.1 












4.0 


32.2 


4.0 


44.3 


68.5 


1926 


16.2 


4.0 




4.0 






4.0 


12.0 


64.0 




52.0 


124.0 



Note; The rate from XU Causes is per 1.000 pop\ilation ; all others per 100,000 populatii 



172 



DOWN-STATI-; Mr.XICIPAr.ITIES 



Tal)le 3. 
Cases of Certain Diseases Reported. 



1 

1 1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


T.vphoirl Fever 




34 


tr, 


Ifi 


20 


6 


,., 


19 


23 


7 


18 


Siimllpox 


13 


44 


92 


174 


31 


1 




3 




4 




Meusles 




2(17 


ISO 


31 


021 


31 


1(10 


376 


4 


260 


84 


Scarlet Fever 


8 


9 


21 


21 


48 


1.') 


34 


66 


62 


16 


39 


\V hoop. Cough 










l.iC 


17 


1S7 


76 


23 


147 


86 


Diphtheria 


73 


12 


19 


18 


«-> 


.14 


32 


23 


12 


17 


11 


Influenza 




3Cr,8 


50.^1 


248 


2 


4 


7 


2 


4 




8 


I'oliomvelitis 


2 


1 




1 


2 








4 




2 


Meningitis 












4 


1 






4 




i'ul)erculosi.s* 










2;") 


37 


14 


32 


29 


.19 


23 


Pneuninniii* 










.11 


64 


82 


47 


.12 


92 


74 


Sypliilis 




3 






28 






.19 


31 


4.1 


73 


(iononliea 










:)4 






4.-1 


19 


23 


52 


Chanrroirl 










1 















*AU forms. 
NoTi:: Case reports are never complete, but they have been 
Illinois. This table indicates improve-ment iniiotifitation i 



Table 4. 
Births and Infant Deaths. 



YEAR 












Number 


Rate'* 


Xuniber 


Rate* 


WIS 






33 




1919 






35 




1920 


503 


21.0 


46 


91.5 


1921 


547 


22.7 


24 


43.9 


1922 


463 


19.1 


47 


101.5 


1923 


585 


23.9 


48 


82.1 


1924 


592 


24.0 


38 


64.2 


1925 


572 


23.1 


37 


64.9 


1926 


545 


21.8 


43 


78.9 



^Deaths of infants under 1 vear of age per 1000 births reported. 
*l*er 1000 population. 



References. 



Annual Reports, State Board of Health, Spring-field, Illinois, various dates. 
Bulletins. Illinois State Water Survey, Urbana, Illinois, various dates. 
U. S. Census Reports, Washingrton, D. C, various dates. 



Jacksonville 

The site of Jacksonville, the county seat of Morgan County, was one of 
the most beautiful locations on the native prairies of that county. For about 
a mile to the east and north of the center of the town, a line of heavy timber 
marked the changing course of Mauvaisterre Creek on its way to the Illinois 
River about twenty miles to the west. 

About four miles to the south a line of timber marked the western 
course of Big Sandy Creek. A mile west was a magnificent grove of large 
timber, through which the land gradually rose to culminate in what was 
called the Mound three miles away. To the south, on another ridge al)out n 
mile away, was another grove, later known as Diamond Grove. 

The town was laid out in 1825 and was located on a well-drained prairie 
ridge. According to Peck's Gazetter, twenty families resided there at that 
time. Dr. Ero Chandler, the first physician, arrived in 1821. 

Located in a spot so favored by nature and lying almost in the very 
middle of Illinois, it was but natural that Jacksonville should become a seat 
of learning. That is exactly what happened, and more, for it not only be- 
came a college town, Illinois College and Jacksonville Female Academy, now 
called the Illinois Woman's College, being located there but one that accom- 
modates three great State institutions, one for the blind, another for the deaf 
and one for the insane. 

Jacksonville was incorporated as a city in 1840 under a special charter 
granted by the legislature. The charter provided for a board of trustees and 
among those elected the next \'ear was Isaac D. Rawlings, grandfather of 
the present director of the State Department of Public Health who bears 
the same name. Subsequently, the city was reorganized two or three times 
under new charters and laws, changing in 1911 to the commission form of 
government and back again to the aklermanic in 1918. 

The population in Jacksonville grew from 1,900 in 1840 to 15,713 in 
1920. Of late years the increase has been small. Of the 1920 population 
86 per cent were native born whites and 7^^ per cent were negroes, a rela- 
tively heavy black element. Nearly 35 per cent were 45 years old or over, 
suggesting the pronounced influence of the State institutions, particularly 
that for the insane, over the age characteristics of the population. This same 
factor is important in the general death rate. 

H i: A LT 1 1 M A cm x ii r v . 

Alarm over the possibility of a smallpox epidemic in 1880 frightened 
local officials into action and the result was an ordinance creating the office 

(173) 



174 DOWN-STATE MUNICIPALITIES 

of hualtli warden. This appears to be a unique title for the office which was 
fillcil by the following physicians : 

C, G. Brown, M. D. 1880-1882 

W. H. King. JI. D. 1882-1883 

Morris H. Goodrick. M. D. 1883-1884 

T. M. Cullimore, M. D. 1884-1885 

For some reason, possibly the passing of apparent danger and the waning 
of popular interest in such matters, the practice of appointing a health war- 
den to keep watch over the health destinies of the inhabitants apparently fell 
by the wayside for a period, only to be revived again at the turn of the 
century. Then came the following: 

L. H. Clamplt, M. D. 1S9S-1901 

George E. Baxter, M. D. 1901-1908 

George F. Dinsmore, M. D. 1908-1909 

A. M. King, M. D. 1909-1922 

These health wardens or officers were employed on a part time basis 
and were expected to function only in emergencies or when some legal 
authority was necessary to abate nuisances or for another cause. Up to 
1922 the health warden was the only person employed by the city to perform 
public health functions of any sort and he was responsible to a committee of 
the city council. 

Voluntary and quasi-public organizations were more active than city 
officials in providing public health service during the first quarter of the 
twentieth century. The Morgan County Anti-Tuberculosis League, for ex- 
ample, began to function early in that period and was responsible for the 
adoption of the county sanitarium law in Morgan County in 1916 and for 
readopting the law in 1924 after it had been abandoned, in the meantime by 
vote. The first open-air schoolroom in the State outside Chicago was opened 
in Jacksonville in 1913 by the tuberculosis league. The next year the school 
board employed a teacher for the open-air school and two years later ( 1916) 
it began the regular employment of a teacher with nursing training to teach 
health and do public health nursing duty in the public schools. 

In 1920 there were four full-time and two part-time public health 
nurses working in the city and county. These were supported by various 
organizations such as the tuberculosis association, Red Cross, school board, 
etc. Furthermore, a series of clinics for crippled children had been held by 
die State Department of Public Health under local auspices and an infant 
welfare station was functioning at a local hospital. 

This was the state of affairs in 1920 when the local chapter of the 
American Red Cross undertook and carried out a community study that 
embraced an account of the public health facilities. In the report it was 



176 



DdW.N-STATI. M IMCII'Al.ITIIv 



Stated that the mayor of JacksonviUe, E. E. Crabtree, had under considera- 
tion the subject of provicHng the city with a more adequate health service 
and that similar ideas were agitating the minds of county otTicials. 

During the next sear Dr. Isaac D. Rawlings was appointed State direc- 
tor of public health in Illinois and he cherished the idea of promoting the 
establishment of countx' health departments throughout the State. Enjoying a 
wide acquaintance in Jacksonville, where he had 
formerly resided, he laid before the local officials 
a plan for creating there a health department that 
would serve both the city and the county and they 
accepted the proposal which gave to them the 
first full-time county health department ever 
established in Illinois. It began to function in 
Ma>-. 1922, with Doctor R. \'. Brokaw at its 
head. He filled the office for two years and was 
succeeded by Dr. Thomas A. Mann who in turn 
was succeeded by Dr. W. H. Newcomb the 
present incumbent. 

How the new organization began to function 
and what it was like is described in the first 
lirector. He sa\ s : 




. Brokaw. M. D. 
Health Director, 
1922-1924. 



quarterly report of it^ 



"Previous to the inauguration of the present program, considerable 
health activity was carried on by public and jirivate enterprise in the 
city and county. All of which, however, lacked coordination. 

"The staff has to date included a field director, a nurse, and an 
office secretary. 

"The field director functions as the Morgan County health officer, 
the city health officer of Jacksonville, and the registrar of vital statistics 
for three contiguous registration areas including Jacksonville and ad- 
jacent territory. 

"The budget of $10,000 is provided .iointly by the Rockefeller 
Foundation, State ot Illinois, County of Morgan and City of Jacksonville. 

"The primary object of the present enterprise is a demonstration ot 
the fact that the county is the logical administrative unit for the pro- 
vision of adequate health service to smaller towns and rural areas. 

"The program is designed to meet the problems of individual and 
community health throughout the entire county, featuring public health 
education, communicable disease control, child hygiene, and sanitation. 

"The work was introduced by the ordinary methods of publicity. 
The reaction was immediate and favorable. County and city officials, 
the medical profession, clubs, and influential citizens have lent a hearty 
and continued support. 

"A census and sanitary survey of the city of Jacksonville was begun 
at an early date. Facts regarding race, age groups, water supply, sew- 
age disposal, and other sanitary features, were obtained as a basis for 
the development of a future improvement program. 



JACKSONVILLE 



177 



Enrol 



Med'C4l Inspection of School Children 
Morgan County 



wanaarm 



Ext MINED 
HoRMiL 159? 

WACCINiTEDjy ,87 



V////^y^^^^Ijf. 



2721 
262S 



^B 





Corrections of Physical Defects 




Morgan County School Children 




1926 - 1927 




477 


V////)\ 


429 - 28* 


'//i, 193 


6IS Legend 

- 31* ^__ 

HH defects 

J//y^ CASES corrected 


^ 66 "1 


31.5% 



178 DOWN-STATE MUNICIPALITIES 

"Communirnble disease control is a major featvire of the work of 
the department. Cases in the most remote areas of the county are com- 
ing under surveillance. In general, there has been a very .gratifying 
lack of resentment toward quarantine regulations. County and city 
officials have commented upon the obvious reduction in the expense of 
quarantining under the new regime. 

"A twelve bed isolation hospital project is well under way in Jack- 
sonville: and the building will no doubt soon be in course of construc- 
tion. At present there are no hospital beds in the city for the care of 
communicable disease. As a committee member, the health officer has 
been able to render material aid in this enterprise. 

"In June. 1922, there was no pasteurized milk .sold in the city 
of Jacksonville. As a result of the efforts of the health officer, a com- 
pany was formed, an abandoned plant was leased, modern equipment 
was installed, operation was begun, and at present the company is dis- 
tributing 150 gallons of pasteurized milk daily. A specially designed 
building is already being considered to provide for the increasing busi- 
ness. 

"Upon the recommendation of the health officer, the city school 
board voted to use nothing but pasteurized milk in the cafeterias and 
grades of the school system. 

"There is every reason to believe that the city of Jacksonville will 
in the near future adopt the model milk ordinance recently suggested 
by the State Department of Health. 

Later the staff of the Morgan Count)- health department was increased 
so that at the close of 1927 it consisted of the director, 2 nurses, 1 inspector 
and a secretary-clerk. 

Water Supply. 

The first ordinance relating to waterworks in the ordinance book of 
Jacksonville, was drawn up in 1869. In 1871 work was begun on a reservoir 
one and one-half miles southeast of the town located on Pullman's Ravine, 
tributary to Mauvaisterre Creek, in what is now known as Nichol's Park. 
The supply was developed in accordance vi-ith plans prepared by E. S. Ches- 
brough of Chicago, $150,000 being appropriated for the purpose. Nichol's 
Park was donated to the city for recreation purposes. At the time the reser- 
voir was constructed, cultivated fields occupied the park area. Strong springs 
used to bubble forth from the ground just south and east of the present 
pavilion and these springs are reported to have been the main source of 
supply for a small pond which formed there. A dam was built across the 
northern outlet of the pond and Morgan Lake thus formed, with a storage 
capacity of 60,000,000 gallons. A vitrified-tile pipe line was laid to the 
pumping station located on the bank of Mauvaisterre Creek, about one mile 
north of the reservoir. Water was pumped to a distributing reservoir of 
2,500,000 gallons, built on Colle,ge Hill about a mile west of the city. 



A School Well OK'd by 
the Health Department. 



Morgan County Nurses 
at Work in a Rural School. 




Lake Mauvaisterre, Source of Jacksonville's Water Supply 



180 DOWX-STATE MUNICIPALITIES 

In 1883 the Gas and Oil Syndicate put down a 1,600-foot well near the 
Wabash Railroad. The city purchased the well and deepened it to 2,200 feet. 
The yield proved inadequate and the well was sold. The well was abandoned 
as a source of thi' city water supply about 18''3. 

In 1888 the Decker well, located just southeast of the pumping station, 
was sunk to a depth of 3,110 feet, being 10 inches in diameter at the top 
and 4->s inches at the bottom. 

In 1890 another well was sunk 200 feet west of the Decker well. In 
1895 the American well, similar to the Decker well, was sunk to a depth of 
3,118 feet, just northeast of the pumping station. 

All three wells flowed into a cistern at the pumping station, from which 
the service pumps drew their supply. The water contained considerable 
hydrogen, sulphide and iron, making it rather objectionable for domestic 
uses. In 1914 only one of these wells was flowing, and the yield from this 
w-as very small. 

The flow of the wells gradually diminished sf) that the supply had to be 
supplemented from other sources. In 1899, a small dam w^as constructed 
across Mauvaisterre Creek opposite the pumping station and creek water 
was allowed to run into the pump cistern when the )ield of the wells became 
inadequate. This arrangement was still in use in 1914. 

In 1898 the project of deriving a suppl\' from Rig ."^andy River, tive 
miles southwest of Jacksonville, was considered, but eventually dropped. 

In 1904 the Jacksonxille \\'ater Company obtained a franchise to supply 
the city with a suitable water supply, derived from wells sunk in the alluvial 
deposits of Illinois River near Blviffs, about twenty miles west of Jackson- 
ville. 

yV pumping station was erected with a combined capacit}' of 6,000,000 
gallons daily and a 20-inch spiral riveted steel pipe line constructed, leading 
to the city. The pumps drew water directly from the wells and discharged 
into the pipe line. Fourteen wells, 10 inches in diameter, sunk to bedrock at 
depths of about 70 feet, were developed. 

From October, 1907, to April, 1908, the company delivered water into 
the city reservoir at Jacksonville. The company was required to make a test 
of suppl\ing 6,000,000 gallons of water in 24 hours every fifteen days, and 
at each of these tests only 2,500,000 gallons of water were delivered to the 
city within the specified time. Following the test in April, 1908, after more 
than 3,000,000 gallons had been delivered within the 24-hour test period, the 
city refused to allow the company to pump into the reservoir for a longer 
period. The waterworks company pulled the strainers from the wells and 
had them recut and replaced. A test which followed resulted in only 
5;000,000 gallons per 24 hours although tiie rate of supply exceeded at times 



JACKSOXVILLE 181 

the required rate. Litigation followed between the city and the water coni- 
pan}-, which lasted for several }-ears. 

In 1912 the water company was incorporated and an agreement reached 
with the city relative to the supply of water. A part of the pipe line was 
repaired, but no water was delivered to the cit_\'. 

The next source of supply adopted was the Widenham-Daub group of 
wells located about one mile southeast of the public square and near the 
Chicago, Peoria & St. Louis Railroad crossing over INIauvaisterre Creek. 
Three drift wells were put down by Widenham-Daub about 1910 and soon 
after two more wells were added by the city, which had purchased the supply 
and the surrounding land. Water was discharged into a collecting reservoir 
from which it was pumped directly into the distributing system. These wells 
were from 58 to 74 feet deep and penetrated alluvial deposits of clay and 
beds of sand and gravel. These wells were used only intermittently until 
1914 when, due to low water in the creek and in Morgan Lake, they had to 
be operated continuously for 22 to 24 hours per da\-. 

In 1914 the supply comprised Morgan Lake, Alauvaisterre Creek and 
the Widenham-Daub wells. The wells were subject to contamination due to 
overflow of the polluted waters of Mauvaisterre Creek. During this year a 
levee was built along the banks of the creek and the height of the projecting 
well casings was increased. The lake and creek water was, of course, at all 
times subject to contamination. 

In 1917, a pump of 150-gallon-per-minute capacity was installed to pump 
water into the service reservoir from Ashelby pond and a drainage ditch 
located in the southwest part of the city. During the same year six test 
wells were sunk in the valley of Mauvaisterre Creek near the north city 
limits, with the view of increasing the supply. 

The serious water problem at Jacksonville had much to do with the 
development of a bottled-water company in the city. This company was 
incorporated in 1902. Water from a spring near Markham was pumped to 
the bottling plant of the company in Jacksonville, and from there distributed. 
At the close of the period covered by this history this company owned more 
than 5,000 glass carboys and water is distributed to many points in Illinois 
through branch distributing stations. The supply has never been under the 
close surveillance of the State Department of Public Health, exercised for 
many years over the public water suppl\-. 

The water problem of the city was studied in detail in 1917 through 
co-operation of the State Board of Health, Geological Survey and State 
Water Survey. Recommendations were made for a thorough investigation 
of the ground-water supply and development of a surface supply in case 
such investigations showed the extension of the ground-water supplv would 
be impracticable. In 1918 the preliminary stuilies were continued b\- the 



182 DOWN-STATK M I' XICIPALITIKS 

co-opcratinti' State agencies, various wells tested and conclusions reached 
that a siippl)^ from wells was impracticable. 

In 1919 work on a surface-water-supply project was begun. An im- 
pounding reservoir was constructed on Mauvaisterrc Creek, with a surface 
area of 234 acres and a capacity of 418,000,000 gallons. A water-purifica- 
tion plant was constructed cc mprising aeration, coagulation, sedimentation, 
filtration and chlorination. 

After the water shortage in 1922-23 the spillway elevation of the reser- 
voir was raised two feet and the reservoir capacity increased to 200,000,000 
gallons. Three of the W'idenhani-Dauh wells constitute an emergency source 
of su[)ply. 

.^ince the construction of the pvunfication plant, minor changes have 
been made in the mixing basin and aeration has practically been abandoned. 
An additional sedimentation basin has been constructed and one filter has 
been added to the original installation. As now constituted the water-supply 
system of Jacksonville comprises the Mauvaisterrc Creek impounding reser- 
voir and the three Widenham-Daub wells as an emergency source, the water- 
purification plant, and pumping station and two distribution and equalizing 
reservoirs. 

In September 1926, due to unprecedented rainfall over the Mauvaisterrc 
Creek drainage area, a serious flood occurred resulting in the inundation of 
about one-tenth of the area of the city. Due to inadequate spillway provision 
the reservoir dam broke and the water-purification plant was flooded. After 
the flood waters receded, the dam was re-built. Due to careful protective 
measures taken no outbreak of water-borne disease resulted. 

There are about 32 miles of service mains and the present water con- 
sumption is about 114 gallons per capita daily. Routine analyses of water 
samples for the city have been made by the State Department of Public 
Health .since May, 1921. 

The water supply is regarded as being of a safe sanitary quality. 

Sewerage. 

A portion of the present sewer system was built in 1895 and additions 
were made in 1901, 1903, 1904, 1906, 1908, 1909, 1910, 1913, and 1916. 
These sewers were built on the combined plan and were paid for by special 
assessment. The development of sew-erage in the city has been in a hap- 
hazard fashion and without regard to a comprehensive plan or the future 
needs of the cit\-. 

At present three distinct systems are in existence with outlets discharg- 
ing into Mauvaisterrc Creek and its tributaries. Practically all of the sewers 
are overloaded. 



JACKSONVILLE 



183 



In 1''21 detailed preliminary studies of the sewerage needs of the city 
were made and recommendations made for the organization of a sanitary 
district. 

In 1927 an attempt was made to sewer some additional areas of the 
city. A group of riparian owners along Mauvaisterre Creek sued for an 
injunction and the same was granted. The present status of sewerage im- 
provements in the city is that no more sewers may be installed until proper 
provision is made for treating the sewage now tributary to the creek. The 
effect of this injunction will undoubtedly be the construction of a modern 
sewage-purification plant in the near future. 

He.ALTH COXDITION.S. 

Judge \\ illiani Thomas came to Morgan County in the autumn of 1826. 
He seems to have been particularly observant of health conditions for his 
letters carry numerous references thereto. In a letter written shortly after 
his arrival he says : 

"From the crossing of the Wabash River all the way to Jacksonville 
there seemed to be prevailing an epidemic of sore eyes. Several families 
in Jacksonville * * * * were severely afflicted". 

Table 1. 
Mortality From Certain Causes. 







■~ 










s: 


























be 


























3 






































YEAR 


1 


■u 


2 


1 


s 


fo 


O 


.So 




= 


|e 


S<H 






























a 


*& 
& 


1 


1 


1 


1 


JZ 


5 " 




! 


it 


Is 


1900 


268 


4 


1 












7 




32 


14 


1901 


350 


5 




i 






' ' k 








3.5 


19 


1902 


364 


15 


2 


1 






1 




1 




47 


25 


1903 


372 


16 


2 








3 




10 


', ', 


47 


17 


1904 


S39 


9 














3 




43 


31 


1905 


301 


6 


















36 


31 


1906 


290 


3 










4 








48 


15 


1907 


321 


5 














"i 




46 


19 


1908 


329 


3 










" i 




2 




36 


19 


1909 


319 


4 






"s 








1 




30 


24 


1910 


364 


5 






... 








1 




43 


34 


1911 


388 


4 










' 2 




5 




39 


23 


1912 


367 


7 










1 




1 




35 


20 


1913 


393 


1 












2 


2 




34 


27 


1914 


441 


7 


















43 


31 


191.-) 


454 


1 














"2 




42 


35 


1916 


.545 


6 












3 


4 




37 


47 


1917 


545 


5 














3 




77 


72 


1918 


617 


8 










' 4 




47 




73 


82 


1819 


475 


4 














15 




43 


50 


1920 


540 


2 










' i 




18 




42 


72 


1921 


448 
















1 




36 


35 


1922 


509 


9 














2 i 




45 


47 


1923 


304 


3 














13 




44 


57 


1924 


518 


2 






2 








2 




46 


32 


192.5 


510 


1 






... 








1 




33 


27 


1926 


635 


6 1 ... 

1 




' 




... 




6 

1 




34 


53 



184 



down-stat:-: municipalities 



Table 2. 
Mortality Rates From Certain Causes. 







s 










„ 


























"fci 
















f^ 










3 


.2 " 




5 


'S'S 


a-^ 


YEAU 


1 
^ 


.l 


1 


1 


M 







|o 




■5 


g5 






O 














^■o 


3 




*_; 


g — 




< 


f 


1 


E 


s 


1 


J3 


.2* = 


0= 


6, 




£C 


1900 


17.8 


26.5 


6.6 






6.6 






46.4 




212.3 


92.9 


1901 


22.9 


32.7 




6.5 






19!6 


i3!i 


32.7 




228.9 


124.2 


1902 


23.5 


96.7 


12 . 9 


6.5 




12! 9 


6.5 




6.5 




303.1 


161.2 


1903 


23.7 


101.8 


12.7 




44.5 




19.1 


25 !4 


63.6 




299.0 


108.1 


1904 


21.3 


56.5 












6.3 


18.8 




269.9 


194.6 


190S 


19.5 


32.9 






e'.e 








19.7 




289.4 


151.3 


1906 


17.7 


18.3 






C.l 




24! 4 


!!! 






293.3 


91.7 


190T 


21.0 


32.8 








!!! 




6.6 


6!6 




301.5 


124.5 


1908 


19.6 


17.9 










6!6 


11.9 


11.9 




214.4 


113.2 


1909 


20.8 


26.1 






ISKli 


6!5 




26.1 


6.5 




196.0 


156.8 


1910 


22.6 


32.6 








6.5 




6.5 


6.5 




280.5 


221.8 


1911 


24.7 


26.0 






13 '6 




13.0 


6.5 


32.6 


!! 


253.9 


149.8 


1912 


23.8 


45.5 










6.5 


19.5 


6.5 




227.5 


130.0 


1913 


2.5.4 


6.5 






is! 6 






13.0 


13.0 




220.7 


175.3 


1914 


28.5 


45.4 












45.4 






278.7 


200.9 


191.-) 


29.2 


6.6 












6.5 


12! 9 




271.7 


226.4 


I9ir, 


35.0 


38.8 








G.h 




19.4 


25.8 




239.0 


303.6 


1917 


34.9 


32.2 






12!9 






12.9 


19.3 




496.6 


464.3 


1918 


39.4 


51.6 










2.5 .8 


6.4 


303.2 




470.9 


529.0 


1919 


30.3 


25.3 














94.9 




272.1 


316.4 


1920 


34.3 


12.4 






6!2 




6!2 


6!2 


112. S 




262.5 


450.0 


1921 


28.4 








12.7 








6.3 




228.2 


221.9 


1922 


32.2 


56! 9 












6!3 


12.6 




284.6 


297.3 


1923 


31.8 


18.9 




'. .'. 




'.'.'. 






82.2 




278.4 


360.7 


1924 


32.6 


12.5 




... 


12! 5 






h'.i 


12.5 




287.5 


200.0 


1925 


32.0 


0.3 














6.3 




207.1 


169.8 


1926 


39.7 


37.5 






6!3 


'.:: 






37.8 




212.5 


331.2 



Note: The rate from .\11 Causes is per 1,000 populatic 



11 others per 100,000 population. 



!H!e continues, saying: 

"The fever and ague had prevailed during the fall in every neigh- 
borhood in the county and especially on the river and margins of small 
streams." 

A few years later the town received a se\Tre check by the ravages of a 
cholera epidemic which carried off a great many inhabitants in 1833. Mr. 
James S. Anderson, a local undertaker at the time, describes ihi.- outbreak 
from start to finish. He says : 

"The first case made its appearance in .May or .lune of the year 
1S33. A mover traveling by wagon through the county stopped here 
and his wife was taken sick. The citizens went to his assistance and 
the case was pronounced a case of genuine Asiatic cholera. The citizens 
conveyed the sick woman and the others to a log caljin outside of town 
so as not to spread the infection. * * * * 

"The woman died and the people burned the clothing, etc., supplied 
the man with money and sent him on. I saw this woman just before 
she died. Myself and several companions went there out of curiosity. 
Two weeks later the second case appeared, being that ct a young man 
from Exeter, who was visiting relatives who kept a boarding house, 
where Marble Block now stands. He died, and the disease began to 
spread rai)idly. 



JACKSONVILLE 185 

"The town at that time contained about 500 inhabitants, fully half 
of which tied to the country. Of those who remained about 75 were 
attacked with the epidemic of whom about 55 died. It was very ma- 
lignant. Besides these quite a number who fled to the country died, 
some of them I believe were scared to death. *** Ross (his partner) 
and I concluded to take our chances and stay in town. We were both 
young, unmarried men. and we left our shop and commenced to nurse 
the sick and we were almost the only ones who devoted our time to it. 
We went from house to house, sitting up night after night, waiting on 
the sick, i)reparing the dead for burial and doing what we could. The 
whole community seemed paralyzed and little business was done. * * * * 
The scourge lasted six weeks and was the most terrible that ever visited 
Jacksonville." 

It i.s recorded that Ductors Samuel L. Prosser and Bezalleel Gillet 
wo.'ked valianth' with the afflicted, serving rich and poor ahkc ur.til the 
epidemic subside) L 

In the fall of 1844, Jacksonville was visited by Dr. Daniel Drake. From 
the local physicians, Doctors Henry Jones, Sainuel L. Prosser and Nathaniel 
English he learned that all forms of autumnal fever occurred there, also 
that they were less prevalent than formerly. Ma- 
lignant intermittents were rare, remittents tend- 
ing to a continued type, rather frequent. On the 
whole, he found that these fevers prevailed there 
in a mitigated degree, compared with the sur- 
rounding region generally. 

These constitute the principal historical ref- 
erences to health conditions in Jacksonville and 
vicinity during the early years of community life 
there but they are sufficient to show that people 
there did not escape the severe hardships of 
Nathaniel English. M. D. pioneer existence on the prairies. Later, how- 
ever, it seems that the cominunity developed a 
reputation for unusually favorable health. Only one case of small-pox was 
reported from that vicinity during the great epidemic wave of the early 
eighties and Eames, the local historian, declared in 1884 that: 

"The health of the city has always been remarkable, the average 
death rate being much lower than that of the average cities of the West." 

\\'hether this reputation was altogether justified on the basis of fact is 
questionable although the community doubtless enjoyed a noticeable free- 
dom from those contagious diseases which ordinarily attract particular pub- 
lic notice and stimulate fear and alarm. At any rate typhoid fever has been 
a problem of long standing and it has entailed a heavy burden upon the peo- 
ple there for many years. Fairly reliable statistics since 1900 show that the 




186 



DOWN-STATE MUNICIPALITIES 



nioi"talit\" rate from Ixplioid has been [jfrsistently higher than modern cities 
like to recognize or talk about when the booster club is active. The source 
of their trouble appears to be in a considerable area of unsewered residential 
district. 

Tuberculosis likewise has been a problem of signilicant magnitude. 
It is complicated by the presence there of the hospital for the insane so that 
statistics are somewhat misleading. Undoubtedly the loss of life among 
citizens has been heavy enough, however. 

The unrefined general mortality rates appearing in iiie accompanying 
tables are not satisfactory evidence of underlying health conditions because 
of the influence of the institutions. People confined in the asylums remain 
there for periods long enough to make of them, technically at least, local 
citizens. This adds intricacy to an already complex problem of analyzing 
mortality returns. 

On the other hand the extraordinary freedom from diphtheria and scar- 
let fever which the city has enjoyed in recent years suggests the successful 
prosecution of a sound public health program and the annual reports of the 
health department carry incontrovertible evidence of satisfactory sanitary 
and h\genic improvements. A reasonable conclusion is that Jacksonville is 
a healthful city which is prepared to meet all ordinary hazards that may 
arise to endanger public health ami that both the city and the county are 
profiting by the services of a modern pulVic health department devoted to 
preventive medicine and heahh ])rim()ti<in. 

Table 3. 
Cases of Certain Diseases Reported. 





1916 


1917 


1918 


1919 


1920 


lil21 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


21 




63 


28 


16 


l.i 


27 


25 


16 


37 


20 


27 


Smallpox 


1 


24 


.■iS 


32 


107 








6 


1 


1 




Measles 


66 


•25o 


134 


16 


.">5 


Sll 


•2 


'24 


037 


4 


28 


306 


Scarlet Fever 


4.5 


9 


.3 




14 


114 


92 


57 


70 


87 


43 


24 


Whoop. Cough 


7 










89 


B 


54 


24 


146 


166 


43 


Diphtheria 


7 


12 


i 




ii 


27 


48 


30 


19 


12 


1 


26 


Influenza 






2025 




00;-) 




4 


9 


6 


3 


34 


8 


Poliomyelitis 


"i 








1 


5 


2 


4 


2 


1 




3 


Meningitis 




"i 


















' i 


4 


Tuberculosis* 


4 




29 






'88 


'49 


82 


72 


91 


95 


85 


Pneumonia* 














25 


107 


62 


36 


100 


89 


Syphilis 






"i 






50 






42 


26 


218 


192 


Gonorrhea 






9 






40 






22 


16 


00 


25 



*A1I forms. 












S'OTK : Ca.se reports are 


lever complete 


but thev hav 


beei 


Tnnrh m 


ire SI 


Illinois. This table i 


Klicates that 


intificatioTi ill 


lackM 


nviUe lias 


reac 


riefcree of cornpleteiies 













JACKSONVILLE 



187 



Table 4. 
Births and Infant Deaths. 





Births 


Infant Deaths* 


YEAR 












\uniber 


Rnte** 


Nu.nber 


liate 


lilOO 


114 


7.5 


31 


272. 


1901 


130 


8.6 


3S 


292! 3 


1902 


213 


14.0 


26 


112. 


1903 


210 


13.8 


20 


95.2 


1904 


234 


1.^>.4 


33 


141. 


1905 


238 


15.6 


32 


134.4 


1906 


210 


13.7 


27 


128.5 


1907 


250 


16.3 


28 


112. 


1908 


196 


12.8 


21 


107.1 


1909 


183 


11.9 


2.1 


136.6 


1910 


165 


10.7 


19 


115.1 


1911 


172 


11.1 


13 


75.6 


1912 


230 


14.9 


17 


73.8 


1913 


235 


l."i.2 


20 


85.1 


1914 


242 


l.-| . 4 


17 


70.2 


1915 


298 


19.2 


24 


80.5 


1916 


263 


10.9 


3.". 


133.1 


1917 


260 


16.6 


24 


92.3 


1918 


286 


IS. 2 


15 


52.4 


1919 


272 


17.3 


39 


143.4 


1920 


286 


18.2 


24 


83.9 


1921 


296 


18.7 


22 


74.3 


1922 


308 


19.4 


26 


84.4 


1923 


307 


19.3 


24 


78.2 


1924 


320 


20.1 


23 


71.9 


1925 


337 


21.1 


23 


68.2 


1926 


353 


22. 


23 


65.2 



•Deaths of infants under 1 
** Per 1000 population. 



of age per 1000 births reporteJ. 



References. 



Annual Reports, Department of Health, J.ackson' 
Annual Reports, State Department of Public H^ 
Illinois Health News, State Department of PiiM 
American Red Cross, Survey of the City of .l;n 
Letters and correspondence, prominent citizeii> 
U. S. Census Reports, Washington, D. C. various 



s, various dates, 
irtield, Illinois, various dates. 
Springfield Illinois, various date; 
linois, 1920 



JoUet 

Joliel has the unique distinction of being tlie locahty where the first 
doctor in IlHnois was located. This was tlie surgeon who was in the iUinois 
country when Father Marquette sojourned at the Chicago portage during 
the winter of 1674-5 and who came to him on January 16, 1675, with Pierre 
AForeau ("La Toupine") when they heard from Indian messengers of the 
holy Father's plight. 

-Vfarquette was suti'ering from an intestinal disorder probably dysentery. 
In his journal he recorded that the surgeon gave him whortle berries and 
"did and said everything that could be expected." The surgeon's name is not 
found recorded in Marquette's journal but recent historical research shows 
that he probably was Louis Moreau, of Quebec. 

Soon after this, Chicago and the mound at Joliet, called Monjolly on 
the old maps, where the surgeon who attended Marquette may have resided, 
were lost track of and closed to the white men for nearly a century because 
hostile Indians occupied the Chicago portagt . 

Toliet again gained prominence when the work on the Illinois and Michi- 
gan Canal was started in 1836. Dr. John H. Ranch reported that in 1838, 
laborers employed on the canal were afflicted with ;i disease resembling 
cholera which struck them down suddenly. Also that nearly all who resided 
along the line of excavation and almost all the laborers on the canal suffered 
with autumnal fever. 

Dr. Daniel Drake on his vo\age up the Illinois River in ibe Fall of 1S44 
visited Joliet. Doctors Schoolfield and N. W. Bowen reported to him that 
the locality was annually invaded by autumnal fever, though it seldom as- 
sumed either a wide-spreading or fatal character. The Irish laborers on ihe 
canal in 1838 and 1839 were the greatest sufferers. 

The canal was completed in 1848 and opened communications with Chi- 
cago. The Rock Island railroad was under construction at the same time. 
The canal and the railroad both passed through Joliet and it was naiural 
that the cholera, which was Ijrought to Chicago on April 29, 1849, sliould be 
introduced in Joliet, within a short time. This occurred and the disease 
raged there until 1854. It is reported that the mortalii;- was 13.8 per 1.000 
population, .\mong the victims was Dr. Alexander M. Com.stock. who came 
to Joliet in IS.v and took an active part in treating the sick, during ihe 
epidemic. 

The village of Joliet was incorporated in 1837 by an act of the legisla- 
ture In 1853 it was incorporated as a city. The population in 1850 was 

(188) 



JULIET 189 

2,659; in 18()0,, 7.104 and in 1870, 7,263. In 1880 it rcacliftl 11, 657, of .vhich 
number 3,148 were foreign born. There were 98 negroes counted in the 
cit}' at that time. During the next decade the population more than doubled 
reaching 29.353 in 1900 and rising t(j 34,670 and 38,442 in 1910 and 1920 
respective!} . 

The city lies on both sides of the Des F'laines River, and the IlHiiois and 
Michigan Canal passes through it. The city is situated mainly in the river 
valley and extends to the bluffs on either side, rising to a height of iifty feet 
above the river level. The soil is underlaid b\' a laver of fine!\ stratified 
li.mestone, 2(J0 feet deep. 

Public Health Service Equipment. 

A board of health, composed of one citizen from each ward, appointed 
by the mayor and confirmed by the city counc'l. constituted the sanitary or- 
ganization of Joliet in 1880. One mejmber of the board was a phwsician. 

Tlic heahh officer was appointed by the mayor, at a salary of $100 per 
annum. His principle duty was the inspectiori of nuisances. 

Smallpox cases were taken to the "pest house" situated outside of the 
city limits. Scarlet fever cases were quarantine.! in t)ie home. \'accinaiion 
•■'•IS not compulsory. 

By law all births were recjuired to \>e reported, to tht county clerk. 

Health Officers. 

One of the first medical health officers of Joliet was Dr. Alfred Nash 
who held that position in 1886. He deserves mention particular!}- because 
of his interest in sanitation. Among other things he invited Dr. John H. 
Rauch, secretary of the State Board of Health to visit Joliet in the interest 
of sanitary improvement. Together they made a brief survey of conditions 
and concluded that the extension of the sewer system was the greater sani- 
tary need of the city. The same recommendation was made forty years 
later after a thorough survey of the city's healtli facilities by Dr. Thomas 
Parran, Jr., of tlie U. S. Public Health Service who at the time was attached 
to the Illinois State Department of Public Health. 

Dr. Chas. Kolm, liealth commissioner in 190! and 1902, started tlie 
laboratory service in the healtli department. For that purpose he secured 
an appropriation of $200. Although laboratorx- facilities have not developed 
commensurate with the needs of the city it was, nevertheless, an import- 
ant advance to make a beginning in that respect. The immediate purpose for 
opening a laborator}- was to provide equipment for making examination of 
water and milk supplies. 



190 DOWN-STATE MUNICIPALITIES 

In 1''04 Dr. Martin Gushing, the commissioner of health at that time, 
succeeded in adding a plumbing inspector to the health service personne'. 
He was followed the next )ear by Dr. W. A. McRoberts who helrl the office 
but a short time, being succeeded by Dr. W. B. Stewart. During this period 
a survey of school drinking water supplies was made and the source in prac- 
tically every instance was condemned. It appears that the supplies v.eie 
drawn largely from local wells. 

The present health commissioner is Dr. Ed. J. Higgins. 

City Hi-.altu Servicic Appraisal in 1926. 

Juliet was one of fifteen Illinois cities in which a careful study and an 
appraisal of local public health services was conducted by the State Depart- 
ment of Public Health in 1926. For this study a survey and appraisal form 
prepared and recommended by the American Public Health Association v.as 
used. The results of this study give a clear conception of present facilities 
for doing public health work. Pertinent quotations from the report read as 
follows : 

"With a total score of only 44G health service in Joliet falls short 
of the standard in many respects. The city officials state that owing 
to low taxable valuation, due to the inability of the city to extend its 
boundaries, all city functions are seriously handicapped for lack of 
funds. The health department consists of a part-time physician and one 
sanitary inspector. In addition the city pays $1,S00 per year to the 
Joliet Public Health Council for the employment of a nurse. Some 
laboratory work is done for the city by local laboratories. The board 
of education employs three public health nurses and the Public Health 
Council, a volunteer organization, employs a supervising nurse and 
five field nurses who conduct in and around .Toliet the prenantal and in- 
fant welfare, tuberculosis and bedside nursing services. 

"Expenditures on the part of the city are $7,715 per annum ;ind 
the total expenditures by all agencies $24,714. giving an annual per 
capita expenditure of 19 cents and 61 cents, respectively. 

"Communicable diseases are handled by the health officer and san- 
itary inspector, no contagious disease nurse being employed. About one- 
halt of the cases of smallpox and most of the cases of typhoid fever 
were hospitalized, but other contagions were not treated in hosiiitals. 
As a result of the smallpox epidemic early in 1925 a large number of 
people were vaccinated against this disease. Xo immunizations were 
done against diphtheria with toxin-antitoxin. 

"Venereal disease cases are incompletely reported and there is no 
clinic service for indigent sufferers of these infections. 

"The number of field nursing visits to tuberculosis patients last 
year was only about one-half the requirement for full credit in the 
appraisal scheme. Two clinics during 1925, with a total attendance of 
32 and a like registration, fall far short of the required attendance of 
660 with an average of 3 visits per patient. Advantage was taken of the 
splendid county tuberculosis sanitarium where beds are free to Will 



JOLIET 



191 



County citizens. It appeared, however, that practically all patients 
hospitalized were well advanced in the disease. One open-air classroom 
is maintained in the public school system. 

"An infant welfare clinic is maintained, 1,700 visits being made to 
it last year. There is no prenatal or preschool clinic, and relatively 
few field nursing visits are made in behalf of these age groups. The 
Public Health Council also supports a crippled children's clinic. This 
organization is covering a broad field of activity with limited personnel. 

"There is no medical inspection of school children; the nurses 
weigh and measure the children, inspect for obvious defects and do home 
visits. Five school buildings in the city (two public and three paro- 
chial) have outside toilets. 

"The Elizabeth McCormick Memorial Fund has been conducting in 
Joliet for a numljer of years a demonstration in health education and 
an intensive study of the group of about four hundred school children. 

"The one inspector employed by the health department does some 
sanitary and food inspection work. The city water supply does not com- 
pletely meet the United States Treasury Department Standards because 



JOLIET 

1%^ — 'i° 'i° T T T T Y r T -T 








VEM. DIS. COtSTROL >»■ 






HEALTH CHILD i^lHH^^ 






SAhlTATIOn [^^m^^^KM 




niLK cohTROL 'ym^K^m 




LABORATORY iS^^HH 


POP. HEALTH IMST^M^ 

PERCEMT OF STAMDARD SCORE 

rod EACH OF TEM MAJOR HEALTH ACTIVITIES 

1925 



This graph illustrates the strong and weak points in Joliet's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in .Toliet was 45 per 
cent of the standard perfection requirement. 



192 DOWN-STATE M UNICirALITIES 

of ;i possibility of contamination between tlie sujiply wells and the dis- 
tribution system. It has been given a provisional certification only by 
the State division of sanitary engineering. It is distributed to approxi- 
mately 95 per cent of the homes. The sewer system, it was estimated, 
serves less than GO per cent of the dwellings, giving the city a very low 
score for this section. 

"The city has an excellent milk ordinance which requires that all 
milk sold in the city be pasteurized. However, no machinery is pro- 
vided by the city for the proper enforcement of this ordinance, and a 
recent investigation of the pasteurization plants shows much to be 
desired in some of them. There are eighteen such plants in the city. 
A local laboratory made for the health department weekly examinations 
of milk from two plants during November and December 192.5. These 
examinations show a constantly low bacterial count, but no information 
was available concerning the bacterial quality of the remaining milk 
supplies." 



Water Supply. 

The original waterwork.s, installed in 1884 by private interests a'.'d 
purchased bv the city in 1888, comprised a group of drift wells about 40 feet 
deep, in the eastern part of the city in the valley of Hickory Creek. From 
time to time additional wells were sunk until finally there were 20 such 
wells serving the city. Later, due to increased demands, it became riecessary 
to drill six rock wells (1,200 to 1,700 feet deep) on the same site. These 
wells entered St. Peter sandstone and secured a large additional suppl_\-. 
After a few more years the supply again became inadequate and an open a- id 
unprotected storage reservoir, deriving its water from Hickory Creek, was 
constructed to tide the city over dry periods. 

In 10(X) the water supply problem was thoroughly studied by Daniel 
W. Mead, who made recommendations for extension of the deep-well sys- 
tem and development of a .shaft and tunnel system, but construction was 
never carried out. 

Until 1907 the city got along as l)est it could by using the existing wells 
supplemented by polluted water from Hickory Creek whenever the v.ells 
alone failed to meet the demand. 

In 1007 construction of a system of isolated deep wells, located in the 
central [xirtion of the city, was begun, one well being installed in 1907, one 
in 1911, one in 1912, two in 1913, one in 1914, and two in 1925. These wells 
are about 1 ,600 feet deep and enter Potsdam sandstone. As these wells were 
developed the original drift wells were gradually abandoned. 

In 1911 the city increased its supply somewhat by pumping into the 
open reservoir at the pumping station, spring water from two stone quarries 
situated one-half mile south of the waterworks. 



.lOLIET 193 

Until 101, \ water from Hickory Creek and the stone quarries was used 
as an auxiliary source of supply, although in 1910. following a typhoid fever 
epidemic, a hypochlorite treatment plant was installed. This plant was rather 
a crude affair and was never regarded as an adequate safeguard. In 1913 
the practice of ulnaining additional water from the creek and quarries was 
discontinued. 

In I'M 5 a second open and unprotected concrete collecting reservoir 
was constructed, adjacent to the old storage reservoir. 

At the present time only four of the first six deep wells constructed on 
the original site arc in service, two wells having been completely abandoned. 
In addition to these four wells, the present suppl}' is obtained from the eight 
deep wells which were progressively sunk between 1907 and 1925. Water 
from the wells is delivered to one of two open concrete collecting reservoirs 
situated at the site of tlu' main pumping station. A fence constructed around 
the collecting reservoirs in 1925 gives some protection a.gainst wilful con- 
tamination. The supply, however, is subject to possible contamination at two 
of the wells in case the cit\' sewers are surcharged and at the open collect- 
ing reservoirs, and th,- sanitary tjuality of the supi)l\' is regarded as duublfu]. 

The consum])tiiin of water has been rather high, a\craging 117 gallons 
per capita in 1921. 

Skwkragk. 

In 1880, about one-third of the household wastes were dischargeil into 
sewers. A large proportion of the houses depended upon privy vaults. 
These were cleaned during the night, under permits issued liy the board of 
health. The night soil was disposed of outside the cit\ limits. 

DesPlaines River at Joliet has a very large flow as the result of the 
discharge into it of Chicago's sewage. \\'ater power is developed at Lockport 
and near the center of Joliet. by means of dams across the river. Des 
Plaines River is decidedl_\- polluted. It is extremely turbid, carries consid- 
erable oil and floating material anil emits a characteristic sewage odor. 

The old Illinois-Michigan Canal crosses DesPlaines River at Joliet b)' 
using a portion of the river above the Public Service Company dam. 

Hickory Creelc and Spring Creek are small watercourses which enter 
the city from the east and then flow southerly through the east part of town, 
having confluence near the center of the east corporate limits. Hickory 
Creek circles to the south and west around the southeast corner of the city 
and joins DesPlaines River. 

The city proper at the present time is extensively sewered on the com- 
bined plan. These sewers, carrying both sanitary sewage and storm water, 
discharge at numerous points along the various watercourses. The sewers 
have been in>talled largeh" in a "piecemeal" fashion as immediate develo])- 



104 DOWN-STATE MUNICIPALITIES 

ments demanded and without regard to a comprehensive plan or the ultimate 
future needs of the city. As a result there are portions of the city not ade- 
quately served and several heavily populated outlying districts where sani- 
tary conditions are deplorable and the need for adequate sewerage facilities 
is acute. 

Health Conditions. 

In common with every other community of the Middle West, smallpox 
and cholera were the barometer of health conditions in Joliet during the last 
quarter of the nineteenth century. Scarlet fever attracted some attention 
but such diseases as typhoid fever, diarrhea, malaria, measles, diphtheria and 
tuberculosis were so common and so thoroughly endemic that both public 
and medical profession seem to have taken them as a sort of matter of course. 
Consequently, we can arrive at no definite idea about the prevalence of these 
infections and can establish reasonable conjecture only on the basis of vague 
references and indefinite statements. 

Smallpox and cholera were different. They came in violent epidemic 
waves. Folks knew that they were contagious. Many had seen their deadly 
havoc and not a few carried the scars of smallpox as a living evidence of 
what might be expected from that disease. Consequently, an outbreak 
caused public concern. The "pest house" crowned a desolate bluff on the 
outskirts of the city. No mischievous boy was ever bold ent)ugh to crash 
out the windows or play ghost there. 

For these reasons the story of smallpox gives a tangible basis upon 
which to build an idea about what kind of health conditions prevailed in a 
community in those days. Even then vaccination was a generally accepted 
method of preventing the disease. If people neglected that precaution and 
permitted their health officer to trail around behind an epidemic like a dog 
behind his master, that fact implies that other and less definite preventive 
methods against other diseases were probably less actively pursued and less 
effectively utilized. 

Accordingly, the experience of Joliet with the smallpox epidemic of 1882 
is illuminating. The story shows how obviously this disease always comes 
to town and illustrates how stubbornly people resist the one clear-cut way 
of controlling its course. The story is by no means peculiar to Joliet but 
rather it is typical of what took place in nearly every town that enjoyed a 
sturdy growth and thriving commerce in those days. This is the way things 
transpired in Joliet. 

In the winter of 1882. tramps in different stages of sniallixix were on 
three different occasions picked up on the streets of Joliet .•uid taken to the 
"pest house". 



JOLIET 

Mortality From Certain Causes. 



195 







i_ 










- 
















> 








t. 


S 






.3 


IE 




YEAR 


1 


^ 










C 


1 


a 




ll 






d 


J 






i 


s 


1 


1 


3 


c 


1 = 


























i^-^ 




1907 


505 


17 








1 


1 


3 


3 




65 


64 


1908 


611 
























1909 


594 
























1910 


680 












... 












1911 


593 
























1912 


499 
























1913 


659 


21 






io 


4 


1 


3 






50 




1918 


1062 


7 






7 


1 


10 


15 


236 




51 


212 


1919 


503 


S 










1 


7 


47 




31 


46 


1920 


447 


5 






5 


1 


4 


8 


24 




27 


49 


1921 


515 


11 






9 


2 


7 


11 


5 




29 


29 


1922 


449 


7 












7 


6 




31 


39 


1923 


503 


1 






2 


2 


3 


3 


24 




25 


36 


1924 


477 


6 






6 


1 




3 


14 




32 


37 


1925 


527 


8 




3 




1 




1 


11 




22 


35 


1926 


593 


4 


... 






1 


4 


3 


22 


" 


""' 


40 



Mortality R,\tes From Certain Causes. 







^ 










- 












YEAR 


1 


3 


1 


X 


S 


i 

g 


1 
1 


iS 


1 


.2 

1 


li 


St 


1907 


14.9 


51.4 






... 


3.02 


3.02 


9.0 


9.0 




196.5 


193.5 


1908 


18.1 
























1909 


17.3 
























1910 


19.6 
























1911 


16.9 
























1912 


14.0 
























1913 


18.3 


58.6 






27.9 


li.i 


2.7 


8.3 






139.6 




1918 


28.1 


17.8 






17.8 


2.5 


25.4 


38.1 


000.5 




129.7 


539.4 


1919 


13.2 


21.0 










2.6 


18.4 


123.6 




81.5 


121.0 


1920 


11.6 


12.8 






12.8 


2.5 


10.2 


20.5 


61.5 




69.2 


125.6 


1921 


13.2 


28.2 






23.1 


5.1 


17.9 


28.2 


12.8 




74.3 


74.3 


1922 


11.3 


17.8 












17.8 


15.2 




78.6 


99.0 


1923 


12.6 








5.0 


5.0 


7.5 


7.5 


60.3 




62.8 


90.4 


1924 


11.9 


15.0 






15.0 


2.5 




7.5 


35.0 




80.0 


92.5 


1925 


13.0 


19.7 




7.4 




2.4 




2.4 


27.1 




54.2 


86.2 


1926 


14.5 


9.6 








2.4 


9.6 


7.3 


52.8 




60.9 


97.5 



Notk: The rate from All Causes is per 1,000 population; all others per 100,000 population. 



Early in March of the same _\ear, the son of a gunsmith returned from 
Chicago to his father's house in Joliet. On the 18th his mother and sister 
were taken ill with hemorrhagic, confluent smallpox and both died. During 
their illness they were visited by a neighbor who caught the disease and died 
shortly thereafter. 

Very little precaution was taken with these cases. The sheets and 
blankets used by the two confluent patients were hung in the yard next to 
a public street to dry. 



196 nOWN-STATE MUNICIPAMTIES 

I'lMiH March IStli tn June 30th, there were a total of 57 cases of small- 
pox rcidiricd in the cil\ with 18 deaths. It cost the city $26,402.07 to quell 
the epidemic. 

In the nieanlime, neii^hhorin.y towns (|uarantined against Juliet, the city 
council ordered schools, churches and all public gatherings suspended, special 
policemen were detailed to guard the infected houses and excitement ran 
high. JMnally the State Board of Health was appealed to and Dr. John H. 
Raucli, the secretary, made a personal visit to the city and urged vaccination 
and the enforcement of quarantine. 

This epidemic of smallpox merely stands out above the many outbreaks 
of that disease, like a given flood or snowstorm above others, because of its 
fierce deadliness and the general public alarm which it provoked. Even as 
late as 192,i the city was visited by an outbreak that yielded 64 cases and 
in 1925 b\' one that produced 23 cases and 3 deaths. 

Typhoid fever began to attract particular public notice about l''0O. I'rom 
that time on there appear references from time to lime of e])ideniics in Joliet. 
Twelve cases in 1902, for example, were attributed to drinking water drawn 
from shallow wells. In 1918 a series of 43 cases were likewise said to have 
resulted from contaminated well water. 

The onl\- reason for pointing out these two epidemics is that the\' re- 
ceived particular epidemiological studies by health officials. Neither was 
unusual and very likel\' the number of cases reported fell considerably short 
of all the cases of the year in the cit\ and its outlying populated district. Joliet 
has alwavs had a high t\']ihoid fever rate. Mortalit}' from this disease is 
ordinarily from two to h\e times the prevailing rate in the .^tate at large. 
The reason probabl} is fmnid in the large unsewered areas that still exist 
there. 

From the morlalily returns in recent \ears it appears that tuberculosis 
was less extensi\'e there than in some of the other cities of comparable size. 
It is significant, however, that the tuberculosis death rate among prisoners 
at the State penitentiary was so excessively high that it attracted especial 
attention as earh as 1870. Reports concerning the condition apparently 
h.-istencd the anti-tuberculosis program in Illinois, a matter that is treatetl 
at some length on page 364 of \'olume 1 of this book'. 

\\'itli the discovery of diphtheria anti-toxin in the nineties and the pro- 
gress made subse(|uent to 1890 against typhoid fever, cholera and malaria, 
people began to regard contagious diseases generally as an unnecessary 
burden rather than one of the necessary evils that complicate the vicissitudes 
of life. C'onsequentlw the more deadl}' infections, such as scarlet fever and 
diphtheria liet;.in tn receive public notice enough to stimulate some recording 
of prevalence by health officers. 



197 



Thus we find thai 7'1 cases of scarlet fever and 38 of diphtheria were 
registered in Joiiet during 1905. There is no evidence to show that these 
figures represent the total incidence of that year while the fragmentary re- 
corded notification from }ear to year implies that case reports picked up 
during the periods when outbreaks reached proportions sufficient to provoke 
public concern and that notification fell off' in comjileteness between these 
epidemic cycles. 

Cases ok Certain Diseases Reported. 



1 1919 
1 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


47 


49 


64 


34 


46 


38 




21 


20 


Smallpox 


1.-) 


Ifi 


11 


.) 


64 


2 


23 




5 


Measles 


9 


r.3 


304 


•'9 


137 


310 


34 


84 


235 


Scarlet Fever 


16 


37 


110 


60 


63 


10.5 


93 


67 


IS 


Whoop. Couffh 






66 


8 


73 


3 


15 


65 


14 


Diphtheria 


40 


36 


l.-)2 


.52 


2.5 


21 


10 


29 


11 


Influenza 


4 






5 


16 


4 


16 


17 


11 


Poliomyelitis 






7 






1 






1 


Meningitis 


3 




■2 






1 


*2 


1 


1 


Tuberculosis* 




22 


32 


64 


78 


.58 


69 


195 


146 


Pneumonia* 


.54 


74 


S9 


78 


91 


107 


73 


102 


69 


S\'philis 






23 






28 


24 


45 


277 


Gonorrhea 






87 






35 


20 


28 


49 


Chancroid 






8 












1 



*A11 forms. 
Notk: Case reports are never complete, but the 
Hlinois, This table indirntes improvement in 



Births and Infant Deaths. 



Infant Deaths 



1918 




1919 




1920 


568 


1921 


707 


1922 


713 


1923 


802 


1924 


800 


1925 


747 


1926 


810 





159 






77 




14.7 


81 


142.6 


18.1 


81 


114.6 


18.2 


67 


94.0 


20.2 


82 


102.2 


19.9 


73 


91.2 


18.4 


71 


95 . 


19.8 


' 


92.6 



■ of age per 1000 births reported. 



An epidemic of scarlet fever that took place in the spring of I'M.i is 
worthy of mention because it reached such alarming proportions that the 
State Board of Health assumed charge of the situation and because the local 
newspapers, presumably expressing public sentiment, suggested the creation 
of a first rate local health department at an annual cost of from $25,000 to 
$50,000. The outbi'eak involved several hundred cases, accurate figures be- 
ing unavailable. There were 140 active cases at the time the State Board 



198 DOWN-STATE MUNICIl'AMTIES 

took charge in May and there were 53 under quaranlnie on June 30th. The 
city spent about $1,500 in emergency work during the epidemic hut the 
newspapers estimated that commercial and other economic losses due to the 
disease amounted to fully $100,000. 

The influenza wave of 1918 struck Joliet with a deadly vehemence that 
has few, if any, parallels in the State. Mortality from the infection reached 
the extraordinary high peak of 600 per 100,000 people while deaths attri- 
buted to pneumonia soared to 539 per 100,000 people. The influenza mor- 
tality rate was higher in Joliet than in any other city embraced in this volume 
and the rate in Joliet from penumonia was exceeded only by that in 
Kankakee. 

These illustrations are sufticient to show that health conditions in Joliet 
have been about average in most respects. The prevalence of typhoid fever 
has been more unfavorable than in many other places and the influenza pan- 
demic spent itself with greater fury in that place than in most other cities. 
For the most part, however, epidemics have come and gone creating senti- 
ment favorable to a strong public health department during the heat of the 
outbreak but invariably leaving behind the chronic problems involved in 
endemic health conditions which probably influence more profoundly than 
is ordinarily realized the severity of epidemics. 

References. 

Annual Reports of the City of Joliet. Joliet, 111. — various dates. 

Annual Reports of the State Board of Health, John H. Rauch, Secy., Springfield, 111. — various dates. 

llistoiy ..f Medical Practice in Illinois — Vol. 1, Lucius H. Zeuch, Chicago, 1927. 

■^^ '''11 It II I'.iitise on the Principal Diseases of the Interior of North America — Drake, Daniel — 
Cinciiii li • I - «'i. 

i: I' 11 Apprai-sal of Health Service for the vear 1923 in Fifteen Illinois Cities — Illinois 

Healll. \. - Mil hine, 1926, Rawlings, Isaac D. 

Hulletin of the State Water Survey, Urbana, 111., — various dates. 

U. S. Census Reports — Washington, D. C. — various dates. 



Kankakee 



In the days of the early explorers the Kankakee-St.Joseph Rivers route 

was used alternately with the DesPlaines-Chicago Rivers route in traveling 

between Lake ^Michigan and the Illinois River. Father Louis Hennepin 

traveled by way of the Kankakee River in 1679 and was impressed by the 

vast marshes in the territory through which the river flowed. He said, 

"The country is nothing but marslies, full of elder trees and rushes; 

and \ve could have hardl.v found for forty leagues together, any place 

to plant our cabins, had it not been for the frost which made the earth 

more firm and solid. * * * * We suffered very much in this passage and 

* * * * most of them (the men) were so weary of this laborious life, 

that they would have run away, if possible, and gone to the savages." 

After Father Charlevoi.x made the descent to Louisiana via the Kanka- 
kee River, then called the Theakiki in 1721, the route was closed because the 
territory was held by the unfriendly Foxes and their allies and later by the 
Pottawottomies, Ottowas, and Chippewas, which were not dispossessed of 
their holdings until the treaty of 1833. 

The settlers who then poured into the territory suffered much from 
malarial fever. Dr. Hiram Todd was one of the first doctors to settle in 
the Kankakee \'alley. He arrived there in 1836 and made his headquarters 
at the village of Waldron on the banks of the Kankakee, opposite the mouth 
of the Iroquois River. His intention was to look after his land interests 
which consisted of 8.000 acres along the banks of these two rivers, but he 
was soon drafte<l t(j look after the sick. 

During an outbreak of smallpox among the Indians in the vicinity, 
Dr. Todd's services were procured and he stopped the spread of the epidemic 
by vaccination of the redskins. They in conse- 
quence held him in high esteem as a medicine 
nian. 

In 1836 Dr. Todd was commissioned post- 
master of Kankakee post office located about two 
and a half miles up the river. This was the 
first use of the modern spelling of the name and 
was derived from the various appellations such 
as Theakiki, Kiakiki, Kankiki. etc., given to the 
river in the early reports and maps of the ex- 
I)lorers. all said to have been derived from the 

Abraham Lennington Small. Indian word Theak, meaning "wolf". 
M. D. 

(199) 




200 DOWN-STATE MUNICIPALITIKS 

One of the early physicians in Kankakee County was Dr. Abraham 
Lennington Small, fatliir nl ilic jjresent Governor, the Honorable Len Small. 

Dr. .Small en,i;at;eil in the practice of medicine at \\'ilmin.g'ton, Illinois 
in IS.tO, and later nio\ed to Ivockville, Kankakee County. He was burn 
September .^th. IS.^O. in Wayne County, Indiana, and was the second of 
eleven children of John and Mary Lennington Small. j(]hn"s father was 
opposed to slavery anil emi,grated west from \'irginia for that reason. The 
family was of Scotch origin. 

Htber early physicians were Doctors Henrv Russell, who came to 
I'liiurbdiinais in bS.^d, C. W. Knott, who was the chief physician during the 
cholera e])idemic of IS.^l. James F. Alazuzan. who arrived in Momence in 
IS.v and settled in Kankakee township in 184i). 

Settlement and Larlv Diseases 

The first house in Kankakee was built in 1834 on ground that is now 
the northeast part of the court yard. The original town was platted June 
8th, 1853, and was called Bourbonnais. The nearb\- station on the Illinois 
Central Railroad was known as Kankakee Depot. 

In 1853 when the Illinois Central Railroad scouts came to Bourbonnais 
and asked for a right of way for the new railroad, the French-Canadians 
and early settlers told them that they were not anxious to have the railroad 
come through the town, giving as their reason that the railroad would scare 
the horses, frighten the children and that the smoke and soot would damage 
the white clothes that the wives would have on the line. For this reason 
the Illinois Central officials decided to buy a right of way two and one-half 
miles southeast. The first town site was called Bourbonnais City, but when 
the people of the county decided to vote on the location of the county seat. 
a contest arose between this new Illinois Central town site and the town of 
Momence. Immediateh the Illinois Central officials feared that the voters 
might suspect Bourbonnais was contesting with Momence and they changed 
the name to Kankakee Depot. 

The election was held on June 21, 1853. The town site projectors of- 
fered as an intlucement the magnificient square as the seat for the court 
house, also the sum of $5000 for the construction of the building. With 
the aid of the voters from the vicinity of Limestone and Illinois Central 
employees, the election was carried by Kankakee Depot. 

The first term of court was held in the upper floor of the Illinois Cen- 
tral freight depot and the second term of court was held at the \'an Meter 
Hotel. In 1865. duriuL; the liuildin;; (d" the court house, the cit\' of Kan- 
kakee was granted a ch.irter by the .^tate legislature which was signed by 
Richard J. Oglesby, (io\ernor. .Section 18 of this charter provides that the 
common council ma\' make regulations to prevent the introduction and spread 



KANKAKEE 201 

of contagious disease in the city. The office of heakh officer was not men- 
tioned in the charter, luit the charter granted the mayor and council permis- 
sion t(i appiiinl (ilher officers than those which were mentioned. Conse- 
quent 1\ the auth(]rity for employing a health officer was there. 

I'.y an act nl the legislature February ISth, 1855, the name of the muni- 
cijiality was changed to Kankakee City. 

In later \ears the city became incorporated under the general law nf 

is;2. 

The natural la\ of Kankakee is high, with a perfect natural surface 
drainage. It is underlaid with a layer of limestone, deep enough under the 
surface of a loose alluvial soil tn afford an e.\ce!lent drainage. 

The city extends back and east of the river a distance of nearly three 
miles sloping gradually to the river frtjni the cast, south and west. The 
north side is drained by Soldier A'alley Creek, running to the west, and empty- 
ing into the river below. Practically all the wells in the city are drilled into 
the limestone which lies only a few feet below the surface. 

Kankakee is one of the smaller of the jjrincipal cities of Illinois. In 
1920 the population was Id, 753. This represented an increase of about 60 
per cent in twenty years. Of the 1020 population 14,363 or 85.7 per cent 
were nati\e l)orn white, 2121 or 12.7 per cent were foreign liorn whites and 
265 or 1.0 per cent were negroes. Nearly 25 per cent were 45 years old or 
over. 

Hi:ai.tit Maciiin'kkv 

.\ fire in the police station destroyeil all the official records made by 
the cit\' council during its early years so that evidence from that source is 
completely wanting, for the period prior to 1S')8. In that year the ordinances 
were revised and among them was one granting the local government power 
to establish a health department with broad authority relating to sanitary 
and hygienic matters. The inclusion of this ordinance in the revised code 
of the city implies the previous existence of a similar instrument that no 
doubt was a part of the city's legal equipment from an early date. It ap- 
pears that a health officer was functioning in 1868 and \'ery likel\- there was 
either a committee or a board of health whose chairman exercised the author- 
ity of a health officer even earlier. 

Since 1898 the legal provision for authorizing the city gcnernment lo 
participate in health work has changed but little. It provides for a hoard 
of health which is \ested with power to emplo\' a health officer and other 
personnel and t(j ilo all of the ordinary functions usual to such an agency. 
A few new ordinances ha\e l)een added to the health and sanit,ir\ code, regu- 
lating milk and food >u|i[)lies. plumbing, theatre \entilation .nnd the- like but 
the basic ailni!nistrati\e scheme remain> unaltered. The capacit\- and :ide- 



202 DOWN-STATE MUNICIPALITIES 

quacv of tlu- health department nia_\- be sunnise'l from the size of the annual 
appropriation which was $2200 in 1927. 

It seems that the first heahh officer in Kankakee was a doctor. Later 
it became the practice to fill the position with laymen and then in 1917 an- 
other change back to the medical profession came. Since 1917 the office 
has been held by a physician. So far as available records disclose, the 
following persons have acted as health officers of Kankakee. 

Miron H. Van Riper, M. D. 1SC7 Charles K. Smith, M. D. 1917 

John H. Van VonVert 189.5 William Yates, M. D. 1923 

John H. Bell 1900 Charles K. Smith, M. D. 192.5 

John Metzgsr 1915 

Besides the work done by the city health department, voluntary agencies 
have been active. The Kankakee Tuberculosis League inaugurated a public 
health nursing service in 1919 and since then that type of service has been 
continued. There has also been a clinic service for crippled children estab- 
lished subsequcntl}- to the infantile paral\sis epidemic of 1917 and continued. 

Water Supply 

The waterworks system was first installed in 1886 by the Kankakee 
Water Works Company and was later purchased by the Kankakee Water 
Supply Company. In 1890 this company was bought by the American 
Water Supply Company and in 1912 it was taken over b\- the Northern Illi- 
nois Water Co., a subsidiary of the above corporation. 

The present franchise which expires in l'>32, requires that the water 
shall l)e suitable for domestic consumption and specifies the amount neces- 
sary for fire protection. 

Lentil 1901 the supply consisted of raw water from Kankakee River, but 
in that year a new 3,000. 000-gallon rapid sand filter plant was constructed. 
In 1910 two more one-half million-gallon filter units were added and the 
settling capacity was increased. Equipment for the use of calcium hypo- 
chlorite was replaced by a modern chlorinator in 1917. Since that time only 
minor ch;inges have been maile in the treatment plant. 

Sewerage 

The first sewers were installed in 1886 and at present there are five 
outlets discharging into Kankakee River below the waterw^orks intake and 
the dam. 

Due to a number of complaints abnut the condition of the river in the 
city it is proposed to construct an interceptor to carry the sewage well below 
the city before discharging it into the river. 



KANKAKEE 



203 



Health Conditions 

Speaking of the sufferings of the pioneers in the Kankakee region in 
1844 Borroughs 

"There was one, two and three day ague * * * * Mostly, however, it 
was just plain 'ague' that a fellow had almost daily and with no let 
up from aching bones, creeping chills, and "shakes' followed by fever. 

"Whole families were thus afflicted, and the misery endured has 
never been adequately set forth by those attempting to describe it. * * * * 
Nine members of the Nichols family were afflicted with the malady at 
the same time, and a favorite practice when the premonitory symptoms 
of chills were felt was to line up in some bright, sunshiny nook where 
the sun shone hot against the cabin and sit and quake and bake until 
the fever came on." 



At an old settlers meeting in 1841, Mr. George Legg said that the physi- 
cal hardships of the early settlers were overshadowed by the almost continued 
fever and ague which sapped the vitality of the pioneers and, coupled with 
prairie itch, menaced the advancement of agriculture. Smallpox was suc- 
ceeded by fever, ague and itch. Quinine proved a boon in the hands of the 
early doctors in this communit}'. 

Dr. Benjamin Franklin Uran, now president 
of the Kankakee County Historical Society, who 
0y has practiced medicine in Kankakee since 1872, 

'^^ states that a cholera epidemic came into the ter- 

^ ritory in August 1838, starting at first in a fam- 

il\ named Magill, who resided on a tract of land 
.1 few miles down the river from Kankakee, which 
i> now part of Governor Small's farm. Strang- 
ers from Indiana, traveling by covered wagon, 
came to the ]\Iagill home to do some trading and 
to acquire food to take on their trip. After the 
strangers departed the two sons of the Magill 
family took sick suddenly and died with a dis- 
ease that was first thought to be "milk sick". 
Then the father and mother followed the same course. It was Dr. Uran's 
opinion that this was a cholera epidemic. He based this conclusion upon 
the description given by a Dr. P. ^V. Knott who had lived through the out- 
break. 

Another cholera epidemic attacked the community in 1851. It is des- 
cribed by Burroughs, who says that it appeared suddenly in June of that 
year in the little community of Bourbonnais. He continues : 

"A party of twenty or thirty French emigrants from Canada came 
to Bourbonnais in June bringing with them the body of a child that 
died on the way the day before a( Joliet. The next morning one of 




Benjamin Franklin Uran, 
M. D. 



204 



now \ -STATE Ml'NMrirAI.ITIES 



them was Ktriekeii down with the terrible scours^e. Tlie weather bein.a; 
very warm these emigrants were lodged in Noel Vasseur's barn. By 11 
o'clock the sfime day, eight or ten more were taken ill and by 10 o'clock 
that night 15 of the men were seized with the disease and all who be- 
came sick, died." 

Table 1. 
^Mortality From Certain Causes. 







1 








^ 


If 






^ 










b 








£ 


D 


rt 




-- 


w'? 


.ii'? 


\K \\l 








^ 




b< 




a) 




>. 




S r 




























































3 


3 


1 


1 


8 


t 


tn 


§, 


^S 


5! = 
It 


WIS 


n:> 


3 








, 


1 




73 




112 


8.1 


1919 


2S.S 














1 


29 




12 


16 


111-20 


224 












2 


1 






12 


20 


1921 


2 2. J 












3 








1.-. 


12 


1922 


251 














;■) 


4 




10 


14 


1923 
1924 


241 


i 










i 


' 4 


4 

7 




8 
12 


1.3 

12 


192.-, 


248 


2 










4 


2 


7 




9 


11 


1921! 


294 


1 






4 




4 


1 


10 




8 1 


24 



Table 2. 
Mortality Rates From Certain Causes. 







E 










■So 
















z 








a3 








.2 


Ul 






s 


fe 








> 


O 


n 




."ti 


'I'J 


.g" 


YEAU 


p 


— 


_, 










aJ 


^ 




-— C 


c ^ 




O 


1 


1 




1 


X 


5 


1 


3 




1 = 

i25 


= < 


1918 


47.:-. 


20.9 








13.9 


6.9 




510.4 




783.2 


594.4 


1919 


14.0 














5 . 5 


161.1 




66.6 


88.8 


1920 


13.1 


ii.7 






11.7 


5.8 


11.7 


5.8 


29.4 




70.5 


117.6 


1921 


12.9 










... 


17.3 








86.5 


69.2 


1922 


14.2 














28. 4 


22.7 




56.8 


79.5 


1923 


13..-) 


5.5 






5.5 




5.5 




22.3 




44.6 


83.7 


1924 


14.0 










5 5 




22.2 


38.8 




60.6 


66.6 


192.5 


13.4 


10.8 








... 


21.6 


10.8 


37.8 




48.7 


59.4 


192fi 


15.6 


2.1 


... 


... 


8.4 




21.2 


5.3 


53.0 




42.5 


122.3 



ilte fidin All Cj 



per 1.000 population; ;ill others per 100.000 populati. 



The outbreak ran a swift, acute, deadly course, accordint;- to Dr. L'ran's 
memory of Dr. Knott's description, causing about 30 deaths within ten days 
and sparing neither Indian, halfbreed nor white. 

Smallpox, likewise, did not overlook the quiet villat;e of Kankakee in 
the early days. Here again we have a verbal report from Dr. Iran who 
was practicing medicine there when an outbreak fell upon the community in 
1877. History is that 40 or 50 French and German families who occuppied 
a group of small houses in a segregated district south of the Illinois Central 
tracks, suffered the brunt of the epidemic. Tlie\' chose smallpox rather 
than vaccination and the result was lieav\- loss of life. Their dead were 



KANKAKEE 205 

buric-d near the liomes and later, w lien the site was utihzed for cominercial 
liuililing, the excavators were frightened away from their work when the 
news went around that tlie bones were those of smallpox victims rather than 
of aborigines. 

Even earlier smallpcix left its indelible impression upun the place. 

A severe epidemic liovered over this little C(jmmunity during the winter 
of 1837-1838. That outbreak was attributed to French emigrants who came 
in from Canada. 

No deaths from smallpox have occurreil in the city during recent \ears 
but occasional outbreaks have come from time to time to disturb the tran- 
c|uility of the public mind and to stimulate the application of control mea- 
sures which ha\e alw a\ s pnjved effective. 

Tvphoid fever in Kankakee has run a unique course. Elsewhere it 
was a chronic problem, recurring with the autumnal season with the regu- 
larity of harvest and weather phenomena. Here it was sporadic. Some- 
times the community escaped entirely with no cases and no fatality during a 
whole year. Again a violent outbreak would darken the prospects of health- 
ful prosperity. Thus in 1900 and 1901, typhoid occurred with great severity 
bringing to the city in November 1901 Jacob A. Harmon sanitary engineer 
of the State Board of Health who was sent in answer to an urgent request 
to make an investigation. He found that 60 per cent of the families in which 
the disease occurred derived their water supply fr((m the Kankakee l\i\er 
which was contaminated with sewage above the cit_\'. The remaining 40 per 
cent obtained their water supply from shallow wells sunk in the stone forma- 
tion at the surface of which were located many privy vaults. Mr. Harmon 
advised the boiling of all water used for domestic purposes whether from the 
river or shallow wells, the closing of all privy vaults and the construction 
of suitable sewage-treatment and water-filtration plants. The latter recom- 
mendation was subsequentl}' carried out by the water-works company. 

The venerable Dr. Uran recalls a significantly severe epidemic that 
occurred in the nineties. More recently- statistical evidence shows that from 
one to four deaths are apt to occur in a \ear or that the city may escape 
without any mortality. Since 1918, for instance, there have been four dif- 
ferent years in which no death from typhoid was reported. On the other 
hand 1927 brought the worst record in ten years, the four deaths \ielding 
a rate of 20.9. 

Influenza was very severe in 1918. There were Th deaths attributed to 
intluenza and 85 to pneumonia, giving a mortality rate of 510 and 594 per 
100,000 respective!}'. Only one or two other nuuficipalities in Illinois under- 
went such a heavy loss to those diseases that _\'ear. 

Alortality from tuberculosis was also extraordinarily heavy in 1918. 
The 112 deaths gave a rate of 783. Since that time, however, the mortality 



206 



DOWN-STATE MUNICIPALITIES 



Table 3. 
Cases of Certain Diseases Reported. 





19-21 


1922 


1923 


1924 


1925 


1920 


1927 


Typhoid Fever 




14 


5 




3 


3 


6 


Smallpox 
































Scarlet Fever 


o 


7 




.53 


56 


19 


15 


Whoop. Cough 


22 








3 




1 


Diphtheria 


19 














Influenza 
















Poliomyelitis 






2 








1 




1 














Pneumonia* 


6 


4 








23 


17 


Syphilis 














2 


Gonorrhea 












" 





*AU forms. 
Notk: Case reports are never complete, but they have been much more so since 1920 than before 
Illinois. A comparison between the figures in this table and those showing mortality in table 
makes obvious the fact that notification is still far from complete in Kankakee. 

Table 4. 
Births and Infant Deaths. 



Infant Deaths 



YEAR 












Number 


I?ate»» 


Number 


Rate* 


1918 






44 




1919 






26 




1920 


347 


20.5 


25 


72. 


1921 


326 


19. 


34 


104.3 


1922 


366 


21.4 


2S 


76.5 


1923 


444 


24.8 


34 


76.6 


1924 


469 


2.i.8 


35 


74.6 


1925 


465 


25.2 


39 


83.9 


1926 


447 


23.8 


37 


82.8 



■ Deaths of infants unde 
• Per 1,000 population. 



1 year of age per 1.000 births reported.. 



from tuberculosis has been more favorable than that found in most of the 
other cities of the State. The rate in 1926 was 42.5, a very low figure. 

Other communicable diseases have run courses that appear to have 
manifested nothing particularly unusual. Diphtheria and scarlet fever have 
risen and fallen with the seasons and with the epidemic cycles characteristic 
of both. Neither is so fatal now as it was prior to 1900. Diphtheria is far 
less prevalent. 

The general death rate is rather high but this is unfavorably influenced 
by the location there of a State hospital for the insane. The percentage of 
people in the older age group is also larger than usual. 

References. 

Reports of State Board of Health, various dates. 
Local official records. 

A New Discovery of a Large Country in America, Father Louis Hennepin, Chioaffo. 1903. 
Legends and Tales of the Homeland, Burt E. Burroughs, Chicago, 1023. 

Dr. Thomas H. Leonard's personal interviews with various officials, physicians and citizens of 
Kankakee. 



Ketvanee 




Edward C. Kent 

First Health Officer. Village 

of Kewanee, 1S88-1890 



Soon after Kewanee was incorporated as a village in 1855 certain mem- 
bers of the village board were organized into a nuisance committee. This 
was the beginning of what later developed into the municipality's public 
health service but the functions of that committee, as the name implies, were 

confined to the abatement of nuisances except 

that it was expected to initiate and carry out 
measures calculated to prevent and control chol- 
era and smallpox whenever epidemics of these 
diseases developed or threatened. So far as 
available, records disclose that no occasion ever 
arose which prompted this committee to attempt 
any significant epidemiological work during the 
forty-two years of its existence. 

In 1890 the village board appointed sort of 
a health board whose duties were entirely advis- 
ory. This board consisted of Doctors W. H. 
Cole. J. H. Mannon and J. C. Nichols ; from 1891 
to 1892 Doctors J. H. Mannon. W. H. Cole and 
E. C. Stilson. During the )ears 1892 and 1893 the health advisory board 
was also suspended, but in 1894 the board consisted of Doctors J- H. 
Mannon, J. C. Smiley and E. C. Stilson, who served up to the time that the 
city was incorporated in 1897. 

When the village was transformed into a city in April 1897. the village 
nuisance committee metamorphosed into the committee on fire and nuis- 
ances and George Tunnicliffe was at once employed at $20,00 per month 
as its executive officer. In July of the same year 
the responsibility for health work was shifted by 
ordinance to the finance committee which ap- 
pointed Tunnicliffe as health officer at $30.00 per 
month. 

In 18'^S another change came when the 
duties and functions of city collector were fused 
with those of health officer and Tunnicliffe, fall- 
ing heir to the double job, was the recipient of 
another advance in salary which now netted him 
$40.00 per month. Except for changes in person- 
nel and some modification in pay this continued 
to be the health arrangement until 1907. 




George Tunnicliffe 

First Health Officer, City of 

Kewanee, 1894-1S99 



(207) 



208 



IIOWX-STATK .M UNICIPAI.ITIES 



John Chisnall succeeded Tunniclift'e in 1899 and was, in turn, replaced 
In- Charles Collins on October 6, 1902. Then fallowed \\'. H. Barrett who 
took (ifhci,' with a new city administration in the sprini,' of 1'1)5. He resis^ncd 
sh<.)rtl\ and was succeeded by B. j\l. Cavanaugh who (juit in the fall ni 1906 
and \\a^ followed by I{. P. Reeser. 

ll i,- interesting to observe that when the monthly rfmuneratiini of the 
oflice was $40.00 only $10.00 were specified for health service and that from 

1902 on to 1907 when the pay was 
$50.00 per month, $20.00 were speci- 
fied as pay for the health officer part 
of the job. 

Bo.-\RD OF He.m.tti Brings Medical 
Ixi-lim;xci:. 
I'roljably the UKJst important single 
change in the public health service 
histiir}- of Kewanee took place in 1907 
when an ordinance creating a board 
of health became effective. Its most 
significant feature was the stipulation 
that the membership should consist of 
a physician and a layman, the physi- 
cian to act in the capacity of city 
health commissioner. For the first 
time we find here an official expression 
of the influence of the medical profes- 
sion in directing the policies and ac- 
tivities of local public health work. 
Dr. \\'. D. Hohmann and .\. 1!. 
Spickler, iluly appointed, constituted 
Thus Dr. Hohmann 




W. D. Hohmann. M. D 

First Medical Health 

Officer. 19117 



the first board of health 

became Kewanee's first medical health ofiicer. 

During the same }ear the medical profes- 
sion manifested its interest and exerted its influ- 
ence in another and probably no less important 
wav when a committee of ])hysicians headed by 
Dr. 11. N. Heflin succeeded in getting the cit_\- 
council to pass a milk ordinance. This legislation 
created a milk commission which was vested with 
authority to regulate the production, handling 
and sale of milk in the municipality. Dr. Heflin 
was made chairman of this commission which 
soon nu'VLied with the liojird of health when Dr. 




A. B. Spickler 
Member First Board of 

Health. 1907 



KEWANEE 



209 



Heflin becanic health commissioner, a positi(in which lie has held continu- 
ously up to the time of this writing. 

The list of lay health officers who have served Kewanee as a village and 
city include : 

E. C. Kent lSSS-1890 W. H. Barrett ISU-J 

W. M. Elliott 1S90-1S92 B. M. Cavanaugh 1905-1 90(i 

George Tunnicliffe 1894-1899 E. P. Reeser 1906-1907 

John Chisnall 1899-1902 Floyd Johnson 1907-1911 
Charles Collins 1902-1905 

The two medical men who have served Kewanee as health commis- 
sioners are: 

W. D. Hohmann, M. D. 1907 

H. N. Heflin. M. D. 1907 to dale 



Commission Form of (^Iovernment Adopted. 

In January 1911 the city of Kewanee adopted the commission form of 
government and the powers and responsibilities of the board of health auto- 
matically fell upon the commissioner of public health and safety. Under 
the new form of government. Dr. Heflin was re- 
tained as health commissioner and a sanitary in- 
spector in the person of James L. Torticil was 
employed. The appropriation to the health de- 
partment for 1911 amounted to $737.00 and of 
that sum the sanitary inspector drew $240.00. 

Another and final change in the legal status 
of the ]iul)lic health service caine to pass in 1920 
when a new ordinance creating again a board of 
health was adopted. Under this arrangement. 
Dr. Heflin was appointed chairman of the board 
and health commissioner. 

The expenditures of the city for public health 
work totaled approximately $3000 in 1926 and 
d the commissioner — on a part-time basis — and 




H. N. Hetlin. M, U. 

City Health Commissioner 

1907 to date 



the paid personnel inclu 
two sanitar\' inspectors. 



Otiikr Oeficial and Voluntary Health Agencies 

Like man}- other places, Kewanee gets a larger volume of health work 
done through quasi official and voluntary agencies than directly through 
the city health organization. In 1926, for example, there were three school 
nurses at work in the community, one nurse employed by the Wolworths 
Manufacturing Company and one nurse employed by the Civic Nurse Asso- 
ciation. All of these four were actively engaged in public health work". 



210 DOWN-STATE MUNICIPALITIES 

Kewanee also supports a clinic for the benefit of crippled children in 
that vicinity. The orthopedic medical and the specialized nursing service 
for the clinic proper is provided b\ the IlHnois Crippled Children's Society 
but local organizations manage the many details which keep this piece of 
work going in that community. Kewanee is, futhermore, the home of Mr. 
E. E. Baker, president of the Illinois Crippled Children's Association, who 
has exercised a very large influence in vitalizing the activities of that organ- 
ization throughout the State. 

Water Supply 

The original waterworks was installed in 1883-1884 comprising a single 
well drawing its supply from glacial gravel deposits in the vicinity of Crystal 
Lake at the northern edge of the city, a pumping station, collecting basin, 
and limited distribution system. The single well proved inadequate and 
the supply was subjected to some surface and shallow-ground-water pollution 
because the water-bearing gravel was not covered with a protecting imper- 
vious clay layer and the area in the vicinity was building up. 

In 1887-1888 three drilled wells, a litde less than 1,500 feet deep and 
drawing their supplies from St. Peter sandstone were drilled near the original 
pumping station and the original well was abandoned except for supplying 
water for road sprinkling purposes. Later, while working on one of these 
wells, it was so damaged that it could not be used, and in 1905 a fourth well 
was drilled in the same locality which well was extended into St. Peter sand- 
stone. Trouljle was experienced in pumping from these wells, possibly be- 
cause the holes may have been crooked, and in 1903-1904 air-lift equipment 
replaced the deep-well pumps. 

The water from the St. Peter sandstone wells was of good sanitary 
quality as drawn from the wells, but it was subjected to some possible con- 
tamination in open basins after withdrawal. It was quite hard and the sup- 
ply did not continue tu meet tiie demands of the growing cit\ . 

In 1908 a new pumping station and two new wells ending in St. Peter 
sandstone were installed near the C. B. & Q. railroad tracks near the center 
of the chy, but these wells and station were not placed in service until about 
1912. In 1911 and possibly other years the city had to purchase water from 
one of the industries that had a separate well supph'. Following a report 
made by a consulting engineer, the new station was placed into service in 
1912 and another well recommended at that time was finally drilled in 1919. 
This last well was 2,497 feet deep and ended in Potsdam sandstone. The 
old pumping station and wells at the northern edge of the city were aban- 
doned and a new half-million gallon storage reservoir built near the new 
pumping station in the central portion of the city. The old one and one- 



KEWANEE 211 

lialf million gallon reservoir near the old pumping station had leaked badly 
for some time so that it was not possible to maintain it full. 

Since 1919 the Potsdam well drilled in that year has served as the main 
source of supply, but the two other wells at the same pumping station have 
been available for emergency or supplemental use. All wells are pumped 
by air-lift. 

The water as drawn from the wells is safe and its sanitary quality as 
delivered to the consumers depends on whether or not it is exposed to con- 
tamination in the receiving basin into which the well water is discharged be- 
fore it flows to the storage reservoir. Cross connections between the city 
mains and the private supplies of several industries might serve to contamin- 
ate the public water supply if the private supplies are not always maintained 
in excellent condition and free from contamination. The water from the 
Potsdam well is even harder than that from the St. Peter wells and there 
has been some local agitation in favor of a supplx- of better mineral quality, 
but no definite plans or possibilities for such improvement have been de- 
veloped. 

Sewerage 

Most of the area in the city drains to the east to .Spoon River, a tributary 
of Illinois River, and the smaller northwest and northern portion drain to 
the north into tributaries of Green River, a tributary of Mississippi River. 

Private drains may have been installed previous to 1890 but in that year 
the first public sewer system was installed by the city and comprised the 
existing 18-inch main outlet sewer to the east and some of the larger sub- 
mains. Since that time several additional districts have been sewered and 
connected to the original sewer district and outlet sewer. 

Extensions and improvements to the sewer system have been very slow 
and inadequate to satisfactorily serve the growing city and maintain sani- 
tary conditions. Up to the close of the period covered by this history sewers 
were serving only about 8,000 population out of the total estimated popu- 
lation of 20,000. Also many of the sewers are overloaded, causing water 
from them to overflow from manholes and back up into basements. Of 
the total estimated population of 20,000, 18,000 are in that portion of the 
city which drains to the east and 2,000 are in the northwestern and northern 
part of the city that drains to the north, in which no sewers at all have been 
installed. 

The original sewer system comprised a septic tank for partially purify- 
ing the sewage. The tank is entirely inadequate to effect any material puri- 
fication of the sewage, and the stream below the outlet has been grossly pol- 
luted for years. 



212 



DdWN-STATI-; .MUMCn'AI.ITIKS 



At the close of thi.s historical period the city was ijlanning to enjiage 
competent consulting engineers to make an inventory of the existing sewer 
s\stem and prepare a report, plans and specifications for an adequate s_\stem 
of sanitary sewers, treatment plant, and also storm-water sewers so that it 
is quite probable that in the near future the existing insanitary conditions 
at Kewanee cauM-il b\ inadequate and defective sewerage facilities will be 
entirelv remedied and the entire built-up area will be provided with adequate 
sewerage and drainage facilities and existing objectionable stream pollution 
abated. 

H HALT II Con nrr IONS 

Kewanee went through the "pest house" and "shotgun quarantine" 
periods like most other cities and villages that existed prior to the twentieth 
century and like most others the records of severe epidemics promptly fell 
into obscurity when the "passover" was done, leaving nothing but tradition 
upon which to depend for history. 

It is related that the water committee of the city council was authorized 
in July 1897 to dispose of the "detention hospital", a dignified name given 
to what in other communities was ordinarily bluntly called "pest house". 
This transaction implies that smallpox and perhaps cholera had not over- 
looked the tranquil village of Kewanee. Doubtless, the "pest house" was a 
monument to the havoc wrought and the alarm inspired by these loathsome 



Table 1. 
AIoKTALiTV From Certain Causes. 







■- 










ic 


























3 














s 


•X, 








> 


6 


s 




1^ 


i"? 


rf «■ 


Y !■: \ 1! 


3 






^ 




b~ 




E 


j- 


>-. 


■5 £ 


c £ 










c. 


V 














£.£ 




6 


J 


5 






X. 


g 


:= 


1 


.2 


J = 






% 


p. 


1 


X 


S 


1 


t 


'~. 


1 


£ 


£2. 


s< 


1907 


203 


8 








1 




4 


1 








1908 


1.54 
























1909 


167 


'.'.'. 






















1910 


148 
























1911 


154 














1 


' 1 




(i 


' 6 


1912 


138 


•2, 








i 




1 


1 




7 


2.'» 


1913 


209 


3 












5 






15 


33 


1914 




2 












2 


' i 




5 


14 


1915 


















1 




10 


17 


1916 




"2 












' 1 


1 


' i 


6 


27 


1917 




•2 


















10 


34 


1918 




2 












' '3 


■36 






78 


1919 




4 












1 


10 




15 


41 


1920 


270 


IS 












3 


38 




15 


41 


1921 


221 


4 








2 




13 


3 




15 


21 


1922 


216 


2 








2 




2 


2 




10 


28 


1923 


246 


4 








1 




1 


10 




11 


31 


1924 


195 








"e 








7 




10 


10 


192.5 


199 














2 


7 


i 


8 


22 


1926 


237 








" '4 




6 




12 


1 


^ 


30 



KEWANEE 



213 



Table 2. 
]\IoRTALiTY Rates Froji Certain Causes. 







„ 










^ 
















> 








s- 


3 






.2 


m 






s 


[£ 








s 


a 


a 




^ 


'gift 


gl? 


YEAR 


3 


._, 




^ 




fc, 




cD 


^ 


>i 


3i 


§1 




3 






& 


s 




ci. 






1 


0^ 






o 


_^ 


j:' 






.-• 


c 


2 


3 




5!!l! 




5 


S 


^ 


■r. 


s 


1 


■S 


3. 


= 


(£ 


Is 


Is 


• 
1907 


22.4 


88. 6 








11.0 


44.3 


44.3 


11.0 


... 






1908 


16.8 


























1909 


IS.l 


























1910 


1.1.8 


























1911 


1.0.4 














i6!6 


16. 






o6!i 


eoii 


1912 


12.9 


IS .'7 








9. -> 




9.3 


9.3 






65.7 


234.7 


1913 


18.4 


26.4 










oi!s 


44.1 








132.4 


291.4 


1914 




16.6 










8.3 


16.6 


"%.'% 






41.0 


116.7 


1915 


















7.8 






78.9 


134.2 


1916 




14.9 






14.9 






7.4 


7.4 




4 


44.9 


202.4 


1917 




14.2 










14!2 










71.3 


242.7 


191S 




13.6 










0.7 


1S).\ 


264!3 






34.0 


531.3 


1919 




26.0 










6 . 5 


6.5 


05 . 1 






97.7 


267.1 


1920 


16. '7 


50.0 




g'2 






6.2 


18.6 


237.5 






93.7 


250.2 


1921 


13.4 


24.3 






12^2 


12! 2 


6.1 


79.0 


18.2 






9] .2 


127.7 


1922 


11.5 


10.7 




.'.■; 




10.7 




10.7 


10.7 






53.2 


149.1 


1923 


12.9 


21.0 








5.2 


2i!6 


5.2 


84.2 




'. 


57 . S 


163.1 


1924 


10.0 








sois 




5.1 




36.0 






51 . 5 


51.5 


192') 


10.0 












5.1 


]6!i 


35.4 




i 


40.5 


111.6 


1920 


11.8 








19.8 




23.7 




47.4 


4 


9 


24.8 


149.2 



per 1000 pninil;itii 



.lU others per 100,000 popiilatic 



Table 3. 
Cases of Certain Diseases Reported. 





1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Tv-phoid Fever 


23 


10 


6 


4 


18 


9 


^ 


17 




7 




3 


Smallpo.x 


2 


1 


3 


2 


96 


14 


11 


4 


;) 




1 


1 


Measles 


580 


38 


258 


4 


33 


31 


346 








118 


7 


Sf.irlet Fever 


44 


8 


12 


2 


139 


143 


190 


53 


23 


11 


17 


18 


Wlinop. ColIRh 


3 


109 


80 


8 


18 


12 


122 


134 


14 


25 


112 


2 


Diphtheria 


14 


3 


14 


2 


24 


34 


106 


16 






4 


6 


IiifliiPiizri 






2765 


399 


2500 


1 


1 


7 


1 


6 


6 


1 


Piiliomvelitis 


12 


5 


1 


2 




1 










2 




Meniiitfilis 





3 


1 






1 


1 


2 


i 


1 







Tuherrulosis* 


;-, 


3 





6 


1 


13 


29 


20 


31 


27 


52 


10 






1 


14S 


7 


60 


47 




91 


37 


62 


116 


50 


Snihilis 






1 






9 









19 


3 


1 


Gonorrhea 












4 






7 


•T 




2 



•All forms. 
Note: Case reports are never complete, but they have been nuicli more f 
Illinois. Kewanee is among the cities where notification now is complet 
rate index to epidemic conditions. 

diseases. Mow frequently smallpox visitesl the community is largely a mat- 
ter of conjecture. That the disease left its mark upon the hearts, and pro- 
bably the faces too, of the local people, the story of the "detention hospital" 
declares. 

P.ut the passing of the "pe.st house" with all of its implications did not 
prohibit the disease nor protect the people against smallpox. In 1911 an 
epidemic involving 79 cases spent itself upon the communit\- and a milder 
outbreak, involving 19 cases, occurred in 1913. 



214 



DOWN-STATE MUNICIPALITIES 



Table 4. 
Births and Infant Deaths. 





Births 


Infant Deaths 


YEAR 












Number 


Rate** 


Number 


Rate" 


1911 






45 




1912 






49 




1913 






74 




1914 






38 




1915 










1916 


337 


25.2 


40 


118.6 


1917 


308 


21.9 


43 


139.6 


1918 


385 


2G.2 


49 


127.2 


1919 


355 


23.1 


25 


70.4 


1920 


372 


23.2 


35 


94.1 


1921 


376 


22 . 


39 


103.7 


1922 


350 


111! 7 


30 


85.7 


1923 


364 


1!1.1 


31 


85.2 


1924 


359 


IS. 5 


33 


91.9 


1925 


379 


19.2 


27 


71.2 


1920 


381 


IS. 9 


36 


94.4 



Some of the data not obtainable. 

* Deaths of infants under 1 year of age per 1000 births reported. 

*» Per 1000 population. 

A return wave of influenza overwhelmed the city in the winter of 
1919-1920 when some 8,000 or 9.000 cases developed, leaving a considerable 
fatality rate behind. 

Other recent epidt-iiiics include 280 cases of scarlet fever in Kewanee 
and vicinity in 1''20 and an unusual prevalence of wliouping- cough during 
the same season. 

In l'^22 an mithreak of typhoid fe\'er caused 3.^ cases of sickness and 
resulted in a careful epitlemiological study by the State Department of Public 
Health. It appeared that the source of the epidemic was a carrier on a 
dairy farm and that the disease had been spread through a local dealer who 
did not pasteurize hi> milk. ( )ne of the two lirothers who operated the 
plant succumbed to an attack of typhoid and the tracing of the epidemic to 
this concern wrecked the entire business. 

During the following winter season a mild epidemic of scarlet fever 
was attributed to a local milk supply. This, together with the typhoid ex- 
perience, led to the adoption of an ordinance in 1''23 which practicalh' re- 
quired the pasteurizatii)!! of the city"s milk supply. 

In the spring of 102() an epidemic of German measles yielded 663 cases 
and was accompanied by a considerable wave of pneumonia. 

These illustrations indicate that the city has experienced what might be 
termed an ordinary health history. Within the course of seventy odd years, 
the public efforts to protect community health and prevent disease have run 
about the average course, beginning with a vague conception that somehow 
there existed a relation between miisances and contagion and culminating 



KEWANEE 215 

with a service directed by a physician who is able to place at the puhhc dis- 
posal as much of modern epidemiology as it is willing to accept and utilize. 
In the meantime, ordinances relating to milk, water, sewage disposal, plumb- 
ing and similar matters have marked the advance of popular knowledge 
about the prevention of disease and the preservation of health. 

References, 

Data supplied by Dr. H. X. Heflin, Commissioner of Health of Kewanee. 
Annual reports of the City of Kewanee, Kewanee, 111., various dates. 

Bulletins of the Illinois State Water Sun-ey, Dr. Edward Bartow, Director. Urbana, lllimiis. various 
dates. 

U. S. Census Reports, Washington, D. C, various dates. 



La Salle, Oglesby and Peru 

These lliree munici])alilies are talvcn toijetlicr because all three now en- 
jo\ the services of a single health department known as the H\gienic Insti- 
tute. LaSalle and Peru are contiguous, constituting a single community 
with twii municipal governments. Oglesb}' is across the ri\er and a little 
south. All three grace the banks of the Illinois River. 

The three cities have this in common. They are strictly industrial. 
In the tri-cities and vicinity are three cement plants, two zinc plants, a clock, 
a wheel and a [dow factorx', a number of coal mines and numerous smaller 
industries. 

The piipulation is strictly industrial in character with a heavy foreign 
element. In l'^20 there were 13,050 people in LaSalle, 4.1o5 in ( )glesby and 
3,860 in Peru. 

Peru W'as incorporated in 1851, LaSalle in 1852 and Oglesby in 1902. 
Each maintained separate and di-stinct governments throughout until 1914 
when a plan, which will be discussed at some length hereafter, for providing 
a health service for all three through one organization was devised and car- 
ried out. 

Hkaltii Macitinicry 

The first board of health in Lai-^alle was appointed in 1852 with John 
Gillett, James Strain and David L. Hcnigh as members. .\ year later Peru 
felt the need of such an agency and the city cnuncil elected J. \'. H. Judd 
and R. P. Wright to constitute the first board ')f health there. After their 
creation, however, the boards of health succeeded in doing very little worthy 
of record. At least no record of an_\- significant activities has survived. 

Some thirty years later, in 1886, a physician by the name of P. AI. I'.urke 
became a member of the board in LaSalle and it seems that from that date 
the medical profession began to exercise an intimate influence over the 
public health affairs in all three communities. At any rate it became the 
customary practice to make some doctor the health officer in each com- 
munity and to remunerate him at the rate of about $300 annually, expecting 
of him no arduous duties except, perhaps, in the face of some emergency 
which everyone, including the health officers, hoped would not arise. But 
emergencies did arise periodically and at such times the boards of health 
and the health officers became active, doing e\erything that their know- 
ledge and resources permitted to bring relief. It was during such an oc- 
casion in the nineties that Dr. A. W. Ilatton did constructive work enough 
in LaSalle to attract |)ublic attention. Sometimes sanitary policemen or in- 

(216) 



LA SALLE, OGLESDV AND PERU 



217 



spectors were emploxed ami again no one was active in health work so that 
expenditures varied from a few hundred to a thousand or more dollars per 
year. 

Ordinances, too, were placed upon the hooks from time to time as 
occasion and public sentiment required liut these, like the activities of the 
health departments, meant much or little according to some momentary emer- 
gency or condition that provoked favor or disdain. It \\as hard enough to 
enforce regulations that seemed to curtail the liberties or desires of any con- 
siderable number of people. In 1''12, for example, when smallpox became 
epidemic. man\' infected or exposed persons were concealed while others 
Ixildly walked the streets in open defiance of the quarantine rei^ulations. 

It was conditions like these coupled with the obvious need for efficient 
liealth service, that led I'rederick \\'. Matthiessen, a wealthy local citizen, 
to inaugurate a plan for giving to the people in 
the three communities a first class, efficient 
pul)lic health service. ( )ne thing he saw clearly 
— that the hoards of health could not pro\'ide the 
sort of service recjuired with the resources at their 
command and the task of increasing their re- 
sources would be difficult. He saw, too, that 
it would be uneconomical to maintain a separate 
health >er\ice of the type desired for each com- 
munit\'. Thus in 1910, he began to manifest 
an interest in the health of these communities 
when he donated $10,000 as an endowment fund 
for the maintenance of a medical librarw The 
next year he pro\ ided the funds for opening and operating a milk laboratory, 
designed tn >upply at ;i reasonalile cost the proper kinds of milk for infants 
and children in the vicinity. 

This laboratory was placed under the di- 
rection of a board of directors, made up of Doc- 
tors W. W. Greaves, R. C. Fullenweider, P. M. 
I'.urke, H. AI. Orr, W. O. Storey, Anna Hen- 
nesy and O. B. Stafford. An expert nurse, 
.Minnie Farrar, was placed in charge and food 
mixtures were made and dispensed upon pre- 
scriptions from physicians. This practice soon 
fell into disfaxor among the doctors, however, 
antl die laboratory became a milk dispensary for 
poor people. Still later the laboratory was fused 
with the Hygienic Institute and was transformed 
into the F-mma Alatthiessen Chancellor ]\Iemor- 
i.al Infant Welfare .Ntalion. 




Frederick W. Matthiessen 




W. \\^ Greaves, M. D. 



218 



nnwX-STATE MUNICIPALITIES 



Thesf experiences 
takiiiL'. He decided t<i 



li'd Mr. Matthiessen into a more ambitious under- 
|)r<i\ide the tliree cities of LaSalle, Oglesby and Peru 
with an adequate pubHc health service if a prac- 
ticable plan could be devised. He took counsel 
with his son-in-law. Dr. Phillip S. Chancellor 
;inil with Dr. ( iiistiu F. Kuediger. As a result 
.\lr. .Matthiessen proposed to endow an organiza- 
tiiin to be known as the Hygienic Institute, with 
headquarters in LaSalle, fully ef|uipped and 
manned for rendering adequate health service in 
the three cities provided each community wi)uld 
accept the director of the Institute as its chief 
health officer and take care of such legal techni- 
calities as were necessary to clothe the organiza- 
tion with whatever authority was re(|uire<l to ful- 
fill its purpi i^es. 
The |)roposition was accepted and the Hygi- 
enic Institute came into existence in 1914 and 
developed into one of the best equipped and most 
complete health departments in Illinois. To 
legalize its functions in the three cities, the 
ma_\ors appoint health officers who are nominat- 
ed by the director of the Hygienic Institute, whose 
assistants they become, and who are paid by the 
Hygienic Institute. This scheme eliminates pol- 
itical influence, insures cooperation and provides 
all necessary authority. 

Futherniore. the parlicii^ating communities Gustav F. Ruediger, M. D. 

Director, Hvgienic Institute, 
1914-1917 




FuIIenweider, M. D. 




parlicipatmg communities 
were recpiired to employ each a sanitary police- 
man, to adopt uniform sanitary codes, to report 
all contagious disease: 




Anna Hennesy-Kinder 
M.D. 



to the main headquarters 
and to manifest good faith in otherw-ise provid- 
ing for complete harmony of service from the 
principal organization. 

Thus the Hygienic In.stitute came into being 
and its continuity is assured by reason of a liberal 
endowment made for the ]iui'pose by its creator. 
It is governed b\' a board of trustees made up 
of five members who elect new members to fill 
vacancies, subject (inly to the disappro\al of the 
-Matthiessen heirs. They constitute the actual 
board of health of the three municipalities 



LA SALLE, OGLESBY AND PERU 



219 




althougli each has a paj)er board of health in order to lawfully settle any 
legal questions that may arise at any time. The first board of trustees was 
made up of Ernst Roth, president, George A. Wilson, treasurer, J. Henry 
Cox, Charles Nodler and Harry A. Bent. Dr. Gustav F. Ruediger was the 
first director of the Institute. Subsequently, Dr. Carl F. Raver, Dr. Edmund 
W. Weis and Dr. Arlington Ailes have occupied the position of director, the 
latter being the present incumbent. 

The Hygienic Institute is housed in a remodeled building adjacent to the 
LaSalle-Peru Township High School. Here are maintained properly fur- 
nished offices with filing cabinets and printed 
blanks for keeping records, and a completely 
equipped laboratory for making bacteriological 
diagnoses and sanitary chemical analyses of 
water and foods. It was thought desirable tn 
have the Institute in close cooperation with the 
hiyh schnol so as to liring the pupils in touch 
with the pulilic health work. This has been 
amply justified as high school classes have fre- 
quentl}- visited the offices and laboratory and 
have had the work explained to them. JNIembers 
of the Institute have frequently been invited by 
the high school principal to give health talks be- 
fore classes or at the general assembly. 

In formulating the plan of organization of the H\ gienic Institute and the 
cooperative health department, economy of operation was not the paramount 
consideration. The first thing sought after was 
efficiency in public health administration, but 
those who advanced the project were desirous 
that original research should also be provided for. 
They therefore, aimed to have assistants enough 
to allow the director and the bacteriologist to de- 
vote considerable time to this important side of 
the work. 

The H\gienic Institute now provides every 
t\pe of service ordinaril}' expected of or perform- 
ed by a health department, delves into the field 
of research and makes itself a general public 
health, medical and welfare center for the com- 
munities it serves, it seems to be meeting fully the purposes for which it 
came into being. A clear picture of the organization is given in the June 
1927 edition of Nation's Health. Its present director. Dr. Arlington .\iles. is 
speaking. 



.J. Henrv Fox 




Harry A. Bent 



220 



DOWX-STATE M U N 1 CI PAI.ITIES 




Carl P. Raver, M. D. 

Director, Hygienic Institute 

1917-191S 



"Despite tlie fart that this is an endowed institution and could 
better afford to be independent than most health departments, every 
effort is made by the director and staff to promote harmony and a spirit 
of cooperation lietween itself and the practicing physician. The dinners 
spoken of above is one method used to ai> 
jiei'se the primitive instincts of the human 
animni, and are enjoyed by the doctors and 
staff as well. These dinners are prepared 
and served by the nurses at cost to the so- 
ciety, after which the physicians enjoy 
tlieir regular monthly piogram in the li- 
lii-ai-y of the Institute. The library is 
l<eiit up-to-date with a rensouable selection 
(if late books and current journals. This, 
together with the laboratory service ren- 
dered the physicians, is of great value in 
piomoting and preserving mutual good 
will. The Institute also recognizes the in- 
aliennbie rights of the physician to trent 
the sick, and the broad principle thnt 
health should be bought and paid for 
the same as any other valuable and purchasable commodity. 

•'The physicians, on their part, are showing confidence in the health 
dejiartnient and their program by endorsing the various diagnostic, 
educational and demonstrational clinics, and by meeting the Institute 
half way in the field of preventive medi- 
cine, especially when epidemics threaten. 
The danger of mentally impoverishing cer- 
tain classes by carelessly e.xtending free 
service is guarded against. The details of 
this cooperative service in the field of pre- 
ventive medicine have not been fully 
solved, but it is being approached with the 
hope of solution along the lines stated 
above. 

"In the matter of community coopera- 
tion, with other agencies, in the field of 
public health, there seems to be entire 
harmony. The three boards of education 
are cooperating with the health program 
in their schools and are assisting finan- 
cially. The tuberculosis society employs 

a nurse, who is. in fact, a member of the Institute staff of nurses, and 
who is under the supervision of the chief of this division. Their other 
expenditures for health have been made in harmony with the wishes 
and with the guidance of the health officials. There are many large in- 
dustries in the community, three of which maintain medical or nursing 
service, and with which the Institute cooperates. The Tri-City Family 
Welfare Society is also well organized and officered, and the chances of 
cooperation and mutual usefulness between the Hygienic Institute and 
this society are many. 




Edmund W. Weis. M. D. 

Director. Hvgienic Institute, 

191S-192.5 



r.A SALLE, OGLESBY A\D I'F.KL' 



221 



"A unique and valuable service of this society is the sponsoring of 
mental clinics, which are held at the Hygienic Institute. The clinicians 
are furnished by the Illinois Institute for Juvenile Research, and the ser- 
vice is taken advantage of by the society, 
the Institute, and the schools. The La- 
Salle-Peru Township High School also 
maintains an unusual service, known as a 
Bureau of Educational Counsel, which gives 
individual study, advice, and guidance to 
students, especially in their mental and 
emotional complexes and their fitness and 
choice of vocations. The psychiatric and 
psychological service for this bureau is 
also rendered by the Illinois Institute for 
Juvenile Research located at Chicago, and 
the physical examinations are made by the 
Institute staff. The Metropolitan Life In- 
surance Company also maintains a full 
time nursing service, but as yet this is not 
under the service of the Institute. There 
is, however, entire harmony and cooperation, which is exceedingly 
important since the Hygienic Institute also maintains a visiting nurse 
service. 

"The organization and activities of the Hygienic Institute have 
grown and changed and kept pace with the ideas of the best public 
health practices, ranging from almost purely sanitary, through pre- 
vention, to the modern idea of health promotion." 




Arlington Ailes, M. D. 

Director, Hygienic Institute 

1925 to date 



La Salle Water Supply 

The fir.'^t waterworks was constructed in 1888 with a spring about two 
miles east of the pumping' station as a source of supply. During 1894 a 
second high-lift pvnnp was added and in 1903 and 1904 extensive changes 
were made. The spring supply was abandoned and a well developed, lo- 
cated in the Ilinois River bottom land at the southeast corner of the city 
just south of the Illinois-Michigan Canal, between Little Vermilion River 
and the Illinois Central Railroad. The well was pumped by a centrifugal 
pump. A larger collecting reservoir was constructed and the present boiler 
room, equipped with new boilers, was built. In 1907 a feed-water heater 
was added and in I'Jll a second well was sunk. 

The two wells in use in 1913 were 39 feet deep and /i-; feet in diameter 
and penetrated a gravel water-bearing stratum. The collecting reservoir 
had a capacity of 35,000 gallons. \\'ater was ]3umped directly into the ser- 
vice main. 

In 1913 a third well was sunk and two elevated equalizing reservoirs 
constructed. 

The waterworks remained unchanged until 1921 at which lime the old 
plant was abandoned and a new plant built. 



222 DOWN-STATE MUNICIPALITIES 

The present waterworks comprises the three drift wells, pumping station, 
and two equalizing resei'voirs. There are about 25 miles of service mains 
and the average water consumption is about 153 gallons per capita daily. 

I'r(im time to time cross connections have been in existence between 
]j()lluted river water and the citv well supply at certain industries. The last 
of these cross connections was broken in 1926. 

Routine analyses of samples from the public water supply have been 
made 1).\ the State Department of Public Health since September 1921. 

At the present time the water at I.aSalle is classified as being of a safe 
sanitary quality. 

La Salle Sewerage 

.\ combined system of sewers, with three 36-inch outlets discharging 
into the Illinois-Michigan Canal, and serving that portion of the city south 
of Eleventh Street has been in existence for several years. There are sev- 
eral areas in the city not adequately served, and no immediate improvements 
are contemplated. 

Poor drainage facilities couiiled with the extensive overflow lands in 
Illinois River bottoms have from time to time produced severe mosquito- 
breeding nuisances. 

Perl' Water Supply 

The first waterworks was installed in 1891. At that time the city was 
too much in debt to issue bonds and build the works, so the Peru Water 
Company was formed and bonds issued for $43,000. Besides this sum the 
city paid $25,000 for mains and hydrants, making the cost of the system 
$68,000. It was the intention of the city to purchase sufficient bonds an- 
nually to acquire complete ownership of the works in nine years, but owing 
to paving expenditures, this was not done and a re-issue was necessary. In 
1914 all but $2,000 in bonds had been taken up b}- the city. .Mthough the 
water company owned the plant, the city alwa^-s operated it. 

The original supply consisted of one well constructed in 1889, 1,365 feet 
deep into St. Peter sandstone, located in the south part of the city. A col- 
lecting reservoir of 250,000 gallons capacity was constructed in 1891, when 
the water plant was built. 

In 1893 another well was sunk 1,254 feet deep near the Chicago, Bur- 
lington & Quincy railroad depot. In 1905 a third well was put down at the 
pumping station site. In 1913 a fourth was constructed. The collecting 
reservoir was not used after construction of the fourth well in 1913. 

At the present time only three wells are in service, the first well having 
been abandoned. Water from the wells flows into a concrete collecting 
reservoir of 360.000 gallons capacity located at the pumping station from 



LA SALLK, OCLESBY AND PERU 223 

whence it is pumped to the (hstribution standpipe. The pumping station 
was being rebuilt in 1926, at which time four cross connections between the 
city supply and that of the Western Clock Company were in existence. 

The present water consumption is about 56 gallons per capita daily and 
the water is regarded as being of a safe sanitary quality. Analyses of 
samples from the public water supply have been made b\- the State Depart- 
ment of Public Health since September 1923. 

Peru Sewerage 

In 1914 the city was said to be quite thoroughly sewered by a system 
of combined sewers, with ten outlets discharging into Illinois River, ranging 
from 15 to 24 inches in diameter. 

In 1925 several portions of the city were affected by the backing up 
of sewage in basements and improvements to the sewer system were contem- 
plated. Recommendations were made for systematic and comprehensive 
study of the sewerage needs of the city, but to date little progress has been 
made. 

Oglesbv Water Supply 

The waterworks was installed during 1915 and 1916. A well 14 inches 
in diameter and 1,645 feet deep was constructed near the center of the town. 
Prior to 1915 a local coal company supplied a number of residences with 
water which previously had been passed through a softening plant. 

At the present time the waterworks comprises the original well which 
enters St. Peter sandstone, the air-lift equipment which was installed in 
1916, an open surge tank above the well, a 15,000-gallon collecting tank, and 
the pumping station. \\'ater is pumped direct into the distribution system. 

The present consumpticm is about 40 gallons per capita. The water is 
regarded as being of a safe sanitary quality. Analyses of samples from the 
public water supply have been made by the State Department of Public 
Health since October 1926. 

Oglescy Sewerage 

A system of sanitarv sewers, which serves the central portion of the 
city, was installed prior to the development of the public water suppK'. 

Health Conditions 

A. D. Jones, who visited the town of Peru on his trip up the Illinois 
River in the late fall of 1838, wrote : 

"Peru is said by many to be unhealthy which the residents on the 
spot stoutly affirm to be highly libelous. Still I need further proof 
that it is not generally unhealthy on that river — not sickly, however, 



224 



now X -STATIC M UNICTPALITIIC: 



that it need be shmined by those who are disposed and determined to 
take care of their health * * * * in these bottoms, swarm such hosts ot 
mosquitoes as New England men never dreamed ot. They fairly malje 
it difficult to breathe and silence was imposed from very fear of inhaling 
tliem with our breath. They were not to be endured and hot as it ^vas, 
we closed the curtains and smolu'd them out with our cigars." 

During the early \ear.s, however, there seems to have been but one epi- 
demic of sufficient importance to impress the minds of the la}- historians. 
It was the cholera outbreak. 

In LaSalle, this epidemic is reported to h.ave killed the inhabitants by 
the hundreds. The burial of the dead of all ages and sexes is likened to 
scenes after a l>attle. 



Table 1. 
Mortality From Certain Causes in LaSalle. 







j_ 










^ 














s 


b 








U 


3 

6 


a 




1 


i? 


cS-S- 


YEAlt 


3 














OJ 


N 






-h 






























o 




1 


1 


2 


g 


1 


s 






IS 


-"5 


1918 


320 


4 






g 




1 


3 


1 

68 




8 


64 


1919 


149 


1 














4 




16 


15 


1920 


196 


4 






2 




2 




17 




7 


25 


1921 


151 


... 


















8 


9 


1622 


1«4 
















2 




4 


14 


1923 


174 


1 










1 




3 




6 


15 


1924 


161 


2 














4 




6 


9 


1925 


161 


... 










3 




;) 




11 


13 


1926 


184 


" 






2 




6 




9 




13 


16 



Table 2. 
AIort.nlitv Rates From Certain Causes in LaSalle. 







s 








^ 


t 






V, 








s 


t. 








% 


n 


a 




"^ 


i" 


nl? 


YEAR 


2S 














S 


a 




































O 




3 




1 


1 


1 


s 


3 
C 


a. 


1 = 




1918 


25.4 


32.4 






40.3 




8.0 


24.1 


548.3 




64.5 


510.1 


1919 


11.5 


7.6 














30.7 




123.0 


115.3 


1920 


14,9 


30.6 






15,3 




15.3 




130.7 




53.8 


192.3 


1921 


11.4 














22.6 






60.2 


67.8 


1922 


12.2 






... 








29.8 


14.9 




29.7 


104.2 


1923 


12.8 


7.3 










7.3 


7.3 


22.2 




44.4 


111.1 


1924 


11.7 


14.2 












14.2 


28.4 




42. S 


64.2 


1925 


11.6 












21.5 


7.1 


35.9 




79.1 


93.5 


1926 


12.6 


13.7 


... 




13.7 




41.4 




62.1 




89. 


109.5 



per 1,000 pii|nil;iti. 



per 100.000 populati. 



LA SALLE, OGLESBY AND PERU 



225 



Beebe says that : 

"During the summer of 1853 cholera again made its appearance, and 
with increased violence. From the first settlement of the town to 184S, 
with the exception of the years 1838 and 1839, when bilious fever pre- 
vailed to some extent, the inhabitants had enjoyed immunity from 
disease, seldom experienced in new western settlements, or indeed, in 
any other. For the space of one year, no death occurred except from 
casualty. Even the ague found few. if any subjects. Throughout the 
summers of 1S50 and 1851. cholera continued its ravages in the surround- 
ing towns and country, and visited Peru but slightly. In the early part 
of the summer of 1S52, when LaSalle and other contiguous places were 
scourged, Peru remained healthy. At length it appeared tc have spent 
its material and departed the entire country. Suddenly it reappeared; 
and while the places i)reviously afflicted remained healthy, Peru was 
devastated to an extent not surpassed, if equaled, by any place in the 
United States. The estimated number of victims was from five to six 
hundred, being about one-sixth of the entire population. It was observed 
that less panic and excitnient were produced than upon its visitation in 
1839. But few cases occurred in the two following years, and from 
that time to the present — 1S5S — the same freedom from disease has pre- 
vailed which distinguished its early settlement." 

This hamnving experience with cholera was evidently the thing that 
first brought a demand for an official public health organization in any of 
the three municipalities. The boards of health that this emergency sum- 
moned into being probably had little to do with it but cholera never again 
spent its fury upon these communities with sufficient force to awaken alarm. 
If it ever appeared there again the fact escaped significant notice. 

One bad epidemic of smallpox in the communities is recorded. It oc- 
curred in lyl2. Due to the character of the population, a good deal of 
prejudice and the lack (jf a strong health department it was hard to manage 

Table 3. 
Cases of Certain Diseases Reported in La.Salle. 





1916 


1917 


1918 


1919 


1921 


1022 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


as 




1 


4 


4 


, 


4 


4 


2 


3 


1 


Smallpox 


2 




1 


1 


1 














Measles 


112 


247 


212 


3 


7 


r,n 


42.3 


hi 


12 


411 


'32 


Scarlet Fever 


43 




7 


1 


20 


18 


27 


27 


4 


2 


161 


Whooping Cough 








... 


10 


18 


28 


18 


116 


190 


10 


Diphtheria 


'30 


'76 


'2s 


4 


40 


.'i'l 




37 


6 


1 




Influenza 






1781 


1« 




13 




2 


.5 


1.) 


f, 


Poliomyelitis 


' h 




1 


1 


5 








•2 




3 


Meningitis 
















"3 


1 




2 


Tuberculosis* 


17 




' '3 




■24 


'i7 


23 


29 


23 


'24 


36 


Pneumonia* 






26 




32 


44 


40 


38 




102 


34 


Syphilis 
















6 


11 


14 


12 


Gonorrhea 
















12 


32 


34 


22 



•All forms. 

No figures avaihible for 1920. 



226 



DOWN-STATE ilU X 1 CI I'ALITIES 




0. C. Yoder. M. D. 
Health Officer, Peru 



and involved over 200 cases before it subsided. Since the orj^anization of 
the Hygienic Institute, smallpox has never stained an appreciable foothold 
in tile territory that it serves. 

1 )i])litheria also visited these communities with particular severity on 
one occasion that made the epidemic stand out in 
bold relief above ordinary outbreaks of that dis- 
ease. This happened in 1888. Scarcely a home 
in which there were children escaped and few 
families withstood an attack without the loss of 
one or more members. Diphtheria was com- 
mon before and after that dreadful experience 
but no other single epidemic of this disease is 
recalled with such grievous vividness. More 
recently a determined campaign by the health 
department against diphtheria seems to have been 
attended with satisfactory results. Only one 
death was registered in LaSalle and Peru in 1925 
and none in 1926. No cases were reported in LaSalle in 1927. although 
the prevalence of the disease in the State at large that \ear advancetl thirty 
per cent above the 1926 figure. 

Problems of typhoid and scarlet fever presented themselves to plague 
the inhabitants of the district on numerous occasions. There were 25 cases 
of typhoid in LaSalle in 1916 but that disease has been practically eliminated 
from the district through successful efforts to cause the abandonment of 
privies and through intelligent sanitary supervision over water and milk 
supplies. Scarlet fever is still an unsolved problem, a rather widespread 
epidemic having occurred in 1927, but it seems to be less malignant than 
in years gone by and there is hope upon the horizon that specific means of 
prevention may shortly be at hand. 

Infantile paralysis did not overlook the district during the epidemic 
wave of that disease in 1916 nor in 1927. In the former year nine cases 
were reported from LaSalle and Peru and some half dozen in the latter. 

Influenza was deadly there in 1918. It caused 68 deaths in LaSalle 
and Peru, yielding a mortality rate of 548 per 100,000 population. Pneu- 
monia was charged with 64 deaths in the same year, giving a rate of 516 per 
100,000. 

Statistics for }ears prior to the opening of the Hygienic Institute are 
incomplete and unreliable but the illustrations cited are sufficient to indicate 
tliat the communities now embraced in the health district suffered from their 
full share of communicable diseases and that the operation of the Institute 
has resulted in a pronounced improvement in health conditions. 



LA SALLE, OGLESBV AND PERU 



227 



Table 4. 
Births and Infant Deaths in LaSalle. 





Births 


Infant Deaths 


YEAR 












Number 


Rate** 


Number 


Rate* 


1918 






45 




1919 






24 




1920 


3.-il 


26.7 


35 


99.7 


1921 


344 


25.!. 


23 


72.7 


1922 


301 


22.0 


21 


69.8 


1923 


320 


23.3 


26 


81.3 


1924 


347 


25.2 


27 


77.8 


1925 


310 


22.3 


30 


96.8 


1926 


301 


20.6 


27 


89.7 



'Deaths of infants under 1 ye 
** Per 1000 population. 



of age per 1,000 birtlis repurted. 



References 



Data supplied by Dr Arlington Ailes, Director of the H^vgienic Institute, LaSalle, Illinois. 

Text supplied by Dr. Arlington Ailes. especially in reference to the early boards of health, cholera 



and other epidemics of thi 
Annual Report of the 
Annual reports of the 
Illinois and the West, 
History of Peru, H. S. 
State Water Survey Bulletin, Bartow 



1 the organization of the Hygienic Institute. 

Ik', fiscal year ending March, 1902, LaSalle, Illinois. 

iiMte, LaSalle, various dates. 

l-.nston, 1838. 



U, S. Census Reports, Washington, D. C, 



"Moline 

Located on the banks of the Mississippi River a few miles above the 
mouth of the Rock River, Moline spreads across most of the intervening 
territory which is only one and a half miles in breadth, with a population 
largely of Scandinavian ancestry, estimated at 34,500 in 1926. F'rincipally 
industrial, the business of the community centers around the manufacture of 
farm implements and tractors. 

Moline is not a communit)' apart but lies contiguous to the cit\' of Rock 
Island on the one side and practically so to East Moline and Silvis on the 
other, while Davenport stretches along the opposite shore of the Mississippi. 
Intimate intercommunications are always maintained between these several 
municipalities and this fact complicates the health problems of the one great 
community. 

-Moline was incorporated as a town in 1848 and under a special charter 
in 1855. It was reorganized as a city under the Cities and Villages Act in 
1872. Another change in the city administration took place in 1911 when 
the commission form of government was adopted and then in 1919 it reverted 
back to the aldernianic form. 

Growth and development in Moline have lieen gradual and substantial. 
The place first appeared as a separate unit in the United States Census re- 
turns in 1860 when 2.028 people lived there although the first white settlers 
arrived about 1828. This number grew to 4,166 by 1870 and to 7,800 in 
1880. In IS'HI there were an even 12,000 inhabitants and in 1900 there were 
17,248. At the end of the next decade the population was 24.199 and 30.- 
734 in 1''20. About 24 per cent of the 1920 population were foreign liorn 
whites and a trifle more than one per cent were negroes. About 21li> per 
cent were 45 \ears old or over. 

Health Maciiinkry 

The Cities and \'illages Act provides for the establishment of local 
boards of health and it is ])robable that Moline adopted an ordinance taking 
advantage of that feature in 1872 when the city was incorporated under the 
Act. 

At any rate we find the cit\' council ado])ting a compulsor\- vaccination 
ordinance in 1881. when .smallpox threatened the community, and the health 
officials busied themselves with its enforcement. Both the passage of the 
ordinance and the activities concerning its enforcement imply the previous 
existence of some sort of official machinery. Not only so but reference 

(228) 



MOLINE 



229 



is made of the fact that Dr. C. Piper was president and Dr. L. G. Dunn, 
secretary, (if the lioard of health in 1882. 

About this time the cit\" spent $6,000 in cnnstructinsjf an iscilation hos- 
I'ital. tor the detention of smallpcix jiaticnts. There seems to have been 
Httle if any change in the legal arrangements for providing a healtli organ- 
ization between 1872 and 1905. During all that period there was probably 
technically in existence a board of health and for the greater part of the 
time it functioned through a lay health officer, usually the chief of police. 
Edward Kittleson, still a member of the police department, filled this dual 
office over a long period. The board of health had on it one (ir more physi- 
cians and apparently the chairman of the board, usually a doctor, was re- 
garded as the administrative head of the city"s health service. 

In 1905 a new practice was inaugurated when an ordinance revising 
the status of the board of health and creating the 
office of city physician was adopted. This 
lilaced the responsibility for administration 
s(|uarely in the hands of the meiiical profession, 
the cit\' physician being paid for his services on 
a part time basis. 

The list of city physicians include: 

R. C. .J. Meyer, M. D. 1!H).5 

A. H. Arp, M. D. 1907 

Perry H. Wessel. Jr.. M. U. 1911 

H. S. Bennett. M. D. 191.5 

W. T. Hinmiui, M. D. 1917 

A. H. Kohler, M. D. 1919 

E. A. Edlen, M.D. 192:1 to date 




R. C. J. Meyer, M.D. 
City Physician, 1905-1907 



With the a(lii]ilii>n of the commission form 
of government in 1911, no material change was 
made in the method of administering the health 
department. The office of city physician was 
continued and the commissioner of public health 
and safety chose to deleg"ate to him the responsi- 
liilities of carrying out the public health duties. 

.\fter a few }'ears of commission government 
the city revertel back to the aldermanic form in 
1919 when an ordinrmce was passed making the 
mayor the citv ph\sician and the health inspector 
a board of health. This was later expanded to 
include other members of the health department, 
which in 1027 included an inspector and a 
chemist, and an alderman. 




E. Z. Eastman 

First Commissioner of 

Healtii and Safety, 

1911-1919 




230 DOWN-STATE MUNICIPALITIES 

\'oluntary and other public or quasi-public agencies have added a very 
considerable strength to the public health machinery of the city so that the 
volume of work done is much greater than the limited capacity of the health 
department staff would suggest. The county participates in tuberculosis 
work through funds collected by tax levy under authority of the tuberculosis 
sanitarium law, the school board employs a nurse and operates a dental 
service while voluntary agencies maintain a clinic for crippled children, a 
system of infant welfare stations, a visiting and 
public health nursing service and allied types of 
work. One of the most complete and active 
health centers found anywhere in the State is in 
Moline under the management of voluntary 
agencies with Miss Mabel Dunlap, a nurse and a 
splendid executive, in charge. 

A good conception of what public health ser- 
vice is maintained may be gathered from the re- 
port of a survey made by the State Department 

of Public Health in 1926. It reads, in part, as „ 

^ E. A. Edlen, M. D. 

follows : City Physician, 1923 to date 

"Scoring 571, or .57.1 per cent, Moline ranks seventh from the top 
among the fifteen cities embraced in the appraisal of public health 
activities. 

"The health department, functioning under the authority of a 
hoard of health, consists of a part time health officer and an inspector. 
The former acts as registrar of vital statistics and is personally active 
in communicable disease control while the latter, who is appointed by 
the mayor, placards premises for quarantine, makes sanitary inspec- 
tions, collects samples of milk and supervises garbage collection. One 
full time school nurse and a part time dentist are supported by the 
board of education, while the King's Daughters and the Red Cross com- 
bine resources in maintaining a public health and bedside nursing serv- 
ice, devoting considerable energy to prenatal and preschool hygiene. 
Voluntary and other agencies are responsible lor far more of the health 
work in Moline than is the city government, efforts of the latter b?ing 
credited with only 149 of the 571 points earned. 

"The tuberculosis clinic is a county project in which Moline shares. 
A venereal disease clinic was discontinued in 1925 after several years 
of operation. Clinics for infants and children appear to be functioning 
less vigorously than in years gone by. 

"Out of the city treasury is expended slightly more than eight cents 
per capita annually for public health service, funds appropriated to the 
health department for garbage collection being excluded. Other agencies 
contributed enough to make the gross per capita expenditures about 39 
cents in 1925. Apparently Moline gets maximum returns on the money 
invested in health projects, ranking relatively high on the score sheet 
and very low in the appropriation column. 



.MOLINE 231 

"Reporting of cases of comniunicable diseases and record keeping 
was reasonably complete. The health officer states that he personally 
visits about one-half of all cases of contagion reported, giving educa- 
tional advice to the household. A sanitary inspector placards premises 
and releases from quarantine. No communicable disease nursing service 
is maintained. Two isolation hospitals, one for smallpox and another 
for other communicable disease patients, are provided in the city. Out 
of 14 cases of diphtheria last year only one was cared for by the isola- 
tion hospital, while but 5 out of 72 scarlet fever patients received hos- 
pitalization. 

"A very commendable practice is that of notification between the 
school and health authorities of all cases of communicable diseases that 
may be of concern to eitlier. 

'"Tuberculosis field nursing service and the follow-up work of post- 
sanitarium cases is done with great thoroughness. A total of 1,020 
visits were recorded as having been made in 1925, whereas the aiipraisil 
quota tor the city on the basis of 13 deaths from tuberculosis during the 
year was only 650. Under the supervision of the county sani'arium 
board a clinical service is maintained for the entire county in wliich 
Moline participates. 

"While local sanitarium facilities are inadequate to take care of the 
community needs, still the county allows $25.00 per week per patient 
for this service to tuberculous citizens. Under these circumstances only 
1,646 patient days were spent in sanatoria by Moline citizens. Further- 
more, the patients who received sanitarium care at public expense were 
mostly moderately advanced in the disease, practically none being in an 
incipient stage. 

"Voluntary agencies provided 210 field nursing visits to prospective 
mothers. There is no prenatal clinic, although an educatioral center 
for prospective mothers is maintained and had 550 visits recorded for 
last year. 

"A rather large percentage of the l)irths of the city take place in 
hospitals. Field nursing visits in behalf of infants are about one-half 
of the required number for a maximum score on that item, while the 
number of infants in attendance on the clinic uumljered l,:;4ii against 
a requirement of 1,642. 

"Field nursing and clinical service for the preschool child were at a 
higher ratio, the score for these items approaching very nearly the 
maximum. It appears that the work done in behalf of the preschool 
child (age 2-6 years) is much more nearly equivalent to the appraisal 
requirement than any other jjhase of public health service in the city. 

"The board of education furnished a visiting nurse and a part-time 
dental surgeon, but no school physician to look after the health of its 
grade school children. In the private schools these activities are under 
the supervision of the King's Daughters. Frequency and completeness 
of the weighing, notification of parents, and the follow-up of under- 
weights meet all reasonable requirements for such activities. 

"Out of 3,474 public school children examined by the dental sur- 
geons, 1.739 were found who needed attention, and 1,311 received treat- 
ments consisting of fillings, extractions and oral prophylaxis. In the 



232 



DOWN -STATE MU XICIPALITIES 



private schools 104 of the 519 ohilrlren found with dental defects were 
given treatment. 

"While the public water supply is ordinarily sate and the super- 
vision good, still the purification plant is heavily overloaded. To this 
condition has been attributed one or more epidemics in the past. A 
house-to-house sanitary survey made by the State Department of Public 
Health in 1920 stowed the existence of 1.635 privies with only 77 per 
cent of the dwellings connected to sewers. While many of the privies 
have doubtless been abandoned during the intervening years, it is reason- 
able to conclude, in view of experience 
elsewhere, that hundreds of these primitive 
accommodations still exist. 

"The city maintains no public health 
laboratory, although a municipal chemist 
is employed who tests the public water 
suiiply daily and examines samples of milk 
and food supplies at the request of the 
board of health. A branch laboratory of 
the State Department of Public Health pro- 
vides facilities for examination of diph- 
theria cultures locally. 

"In summing up the situation in Mo- 
line, it can be fairly stated that the local 
health department is doing all that is 
humanly possible with the limited person- 
nel at its command. The president of the board of health, the city phy- 
sician, the registrar of vital statistics and the health officer are one and 
the same man; and he is on a part-time basis with a salary of $600 per 
year. The health inspector, in addition to his multiplicity of re- 
sponsibilities in the health department, assumes supervision of the 
collection and disposal of garbage." 




\. E. Anderson 
City Chemist 



Water Supply. 

The first waterworks at Moline vi'as constructed by a private company 
in 1883 and pin-chased by the cit\- in 1S87. The supply was obtained from 
Mississippi River. 

The city installed a mechanical filtration plant in 1902, consisting of 
three filters. In l''ll, two more filters were added. Hypochlorite was used 
in that year and was replaced by liquid chlorine in 101, t. 

It was estimated that the typhoid rate was about four times as hijjh 
previous to the installation of the purification plant, as it was later. How- 
ever, in the winter of l''17-18, typhoid became more prevalent and an investi- 
gation indicated that cit\ water was the cause due to the use of insufficient 
chlorine. 

I'ntil recently cross connections lietween the raw and filtered water 
made it necessary to classify the suppl\- as doubtful. At present, the plant 
is old ;uid liadh in need of reconstructing; and enlarCTinaf. 



233 



MOLIME 




VITAL 5TATI5TICS«1 

conn. Dis, coriTROLsi 

VEh. DIS. COriTROL 
TUB. COMTROL 
HEALTH CHILDs<--n5 
HEALTH 5CH. CHILD ^ 
SAMITATIOri^ss."-^ 
niLK COMTROL 
LABORATORY 
POP HEALTH m5m 



PCRCEMT OF STAMDARD SCORE 
FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 
1925 




Tliis i;raijh illustrates the stioiis and weak iioints in .Moline's pulilic 
health service, official and voluntary, as it existed in 192.5. It is based uiion 
a personal survey and rated ui:on the standards evolved by the American 
Puljlic Health Association. The total efficiency rating in Moline was 57 
per cent of the standard perfection reriuirenient. 



Reports on tlic pollution of the river and the purification plant prepared 
by Alvord & Burdick, sanitary engineers, and Dabney H. Maury, consulting 
engineer, recommend reconstructing the filters and increasing the storage 
capacit}'. 



Si:\vi;ra(;k. 

The first sewers were installed about \'Hr> and since that time the sys- 
tem has been extended luitil, at present, the most of the city is adeqitately 
sewered. The system is built on the separate plan. There are t\\d sanitary 
sewers discharging i^aw sewage below the waterworks intake and one sanitary 
sewer discharging treated sewage above the intake. The treatment includes 
Imhoff tanks and chlorination. 

The ri\er is badly polluted b\ other cities as well as Aloline. and many 
complaints ha\e been made. 



234 DOWX-STATK MUNICIPALITIES 

IIl'.Al.TH COXDITIOXS. 

\\ liilc tuberculosis, typhoid fever, diphtheria and pcrhajis other infec- 
tions were undoubtedly causing far more damage to health and life smallpox 
is the deadly disease about which centers practicall\ the whole story of com- 
nnniit\- health during the early days. Tradition of earlier suffering very 
likcl\ grew dim in the glare of subsequent epidemics so that the first im- 
l)oriani outbreak of which record is available took place in 1881. During 
that \ear smallpox, carefully concealed in a bale of rags, arrived in Moline. 

A great epidemic wave of smallpox was just starting in the .'^tate. f-)ne 
of the most deep seated foci was in Chicago, the great immigration terminal. 
I'rom that point a bale of rags was consigned to a factor) in Ahiline and 
eight of the employes who handled it promptly came down with smallpox. 
Exposure of citizens had been general so the disease started to spread. 
Alarmed at the prospects of a general epidemic compulsory vaccination was 
ordered by the city council so that the outbreak was limited to 21 cases and 
some half dozen deaths. During the next few years smallpox could not get 
a foothold in the city although introduced on several occasions and in spite 
of the fact that a general epidemic prevailed in the State during the early 
eighties. The wholesale vaccinations iluring the autumn of 1881 rendered the 
communitx' immune. 

Like every other good thing the immunity against smallpox wore oflf 
with the passing of time and the neglect of vaccinatitin. Xew immigrants 
came in, new babies were born and even the immunil\ in those who had been 
vaccinated grew less complete as time went on. Consequentlv, the city was 
again open to danger and danger usually seeks out favorable places. So 
from about 1900 on Moline has been a rather chronic focus of smallpox. 
Records are incomplete for the first fifteen years after that date but begin- 
ning with 1916 up through 1927 the city has not entirely escaped the disease 
in an\ \ear. Case reports have varied from 1 to 102 per year while 
the character, of the disease has manifested itself in every degree from ex- 
treme mildness to extraordinary malignancy. In 1''24, for example, nine 
out of 52 cases that occurred in Aloline. R(.)ck Island and ."sterling, termin- 
ated fatally. 

Tvphoid fever has been a chronic problem in Moline for years. The 
citv escaped during a whole \ear without a single case for the first and only 
time, so far as records disclose, in 1927. The worst experience occurred 
in 1917 and 1918. Toward the end of December 1917, a serious outbreak 
of typhoid fever developed. The first cases appeared late in July and in- 
creased numbers were reported during the following months. In the middle 
of January 1918, the disease reached epidemic proportions approximately .SO 
cases being reported during the first half of the month. 



Table 1. 

IMoRTALiTY From Certain Causes. 



235 



YEAU 


3 




1 






1 




•3 




6 

1 




1 


1 




1? 


S 


1906 
15107 
1S08 
1!)0» 
1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
192G 


276 
286 
309 
352 
276 
443 
358 
502 
436 
383 
386 
373 
614 
389 
371 
300 
281 
344 
311 
347 
359 


3 

7 
5 
18 
15 
12 
13 
(i 
12 
7 
24 
11 
3 
1 
1 
4 
1 
1 
1 












1 

' i 

"7 
"i 

4 
2 

"i 


23 

1 

3 
1 

i 

4 

6 
1 

' 1 


1 

"i 

1 

' i 

7 

' "5 
"3 


8 
10 

1 

7 
3 

2 

1 
4 
7 
(> 
3 
3 
1 
1 
3 
4 
1 


" '2 
8 

1 
134 
19 
15 
1 
(i 
7 
6 
7 
8 




L 


26 
44 
26 
32 
33 
38 

27 
41 
33 
10 
40 

2(1 
17 
23 
20 
20 

13 

18 


36 
2S 
35 
32 
30 
46 
30 

■33 
47 
48 
41 
89 
31 
46 
12 
12 
31 
13 
15 
29 



Table 2. 
AIoRTALiTY Rates From Certain Causes. 



YEAil 


3 

a 


1 


1 


•X 


S 




1 

1 


■c 


1 


^, 


Is 


c'^. 


1906 


12.8 


14.0 












23.3 




37.3 






121.3 


IflS.O 


1907 


12.9 


22.6 










9 


(» 


104.0 


4 


=, 


45.2 






198.9 


126.6 


1908 


13.5 


21.9 














4.3 






8.7 


8.7 




113.9 


153.4 


1909 


14.9 


29.7 










12 


7 


21.3 


4 


2 


4.2 


4.2 




136.1 


136.1 


1910 


11.4 


20.6 










4 


1 


12.3 


4 


1 


20.6 






136.3 


123.9 


1911 


17.8 


72.8 














4.0 






28.1 


4.0 




152.8 


183.1 


1912 


14.0 


58.8 
















7 


8 


11.7 






125.4 


117.6 


1913 


14.1 


45.8 










3 


K 


3.8 






7.6 






103.2 




1914 


16.2 


48.4 






















7.4 




152.8 


123.1 


1915 


14.0 


21.8 




















7.2 


10.9 




120.1 


171.1 


1916 


13.7 


42.6 




















3.5 


17.7 




56.8 


170.6 


1917 


12.6 


24.3 














13.8 


3 


4 


13.8 


3.4 




138.9 


142.4 


1918 


20.4 


85.7 












(1 


21.4 


1(1 


7 


25.0 


478.5 




114.2 


317.8 


1919 


13.2 


35.8 














3.2 






19.5 


61.8 




84.6 


100.9 


1920 


12.0 


9.6 










3 


2 




16 


1 


9.6 


48.3 




54.8 


148.3 


1921 


9.7 


3.2 




















9.5 


32.0 




72.9 


38.0 


1922 


8.7 


3.1 




















3.1 


18.6 




62.1 


37.3 


1923 


10.5 


12.2 










12 


2 




« 


1 


3.0 


21.7 




61.1 


94.8 


1924 


9.3 


3.0 










i; 











9.0 


18.0 




66.0 


49.0 


1925 


10.2 


2.9 














2.9 


S 


7 


11.7 


20.6 


.9 


38.3 


44.2 


1926 


10.4 


2.9 










- 


9 


3.8 






2.9 


23.2 


" 


52.1 


84.0 


XOTE : 


"he rat 


=• from 


\ll ( 


3a u 


es 


is r 


sr 1 


300 


popula 


tion 


a 


1 olhcr 


Iior 100.00 


lir 


pulatio,, 





DOVVX-STATF. MUXirirALITIES 



The State Department of Public Health was called upim td make an 
investigatinn. The findings pointed strongly to the water supply as the 
soiux'e nf infection and after remedial steps were taken the epiilemic abated 
ill llu' latliT ]>art of Januar\. and the situation seemed practically cleared up 
during l-"cl>ruary and .March. 

Table .1. 
Casus oi- Ci;rtain Diseases Reported. 



1 

1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


•I'viilioid Fever 


!)7 


47 


334 


40 


9 


14 


6 


13 


, 


3 


_ 




Sinuilp.i.t 


28 


102 


8 


33 


94 


70 


4 


7 


20 


1 


1 


5 


Measles 


10 


110 


4.59 


28 


452 


159 


17 


1042 


357 


37 


247 


1026 


Srarlet Fever 


r.3 


OS 


77 


21 


23 


41 


24 


20 


21 


75 


73 


33 


Wli. ,.!,,. C.u^'li 


1 


32 


99 


31 


164 


43 


32 


219 


23 


373 


91 


179 


liiplilli.Ti., 


26 


52 


64 


57 


73 


22 


16 


44 


91 


14 


49 


7 


Irillnt'iizj 






2008 


42 


247 


2 


69 


11 


2 


s 


7 


4 


I'l.li.iiinelitis 


' 4 


"s 




1 




1 




1 




1 


2 




Meiiiiisitis 




1 


' "i 


6 


i 


2 


i 


1 


1 




1 




Tuberculosis* 


19 


s 


5 


11 


69 


114 


93 


77 


68 


55 


87 


143 


Pueunioniii* 


... 








50 


44 




54 


31 


77 


129 


97 


Svphilis 


1 




"i 


' 6 


00 


68 


70 


57 


56 


45 




21 


(i.uuu-rhe:i 






(13 


127 


244 


294 


142 


137 


111 


70 


47 


39 


CluiTicroid 






3 


^ 


7 


11 




3 




... 







♦.Ml forms. 
NOTIC : Case reports 
Illinois. 



never complete, but they lune b 
table indicates signific^int iinpri 



In .\pril 1018, the disease reappeared, with an increased number of 
cases during May and again assumed epidemic proportions in June and in- 
creased in seriousness during the first half of Julw In the first fifteen da}S 
of this month, 125 cases were reported. 

A more painstaking and exhaustive study of the situation was made 
which linall\ determined that the epidemic was due to the faulty operation 
of the water plant, whereby raw and untreated water from the Mississippi 
l\i\er had been permitted to enter the local supply. 

The epidemic carried over into January of l''!'.* liut since that time 
the typhoifl rate has not lieen unusually high although the city had but one 
free \ear, \'>27, from the disease. 

Tuberculosis was at one time of major importance as a cause of death 
in .Moline but the careful and persistent work a,gainst that malad}' has re- 
sulted in a \ei'y satisfactory improvement in that respect. The mortality 
rale of .s2.1 ])er llH),(K)(l population in I'lid was one of the most favorable 
among the cities of the .State. None of the other communicable diseases 
have manifested themselves in any extraordinary fashion in IMoline, with 
the possible e.xception of influenza and ])neunionia. The mortalitv rate in 
.Moline from these two inlcctioiis together was the sixth highest among 
municipalities of the State in I'MS. With l,i4 deaths attributed to inlluenza 
and S'» to |ineinnonia in that \ear, the niorl.'dity per 100,000 mounted to 
478. .S and 317.8 resi)eclivel\ . 



237 



Table 4. 
Births and Infant Deaths. 



1 

1 Births 
1 


Infant Deaths 


YE Alt 

Number 


Hate** 


Number 


IHate* 



1!IOO 






37 




1901 






38 




1902 






37 




1903 






34 




1904 






38 




190r, 






41 




ISOfi 


434 


20.3 


51 


117.5 


1907 


490 


22.2 


64 


130.6 


1908 


473 


20.8 


54 


114.1 


1909 


385 


10.4 


51 


132.4 


1910 


480 


20.0 


43 


89.4 


1911 


563 


22. 8 


48 


85.2 


1912 


508 


20 ^0 


57 


120.0 


1913 


5f,5 


22.0 


69 


128.0 


1914 


626 


24.0 


50 


86.0 


1915 


512 


18.2 


53 


96.0 


191(i 


597 


22.0 


56 


92.6 


1917 


547 


IP. 7 


36 


61.1 


1918 


554 


19.fi 


57 


92 . 6 


1919 


579 


19.7 


44 


75.0 


1920 


834 


26.8 


37 


44.4 


1921 


739 


23.3 


32 


43.3 


1922 


658 


20.4 


32 


48.6 


1923 


626 


19.1 


41 


65.5 


1924 


630 


18.9 


39 


61.9 


1925 


643 


19.0 


27 


42.0 


192(5 


662 


19.2 


40 


60.4 


1927 


732 


20.08 


31 


42.3 



* Deaths of infants under 1 
*• Per 1000 population. 



of age per lOOil births reported. 



Altogether, however, Mohne enjoys splendid cominunit\ health in spite 
of her unhappy experiences with some of the epidemic disorders. The gen- 
eral death rate is lower than that for the State and lower than that for most 
of the comparable municipalities in Illinois or any other state for that matter. 
Deaths among infants less than a year old are likewise few in number com- 
pared with other places. The rate in 1926 was 60.4 per 1,000 live births, 
a figure just one-half of that for 1912. Since infant mortalit}' is regarded 
as a sensitive index to health conditions and to the effectiveness of public 
health service, the prevailing low rate during recent years may be accepted 
as a manifestation of effective infant and prenatal hygiene service in Moline 
and of a relatively good condition of public health. 



References. 

Revised Ordinances, Citv of lloline, niinois, 1920. 

Annual Deports of the State Board of Health, Springfield, Illinois, various dates. 
Report of an Apprni-;il r.f Hoalth Service for the Year 1925, in Fifteen Illinois Cities, Isaac D. 
vlings, M. D., Direrl". "1 I'ulilir. Health, Illinois Health News, Ma.v-.Iunc, 1920. 
Bulletins of the IIIu.mi- ^i m. Water Survev, Urbana, various dates. 
U. S. Census RepniK. n .i.lji.i^i.jn D. C, various dates. 



Oak Park 

B\ Dr. 1-raitk S. Nccdhain. Health Coiiiiiiissio)icr. 

Joseph Kettlestrings, an Englishman from Yorkshire, was the first white 
settler within the boundaries of what is now known as Oak Park. With 
his wife and three children he came here in 1833, making the journey from 
Cincinnati in a covered wagon. At that time, according to William Halley 
in his Pictorial Oak Park, "Not a vestige of civilization was visible. Chicago 
itself was only an outpost village of a few inhabitants. There were no rail- 
roads and no country roads. There were, however, few Indians to fight, 
no trees to blaze for pathways through dense forests, but still the pioneers 
had hardships to endure. The land itself was not yet pre-empted nor open 
for settlement and those who had settled were simply squatters." 

Two years later, when this land was put up for sale, Kettlestrings 
purchased the quarter section known as Oak Ridge because, as he said, "It 
was the only dry land between Chicago and the Aux Plaines", — as the Des 
Plaines River was called. The home of oak boards which he erected on 
this land was the first house of any kind ever built in Oak Park. Later, 
when suitable additions had been made tu this building, he started a tavern 
known as "Oak Ridge House". He had been working, meanwhile, for 
George Bickerdike, who owned a saw mill on the banks of the Aux Plaines, 
and eventually Kettlestrings became his partner in the business. 

The sale of public lands, of course, brought more settlers and the busi- 
ness man, and in 1848 the first train ran from Halsted Street to the Des 
Plaines River. Later this road became the Chicago & Northwestern railway 
and transported grain brought by the farmers from west of the Des Plaines 
River to Halsted Street. 

In 1858 the town could not boast more than half a dozen houses, all 
situated on Lake Street. The school house had been erected in 1855. The 
first drug store and doctor's office were opened in 1866, just after the Civil 
War, by Dr. Orin Peak. 

The name "Oak Park" dates only from 1871, when the Noyesville post- 
office and the Harlem railroad station were changed to conform to the new 
name. At that time and until 1902, Oak Park had no local governing body, 
being part of the town of Cicero. However, when Cicero was organized in 
1857, the residents of Oak Park had a large part in determining Cicero 
policies through a controlling power in elections, and this condition existed 
until 1867. From this time on there were fewer Oak Park men on the 
board and finally, in 1809, the misuse of privileges by officers of the board 
caused Oak Park to secede. 

(238) 



OAK PARK 



239 



Election of officers followed in ( )ak Park on December 17, 1901, and 
village government was inaugurated January 2. 1902, witli Allan S. Ray as 
the first president. 

Since then its po|)ulatiiin has increased rapidly and many changes and 
improvements have taken place. All of the streets and many of the alleys 
are novi^ paved. The sewerage system, wliicli was installed in 1891, has been 
enlarged to meet the increased demand, and an adequate supply of good 
water has also been provided for the village needs. 

The village of Oak Park is located directly west of Chicago and con- 
stitutes a rectangular area, three miles long and a mile and a half wide. On 
the north and east it is bounded by the city of Chicago, on the south by 
Berwyn and Cicero, and on the west by Forest Park and River Forest. 

The population of Oak Park has experienced its greatest period of 
growth since 1900 and particularly since 1910. There were 500 inhabitants 
in the village in 1871 and 10,000 in 1902. The census returns showed 
1').444 in 1910 and 39.900 in 1920. Of the 39,900 there were 9,877 or 24.7 
per cent in the 45 years or c>ver age group and 85.4 per cent were native 
born whites. Only 169 negroes, a matter of four-tenths of one per cent, 
were residents of the village. 

Health Department. 
On January 5, 1905, an ordinance was adopted by the village of Oak 
Park, creating a department of health. The first board of health was ap- 
pointed at that time, comprising Drs. W. E. Potter, H. G. Vaughn and 
A. F. Storke. Another ordinance providing health regulations was passed 
on January 14th. 

The health of the community was cared for l)y boards similarly a])- 
pointed until April 20, 1916, when Mr. C. E. Buck was appointeil as the first 
commissioner of health. Three months later, on July 20th, an ordinance 
was passed creating the first advisory medical 
board, consisting of the following: Drs. W. E. 
Potter, W. A. Ribbeck, G. W. Beebe, H. C. 
Vaughn, C. W. Poorman and J. W. Tope. 

About a year and a half later Mr. lUick re- 
signed and Dr. Frank S. Needham was appointed 
commissioner of health on Januar)' 17, l'M8 and 
has continued in office to date. 

As the result of a court decision in connec- 
tion with the quarantining of contacts, during a 
smallpox epidemic in another city in Illinois, the 
villa.ge of Oak Park amended the above ordi- 
Frank S. Neefiham, M. D. „ance on Mav 17, 1922, creating a board of 
Commissioner of Health, , , , '. . , . . ■" r i i i 

1918 to date health to consist of the commissioner of health 




240 DOWN-STATE MUNICIPALITIES 

and six otlier members selected from among the physicians of the village, to 
be appointed by the president, with the advice and consent of the village 
board, the commissioner of health to act as executive ofificer. The mem- 
bers of the first board of health so ap])ointed were as follows: 

Frank S. Xeedham. M. D.. Commissioner and ex-officio Chairman. 
L. W. Beebe, .M. D. W. L. Ruggles. M. D. 

C. E. Hemingway. M. U. W. T. Hughes. M. D. 

A. H. Parmalee. M. D. M. D. Jones. M. D. 



OAK PARK 

l% y ? ' : ° ^f ^ 



VITAL STATISTICS^ 
conn. DI5. COTiTROLwl 
VEh. DI5. COMTROL ^ 
TUB. COMTROL 
HEALTH CHILD^-i-il 
HEALTH 5CH CHILD '^ 
SAMITATIOh'^-"'-^"Il 
lilLK COMTROL 
LABORATORY 
POP HEALTH mt 



I PERCEMT OF STATIDARD SCORE 

FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 
[ 1925 I 

This graph illustrates the strong and weak points in Oak Park's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in Oak Park was 60 
per cent of the standard perfection requirement. 



The system of public health administration created by the ordinance of 
1922 continues to prevail. Under this ordinance the health department 
meets all legal requirements necessary for performing satisfactory service 
and for dealing adequately with all problems which the health authorities 
are likely to face. It ranked well up toward the top among fifteen leading 
cities of the State in a health service appraisal made by the State Department 



OAK PARK 241 

of Public Health in 1926, based upon the 1''23 activities. In the appraisal 

report we read : 

"The score of 599 gives Oak Park fifth place among the fifteen cities 
studied for efficiency and adequacy of public health service. This city 
is unique in being the only one of the group in which there is a board 
of health, all members of which are physicians, and this board has been 
of much assistance to the health officer in promoting a spirit of harmony 
between the health department and the local medical profession. Those 
activities which have been undertaken by the health department have 
been well carried out. A number of important services, however, are 
not under the direction of the health department. The health depart- 
ment employs one nurse for work in the parochial schools, but other 
school hygiene activities are under the direction of the board of educa- 
tion. 

"Infant welfare work is conducted by the Infant Welfare Society, and 
tuberculosis service by the Chicago Tuberculosis Institute. The health 
department handles vital statistics, contagious disease control, food and 
milk control, sanitary inspection and laboratory services. 

"The city health budget is $16,000 per annum, funds from other 
sources bringin.H' the total yearly expenditures up to $43,532, a matter of 
31 cents and S5 cents per capita, respectively." 

ViT.vL Statistics. 

The commissioner of health is the registrar of vital statistics and the 
records are maintained at the department of healtli. From the year 1917 to 
date, such records are intact and available for use. 

Published statistics usually are made up of all the births and deaths 
which occur in the village. This circumstance, coupled with the fact that 
a large maternity hospital to which many obstetric patients from other com- 
munities come, is located in Oak Park, makes it appear that the people of 
this village are unusually fecund. According to these gross vital statistics 
annual birth rates of from 30 to 50 per 1,000 population are common. As a 
matter of fact these rates shrink to a range of 12 to 20 when the data are 
analyzed to show the births in families who reside in Oak Park. 

Epidemics. 

During the year 1915 an epidemic of typhoid fever appeared in this 
C(jmmunity, caused by a typhoid carrier who was employed in the kitchen 
of the high school lunch rooms. About thirty cases of the disease developed 
among the pupils and teachers of that school. 

The year 1918 brought the influenza epidemic from September 23rd to 
December 31st. There was a total of 1,368 cases of influenza reported, with 
47 deaths from that disease. Seventy-six deaths from pneunu)nia also oc- 
curred during the same period. 



242 



DOWN-STATE MUNICIPALITIES 



Table 1. 
Mortality From Certain Causes. 



YEAR 


3 

3 


1 




1 


s 


1 

fa 


1 

5 
1 


Diphtlieria 
Influenza 


J 


If 

p 


ll 

3^ 

IS 


1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
192r. 
1926 


■l.-,6 
519 
448 
ri39 
527 
566 
651 
708 
759 
824 


... 
1 

' i 

3 

i 


'.'.'. 






4 

1 
4 

1 

"3 


' i 
2 

1 

1 


12 47 

2 29 

3 11) 
5 8 

4 5 
2 7 

1 4 

2 8 
4 13 






16 
16 
16 
13 
8 
17 
31 
22 
15 


'76 
50 
68 
37 
29 
39 
29 

■53 



Tal)le 2. 
Mortality Rates Fro.m Certain Causes. 







t. 










- 
















> 








t. 


"i 






r. 


»• 








fc. 








5; 





rt 




■2 


1" 


.2? 


YEAR 




•v 




g 








S 


rt 


■i 


"3 ^ 








B 


























S 




- 

1 


X 


is 




^ 


&- 


11 


Is 


1917 


13.5 
























1918 


14.4 


2 


8 








11.1 




33.5 


131.2 




44.6 


212 . 2 


1919 


11.8 






2.6 






2.6 


2.6 


5.2 


76.6 




42.2 


132.1 


1920 


13.5 












10.0 




5.0 


20.0 




32 . 5 


170.4 


1921 


12.3 


2 


3 






2.3 


4.6 




11.6 


18.6 




30.2 


86.0 


1922 


12.5 












2.2 


4.4 


8.9 


11.1 




17.7 


64.3 


1923 


13.7 














4.2 


4.2 


14.8 




30.0 


82.5 


1924 


14.3 


6 


I) 






2.0 


6.0 


2.0 


2.0 


8.1 




62.8 


.58.7 


1925 


14.8 














1.9 


3.8 


15.5 




42.7 




1926 


15.4 


i 


8 








3.6 


3.6 


7.4 


23.4 




28.0 


99.0 



Note: The rate from All C:u 



per 1000 pnpnlnti. 



nil others per 100,0110 populatii 



Smallpox appeared in Oak Park at the close of the _\ear 1920, 36 cases 
being reported. The State regulations for the prevention and control of this 
disease were established and unvaccinnated children were excluded from 
school, which involved legal entanglements. The case was finally disposed 
of in the courts in favor of the defendants. 



School Nurses. 

The first school nurse in Oak Park was appointed in January, l'U6, to 
take care of all schools in the village and to receive a salary paid jointly by 
the board of education and the village. 

Following the influenza epidemic in 1918, school inspection was 
arranged for and the number of nurses increased to four in the grade 
schools. Two other nurses were provided by the high school. 



OAK PARK 



243 



Tabel 3. 
Cases of Certain Diseases Reported. 





1921 


ly22 


1923 


1924 


192.-. 


192(1 


1927 


Typhoid Fever 




4 


12 


12 


4 


3 


3 


Malaria 












2 


1 


Smallpox 







3 


3 











Measles 


1244 


2S6 


.i34 


314 


1088 


108 


1044 


Scarlet Fever 


17S 


94 


86 


142 


168 


110 


133 


Whoop. Cnnsli 


22 I 


53S 


37S 


2fi7 


404 


173 


264 


Diplnheria 


107 


99 


:'.8 


34 


3B 


27 


36 


Influenza 




33 


22 


8 


9 


42 


12 


Poliomvelitis 






1 






1 


4 


Meningitis 


■■'■ 


1 


2 




4 


1 


3 


Tuberculcsis* 


41) 


3.-) 


30 


40 


40 


f>7 


.'>.') 


Pneumonia* 


111 


119 


140 


140 


1.57 


213 


l.-)3 


Syphilis 








1 


1 






Gonorrhea 


1 


1 


1 


3 


3 




4 



*AI1 forms. 
Note : Case reports are never complete, but they have been much i 
Illinois. This table indicates improvement in notification more tl 

About three years later the nursing force was increased to its present 
size, that is, five nurses for the grade schools, whose salaries are paid by 
the board of education, one nurse provided by the high school, and one nurse 
for parochial schools and health department work, whose salar\- is paid by 
the village. 

Laboratory. 

The laboratory in the health department was first established in a meagre 
way in 1905 and continued until l')14, when a full time bacteriologist was 
employed. 

At present a well-equipped laboratoi"}- is maintained as a part of the 
health department. Regular examination is made of the drinking water and 
all milk and cream sold in the village, in addition to the usual routine work, 
including examination of cultures, smears, etc. 

Talile 4. 
Births and Infant Deaths. 





Bi 


ths 


Infant Deaths 


YEAR 












Nuniher 


Rate" 


Number 


Rate* 


191Y 


777 


23. C 






1918 


941 


23.6 


41 


43 . 5 


1919 


913 


24.1 


43 


47.0 


1920 


1207 


30.2 


67 


65.5 


1921 


1224 


28. 4 


66 


53.9 


1922 


1.503 


33.3 


82 


54.5 


1923 


17S1 


37. 7 


66 


37.0 


1924 


2152 


43.6 


63 


29.2 


192.'> 


2283 


44.4 


80 


35.0 


1926 


2531 


47.3 


89 


35.1 



Kier 1 year of age per 1000 births reported. 



244 DOVVX-STATK MUNICIPALITIES 

Watkk Sri'j'LV. 

Oak I'ark oljlaincd its water sii])ply from in(li\i(kial wells until the 
year 1885, when deep wells were drilled, a reservoir constructed and mains 
laid. This remained the source of suppl\ until 1909, when Oak Park first 
connected with the water system of Chicago and a portion of the village 
enjoved this service. During the }ear 1912 the connection was completed 
and ( )ak Park received Lake Michigan water in all of its mains, pressure 
heing maintained by its own pumping station. 

The supply thus olHained proved to be inadecjuate at certain times of 
the day, especially during the summer montlis, so in 1912 a reservoir was 
constructed and installed, with a capacity of 5,000,000 gallons, enabling the 
village to maintain a reserve amount for use when the Chicago supply be- 
came low. 

Adjoining the reservoir is the ])umping station, which has six pumps. 
These may be used, in combinatiini, to raise the pressure to 45 pounds for 
domestic use and 60 pounds for lire protection, throughout the 101.38 miles 
of water pipes in the entire village system. 

Seweracf-:. 

The sewer system in Oak Park was laid about 1S'>1. draining south and 
empt_\ing into the Drainage Canal. Since that time two additional sewers 
have been laid in Chicago Avenue and North Avenue, flowing westward 
through the sanitar}- district sewage plant located in Maywood, Illinois. 

Oak Park now has 88 miles of sewers, ranging in size from b" to 84" 
in diameter. 

Privies are not allowed to be maintained within the village limits, as all 
streets have access to sewers. 

Garbage Collection and Dlsposal. 

The present incinerator was built in 1907, at an approximate cost of 
$12,000, with an estimated capacity of burning 30 tons a day. At the present 
time apprnximateh' 60 tons of garbage alone are burned dail\'. 

An ordinance [)n)vides for careful wrapping of all garbage, covered 
metal containers and other s;mitary precautions. 

S.\NITARV IxSPECTrOX. 

In addition to the nurse, bacteriologist and quarantine officer, the depart- 
ment employs a sanitary inspector, whose dvity is to examine all stores where 
food products are dispensed and to investigate insanitary conditions. 



OAK PARI-: 245 

Oak Park has a milk ordinance similar to that in effect in Chicago, 
which rec^uires all herds furnishing milk sold within the limits of the village 
to be tuberculin tested, as well as regular re(|uirements pertaining U> butter 
fat, bacteria and adulterants. 

Hospitals. 

There are two general hospitals in Oak Park, with a total capacity of 
about 500 beds. There is no cmitagious disease hospital but, when neces- 
sar\', patients with contagious infections ma\' be removed to the Cook County 
Hospital, or arrangements made for care at the Municipal Contagious Hos- 
pital or the Isolation Hospital in Chicago. 

During the year 1926 the health department purchased a new modern 
ambulance for the removal of such patients. 

Oak Park Hkaltii Center. 

The Chicago Tuberculosis Institute was responsible for the tuberculosis 
work begun in Oak Park. The first nurse employed by the Institute opened 
the first health center here on JNIarch 19, 1917, which was located in a store 
on Roosevelt Road and Harvey Avenue. Larger quarters were necessary 
in two 3'ears' time, when the health center was moved to Maple Avenue and 
Madison Street, where the Child Welfare Association was quartered. Regu- 
lar weekly clinics were held, with a local doctor specializing in tuberculosis, 
in attenflancc. 

In December of 1922, Dr. H. H. ]5ay came to the staff of the Chicago 
Tuberculosis Institute and has since been the attending clinician, having two 
clinics a month in Oak Park. 

Two years later, in 1924, the Institute severed its connection with the 
Child Welfare Association and moved into quarters of its own. The present 
health center is at 1145 Washington Poulevard, (Jak Park. 

The health center work is hnancetl entirely by the sale of Christmas 
seals through the Chicago Tuberculosis Institute, of which Mrs. Theodore 
B. Sachs is superintendent. 

Child Welfare Work. 

In the wSpring of 1919, the Oak Park Center of the Chicago Infant 
Welfare Society, which had been supporting a station in Chicago for three 
years, was asked by the Associated Charities of Oak Park to take over an 
infant welfare station which they had been trying to maintain for three or 
four years under great difficulties. 

This was done and from a registration of 52 babies, with one confer- 
ence each week, the attendance increased so rapidly that by 1924 the station 



246 DOWX-STATE Ml.XICIPALITIKS 

was holding three clinics for infants and one-pre-school clinic each week. 
Many mothers, who learned the value of the education received at these con- 
ferences, continued to attend and bring others with them, even after moving 
to other suburbs, until it became necessary to open three additional stations in 
nei.^hborins' towns. 

At the present time. Oak Park station has a registration of about 750, 
with ,111 average attendance at clinics of 40 babies and 15 children of pre- 
school age. The discharges for non-attendance, removals and age limit are 
offset by new registration of infants, thus maintaining the above average. 

The two nurses at this station visit the homes to demonstrate preparation 
of food formulas and render aid and instruction to the mother concerning 
general care of the baby. These nurses, together with a iihysician, are in at- 
tendance at each conference. 

The slogan of thte organization is "keep the well baby well", and their 
aim to instruct mothers to give their babies proper food, fresh air and rest, 
— above all, to consult a physician when the baby is ill. 

Heat. 

In January. 192,\ an orilinance was passed relating to heated apartment 
buildings, stores and factories, requiring that owners or agents must main- 
tain a minimum temperature of 60 degrees Fahrenheit at 6:30 A. M., and not 
less than 68 degrees Fahrenheit from 8:30 .\. AI. to 10:30 P. M. 

Plumbers. 

The board of examiners of plumbers was created in the year 1917. for 
the purpose of conducting examinations for the licensing of journeyman 
and master plumbers. 

Mr. W. A. Bunge, master plumber, and Mr, .Vlliert Lajeunesse, jour- 
neyman plumber, comprised this first board, with Dr. Frank S. Needham, 
health commissioner, as ex-officio chairman. 

Referen'ces. 

Xei'ilhaiii, Oak Park. 



Peoria 



Several starts were made under three or four names and the exact site 
of settlement was changed at least once before a permanent community got 
under way to make the present cit\' of Peoria. In 1680 the indomitable 
LaSalle gave it the name of Creve-Coeur when he felt heart-broken at the 
news of the loss of his boat the "Griffen". For a hundred years thereafter 
the place was a trading post where Indians, trappers and voyagers met to 
exchange their wares. 

In 17'il Robert Maillet built his house a mile and a half below where 
the cumniunity was located at that time because he thought it more healthful. 
The land was higher and drier and the drainage better. He was followed 
by all of the inhab.'tants and the new place was called LaVille de Maillet. 

Then came in 1797 a band of 126 Virginians who arrived after a gruel- 
ling journey thrdugh the woods, prairie and swamp only to be virtually ani- 
hilated by a putrid and malignant fever (probably diphtheria) that fell upon 
them in the overcrowded cabins that had been opened hospitably for their 
reception and comfort. It appears that none but French were occupying 
the place in 1812 when Captain Thomas E. Craig, under orders from Gover- 
nor Ninian Edwards, razed the place by fire after a brief bombardment and 
took captive the 75 white people who were there. All had French names 
but one and he was a Frenchman wlio had adopted an English name. 

A little later a military furt was established there b_\' the Amer.cans 
who called it I'ort Claris. This seems to have been the last change before 
the permanent civil communit}' that developed into Peoria began in 1819. 
Tlie fort was burned in 1818 by the Indians. Thus the present city of Pecjria 
began the next year after Illinois was admitted into the L'nion as a full 
fledged State. 

For fifteen years the struggling colony was 
scarcely more than a prcjspective community, too 
small to suggest organization. Then in 1835 a 
village government was created with Dr. Rudol- 
phus Rouse as president of the first board of 
trustees. The next decade was marked liy a 
gradual growth so that the community with some- 
thing less than 1.000 souls was incorporated 
as a city in 18.VJ. .\ few- years later, 1845, the 
first distillery, which proved to be the beginning 
of a tremendous industry that won for Peoria a 
naticin wide rc|)Utati(jn. was eslablished. 




HiKlolphiis RoM.se. .\1. D. 



(247) 



248 DOWX-STATIi MUXICIPAI.ITIKS 

Peoria lies on the west bank of Peoria Lake, a widening of the Illinois 
River, about 160 miles southwest of Chicago. The city is located on a 
plateau which rises from the lake to an average elevation of 85 feet abo\e the 
water level and varies in width from one-half to one and a half miles. IJack 
of this plateau are the bluiifs which rise from ItX) to 125 feet higher. Lake 
Peoria is about a mile wide and 20 miles long. .Many residences on the blufifs 
overlook the river, lake and surrounding country. 

The development of the city began with the opening of the Illinois and 
Michi.gan Canal in 1848. This prcjved of two-fold significance for it not 
only brought ccimmerce and industry. Init also a danger of invasion by 
disease, especially the dreaded cholera which broke out in Chicago in the 
following year and remained epidemic there fi)r aljuut f<iur years. 

In 1840 the population of Peoria was L467. P>y 1850 it has grown to 
5,095 and to 14.045 in 1860. The next six decennial census years found the 
city with 22,849, 29.259, 41,024, 56,100, 66,950 and 76,121 inhabitants re- 
spectively, the last figure being that for 1920. Of these 76,121. eighty-six 
and nine-tenlhs per cent or 66,177. were natise burn whites while 10.2 per 
cent or 7.7''0 were foreign born whites and Z.S per cent or 1,170 were 
negroes. There were 19.213 or slightly more than 25 per cent who .gave 
their age as 45 or more \-ears. 

HkAI.TI I MaCI 1 INHKY. 

The first profession;d health service of any permanent character in 
Peoria started with the arrival of Dr. Augustus Langworthy in 1824. He 
found less than 1,500 settlers in an area embraced in a radius of more than 
one hundred miles. Other phxsicians who located there during the early 
days inchiiled Rudolphus Rouse, Alfred Castle, I'.dward Dickinson and 
Joseph C. I'l'ye. l!y 1848 there were at least seven resident physicians in 
Peoria for in that \ear tlie Peoria City Medical Society, the first city medical 
society in Illinois, was organized with seven charter members. That was 
an important event in the health history of the community. 

This society began at once to exercise an active interest in public health. 
No later than January 10, 1849, it passed a resolution praying the city gov- 
ernment to create a board of health composed of four phxsicians and four 
non-medical members. This movement was precipitated b_\' fear of cliolera 
which was raging at the time in the L^nited States and while official records 
are l.'icking concerning the consequent response of the city council. Dr. 
O. B. Will of Peoria, who furnished the minutes of the medical society 
relating to the resolution, presumes that a board was appointed and began 
to function. He says: 

•■.•\11 of which means, as I talie it. tliat while nothing fan be found 
ro.si)ectin.i; the action of the "Town Council', it is fair to |)re=unie tint 



PEORIA 249 

the medical represeiitfitives consisted of Doctors Francis A. McNeil, 
Rudolphus Rouse, Edward Dickensen and Blias Cooper, particularly 
since Dr. Rouse was head of the Council." 

It is verv probahlc that a hoard came intn existence then and doubtless 
was very active during tlie summer of 1840 when the cholera which the doc- 
tors feared played deadly haxoc in the community. It is probable also that 
this or some similar bcjard continued to exist. technicall\' at least, until a 
reorganization (_)f the city goxernment in \S78. 

In that \ear the revised ordinance provided for a board of health C( m- 
posed of three members. One member, at the time, was a physician. It 
was vested with the broad powers and responsibilities common to such boards 
in municipal and state experience with the usual limitation of activities guar- 
anteed by short appropriations. Annual expenditures amounted to about 
$5CX).00 of which $200.00 went to the president of the board for executive 
duties which were a function of the office. Apparently the practice frotn 
date of reorganization was to appoint a physician chairman of the board and 
in his capacity as its executive officer he was actually the health officer of the 
community. Doctors who filled the position include : 

.John H. Niglas. M. D, 1880 Marcus Whiting. M. D. 1888 

J. L. Hamilton. M. D. 1882 B. M. Ross, M. D. 1891 

L. H. Si)aulding. M. D. 1S84 

In 1898 it became the practice to appoint a physician as health officer 
and to designate him as the commissioner of health. Physicians who held 
that position include : 

Alliert Weil, M, D. 19"" 

.1. Rix SchoU. M. D. 1909 

Edward Hassom, M. D. 1913 

E. A. Garrett, M. D. 1916 

George Parker. M. D. 1917 

E. A. Garrett, M. D. 1919 

Sandor Horwitz. M. D. 1923 
192.'5 to date 

Thus it appears that Peoria is one of the very few places in Illinois 
where the practice of employing laymen as health officers never prevailed. 
At first the president of the board of health always a physician, exercised 
whatever executive powers were necessary to accomplish the health projects 
undertaken. Later the commissioners of health, always physicians, exercised 
those functions. 

No radical change in the scheme for providing public health work in 
Peoria has marked the development of that service except the one in 1898 
when the board of health was abandoned and in its place a department of 



J. W. Hensle.v. M. D. 


1898 


F. C. Bourscheidt. M. D. 


1899 


J. T. Sloan, M. D. 


1901 


W. R. Allison, M. D. 


1901 


Lewis A. McFadden, M. D. 


1901 


H. M. Hayes, M. D. 


1903 


Elmer M. Eckard, M. D. 


1905 


.Toel A. Eastman, M. D. 



250 Dowx-STAxr. mi'Mcii-alitiks 

licaltli created with a commissioner and emi)lo_\cs appointed by the mayor 
Id man it. liefore tliat time the board of health was the responsil)lc agency. 
Since that time resjxinsibihty has been transferred by the mayor upon the 
commissioner of hcallli. 

The first nicihcal health oflicer, Dr. Jnhn X. Xigias was a man of 
unique liistory. He tied frcjui ( lerniany to a\ui(l incarceration because of 
his revolutionary activities in that country. He left a practice he !iad built 
up in Peoria to win distinction as a medical officer in the Union Arni\ of the 
("i\il War and later in the capacity of health officer of Peoria he earned a 
reputation a> an epidemiologist. He introduced in his C(jnmiunil\ the use 
of antiseptics and he promoted the practice of isolation of jjatients suft'ering 
from contagious diseases. 

Too little was known however, in those early da_\s to steer the city di- 
rectly into the practices of modern preventive medicine. It therefore went 
through the "pest house" period, maintaining on the outskirts of the com- 
munity a building in which smallpox patients were housed with all of the 
vigor and fear that might have surrounded a leper. Comforts and conveni- 
ences were doubtless scarce enough in the "pest house." 

However the development of hospitals, the first of which was opened 
in 1876 by the Franciscans, and the growing public confidence in the efficac}' 
and safety of vaccination led away from the "pest house" which fell into 
disuse about the turn of the century. 

Beginning about 1900 the health department began to grow in resources 
and functions taking on new employes and new activities as occasion arose 
and the increasing demands for preventive medicine manifested themselves. 
.\ milk ordinance, for instance was adopted in 1898 and the health depart- 
ment began to enforce it about in 1899. About the same time considerable 
attention began to be paid to sanitary matters such as privies, garbage, etc. 
These activities required additional personnel in the shape of inspectors. 

Then in 1907 a laboratory was established with Dr. John F. Sloan in 
charge as bacteriologist. In 1921 a venereal disease clinic for treating indi- 
gent persons w-as opened. Along with these new projects more rigid sani- 
tary supervision iner milk supplies was required by revised ordinances 
adopted from time to time w hile the ([uarantine and isolation of patients with 
communicable diseases became more and more technical. These increasing 
demands entailed larger and larger exjienditures and rei|uired more and more 
personnel imlil the close of \'>2? fouml the health department with a staff 
of ten members made u[> of a part time commissioner of health, a ])art time 
laboratory director, one nurse, one clerk. f(jin- full time and one ])art time 
inspectors. 

\'<jluntar\ and quasi-public agencies also sprang up or began to assume 
pul)lic health actixities in the city soon after the turn of the century. The 



TEORIA 251 

Associated Charities, for example, made a study of tuberculosis in the city 
in 1903 and recommended as a result that the disease be made reportable. 
The Peoria Society for the Prevention of Tuberculosis came into existence 
shortly thereafter and in 1905 joined with the Associated Charities in em- 
ploying a nurse to work under the commissioner of health. 

Ily l''l? popular sentiment toward the tuberculosis problem was such 
that an election providing for the erection of a municipal tuberculosis sani- 
tarium resuhed in favorable action. Buildings for this purpose were con- 
structed and patients began to l)e received in 1919. 

Infant and child hygiene work began under tlie auspices of xoUmtary 
agencies while the school board undertook to provide a health service for 
the children by the emploxment of nurses, dentists and a physician. These 
developments fountl the city at the close of this historical pt'i-iod with a 
corps of six part time physicians, one full time phy.sician. cme full time 
dentist, four full time and one part time inspectors, seven full time nurses 
and several clerks engaged in public health service in one capacity or another 
in the city. 

A good description <.)f just wh;it was being done is found in the report 
of a surve}' and appraisal made early in 1926 by the State Department of 
Public Health. It was based on the 1925 record and was one of fifteen made 
in the State at the time. From the report we read : 

"The largest of the fifteen cities studied, Peoria stands sixtli from 
the top for adequacy of public health service. The score earned by 
Peoria is 580 or 58 per cent of a possible ma.ximum. 

"With an almost complete change in personnel last year (l!t25), the 
city health department gives promise of marked improvement in organ- 
ization which will increase efficiency in communicable disease control, 
vital statistic record keeping, sanitary and laboratory work and venereal 
disease supervision — the activities in which it is engaged. Tuberculosis 
clinics, field nursing and sanitarium services are provided from the 
resources of the municipal tuberculosis sanitarium board, while the 
board of education is responsible for an excellent school hygiene pro- 
gram. Public health and bedside nursing and prenatal and infant 
hygiene clinics are conducted by the public health nursing association. 
This association also maintains a Neighborhood House where all public 
clinics except those for venereal and school dental patients are held. 

"With the city government contributing 16 cents per capita the 
total expenditures for public health woik in 1925 amounted to (it cents 
per capita. Eleven out of the fifteen cities appropriated more, propor- 
tionately, for health service than did Peoria. 

"Computing no mortality rates. attemiitiiiL; no lorrclafiou lietween 
death certificates and contagious disease or birth leports, making no 
graphs or charts. Peoria not only ranks lowest for vital statistic record 
keeping but losss the splendid advantages which a careful study and use 
of these important data provide. 



IX)\VN'-STATE MUNICIPALITIES 



PEORIA 



VITAL STATISTICS \k 
COMM. DI5. COMTROLl^zl 
VEM. DI5. COMTROL^ 
TUB. CONTROL [z3 
HEALTH CHILD -»!' 



HEALTH 5CH. CHILD m 
SAHITATIOM "=°^-/&°- ^ 
niLK CONTROL !«f^ 
LABORATORY 
POP. HEALTH IhST.^ 



PERCEMT OF STATiDARD SCORE 
FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 



Thisi graph illustrates the strong and weak points in Peoria's public 
health service, official r.nd voluntaiy, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in Peoria was 58 per 
cent of the standard perfection requiienient. 



"Reporting of cases of contagious diseases seems reasonably com- 
plete, the activity of the director of school hygiene in locating and re- 
porting cases being especially commendable. There is no communicable 
disease nursin.g' service e.xcept occasional visits made by the public health 
nursing association. A communicable disease hospital is maintained by 
the city health department. In 1925. 86 out of 350 eases of scarlet fever 
and 19 out of 28 cases of smallpo.x were hospitalized. The hospital, ap- 
parently, is not used for diphtheria, whooinng cough or measles. Im- 
munizations against diphtheria by toxin-antitoxin have not been per- 
formed or promoted by the health department and only 58 per cent of 
the grade school population are protected against smallpox. 

"Case reports of venereal disease are above the average but attend- 
ance on the local clinic, which is efficiently managed, falls a little short 
of the requirements for full credit. There is a lack of follow--up service 
designed to prevent patients from quitting treatment too early for public 
safety. 

"Peoria has made more progress than any of the other fifteen cities 
surveyed in organizing open-air classrooms in the schools. Four such 
rooms were in operation last year, the average attendance being about 
1 :'.."> iiupils. and an additional room is being opened this year. 



253 



"The public health nursing "ssoci;Uioii condurts the field nuisins 
service for prenatal, infant and preschool cases. Prenatal, infant and 
preschool clinics are held at the Neighborhood House, but these clinics 
are not well attended, only 273 new children being registered last year. 
A large proportion of the patients, too. are sick babies. The Peoria 
medical society recently has endorsed and is to sponsor a prenatal and 
infant welfare center which should meet the need in this field of health 
work more fully. 

"The board of education employs a full-time physician with two 
nurses and a clerk, and a full-time dentist with one assistant, these ac- 
tivities being carried out by two separate departments. The school 
hygiene in Peoria takes first place among the fifteen cities surveyed. 

"The first concern of the school hygiene department is the control of 
contagion. Last year (1925) a total of 197 cases of contagion were dis- 
covered and reported, in addition to 3S5 cases of pediculosis, impetigo 
and pink eye. Nearly l.GOO children were excluded from school because 
of suspected contagion and more than 50,000 were inspected for evidence 
of contagious disease. Routine weighing and measuring of children 
is not practiced. Routine physical examinations are made each 
year of the first, third, fifth and seventh grades, nearly 4,000 such ex- 
aminations being made last year. T\vo thousand special examinations 
were made, in addition, on recommendation of the teachers and to 
select children for open-window rooms. All children who fail in their 
grades are given a careful examination which is repeated each month 
until correction of defects has been secured. The school health program 
is unique in the intensive w'ork which is done on this group of children, 
the results of which have been most encouraging. The demonstration 
thus made is increased scholastic efficiency when physical conditions are 
improved, and the successful control of contagion have been the im- 
portant factors in convincing the education authorities of the value of 
its school hygiene program. 

"In addition to measures for the control ot contagion and for the 
detection and correction of physical delects, considerable effort has been 
directed towards health education both by lectures to the pupils and by 
interesting teachers in this problem. 

"The percentage of physical defects corrected, as shown on the 
records, is almost up to the appraisal renuirements for full credit and 
doubtless would exceed this quota if a follow-up nursing service checked 
up on all corrective measures. Visits of nurses to the homes of school 
children were about two-thirds of the required number. 

"The dental work in the Peoria schools is one of the pioneer pro- 
jects of its kind in the country and easily stands first among the group 
of cities. 

"The development of this s|)lendid undeitaking was due primarily 
to the efforts of two or three local dentists, wlio a decade or more ago, 
induced the school board to permit the dental society to introduce this 
work. The growth of the dental department has been gradual and has 
reached its present efficiency as a result of the ability and enthusiasm 
of the present director who has been emidoyed since 1917. The dental 
hygiene program embraces: (1) education: (2) dental inspection: (3) 
clinical service. Dental education is carried out through lectures by the 



254 DOWN -STATIC MUNICIPALITIES 

dentist in every grade schcol room every year. The lectures given vary 
for each grade. The children's interest in dental hygiene is aroused and 
each room carries out a dental project; in some cases this is combined 
with the art work and many interesting posters have been prepared; in 
other instances, it has been combined with the English work and the 
children write compositions concerning some aspect of dental health. 
Wednesday of each week is devoted to lectures. Each lesson is con- 
cluded with a thorough drill in toothbrush technique. Lectures are also 
given before mothers' clubs, parent-teacher's association, teachers' train- 
ing classes and teachers' assemblies. Each year, examinations are 
made of the second and fourth grades. 

"The striking fact should be noted that l.OTK children in a total of 
4,307 examined had good teeth; and that of tlie remainder l.lStJ were 
receiving dental care at the time of the survey. In other words, more 
than one-half of the children at the time of the examination had good 
teeth or were then receiving dental care. When the thoroughness of 
the examinations is considered, this record falls little short of remark- 
able. 

"Two schools are provided with dental equipment. At these clinics 
only children unable to pay for private dental work are admitted. In- 
come in relation to the size of the family, determines eligibility for 
treatment. Four days per week are given to the clinic work during the 
second semester. During the first semester four afternoons per week 
are given, the remainder of the time being used for the dental examina- 
tions. Orthodontic treatments are not given nor are permanent teeth 
extracted. For needy cases these services are given gratis by local 
dentists. The service thus given by one dentist figured at current rates 
amounted to more than $1,000 last year. Five hundred fifty patients 
made a total of 2,210 visits to the dental dispensaries last year. 

"The public water supply in Peoria is of good quality and is dis- 
tributed, it is estimated, to 95 per cent of the homes. Only 66 to 70 
per cent of the homes are connected with the sewer system. There is 
no record of the actual number of open privies. Sanitary inspection 
service is handled by two untrained inspectors. Last year many notices 
were given for sewer connections but relatively few were complied with. 
Food establishments are inspected and are licensed by the city for 
revenue. 

"Ninety-two per cent of the Peoria milk supply is pasteurized and 
a small amount (150 gallons per day) is certified. Milk supply control 
has been under the direction of one part-time inspector who has had 
experience in pasteurization plant operation. Plants have been fre- 
quently inspected and during the year 116 samples of pasteurized milk 
were analyzed. The bacteriological counts were in excess of the stand- 
ard and no examinations were made of milk before pasteurization. No 
inspections were made of producing farms. The inspector recently has 
been placed on a full-time basis. 

"The city health department maintains a small laboratory and em- 
ployes a local physician who is part-time bacteriologist. Apparently 
milk analyses and diphtheria examinations constitute the major part of 
the work. Water analyses are not made regularly." 



PEORIA 255 

WaTF.R SlTPLY. 

TIiL- water supply was installed 1)_\- the city in IB'iS. Since 1889 the 
waterworks system has been owned and operated by the Peoria Water Works 
Compan}-, a private corporation. The ordinance conveying the municipal 
plant to the private company in 1889 provided for a repurchase b\- the city 
or a renewal of the contract in 30 years. It allowed the free use nf water 
for practically all public purposes and for public and charitable in>titutions. 

The original works comprised a group of wells located in the northeast 
](iiiti(in of Averyville between the tracks of the Peoria branch of the Rock 
Island railroad and Illinois River. A large main well, now used as a col- 
lecting well, 34 feet in diameter and ()0 feet deep and extending into gravel, 
was in ser\ice in 1892. 

I'efore the opening of the Chicago Drainage Canal, during summer 
seasons when the water level in the ground was low, it was impossible under 
the existing arrangements to prevent the pumps from sucking air. Conse- 
quently the main well was pumped dry and a circular steel tank 20 feet in 
diameter and 12 feet in depth was installed in the bottom of the well. Foot 
valves placed in the bottom of the tank made it possible for water to flow into 
the well without flowing back. The pump suction terminated in this tank 
about one foot from the bottom. 

In 191'> the water suj^iily comi)rised the main collecting well and seven 
auxiliary and reserve wells at the original waterworks site and two wells 
located about 2)/^ miles north of the main pumping station. All of these 
wells discharged into the main collecting well. There were also two jjinnp- 
ing stations, one being held in reserve. 

One of the reserve wells was sunk in 1908 ami the two somewhat iso- 
lated wells were constructed in 1910 and 1911. Water was pumped from 
the main collecting well directly into two 30-inch cast-iron supply mains, 
one of which lead to an equalizing reservoir of 19,000,000 gallons capacity 
on Peoria Heights constructed in 1892, and the other through the village of 
Averyville direct to the city. 

The present supply comprises a system of wells from which water is 
pumped direct into a distribution system in one service with an equalizing 
storage reservoir. The supply works comprise one main well completed in 
1892, four auxiliary wells constructed in 1899, one reserve well constructed 
in 1909 and eight supplementary wells constructed between 1895 and 1913. 
Total available yield is estimated at 17,700,000 gallons daily. The wells vary 
from 40 to 90 feet deep and penetrate gravel formations. Two pumping 
stations are maintained, one always acting as a reserve. One station was 
built in 1890 and the other in 1913. The open equalizing reservoir is still 
in service. The pumping equipment comprises four pumps with a combined 



256 DOWX-STATE MUNICIPALITIF.S 

capacity of 17,200,000 gallons per da)-. There are approximate!}- 150 miles 
of distributing mains and the static pressure maintained varies from an aver- 
age of 48 to 99 pounds per square inch. The average dailv water consump- 
tion is about 97 gallons per capita. 

In 1918, an epidemic of intestinal disturbances in which approximately 
30,000 cases developed was attributed to contamination of the water supply. 
The source of contamination was calculated to be polluted river water which 
entered the supply wells through an underground route. The epidemic oc- 
curred during high-water stages in Illinois River. In 1919 a mild outbreak 
of d}-senterv occurred in which 3,000 cases developed. The cause was 
thouglit to be identical with the cause of the 1918 epidemic. 

In 1920 a considerable number of cases of enteritis developed, but in- 
vestigation established that the water supply probabl_\- was not involved, 
although conditions were similar to those in 1918 and contamination of the 
supply was possible. 

In 1922 minor changes were made to eliminate the danger of contami- 
nation during- high-water conditions and provision made for the installation 
of chlorinators for emergency purposes. The water supply at the present 
time is regarded as of a safe sanitary Cjuality. 

Sewerage. 

In 1880 most of the liquid wastes of the city were discharged into cess- 
pools. About ten per cent of the houses were provided with indoor toilet 
facilities, the remainder being dependent upon privies. Priv}- vaults, by 
regulation, had to be 10 feet in depth. Night soil was reuKned liy scavengers 
to points outside the city limits. 

Sewers have been built im tlie combined plan with se\-eral outlets into 
Illinois River. In addition there are many industrial sewers and the prob- 
lem of disposing of industrial wastes is an acute one. In 1926 preliminary 
studies of the sewerage needs of the cit}' were carried on and recommenda- 
tions made for the organization of a sanitary district, the construction of an 
intercepting sewer along the river front, a sewage-treating works, and mis- 
cellaneous internal improvements. The Peoria Sanitary District was organ- 
ized during 1927. 

At the present time it is estimated that only aliout 70 per cent of the 
population are connected to the sewers. 

Health Conditions. 

The first account we have of health conditions in Peoria is that of 
Robert Maillet who caused the communit\ to move a mile and a half down 
the river to a more healthful location. lust what the unhealthful conditions 



PEORIA 257 

at the original site were is not disclosed but more than likely the\- were ills 
attributed to poor drainage. 

Next came the disaster to the colonists from Virginia referred to at the 
opening of this article. To their sad experience more, perhaps, than to any 
other one factor was due the reputation for unheahhfulness which spread 
abroad throughout the civilized world concerning the Illiudis territory. 
Physicians think that their trouble was diphtheria. 

^^ hat health conditions were like during the cholera wave that followed 
the Black Hawk War may be surmised from a descriptive paragraph taken 
from James Haines. Quoting from his "Early Settlement of Illinois", we 
read : 

"Time had but little softened grief for those slain by Indians when 
the cholera spread a funereal pall over the same territory lately stricken 
by war. The swift flying messengers on horseback in pursuit wherever 
to be found dotted the prairies with omens of dread. For when the fell 
disease struck its victim no time could be lost before remedies were 
applied. Death was the quick result if potent relief w-as not found 
within the early hours of attack. In my family four were fatally 
stricken in as many days. Many who were not at once attacked fled 
their homes, only to meet death a little later in the lonely prairie or 
unsettled forest. Bereavement and sorrow was widespread, almost 
universal over a great part of the West. Typhoid and other fevers fol- 
lowed this dreadful visitation, swelling the death list generally from 
those who escaped the cholera. Indeed, the 'cholera year' as it was 
long referred to, was a period of gloom from which memory turns in 
horror. From this period may be dated most of our country grave- 
yards, being then set apart for liurial of our first dead." 

Another reference to this same period, a little later perhaps, is found in 
Drown's "Record and Historical View of Peoria". Here we find : 

"During the autumn of 1S?,i considerable sickness prevailed and 
many deaths occurred among the inhabitants. Those who kept their 
health and those who recovered from their sickness put their shoulders 
to the wheel with renewed vigor, and the town for several years grew 
rapidly." 

Zeuch finds evidence of a severe epidemic of yellow fever that occurred 
in 1836 in Peoria. Dr. and Mrs, Alfred Castle are said to have greatly 
endeared themselves to the community through their untiring and self-sacri- 
ficing services to the sick during that dreadful experience. 

A. D. Jones, in his "Illinois and the West," states that the ferryman who 
took him across the river at Peoria in 1838 said "that it was mighty sickly 
there ; everybody had the chills and fevers". 



258 



DOWN-STATE M UXICIPAI.ITIES 



Doctor Daniel Drake visited Peoria in 184-1 while un one of his obser- 
vation excursions and learned from Doctors Dickenson, Rouse and Fr\ e that 
both remittent and intermittent fever was prevalent in the vicinity. Dr. 
Frye reported that the intermittent was more prevalent in the low, wet 
timbered spots. 

Again in 1849 the dreaded cholera returned. Local physicians had 
given warning of its probable coming and efforts to ward it off had been 
made with no avail. Its violent deadliness is described by Alunsell in his 
History of Peoria Count}'. A paragraph taken from that volume reads : 

"A terrible e|)ideniic of cholera having broken out in the summer 
of 1S49 the commissioner, on Jub' 11th. granted the use of the three 
upper rooms in the Court House for cholera patients of the city and 
county; also such beds and bedding as might be needed at the poor 
house, the county to stand the expense of furnishing the sick with all 
medical and hospital stores and provisions as well as nurse. These 
rooms were used as long as needed for this purpose." 

Among the prominent citizens who succumbed to attacks of cholera 
during the epidemic were listed Samuel H. Davis, publisher and William 
Mitchell, postmaster. 

Table 1. 
Mortality From Certain Causes. 







. ■- 










^ 












YEAR 


1 

3 


1 

1- 


s 


1 


1 


■Si 


6 


f 


1 


1 


i'S 


i ^ 


1900 


279 




... 












i 








1901 


774 
















:;: I 








1902 


745 












.:; 








'7.5 




1903 


772 














'27 










1904 


8S4 
























190.^> 


1081 




















'84 




1906 


732 
























1907 


SOI 


16 










■■.5 


'is 






130 


'78 


190S 


S37 














... 










1909 


898 


'is 
















'7i 




1910 


990 






















1911 


994 
























1912 


905 
























1913 


952 














2 






'56 




1914 


973 




















70 




191."i 


























19lri 


lilG 
























1917 


1247 












\ .' \ 








'so 


14.5 


191S 


1397 


'io 








1 


"e 


■■7 


232 




81 


193 


1919 


ino.-i 


4 








8 


2 


14 


91 




74 


92 


1920 


1174 


3 








7 


7 


19 


62 




60 


115 


1921 


1014 


5 








s 


1 


21 


7 




40 


58 


1922 


1 OIlCi 


2 


2 






3 


% 


7 


31 




61 


75 


1923 


1218 


11 


1 






6 


4 


4 


41 




48 


113 


1924 


1102 




2 






1 






12 




63 


88 


1925 


1125 










1 


"3 


i 


33 


i 


38 


80 


1926 


1108 


"z 


"i 


... 


' 's 


4 


1 


6 


34 


1 


39 


72 



259 



Table 2. 
Mortality Rates From Certain Causes. 



YEAR 


1 

1 


> 
3 


s 


1 

1 


i 
s 


> 


1 

6 

c 
si 


1 
Q 


52 


c 


•2--, 

|i 




1900 
1901 
1902 
1903 
1904 
190.5 
1906 
1907 
1908 
1909 
1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 


4.9 

13..-; 

12.8 
13.0 
12.9 
17.5 
11. G 
12.5 
12.9 
13.6 
14.8 
14.6 
14.0 
11.9 
13.7 

15.4 
17.0 
18.7 
14.1 
15.3 
13.0 
13.5 
15.3 
13.7 
13.8 
13.4 


10.6 
is.k 

5.2 
3.8 
6.4 
2.5 
13.8 

s.'e 




'.k 

L.2 
-.4 

.2 






)'.6 


4 

7 

8 

2 

i 

10 
9 

10 
3 
7 
1 
1 
4 



3 

8 

2 
2 

8 


'. .. 

i'.s 
s'.s 

2.6 
9.0 
1.3 
3.8 
6.0 

3.6 
1.2 


45!4 

2.9 

9.'7 
IS. 4 
24.6 
27.0 
8.9 
5.0 

i!2 
7.2 


322! 
119. 

80. 
9. 

39. 

51. 

14. 

41. 

40. 


3 

J 

3 
7 

i 


'. '. . 

i!2 
1.2 


128!9 
130 !.5 

204! 6 

107^9 

S6!4 
99.2 

109! 6 
111.1 

97.3 
77 9 
51.4 
77..') 
60.3 
77.7 
46.6 
47.2 


106^7 

i9i'.e 

268.0 
121.0 
149.3 
74.6 
95.3 
14.1 
108.6 
104.1 
87.2 



All Causes is per 1000 populatit 



all others per 100,000 populati. 



This appears to liave been the last outbreak of cholera of any significant 
magnitude and it was indeed enough. Peoria had certainly suffered enough 
from that harrowing plague. 

Smallpox likewise had a long and ugly history in Peoria but it never 
reached the fatal proportions characteristic of cholera. The "pest house" 
that defied small boys and tramps alike was a monument to the fear and 
alarm which the disease had inspired even before 1880. Records are unreli- 
able and nothing more than vague references to smallpox in those early 
years are available but it must have required a considerable outbreak at one 
time or another to bring into operation the pest house. 

Throughout the years since the time when records became more reliable 
smallpox has occurred sporadically. Epidemics involving from 100 to 500 
cases were reported in 1885, 1901, 1907, 1909, 1916, 1917, 1918, 1919 and 
1922. 

While both cholera and smallpox provoked greater alarm and concern 
because of the suddenness and dramatic character with which these diseases 
descend upon a community, tuberculosis doubtless was a more destructive 
ailment in the life of Peoria than either of the other two. Indeed it prob- 
ably was Peoria's major health problem for many ^ears although few people 



260 



DOWN-STATE M UNICIPALITIES 



Table 3. 
Casks ov Curtain Diseases Reported. 



1 1916 

1 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 






8 


9 


9 


10 


7 


73 


« 


6 


15 


3 


Smallpox 


146 


125 


264 


207 


38 


64 


251 






24 


7 




Measles 




1404 


170 


30 


492 


40 


31 


904 


36 


142 


1101 


707 


Scarlet Fever 


143 


170 


63 


203 


399 


599 


237 


184 


95 


243 


128 


76 


Whoop. Cough 












11 


142 


97 


58 


108 


227 


72 


Diphtheria 




232 


90 


2.-) 3 


l.iS 


289 


66 


37 


19 


12 


21 


22 


Influenza 






7260 


12.>2 


7.')0 




6 


21 


4 


24 


24 


13 


Poliomyelitis 




1 




1 




8 






1 


6 


1 


5 


Meninf^itis 




13 


5 


3 


1 


9 


2 


3 




1 


2 




Tuberculosis* 












142 


98 


101 


288 




138 




Pneumonia* 












18 


42 


36 


61 


94 


157 


91 


Syphilis 






98 






289 




228 


119 


119 


150 


477 


Gonorrhea 






286 






422 




492 


246 


347 


303 


004 


Chancroid 












27 




6 








4 



•All forms. 
Note: Case reports are never complete, but they have been much more so since 1920 than before in 
Illinois. This table indicates considerable improvement in notification, although reports of pneu- 
monia, tuberculosis, influenza and some of the others are manifestly far below the actual incidence. 

Table 4. 
BiRTiis AND Infant Deaths. 



Infant Deaths 



YE-\U 












Number 


R;ite" 


Number 


Rate* 


1918 






137 




1919 






99 




1920 


1209 


15.S 


134 


110.8 


1921 


1322 


17.0 


115 


87. 


1922 


1335 


17.2 


121 


90.6 


1923 


1417 


17.8 


126 


89.0 


1924 


1311 


16.3 


111 


84.7 


1925 


1517 


18.fi 


110 


72.6 


1926 


1503 


18.2 


92 


61.2 



age per 1000 births reported. 



recognized it as such until after the turn of the centurx'. During the nine- 
ties, for instance, when the registration nf deaths was far from complete, 
more than fifty fatalities per year were charged against tuberculosis. In 
1884 when the population of the city was about 35.000. there were 82 deaths 
attributed to tuberculosis. In l'^02 there were 73 and in 1905, 84 deaths 
attributed to that cause. 1m ir the three years ended with 1927 the average 
annual number of deaths from tuberculo.sis was 41 although the population 
was liver 20,000 greater than in 1900. These data show what a scourge 
tuberculosis really was in Peoria for a long period. Cholera kills quickly 
and the fatalit}' ratio is high. .Sometimes smallpox is extremely mortal and 
sometimes not but rarely is the prevalence rate very high. Tuberculosis is 
a slow devitalizing disease that leaves ten people sick for each one it kills. 
.\ bit of arithmetic baseil upon the deaths reported will give one an idea of 



PEORIA 261 

the heavy burden which that disease has phiced upon Peoria. Apparently 
the measures employed against it have proved splendidly effective. Deaths 
per year are now but little more than one-half what they were in 1900 while 
the rate per 100,000 people is one of the most favorable among Illinois 
municipalities. 

T\phoid fever appears to have been a problem of less magnitude in 
Peoria than in many other places. From the meagre records available it 
seems that after 1910 the disease has not lieen widespread although an out- 
break in 1923 resulted in 11 deaths. Before 1910 it was common to tind 
fr(.im 13 to 20 deaths per year attributed to t\i)hoi(l. That suggests from 
100 to 200 cases in a population under 60,000. 

Diphtheria and scarlet fever ha\e run cnurscs similar to those observed 
in municipalities generally. Up to 1900 diphtheria was particularly deadly 
and even as late as 1903 an outbreak carried off 27 souls. More recently the 
number of deaths has been quite small. Scarlet fever has declined in malig- 
nancy but not so much in prevalence. Both these diseases have appeared in 
epidemic waves from time to time, the one growing less and less extensive 
even in epidemic \'ears and the other changing but little in magnitude of 
prevalence but becoming milder in form. 

The influenza epidemic of 1918 was moderate in Peoria, comparatively 
speaking. Mortality amounted to 322 per 100,000 population from influenza 
and 268 from pneumonia. The combined figure of 590 was exceeded in a 
dozen other Illinois cities. About that many had lower rates. 

(iencral health conditions are subject to some improvement in-so-far 
as the mortality rate may be accepted as a barometer. The rate has ranged 
above 13 per 1000 steadil)- and that is a good deal higher than for the State. 
In small places homes fur the aged and hospitals are apt to affect death rates 
rather decidedly in an unfavorable way but Peoria is approaching, if not 
already there, a size that should have al)sorbed a good deal of the unfavor- 
able influence of those factors without any marked effect on the general 
death rate. 

References. 

Data furnished by Dr. Joel Eastman, health commissioner of Peoria. 
Data furnished b.v Dr. George Parker, former health commissioner of Peoria. 
.\nnual reports of the Citv of Peoria, various dates. 

.\nnual reports of the State Board of Health, Dr. John H. Rauch, Secretary, Sprin!ffieI<I, Illimiis, 
various dates. 

Ifivton ..f Mcdi.al PiM.ticp ill Tlliiini-. Vol. l.Dr. Lucius II. Zeuch, Chicago, 1927. 

I,'. ■..II ..; -I . .1 !iM..i, ir ., ( ' . ~r I'r'., Illinois "Health News," Mav-.Iune, 11120. Dr. 

Is:i;ir h I: I;. , hn. i. , .i n. ,. ,i .i r .i.:i. l|...,hli. 

I, III' -.!( I .. Mil , .litiii. llHi.- I'uiilh ;(ii,,n No. 10, lUO.-i, Illinois Historical Library. 

II - ih.l IlM \\. I, X, II. .Iniies, Uostnn, ls:)S. 

I.'r-t.l .ii.l III I. -II. il \ie\v of Peoria, S. DeVVitt Drown, 1830. 

llliN.i- Niii- Willi Survey Bulletins, Edward Barton, Urbaua, vurious dates. 

I ^ i.n-iK i:.ii'iiis. Washington, D. C, various dates. 



Qtiincy 

Ouincy is located on the east bank of the Mississippi River, 150 miles 
above St. Louis. The city and surrounding country is hilly, except along 
the ri\er. A short distance to the north there are several bluffs and mounds, 
which rise from 150 to 250 feet above the river level. Beyond these, to the 
north and south of the cit}- the land is low and moist, or so-called "Bottoms." 
These have been drained. 

The site and vicinity belong to the carboniferous limestone period, with 
coal seams in the vicinity. The surface rocks are limestone, and the under- 
lying strata, from above downward, are clay, loam, gravel and limestone. 
The strata are horizontal with no dip nor slope. Soil-water flows in continu- 
ous fissures in the rocks, and through the gravel strata. 

Quincy is an old cit\', as Illinois cities go. It was founded in 1822, and 
incorporated in 1825. It was once "The Crossing" and "The Track's End." 
Here in the early days of the settlement of the Great West the flood tide of 
immigration stopped for a time before it crossed the Mississippi by ferry. 

The river with only a ferry for crossing was like a dam holding back 
waters. The flood was a tide of humanity. Ouincy was then a stormy, 
seething mob. It was the frontier, the jumping off place. Gunmen and 
gamblers, rough people of every sort, men without money and men with 
much mone\' congregated here. 

I'inally came the railroad bridge, tracks on through to the Great West 
beyond. Building the bridge was like breaking a dike. The reservoir of 
humanity rushed out. Streams of men who came after flowed through 
without stopping. This was followed b}- a different day for Ouincy. Busi- 
ness fell off. Then came \ears of quiet, almost stagnation. Finally 
Ouincy built in a newer and sounder wa}', gradually the Ouincy of today. 

Returns from the I'nited States census bureau show population figures 
for Ouinc\' for each decade beginning with 1840. In that year it had 2,319 
inhabitants. This number almost tripled by 1850 when the population reach- 
ed 6,902. For the next fifty )ears the city settled down to a substantial de- 
cennial growth, finding itself the home of 36.252 people in 1900. Since then 
it has experienced no growth, the 1920 census revealing an actual loss of 609 
below the 1910 returns. Of the 35,978 people there in 1920. 32,349 or 
89.9 per cent were native born whites, 2,411 or 6.7 per cent were foreign 
born whites and 1,210 (ir 3.4 jier cent were negroes. Something over 29 
per cent were above 45 }-ears of age, a percentage larger than that for an\ 
of the other cities in the State. 

(262) 



263 




Health Machinery 

The hard campaign waged by the physicians of the county against chol- 
era and other diseases which swept the country in 1849, called very forceful 
attention t<i the necessity of organization and cooperation, both to meet emerg- 
encies and for purposes of consultation and 
progress in ordinary times. Accordingly 
Adams County Medical Society was organized 
in Ouincy, March 28, 1850, at a meeting pre- 
sided over by Dr. Samuel W. Rogers. It is 
the third oldest medical society in Illinois, its 
on]}' seniors being the Aesculapian Society of 
the Wabash Valley, and the Rock River Medi- 
cal Society, both founded in 1846. The Adams 
County society antedates the State Medical 
and the Chicago Medical society by about two 
months. 

The officers selected were : Joseph N. 
Ralston, president, Samuel W. Rogers and M. 
Shepherd, vice-presidents; J. R. Hollowbush, 
recording secretary ; Louis Watson, corres- 
ponding secretary. 

This society gave much attention to sani- 
tary matters and l>y its persistent efforts 
secured the creation of a board (.)f health by 
the city and the adoption of a system i-f mortu- 
ary registrations, several years previous to the 
passage of the present State laws relating to 
these matters. 

Naturally general sanitation early en- 
gaged the attention of the medical society. 
Thus in November, 1865, Doctors Edward G. 
Castle and Joseph Robbins appeared before the 
citv council and asked that, in view of a prob- 
able visitation of epidemic cholera, steps be 
taken to put the city in a proper sanitary condi- 
tion. The authorities acted promptly, created a 
board of health of which Dr. Castle was made 
president, and under his direction the city A\as 
placed in such hygienic condition that when, 
in the following summer, disease came up the 
Mississippi River. Ouinc_\- escaped with less 
than a dozen cases, and only two or three of 
these were fatal. 



.lo.seiili .\. l;:il.-,iuu. .\1. D. 
First President Adams County 

Medical Society. 1850. 
(President 1S64. 1865 and 1866. 1 




•Joseph Robbins, M. D. 



264 



DOWN-STATI', M UNICI I'Ar.ITI I'.S 




Dr. I'rancis Dnulc, representing the county society, organized in I860, 
a more eflicicMU lioard of health, replacing the old body which after the 
cholera failed to ;ippear had \'irtually dro[)])ed out of existence. 

The I'corganized i)(iard comprised hve members, three of whom were 
regular ]ihy>ician.s. .Ml were appointed by the mayor, himself a member ex- 
ofificii'. I 'r. I )ru(K' str\ ed as its chief officer and registrar, with only nominal 
compensation for twenty years or more. 

It became the practice, probably much 
earlier than the time when the board of health 
was organized, to appoint a ddctnr. at a small 
or nominal .salary, known as the cit\ physician 
to look after indigent sick which the commun- 
ity found upon its hands. He became subject 
to the board of health which ordered him to 
put on a general vaccination campaign in 1871. 
.\t that time Dr. Piatt was city physician and 
he reported ')()4 vaccinations. During the pre- 
cefling _\ear Dr. Piatt established the city 
dispensaries. 

It afforded ready means of relief to the 
Francis Driuie. M. D. indigent sick and also saved $100 to $150 per 

First Adams Count.v Pliysician nionth to the cit\- in the difference between 
to Celebrate 50 Years o£ , ' . . 

Continuous Practice. medicmes and prescription prices and whole- 

sale rates. Previous to this time prescriptions 
had been given out, but no drugs were procured at wholesale prices and 
dispensed from the dispensary, which was open from 9:00 A. Al. to 4:00 
P. M. daily. 

.-Viiothcr city |.)hysician found to his dismay that public office is not 
alwaxs the easy jiath to financial comfort and mental tranquility which it 
sometimes appear^ and he was not one who minced his words in expressing 
his opinion of the matter. Herewith is ipioted from his report of 1873 a 
statement of his activities fur the \ear and of his determined attitude toward 
the job which lie expressed with vigor: 

"Visit.s made in the city 1592 

Patients visited in the city 450 

Office consultations 515 

Patients treated at city hospital 54 

Average number per day 5.5 

Visits paid to hospital 119 

"To this I add iitlendance on ten acrouphmeiits and the coniiiouud- 
ins of 2.'i(;ii i)rescrii)tians. 

"This report closes my career as city physician and llrinl; C^d for 
it. 



QUINCY 265 

"I congratulate myself upon my release from such a public burden 
at such an insignificant salary, six hundred dollars per annum; and I 
thank the Honorable Council for their practical appreciation of my serv- 
ices by refusing me additional pay for services made additional by the 
severest and most protracted winter we have ever seen and also by the 
outbreaking of two epidemics (smallpox and cerebrosiiinal meningitis) — 
causes which human wisdom could neither anticipate nor prevent. 

"Before closing this report, I cannot forbear expressing my ad- 
miration for the consistency of your Honorable Body in allowing the 
Overseer of the Poor extra compensation for his services rendered 
paupers and yet disallow the City Physician extra compensation for 
extra services rendered the same paupers nor can I forbear expressing 
my appreciation of that consistency of your Honorable Body which 
would and did allow the City Sexton double pay for the interment of 
smallpox cases and yet disallow the City Physician extra compensation 
for medical attendance on them. 'Consistency, thou are a jewel!' is the 
jiioud ejaculation of your retiring City Physician. 

"Respectfully submitted. 

Samuel A. Amery, M. D. 

City Physician." 

Tlie same _\etir the board uf health declared in it.s report that ".Modern 
science has demonstrated beyond all controversy that a very large percentage 
of disease is preventable by proper sanitary regulation." 

Cut off from the stimulation of deadly epidemics, however, the board 
of health soon fell into a dormant paper organization with the result that 
the medical profession dropped almost completely out of the picture. 
Indeed in 1885 the mayor and three alderman constituted the board which 
had power to nominate and elect to membership three physicians in case of 
emerge!ic\'. From this time on for a long period the executive officer of 
the board was a layman who drew pay varying from about $100 to $600 
annually. Garbage collection and scavenger service were under the 
jurisdiction of the board so that it handled a considerable sum of money and 
employed a number of people. It also had charge of quarantine, fumigation 
and the other functions common to health departments or boards. 

Boards of health came and went for a long time. Some were large, 
some small. Some had on them physicians. Others did not. The 
executive or health officer continued to be non-medical Init the staff increased 
and the rate of pay. 

This was the state of affairs in 1020 when the periodic ascendency of 
public interest in health problems, probably intensified by national activities 
in that field during the war, resulted in the erection of a public health dis- 
trict in Ouincy. This was done by popular vote in conformity with a law 
passed by the legislature in 1917. It provided among other things: 

"1. That any town, or two or more adjacent towns in counties 
imder township organization, or any road district, or two or more road 



266 nOWN-STATF. MUNiriPAI.ITIES 

cUstrifls in counties not unilei' township orsiini/.ation. or any town or 
towns in a connty nnder township oriranization. may l)e organized into 
a public health district. 

"2. That, upon presentation of a petition signed by not less than 
5 per cent of the total vote cast In any town or road district, and filed 
with the town or road district clerk at least 30 days before the regular 
election, the proposition shall be submitted to a vote of the people at 

the next town or road district election. 

"3. That the supervisor at large, the townshi]} clerk and the 
assessor shall constitute the board of health and shall select a health 
officer from a list of eligibles submitted by the State Board of Health. 

"4. That an annual tax levy, in addition to all other taxes which 
now or hereafter may be authorized to be levied on the aggregate valu- 
ation of all property within the public health district, not to exceed 
2-i'i mills on the dollar on all taxable property embraced within such 
public health district according to the valuation of the same as made 
for the purpose of the State and county taxation, may be made — this 
tax to form, when collected, a fund to be known as the 'public health 
fund'." 

Quincv was the first cit_\- in the State to take advantage of this law and 
since that time she has had one of the best equipped health departments in 
the State. Its organization is outlined as follows ; 

"1. Registration division where all deaths and birth certificates 
for the townships of Quincy, Melrose, Riverside and Ellington are re- 
ceived and recorded, and from which all burial and transit permits are 
issued to undertakers. 

"2. Communicable disease division in which all contagious and in- 
fectious diseases are registered, and from which history cards of each 
case are forwarded to the State Department of Ht-alth at Springfield. 

"3. Clinical laboratory division in wiiich specimens of blcod, 
sputum, throat swabs, smears, feces, water, milk, etc., are examined 
by an expert bacteriologist and serologist. This work is done free upon 
request of local physicians. During the first eight months of its ac- 
tivities upwards of 1200 free examinations were made. 

"4. A sanitation division, where all complaints in regard to in- 
sanitary conditions are registered and investi.gated. In addition the 
sanitary officer inspects restaurants, dairies, meat and fish markets, 
grocery stores, soft drink stands, etc. Also all complaints for non- 
collection of garbage are received by him. the garbage collector is noti- 
fied, and a weekly report forwarded to the mayor. 

"."i. A quarantine division, the responsibilities of which are to 
establish and enforce quarantine for all contagious diseases, and to 
report all such quarantines to the public library and to the proper au- 
thorities, either school or business, as the case may be. Release from 
all quarantines is likewise reported. 



267 



"6. A social hygiene division, presided over by a registered pliy- 
sician and a social worlier, in wliich all indigent, cases of venereal 
diseases are treated free. During the first six weeks after its establish- 
ment this clinic received o40 visits for consultation, examination, and 
treatment. Thirty-nine patients were under treatment at the end of 
that period. 

"7. Dental clinic division, for the treatment of children of school 
age. This clinic was opened on February 28, and bids fair to have more 
worlv tlian it can handle." 




John W. H. Pollard, M. D. 
Health Officer, 1921-1924 



Under .this new organization. Dr. John \\'. H. Pollard of Lexington, 
\'irginia, was chosen as the first health officer 
an'd he served the community in that capacity 
from July 1921 until 1924 when William D. 
Wrightson, a sanitary engineer, was elected to 
succeed him. Wrightson was succeeded in 1925 
!)}• Dr. Thomas W. Rhodes who is still in office. 

From 1900 to 1920, Quincy saw much public 
health activity. During that period an infant 
mortality surve.\- was made by Miss Nannie Lack- 
land, R. N., of the Children's Bureau, Washing- 
ton, D. C. This was sponsored by the Quincy 
Council of National Defense. It was found that 
too man\' babies were dying under one _\ear of 
age; that there were too many deaths of infants due to prematurity and con- 
genital debility; also that stomach and intestinal conditions were responsible 
for a great nunil)er of infant deaths. 

Better birth registration and education of 
mothers in prenatal and infant care, and especially 
in the feeding of children were recommended as 
remedies for these conditions. 

Two better babies conferences were held at 
Cheerful Home Settlement. Members of the 
Adams County medical and dental societies and 
nurses from Blessing Hospital cooperated in this 
movement. The attendance at the first confer- 
ence was 112, and 432 at the second. 

In 1918, following these conferences, in order 
to emphasize "Children's Year" and to afford an 
opportunity for giving advice to post-infantile- 
paralysis cases left after the epidemic of this disease in 1916 and 1917, Dr. 
Elizabeth B. Ball, who at that time was secretary of the Adams County ■Med- 
ical Society, proposed to the society that it go on record as favoring the 




Thomas W. Rhodes, M. D. 
Health Officer. 192.5 to date 



268 



DOWN-STATIC M UNICIPALITIES 




Eli^iilieth B. Ball, M. D. 

Long-time Secretary of the 

Adams County Medical 

Society 



establisliment of a crippled cbililrcn's clinic in 
Ouincy. She also sus^tjesled that the clinic be 
similar to the ones alread}' in o])eration in various 
pan- (if the State, and that it be conducted by an 
(irihiipeihst from the .State Department of Public 
Health. A mcilion was duly made, seconded, 
and carried that this be done. The clinic was 
established and held at I'lessing Hospital for 
several \ears, and many unfortunate crippled 
children were helped to such an extent, that 
instead of being handicapped wards of the State, 
they are or will become self-sustaining useful 
citizens. 



In the same manner an infant-welfare station was opened at Cheerful 
Home, to which mothers could bring their babies every ^\'ednesday after- 
noon. A physician and a nurse were in attendance at this time. 

A conference for mental defectives was also established in Ouincy in 
1918. Once a month a physician from the State Hos|)ital for Mental Dis- 




Cheerful Honx 




1. A Unit in a Mammotli Parade Manifesting Public Interest in Health. 

2. Two Views of "Hillcrest", Adams County Tuberculosis Sanitarium. 

3. An Inside View of "Cheerful Home". 



270 



DOWN-STATE M UNICIPALITIES 



eases at Jacksonville gave mental tests, and made recommendations as to 
the handling of the cases. The probation officer furnished most of the 
cases for this work. The \'isiting Nurse Association cooperated in the 
undertaking. 

During the influenza epidemic in 1918, daily medical inspection of the 
school children was carried on. 

In 1919 classes in nutrition were established in some of the public 
schools. Miss Martha D. Fitzgerald, R. N., supervisor of visiting nurses and 
at present head resident of Cheerful Home, was in the main responsible for 
this work. 

The Cheerful Home Association has played an important role in the 
improvement of health conditions and in rendering social service in Quincy. 
In the spring of 1901, Mr. Lorenzo Bull announced his intention of present- 
ing the property formerly known as Wells residence. No. 421 Jersey Street 
for use by this Association. The gift was accepted. Following this the 
Association reorganized and incorporated. 



QUIMCY 





VITAL STATISTICS E° 

conn DI5 coriTROLs^ 

VEh DI5 COnTROL 
TUB COHTROL 
HEALTH CHILDs."- 
HEALTH 5CH CHILD ^ 
SAMITATIOh'^i^? » 
niLK COMTROL '^^ 
LABORATORY 
POP HEALTH IhSTI 




PERCENT OF STANDARD SCORE 
FOR EIACH Of TEM MAJOR HEALTH ACTIVITIES 



_IS25_ 



This graph illustrates the strong and weak points in Quincy's public 
health service, official and voluntary, as it existed in 1925. It is based 
upon a personal survey and rated upon the standards evolved by the Amer- 
ican Public Health Association. The total efficiency rating in Quincy was 
47 ijer cent of the standard perfection requirement. 



271 



The object of the Cheerful Home Association as stated in its by-laws 
is "to promote right living, thrift and happiness by means of instruction in 
useful knowledge, industrial training, wholesome recreation, and friendly 
visits." 

Among all the educational and philanthropic organizations in Ouincy, 
there is none that is doing a more necessary or hopeful work than the 
Cheerful Home Association. 

In 1907 the Association started a day nursery, which in the last few _\-ears 
has taken over a large part of the first floor of the settlement. The daily 
attendance ranges from 25 to 50. Two nursery mothers are in charge. 
The children cared for during this period were nearly all immunized against 
diphtheria. 

A social service is conducted in connection with the institution. A 
visiting nurse service was undertaken in 1914, doing bedside nursing and 
corrective work, teaching home nursing and making infant-welfare calls in 
the home. In 1926 a nursery school for cultural training was established 
in connection with the institution. 

Cheerful Home Association has been working for the establishment 
of an isolation hospital by the citw and for better housing conditions. 

In February, 1903, Miss Clara L. iVdams entered the settlement, as the 
first resident worker. Miss Martha D. Fitzgerald, R. N., is head resident now 
and through her popularity and untiring efforts, the work of Cheerful Home 
has been crowned wdth great success. 

The Adams County Anti-Tuberculosis League has been a tremendous 
factor in the public health activities of the city. 
Through its initiative a splendid tuberculosis sani- 
tarium is located a short distance outside of 
Ouinc\- and a good field nursing service is main- 
tained. 

The Red Cross and other voluntary organiza- 
tions have likewise been active. 

The State Department of Public Health made 
two surveys in the city. One was an exhaustive 
sanitary study, made in 1920, involving a house 
111 house canvass and was undertaken for the pur- 
pose of providing accurate information upon 
which to base the program of the newly adopted 
health district. The other was made in 1926 
as a basis for appraising the health facilities of 
the cit\- and the result is shown in an accompanying illustration. The report 
of the survey reads, in part, as follows : 




T. B. Knox. M. D. 
First President, Adams 
County Anti-Tubercu- 
losis League, 1913 



272 



now X -STATE M T XICIPALITIES 



"For iuleqiKicy oT puljlic health service Quincy, with a score of 472, 
or 47.2 per cent, ranks tenth among the fifteen municipalities studied. 

"The health department is distinctly unique in that it operates 
under a State health district law, adopted by popular vote in 1920, where- 
by ample funds for a completely satisfactory program can be collected 
through taxation. A board of health consisting, a.s required by law, of 
the township clerk, assessor and supervisor-at-large, administer the 
public health affairs of the city through a full-time health officer whosa 
staff includes a part-time dentist, a sanitary inspector, a practical nurse 
and a clerk. Laboratory service is secured by contract with a local 
concern. The county tuberculosis sanitarium board and the county 
anti-tuberculosis league each employ a nurse for field duty while the 
Cheerful Home Association maintains four nuises who engage in bedside 
nursing and promote infant and prenatal hygiene. 

"The work of the health department is confined largely to vital 
statistics, communicable disease control, dental hygiene, sanitation 
including supervision over milk supplies, diagnostic laboratory service 
and limited popular education. Other agencies named above do tuber- 
culosis field nursing and promote prenatal, infant and child hygiene. 
Clinics are maintained for the diagnosis of tuberculosis and for dentistry 
among children, the one for venereal disease patients having been 
abandoned early in 1925. 

"Oddly enough, Quincy is in a position to provide, through taxation, 
funds sufficient for a well rounded, adequately extensive public health 
program and yet neither the amount invested in this basic governraenfil 
function nor the breadth of the service undertaken measures up to what 
is regarded as a reasonably satisfactory degree. Total expenditures 
from all sources for health work amount to about .54 cents per capita 
per year. Over 45 cents of this is contrilnited by the l)oard of health, 
making a much larger percentage from the niuniciral government than 
in any other of the fifteen cities." 



Water Supply 
The legislature in 1868-1869 passed a law b\ which the cit\ of Ouinc\ 
could issue bonds, build waterworks, and create 
a board of water commissioners. In that year a 
])ump house was constructed near ]\Iississippi 
River at the end of Main Street. Six-inch mains 
were laid on IMain Street and three fire hydrants 
were provided. 

In August 1S7,^, the city council passed an ordi- 
n.nicc under w hich a 3U-year franchise was given 
to the Ouinc\^ Water Works Compan\- to main- 
tain and operate the water supply. When this 
franchise expired in 1904 the Citizen's Water 
Works Company, acting as a holding company Colonel Edward Prince, 

f(ir the cilv. took over the waterworks and sold Hydraulic Engineer Project- 
ed and Constructed Water 
U to the citv m 1916. Works in 1S73 




273 




A survey made tor the State Board of Health in 1885 indicated that 
three-fourths of the pojjulation used cistern water for all domestic purposes. 
At that time the v'wl-v water was allowed to settle and was pumped to a 
reservoir, from w iiicii it was fed to the mains by gravity. 

The city of Ouincy possesses a distinction, in 
that it was one of the first cities in this country 
to adopt the use of filtration as a means of puri- 
f_\ing its water supph'. The hiter plant was 
constructed in 1891 and was in service until 1914. 
This city was also one of the first to adopt hypo- 
chlorite as a sterilizing agent, which was done 
soon after the first experiments in 1908. 

On .September 1. 1914. the city put in service 
a new mechanical filtration plant. The plant at 
that time was modern and adequate for the city's 

„ ,, needs. Liquid chlorine replaced hypochlorite in 

Lorenzo Bull ' i . i 

Joint-owner Water Works the new plant. 

up to lfl04 Several changes and atlditions have been made, 

hut the plant still is essentially as constructed in 
1914 and is still delivering an adequate supply of 
safe water. 

Sewerage 

In 188.^ there were two city sewers, three feet 

in diameter, emptying into a creek tributary li > 

Mississippi River. 

Since that time the system has been extended 

to include several outlets but it is still inadequate. 

Several nuisances have been reported. 

In a report on the sewerage facilities by Black 

& Veatch, consulting engineers, prepared in 1926, 

it was recommended that intercepting sewers be ,,,•„• td o n 

'^ " William B. Bull 

constructed to carry most of the sewerage direct Joint-owner Water Works 
to Mississippi River. ' "P t° ^^^'^ 




Health Conditions 

On Jul\- 4, 1833, Asiatic cholera first made its advent into Ouincy. The 
expense of fighting the epidemic was borne by pulilic subscription. The 
record shows that $26.81 were contributed. 

.\t the time of this outbreak a citizens' committee with William (1. 
Flood, as chairman, was formed, to take the actions deemed necessary in 
the emergency. That the committee acted with vigor is shown by an 



274 DOWN-STATE MUNICIPALITIES 

excerpt from tlie minutes of the first meeting, preserveil in tlie handwriting 
of Honorable Orville H. Browning, who acted as secretary, which reads: 

"At a meeting of the citizens of Quincy, July 6, 1S32, to consult upon 
the means of preventing the further spread of cholera, it was 

"Resolved, that the town of Quincy be divided into three districts 
and a committee of Vigilance be appointed in each district. 

"Resolved, that J. T. Holmes, O. H. Browning and R. S. Green, 
Chairmen of the Committees of Vigilance shall constitute a Board of 
Health for the Town of Quincy; that they shall meet at the Court House 
each morning at eight o'clock and oftener if necessary and shall have 
power to make all necessary arrangements to procure attendance and 
nourishment for the sick and burial for the dead." 

This epidemic cost the village 33 lives within five days out of a popu- 
lation of 400. It ran the true course of cholera, short, acute, deadly. 

Tn March 1849, the same type of cholera broke out again. This time 
the number of deaths was placed at 400 out of a population of about 6000, 
a ratio about the same as that of 1833. After the first fatal burst of the 
epidemic, the disease subsided but smouldered in the conmiuiiity until 1851. 
Dr. Joseph N. Ralston, one of the physicians who did much to stem the 
tide of the epidemic, denied belief in the infectious and contagious nature of 
the disease. The "sulphur remedy" seemed to be the favorite treatment 
among the local physicians. 

Among other remedies, one used on two }oung ladies by a religious sect 
deserves mention. It reads ; 

"The process consisted of anointing with oil, prayer, brandy, i)salm 
singing, flannels, e.'chortation and hot water. The prescription was 
carried into effect with great vigor and perseverance throughout the 
entire night and in the morning the patients were quiet and without 
pain. — both being dead." 

Dr. Francis Drude was a new arrival in Quincy at the time of the epi- 
demic. He came from Germany in 1848. In his reminiscenses he relates 
his experiences during the cholera season of 1849-51, in part as follows: 

"Cholera made its first appearance in Quincy in June, 1849. It 
was imported by immigrants coming on a sailing vessel from Europe 
by way of New Orleans. It was a family by the name of Jost. They 
had lost the head of the family and two children or the way from Xew 
Orleans here. They found shelter with their relative. Leonhard Schraitt, 
living in Hampshire Street, between 8th and 9th Streets. 

"During the first months of its appearance, the disease proved to 
be the most, malignant in its character. Then it lost much of its 
virulence, appearing in a much milder form in 1850-51. 

"The worst cases of cholera occurred 1 to 3 o'clock at night, the 
attacks were often so severe, that when called an hour later, we would 
find the patient in a state of collapse. 



QUINCY 



275 



"In regard to mortuary records, Qiiincy was at this time in a 
rather primitive, unorganizert. yes, chaotic condition. No certificate of 
deatli was required, tlie two sextons, one American, one German, buried 
a corpse placed in a coffin box, at once when notified. 

"Quincy had at this time scarcely a papulation of GOOO inhal)itants. 
Without records, it is. therefore, quite impossible to make an estimate 
of the percentage of the dead. 

"I cannot close the reminiscenses without mentioning an episode 
that occurred to myself. It was at the end of the most busy season of 
1859. Daily from early in the morning until late in the evening I had 
worked. For many a week, every night, someone would disturb my 
short slumbers. 

"Once at midnight 1 woke up dreaming that I was taken sick with 
the disease, and would be a corpse at daylight. This horrid dream had 
prwluced a cold sweat all over my body, the rolling of my intestines 
could be heard by an outsider. Being wiped dry and re-dressed, I took 
a dose of calomel and quinine, each 5 grains, and lay down again. I 
Boon fell asleep and rested till late in the morning when I awoke 
^eak, but restored to my usual business. 

"Dr. Woebken. a young German physician, having a great run of 
custom, presented a similar example, which, unfortunately ended his 
brilliant career. I recollect his case quite 
distinctly. He came to his office about 11 
A. M., felt quite exhausted and had to lie 
down. He told his friends at his bedside 
that he would be a corpse in about three 
or four hours. He had no confidence in 
any medicine, refused every advice and 
medication, and made his prophetic words 
true. He died at 3 P. M. 

"Dr. Stahl. another German physician, 
who had lived in Quincy about 6 years be- 
fore the cholera season, after treating a 
good many patients with cholera, and los- 
ing an alarming big percentage, felt so 
disgusted with the practice of medicine, 
that he quit it entirely, having lost his wife and two children within 
one week. 

"Almost had I forgotten to mention my old friend. Dr. Louis Wat- 
son, who lived here during the whole season. At 10 o'clock he would 
regularly frequent the then old, fashionable Hall of John Nelscbs , take 
a big glass of Dayton ale, into which he would invariably put five grains 
of quinine, believing that it was a sure preventive of the disease." 

In reference to health conditions in the fifties, Dr. Daniel Stahl wrote 
as follows : 

"We have here in autumn bilious diseases, more or less, for instance 
the ague, the intermitting, and the properly called bilious fever. In 
very rare cases however do these diseases prove dangerous; every new 
resident in the West acquiring in a short time the knowledge of the 
very simple remedies by which their care is effected. 




Daniel Stahl. M. D. 



276 



DOW N -STATE M U N ICI PALITIES 



"Fifteen or twenty years aso those diseases, together with those 
sure always to accompany them, the hepatical diseases, hypochondriasis 
and jaundice, held such a formidable sway, that they spared but very 
few especially of the immigrants. * * * * 

"Diarrhea prevails to some extent liut always in a mild form, being 
very rarely, if ever, dangerous. ' 

The statistical tables show that (Jiiincy has had Irdtihlu en(niL;h fi'din 
communicable diseases cif all kinds but that a vast amount of her suffering 
is now ancient histmy if present conditions may be regarded as a basis for 
forecasting. Typhoid fever was a bad problem until 1917. Smallpox 
periodically alarmed the community. Diphtheria has exacted a heavy loss 
of life. Tuberculosis was once a common plague. Influenza caused a 
sharp ;i(Kance in the death rate of 1918. 

Table 1. 
MoiJTALiTY From Certain Causes. 



YEAR 


P 


ElH 




^ 






1 

6 


Is 


s 


% 


•2^ 

11 


'c E 


















.£=0 






P 






U 


.£ 


b 


^ 


"z 


■7; 


g 


JS-C 


3 





5- 


















&c 












^ 


P 


_ S 




m 


v: 


5 




C 


Si 


11 


il 


1875 




114 


2 




■2 


_ 




21 






86 


48 


1S70 




58 


1.5 




8 


13 


'20 


17 






122 


49 


1877 




37 


9 






10 


19 


55 






104 


38 


1878 




21 


21 






6 




35 






91 


37 


1S7!) 




47 


10 








in 


13 






117 


42 


1880 




40 


10 




' '7 


1 


14 


41 






101 


68 


1881 




49 


17 




3 







55 






81 


31 


1882 




21 


13 




1 


27 




20 






75 


31 


1883 




25 


5 






21 




68 








20 


1884 




311 


12 






12 


7 


49 






85 


43 


1885 




24 


7 






1 


3 


15 






103 


32 


1895 


548 


24 






5 


1 




19 






53 




1896 


521 


17 








3 


i 


32 






41 




1897 


545 


9 








1 




15 




'. '.'. 


47 




1898 


522 


8 






' i 


.5 


2 


3 






51 




1899 


528 


7 


2 






2 


1 




".3 




29 


■57 


1900 


568 


11 


3 


"i 


1 




1 


10 


1 




68 


23 


1901 


542 


15 








" '4 




1 


10 




74 


29 


1902 


561 


21 




2 


2 


18 




11 


4 




73 


20 


190,'i 


552 


15 




1 


1 


2 


i 




S 




61 


37 


1904 


580 


20 










... 


3 






79 


61 


1905 


472 


3 




""2 


"3 


i 


2 


2 


2 




56 


47 


1900 


505 


13 








1 




3 


8 




51 


19 


1907 


602 


8 






;", 


8 


' (i 


22 


11 




77 


28 


1908 


577 


9 










5 


7 


12 




75 


32 


1909 


496 


14 












9 


4 




62 


37 


1910 


620 


10 








"•2 


' 's 


10 


3 




62 


50 


1911 


673 


11 






' '9 




1 


14 


7 




66 


60 


1912 


535 


34 










12 


5 


3 




64 


31 


1913 


S75 


24 








i 




6 


9 




54 


37 


1914 


543 


13 










2 


1 


4 




63 


37 


1915 


504 


10 










9 


3 


22 




61 


48 


191(5 


010 


3 






ii 


' 's 


1 


6 


13 


'.'.'. 


74 




1917 


5K9 


8 






1 




1 


8 


14 




43 


54 


1918 


859 


4 






4 


' 2 


1 




126 




67 


85 


1919 


473 


4 









1 


3 


3 


26 




44 


37 


1920 


554 


4 








4 


2 


4 


25 




36 


40 


1921 


511 


5 






6 


3 




12 


"4 




27 


15 


1922 


557 


3 








7 




3 


3 




27 


25 


1923 


600 


2 






2 


1 


2 


3 


11 




18 


46 


1924 


536 








6 


1 


2 


2 


3 




19 


29 


1925 


585 














5 


6 




23 


27 


1926 


605 


" i 






' '3 




'i(i 






;;: 


30 


36 



277 



Table 2. 
Mortality Ratf.s From Certain Causes. 







s 








f. 


1 






m 








<u 


b 








1 


6 


ca 3 




jS 


'%'s 


.2 2' 


YEAR 




^ 




g 




fc- 




S£ 




% 


■3s 


|E 




53 






a. 


V 




c. 


xO 


a 




u ° 






o 


s 


3 






~ 




J=-a 


i 





s- 


i- 




^ 


-? 


s 


1 


% 


-I 


g 


3' 


^ 


"o 


11 


Is 


187-1 




438.8 


7.6 




7.6 


' 19.2 




80.7 






330.7 


184.6 


1S7B 




150.0 


57.6 




30.0 


50.0 


76 .'9 


65.3 








469.2 


188.4 


1S77 




92.3 


34.6 






61.5 


73.0 


211.5 








400.0 


14B.1 


1878 




77.7 


77.7 






22.2 




129.6 








337.0 


137.0 


1879 




137.0 


59.2 








59 .2 


48.1 








433.3 


155.5 


1880 




148.1 


37.0 




2.5 .'9 


3.5 


51.8 


151.8 








374.0 


251.8 


1881 




160.0 


60.0 




10.0 


21.4 


3.5 


196.4 








289.2 


110.7 


1882 




75.0 


46.4 




3.2 


96.4 


3.5 


71.4 








267.8 


110.7 


1883 




89.2 


17.8 






75.0 




242.8 








196.4 


71.4 


1884 


'. '.'. 


106.8 


41.3 






41.3 


24 .'i 


165.5 








293 . 1 


148.2 


1885 




82.7 


24.1 






3.4 


10.0 


51.7 








355.1 


110.3 


1895 


16.1 


70.8 






14.7 


2.9 


5.9 


56.0 








156.4 




1896 


15.1 


49.4 








8.7 


2.9 


93.1 








119.3 




1S97 


15.fi 


25. S 






'. '. '. 


2.8 




43.0 








134.9 




1898 


14.7 


22.6 






2.8 


14.1 


h'.e 


8.4 








144.4 




1899 


14.7 


19.5 


5 . 5 






5.5 


2.7 


.5 . 5 


8!3 




81.0 


159^3 


1900 




30.3 


8.'3 


2^8 


2.'8 




2.8 


27.6 


2.8 




187.6 


124.1 


1901 


14 is 


40.8 








ii!6 




2.7 


27.2 




201.5 


79.0 


1902 


15.0 


56.4 


k'.l 


5!4 


'^'a 


16.1 




22.0 


11.0 




196.2 


110.2 


1903 


14.7 


39.8 


8.0 


2.6 


2.6 


5.3 


2.6 


13.3 


21.3 




161.9 


98.2 


1904 


15.4 


52.4 












7.9 


13.1 




207.1 


159 . 9 


1905 


15.6 


27.5 


2^7 


5.5 


.C 


8.2 


liio 


13.7 


19.2 




205.9 


107.1 


190(5 


12.9 


33.2 


7.7 






2.6 


... 


7.7 


20.5 




130.4 


48.6 


1907 


16.5 


21.9 


7.7 




u.h 




16.4 


00.3 


30.1 




211.0 


76.7 


1908 


14.4 


22.5 


2.5 








12.5 


17.5 


30.0 




187.3 


79.9 


1909 


13.6 


38.3 


2.7 




'.'.'. 




... 


24.6 


10.9 




169.6 


101.2 


1910 


16.6 


27.3 


8.2 








21.9 


27.3 


8.2 




169.4 


136.6 


1911 


18.1 


30.0 






24.6 




2.7 


38.2 


19.1 




180.2 


163.8 


1912 


14.7 












32.7 


13.6 


8.2 




174.fi 


84.6 


1913 


15.8 


65^4 


2.'7 






2.7 




IB. 4 


24.5 




147.1 


100.8 


1914 


14.9 


33.4 










.5.4 


2.7 


10.9 




171.5 


100.7 


1915 


15.6 


27.2 


2. 7 




!:.' 




24.5 


8.2 


.59.8 




165 . 9 


130.6 


1916 


16.9 


8.2 






29.9 




2.7 


16.3 


35.3 




201.1 


149.5 


1917 


16.3 


21.7 






2.7 




2.7 


21.7 


38.0 




116.7 


146.6 


1918 


23.8 


10.8 






10.8 


5.4 


2.7 


13 . 5 


340.5 




181.0 


229.7 


1919 


13.1 


11.1 


s.'s 




2.7 


2.7 


8.3 


8.3 


72.2 




122.2 


102.2 


1920 


15.4 


11.1 








8.3 


5.5 


11.1 


69. 4 




100.0 


111.1 


1921 


14.2 


13.9 






16.'7 






33.4 


11.1 




75.1 


41.7 


1922 


14.9 


8.0 








18. '7 




8.0 


8.0 




72.0 


66.7 


1923 


16.0 


5.2 


2.6 




5!2 


2.6 


5^2 


7.8 


29.4 




48.1 


122.9 


1924 


14.3 








16.0 


2.6 


5.2 


5.2 


7.8 




50.6 


77.3 


1925 


15.6 














13.3 


11.0 




61.3 


69.2 


192(1 


15.4 


10. '6 






12.0 




4.0 


7.6 


22.5 1 ... 


76.5 


91.8 



The rate from .\II Ca 



per 1000 population ; all others per 100,000 pnpiil.ition. 



But it appears that a new day has come for communit} health in (Juinc)'. 
The 1926 mortahty record was exceptionally favorable viewed from the 
standpoint of communicable diseases, compared with that of 1900 and most 
of the intervening years. Epidemics will continue to come and go but it 
is probable that the health department will be able to keep them under suf- 
ficient control to prevent the terrible havoc that has often followed their 
advent into the community during years gone by. 

A fair conception of what (Juincy has experienced in her long journey 
toward a healthful city would scarcely be complete without mention of Slab 
Hollow and the "pest house." These two institutions held sway in the com- 



278 



DOWN-STATK iMUNICIPALITIES 



Table 3. 
Cases of Certain Diseases Reported. 



1 1916 


1917 


1918 


1919 


1920 


1921 


1922 


1923 


1924 


1923 


1926 


1927 


Typhoid Fever 


7 




20 


16 


10 


15 


15 


23 


13 


17 


21 


11 


Smallpox 


2 


.58 




14 


30 


31 


8 




3 


7 






Measles 


SO.-. 


191 


194 


1 


16 


478 


6 


253 


613 


207 


649 


217 


Scarlet Fever 


7 


22 


19 


73 


77 


.50 


126 


47 


48 


38 


98 


89 


Whoop. Cough 












14 


12 


177 


116 


8 


232 


72 


Diphtheria 


45 


72 


fi2 


27 


44 


36 


31 


41 


14 


28 


30 


14 


Influenza 






2909 




402 




39 


176 


9 


16 


14 


9 


Poliomyelitis 


4 


.) 




1 




1 




2 




1 






Meningitis 


1 


3 


2 


1 


1 


1 




1 




2 






Tuijerculosis* 






r.i 






77 


103 


70 


31 


59 


66 


39 


Pneumonia* 






82 






14 


92 


192 


89 


9 


96 


83 


Syphilis 






6 






57 






69 


24 


26 


53 


(Junorrhea 


1 




30 






64 






95 


48 


18 


41 



*.\11 forms. 
N0TK8 Case reports are never complete 
Illinois. This table indicates 



Table 4. 
Births and Infant Deaths. 



Inf.int Deaths 



1875 
1876 
1877 



1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
190,S 
1909 



1923 
1924 
1925 
1926 



Number 


Rate- 


Number 


Rate* 








469.2 






149 


573 






142 


546.1 






157 








146 








96 








63 








99 








97 








lis 








49 








69 








100 








78 








05 








64 








48 




590 


is. 4 


51 
56 


98.7 


573 


14.4 


50 


87.2 


644 


16.6 


57 


92.2 


.536 


13.7 


37 


69.0 


701 


19.5 


49 


69.9 


67!) 


18.9 


42 


61.9 


697 


19.4 


.\ri 


77.5 


773 


20.6 


47 


60.8 


766 


20.4 


49 


64.0 


798 


21.3 


73 


91.4 


,., 


19.3 


■'■' 


72.6 



" Deaths of infants 
Per 1000 populatic 



nf age per 1000 births reported. 



QUINCY 



279 



inuiiit\ over a period of years and were responsible for many a shudder to 
tliinkint; citizens of unfortunate victims of their influence or function. 

The story of Slab Hollow in Ouincy holds something to put towns and 
cities to analyzing. Slab Hollow was a gulch. Poverty-stricken people 
lived there. They huddled in shacks crudely fashioned out of discarded 
slabs which men and women and children dragged from a nearliy sawmill 
to patch together into inhuman abodes. 

Here in Slab Hollow the grass was worn away, here was sickness and 
death. People from the outside shunned it. Just over the ridge was 
another place that was shunned — the pest house. 

Gone now is Slab Hollow. Gone the pest 
house. They went in the main because one man, 
in the beginning, rebelled against them. He was 
IL J. Parker, banker. His widow, now gray 
haired, carries on for him. Air. Parker felt 
that Slab Hollow and the gloomy pest house 
should go. First Slab Hollow and then the pest 
house were rooted out. In their place stands 
all the beauty of the public parks system of the 
city. 

And the point of it is that when the slab shacks 
of .^lal) Hollow vanished the poverty that was 
there vanished, too. The people were forced 
into better living! 

The property which was called Slab Hollow consisted of ten acres of 
ground bounded by Cedar. Spruce, Third and Front Streets, and belongs to 
the Wabash Railway Company. About I9I0, Air. F. J. Parker, president 
of the Ouincy Park and Boulevard Association, took up with President 
Delano of the \\'abash Railway Company the matter of leasing this pro- 
perty to the Park and Boulevard Association for an addition to the park 
system. Mr. Delano was agreeable to the proposition and the lease was 
made at a nominal amount per year. Up to the time the lease was made the 
property was occupied by a very undesirable lot of squatters, poor white 
trash, negroes, and all sorts of combinations of these races. 




Edward J. Parker 

President Park and Boulevard 

Association, 1SS7-1912 



References. 



th B. Ball. Pediatrician, Division Child Hygiene. Departn 
.\dams Count.v Medical Societ.v. 



DM:i Mii.|.li..l la \h. 
lle.llth. f.irir. 1 U -. , i.iiM 

Annn.il ,r|,M,i- Ml 111, 

.\nniuil i.-i.Mii. ,.f III, li,i:,i,l ,,f health lif the Quinev Public Health Distrir 

Uep<jits of the Cheerful Home Settlement. Miss Martha D. Fitzgerald, I! 

Heport of l>r. Isaac D. Rawlings, Director of the State Department Publi 
of Health .Service of Fifteen Illinois Cities in 192.5, Illinois Health News, Mav- 

Aimual Reports of the State Board of Health. 

Ilistnrv of Medical Practice in Illinois, Vol. 1. Zeuch. L. H., Chicago, 192 

Illilll.i^ A- It Is, Fred Cerhard, Chi<aKo. IS.".-, 



X., Head Res 
Health on an 
mie, 1926. 



ident. 
Appraisal 



Rockford 



Rockfurd has established a well earned name and reputatiun in the 
health history of the State. In this connection it may be tittin.s^ to recall 
lohn 11. 'riuirstun's story in regard to the origin of the city's name. To 
the earh tra\elers from Chicago to Galena, the locality of the rock ford in 
the Rock River was called "Midwa_\" because it marked the beginning of 
the second half of the journey between the two towns. 

Thurston says when the original claimants of the mill privilege met in 
Dr. |. C. Goodhue's office on Lake Street in Chicago to name their claim, 
which the\ hoped at some time would become a 
town, the name "Midway" was not in favor. 
\'arious other names were suggested and reject- 
ed until Dr. Goodhue said : "Why not name it 
'Rockford' from the splendid rock bottom ford 
on the river there?" The name seemed approp- 
riate and was at once unanimously accepted. 
This happened in 1835. but the legislature, meet- 
ing in Vandalia in 1836, in its proceedings still 
referred to the site as "Midwa}'." But news 
traveled slower to the capital in those days than 
reports of contagious disease do now. 

This same Dr. Goodhue, who was not satisfied 
<nown only as a midway halting place between 
Chicago and Galena, put into effect his convictions, and went to Rockford 
in 1838 and settled there. 




.Io.siali C. Goodhue, M. D. 
that Rockford should be 



In Chicago he had been an alderman from the first ward, in which office 
he was succeeded fifty years later by "Hinky Dink" Kenna. As a council- 
man, he took a leading part in the establishment of the public school system, 
in fact is known as the father of Chicago's public schools. In 1834 he 
served with Dr. W. B. Egan as a sanitary ofiicer of the Town of Chicago 
under the \"igilance Committee which was acting then to protect the city 
from an\ fiu'tlier invasion of the cholera. 

In this capacity it was a part of hi^ dut\ to enforce the first .sanitary 
ordinance of Chicago, which was passed i)y the town council in 1833. This 
prohibited the throwing of refuse into the Chicago River, a simple provision 
yet very significant, in that it was the forerunner of the great efforts made 
in the next 75 years to solve the great sanitar}- problem of the citw namel.\-, 
the pollution of the river and the contamination of the water suppl\ . 

(280) 



ROCKFORD 281 

Dr. Goodhue was a close friend and associate of Dr. Daniel Brainarci 
and with him was one of the founders of Rush Medical College, and is 
named as one of the original trustees in the charter granted to that institu- 
tion in 1837. 

When Dr. Goodhue became a resident of Rockford, he continued to tlis- 
pku' the same interest in |)ul.ilic affairs as he had in Chicago. In 1846 , 
he organized the Rock River Medical Socict\-, one of the earliest in the 
State, and became its first ])resident. 

If the early proceedings of that society were available, they would 
pnjhablx show that the health of the community was given much consider- 
ation and the first efforts to check the ravages of contagious diseases were 
made by public spirited members of this society. 

Rockford appeared first in the U. S. census returns in 1860. At that 
time 6.979 people inhabited the place. By 1870 the population figure had 
grown to 11,049 and to 13,129 in 1880. The next decennial census year 
found 23,584 souls in Rockford and this nuniljcr had increased to 31,051 
when the new century began. In 1910 the population was 45,401 and in 
1920 it was 65,651. Of the 1920 population 47,782 or 72.8 per cent were 
native born whites, 17,343 or 26.4 per cent foreign born whites and 490 or 
0.7 per cent negroes. There were 14,584 or 22.2 per cent in the 45 or over 
age group. 

PuuLic Hkalth Skrvuk Maciiinkry 

The stor_\' of public attempts in Rockford to protect itself against the 
ravages of disease divides itself into periods that correspond very closel\- 
to the advancements in sanitary science. At the outset attention was con- 
cerned almost wholly with environmental conditions that dealt principally with 
physical cleanliness of streets and premises and with the abatement of 
nuisances. As time went on bacteriology came into practical use and the 
citizens of Rockford through their local officials took advantage of the new 
methods prescribed by it more promptly and on a larger scale than most 
other communities of like magnitude in Illinois. 

To begin with the sanitary efforts were handled bv laymen independent 
of the medical profession. This arose, as it did in other places, not from 
;i lack of confidence in physicians of the day but because doctors were regard- 
ed as a profession dealing only with the cure of disease and the alleviation 
of the sick and not as men whose training fitted them to cope with external 
conditions that were regarded as the source of contagious infections. An- 
other reason was that doctors were busy people and could ill afford to devote 
their time and talent to the current sanitar\- procedures, the benefits of which 
were doubtful enough. Futhermore, the remunerations provided for per- 



282 DOWN-STATE MUNICIPALITIES 

sonal service and the resources for carrxing out constructive programs were 
onlv too meagre. 

Thus the first public health efforts in Rockford were an expression of 
this prevailing attitude. An epidemic of cholera that reached the cit\- in 
1853 led to the adoption of an ordinance requiring the abatement of nuisances. 
In June of 1854, therefore, a board of health was organized and Newton 
Crawford was employed as its executive officer. This was the beginning 
of what may be termed the lay or non-medical period of public health service 
in the city. It continued for almost exactly thirty years during which time 
only one physician was named among the long list of health officers who 
included the following: 

Newton Crawford 1S54 J. Fisher ISfiS 

T. B. Potter 1S55 R. H. Paddock 18(i4 

E. H. Potter 1S56 T. Sully lsG.5 

Dr. R. P. Lane 1857 G. H. Platter (.3 months) ISiJG 

E. C. Roberts 1858 T. Sully 18G7-1S79 

M. T. Upright 1859 P. A. Coonradt 1880-1881 

A. J. Pennock 1860 T. Sully 18S2-1S84 

A. Halstead 1861-1862 

During this lay period numerous ordinances of a sanitary nature, relat- 
ing for the most part to nuisances, were adopted and placed under the juris- 
diction of the health officer for enforcement. In 1860, for example, a code 
of sanitar\' regulations was adopted and the next year an ordinance concern- 
ing barber shops was added. Then folh.iwed from time to time new regu- 
lations, prescribed by the city council, relating to plumbing (1875), weeds 
and grass in streets and alleys (1877), scavenger service (1878), inspection 
of slaughter houses (1878), sewage disposal (1880) and the reporting of 
cases of contagious diseases. Apparently the continuity of the original 
board of health was not maintained for in 1879 the ma\or apjiointed a com- 
mittee from the city council tn form a board of health. 

I'"rom this account it is clear that ]nililic health work in Rockford up to 
1885 was chiefly a matter of abating nuisances and promoting general com- 
munity cleanliness. Responsibilit\' for providing this service was vested in 
a sanitary policeman, the health officer, who had authority to employ medical 
service when circumstances required it. The city paid from $200 to $450 
a \ear to the health officer. 

I'eginning with 1881, three years before the medical profession took 
over the direction of public health affairs, a series of ejiidemic events brought 
health protective measures to pass in a hurr\- for two years. Scarlet fever 
and smallpox were the chief offending infections during this period, the first 
causing 53 cases of illness in 1881, with a recurrence the next year and the 
second bringing 23 individuals to bed and 3 to their graves. 



ROCK FORD 283 

Public concern over this situation led to the expenditures of $593.75 in 
health work during 1881. an unheard of sum up to that time; the building 
(1882) of a pest house on the outskirts of the city at a cost of $2,000 with 
an additional $175 per annum for its operation; the construction of a gen- 
eral hospital (1882) now known as the Rockford General Hospital; and the 
placarding (1882) of houses in which scarlet fever existed. 

These developments manifested a distinct tenderness of the public con-, 
science toward health service and demonstrated the important fact that the 
people were willing to pay for any reasonable activity that promised pro- 
tection from epidemic attacks. According!)- we are not surprisetl to observe 
signs of substantial advancement in the years that follow. 

Period of Medical Influence 

The years of 1884 and 1885 mark two important changes in public health 
administration of the city. Both involved a reorganization of the board of 
health. The first provided a board of four members, made up of the mayor, 
the health officer, the city marshal and an alderman. At the same time the 
city council inaugurated the practice of maintaining a standing committee 
on health. 

The second change provided for the organization of a board of health 
"consisting of the mayor, city marshal, the chairman of the committee on 
health of the cit\' council, and a health officer who shall be a resident prac- 
ticing ph\sician possessing the requisite knowledge of sanitary science and 
preventive medicine, and shall be appointed by the mayor with the consent of 
the city council." 

Here we find the influence of the medical profession manifesting itself 
and from this date forward that influence plays an increasingly important 
part in the public health service of the city. This is significant because it 
probably became a big factor in giving to Rockford what is today one of the 
finest health departments for cities of its size in the country. 

But the administrative reorganization of 1885 did not stop with provid- 
ing a more satisfactory and serviceable board of health. The board was 
clothed with vigorous authority. For one thing the health officer could 
forcibly hospitalize persons found sick in the city of "any pestilential or 
infectious disease." Strict reporting of all cases of communicable dis- 
eases was required. Compulsory vaccination of school children, as required 
by the State Board of Health, was made mandatory. The keeping of vital 
statistics was ordered by ordinance. 

These requirements together with numerous others expressing the 
most advanced sanitary and hygienic ideas of the day indicate a lively public 
interest in health problems and suggest a well advised and deliberate policy 
on the part of those in charge. While not largely compared with present 



284 



)W \ -STATE M f X UI I'ALITIES 



(lay r.\|)cn(lilurc> for tirst class health service, the appropriation of 91,425 
to the liL-allh department in 1885 was generous for that time when the State 
appropriated only $9,000 for such purposes. Moreover, the same generous 
attitude added dignitx- to the health department by providing it with furnished 
quarters uf its own in the city hall. The property schetlule showed a desk, 
a stove, a bill tile, a pick and an uthcer's badge. Just what the function of 
the pick was is left to the imagination. 

Beginning with 1885 none but medical men have served Rock ford in 
the capacity of health officer. The position was on a part-time basis until 
1923 when the present health commissioner, Dr. N. O. Gunderson, found it 
advantageous to the service and the public to convert the office into what is 
practically a whole-time proposition. 

The list of physicians who have acted as health oflicer or commissioner 
of health, as the officer was officially known after 1892. includes the 
following : 

Health Officers of Rockford 
1885—1927 



Dr. E. E. Oder 
Dr. W. B. Helm 
Dr. W. A. Boyd 
Dr. G. W. Rohr 
Dr. C. E. Crawford 
Dr. E. Lotgren 



1885-1SS7 Dr. C. E. Crawford 1907-1910 

1888-1890 Dr. W. E. Park 1911-1916 

1S91-1894 Dr. G. S. Lundliolm 1917 

1895-1900 Dr. W. H. Cunningham 1918 

1901-1902 Dr. J. S. Lundholm 1919-1920 

1903-1906 Dr. X. O. Gunderson 1921 to date 



.Mong about 1890 the responsibility for garbage removal was place 
the health department, a common practice of 
municipalities, and appropriations were made to 
include that item. The strength of the depart- 
ment may be surmised from the fact that its 
total appropriation for 1892 amounted to $2,tX)0 
with $157.50 specified for garbage removal. 
Most of the money was spent during that and 
immediately subsequent years in making house 
to house sanitary inspections, a practice that was 
believed to be of the greatest importance in dis- 
ease prevention and one that was probably stim- 
ulated by the policy and emphasis of the State 
Board of Health. Fumigation of premises, 
especially where contagious diseases had existed and public buildings includ- 
ing schools was also an important function so far as time and expense was 
concerned. 

.\biiut 19()(J it became the custom to retain on the staff of the health 
department a regularly eni])li)yed sanitary insjiector. Work of this char- 




Charles E. Crawford, M. D. 

Commissionei of Health, 

1901-1902; 1907-1910 



286 



DOWN-STATE JI UN' K'l I'AI.ITI ICS 



actcr frL-(|ueiitl\- retiuircil a larger staff but ailditimial help was put on tem- 
porary ilut> fruiii time In time as occasion arose. 

The heallli (lei)arlment continued to grow _\ear hy year in size, function 
and influence until 1917 found it with an annual appropriation of $8,250.00 
and consisting of the commissioner of health, one clerk, two sanitary in- 
spectors and a chemist (part-time). It had a small laboratory for testing 
samples of water, milk and food and for doing some bacteriological work. 
The functions of the department embraced vital statistics, communicable dis- 
ease control, food and dairy inspection, abatement of nuisances, laboratory 
service and supervision over garbage removrd. 

Then came the World War that brought with it to Rockford a sudden 
and tremendous influx of population, due to the proximity of Camp Grant. 
This created complex health problems of greater magnitude than the city 
had before experienced. Not only so but the activities of the Federal and 
State authorities emphasized health more vigorously than that subject had 
ever before been emphasized. The influence of this general movement fell 
with particular force upon Rockford not only because of the acute problems 
that suddenly faced it but because the public conscience had for more than 
fifty years been growing in its respective attitude toward sanitary and hygi- 
enic service. 

During the war, therefore, Rockford welcomed the widening scale of 
puiilic health work made possible by the establishment there of a sanitary 
district, including the camp, with a State district health superintendent in 
charge and on its own initiative the city carried out an exhaustive sanitary 
study, including a house to house canvass, supervised by a staff member of 
the State Department of Public Health. This project was undertaken with 
the view of bringing to Rockford a health service organization commensurate 
with the needs of that rapidly growing munici- 
pality. 

As an outcome of all these influences, we find 
the health department taking on a nursing service 
in 1918 and by 1920 the personnel included a 
nurse, a cjuarantine officer, two sanitary inspect- 
ors, a chemist and a bacteriologist. The next 
year Dr. N. O. Gunderson was appointed health 
commissioner and this event marked the beginning 
of a period during which Rockford has enjoyed a 
public health service of the first rank. 

One of the first things Dr. Gunderson did was 
to complete the organization of the department 
intd bureaus. He charged each with specific 




N. O. Gunderson, M. D. 

Commissioner of Healtli, 

1921 to date 





Two views of the Rockford and Winnebago County Tuberculosis Sanitai-iuni. 



288 DOWN-STATE MUNICIPALITIES 

responsibilities and required from each periodical reports that not onl\- stim- 
ulated the best efforts of the staff but provided the commissioner with valu- 
able data serviceable in measuring the capacity of his department, in fdrm- 
in.ij; policies and in dealing with appropriating bodies. 

L'nder Dr. Chmderson. who continues as health commissioner at the 
present time, the health department has developed into a strictly modern 
public health service organization. 

While still falling short of what might be regarded as the ideal, it par- 
ticipates in nearly every phase of work embraced in the modern conception 
of what official preventive medicine implies and gives to the city a thoroughly 
sound and well rounded program. 

Other Official and Voluntary Agencies 

Like most other communities the public demand for health service in 
Rockford exceeds that which officials of the municipality have arranged to 
supply and consequently we find that voluntary organizations and the board 
of education engage in hygienic and sanitary activities on a considerable 
scale. Indeed the other agencies combined spend more money than does 
the health department proper for purely public health work. 

In addition to these organizations the city voted to establish a municipal 
tuberculosis sanitarium in 1914 and opened the institution two years later. 
Winnebago county, in which Rockford is located, voted a tuberculosis tax 
in 1922 and arrangements were made by officials for the city and county to 
operate the sanitarium jciintly for the lieneht of all citizens both urban and 
rural. 

In 1926 a stud\- of the health activities in Rockford. including both 
official and voluntar_\ , was made by the State Department of Public Health. 
The data collected were compared with similar information gathered in four- 
teen other cities in the State of comparable rank and were also reduced to a 
numerical expression in the form of a score, based upon a possible perfection 
rating of 1000 points. The fact that Rockford earned 770 points, standing 
next to Evanston with 812 as the highest scoring of the fifteen cities, indicates 
the character and extent of present day service there. 

The following (|uotation from the report of that stud\ indicates the 
character and comprehensive nature of Rockford's public health program 
and organizations : 

"Enjoying a public health service far above the average of the 
fifteen cities studied, Rockford scoring 770, or 77 per cent perfect, ranks 
second to Evanston only in the appraisal results. All health activities 
are on a much higher plane than the average. Especially is this true 
of vital statistics, tuberculosis, milk control, laboratory and health edu- 
cational services. The health officer gives practically full-time services 
and administers a very efficient department, although many activities 



ROCKFORD 289 

are not under his direction. The board of education conducts all school 
hygiene work, employing a part-time physician, dentist and five nurses. 
The tuberculosis, prenatal. Infant and preschool work is conducted by 
the Rockford Visiting Nurse Association. For the tuberculosis ac- 
tivities the Municipal Sanitarium Board pays $2,000 per annum to this 
Association for field nursing service. The city health department 
conducts all of the other phases of health service and in addition 
handles garbage collection. The expense of garbage collection has been 
eliminated in estimating costs. Expenditures for health service by the 
city health department for 1925 amounted to $28,500 or 37 cents per 
capita. Other agencies spent money suflScient to bring this figure up 
to $61,267 or a grand total of about 65 cents per capita." 



ROCKFORD 



ra 'p 'p y "p — I- 



VITAL 5TATI5TIC5§1 
conn. DI5. CONTROUEI 
VEh. DI5. COMTROL :^^1 
TUB. CONTROL Si 
HEALTH CHILD=<:^"-^ 
HEALTH 5CH. CHILD ^J 
5AhlTATI0h's?icX^^ 
MILK COhTROL ^1 
LABORATORY >^M 
POP.MLALTH IMSTkI 



PERCENT OP STAMDARD SCORE 
FOR EACH OF TEM MAJOR HEALTH ACTIVITIES 
1923 



This graph illustrates the strong and weak points in Rockford's public 
health service, oflScial and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in Rockford was 77 
per cent of the standard perfection requirement. 

The significant developments in the pubhc health machinery of the city 
may be briefly summarized chronologically as follows : 
185^1 — First board of health organized. 
1854 — First health officer employed. 
1882 — Began quarantining for smallpox and scarlet fever. 



290 DOWN-STATE MUNICIPALITIES 

18S-1 — Reorganized board of health and created stanchng committee on 

health in city council. 
1885 — Mandatory requirement that health officer must be physician. 
1891 — Plumbing in.spector employeil. 
1902 — Milk inspections started. 
1904 — Dairy inspection inaugurated. 
1910 — Medical inspection of school children started. 
1911 — Visiting Nurse Association organized. 
1912 — City laboratory opened. 

1913 — Fresh air rooms in schools started operation. 
1915 — Fresh air camp opened. 

1915 — Bureau of communicable diseases established. 
1916 — Municipal Tuberculosis Sanitarium opened. 
1916 — Bureau of food control created. 
1917 — Bureau of vital statistics organized. 
1918 — Tuberculosis clinics started. 

1922 — County adopts Glackin tuberculosis sanitarium tax. 
1923 — Health commissioner began devoting full time to duties. 
192-:1 — Bureau of ventilation and heating, bureau of publicity and bureau 

of water safety and typhoid control established. 
1925 — Pre-natal clinics started. 

Water Supply. 

The original waterworks were installed in 1874-75 when Rockford had 
a population of about 12,000. It comprised a pumping station on the west 
side of Rock River, an infiltration well beneath the station, some tile drains 
connecting springs to the infiltration well, a pipe line from the river to the 
infiltration well, and a limited distribution system. Since the original instal- 
lation, numerous changes and additions have been made from time to time 
to make available an adequate supply of safe water to meet the growing 
needs of the city. The city has faced threatened water shortages several 
times. 

By 1881 the first installation had become so inadequate that a dug well 
about 50 feet in diameter and 38 feet deep with a 12-foot shaft going 10 feet 
deeper was sunk south of the station. In 1883 the infiltration system was 
cleaned, possibly with the hope of increasing the yield, but river water had 
to be admitted from time to time and by 1885 the main part of the supply 
was being obtained from the river. 

In 1885 after consulting Professor T. C. Chamberlain, then of the 
Geology Department of Beloit College, the first artesian well was sunk at 
Rockford. The well was about 1,530 feet deep and water rose about 136 
feet above the citv datum-line or 35 feet above the average Rock River water 



ROCKFORD 291 

level. In each of the four succeeding years another artesian well was drilled. 
In 18'Jl the combined flow from the five wells reported as 1,100,000 gallons 
daily, was not adequate, and an engineering committee was appointed to 
report on the water question. The static water level of the wells was then 
about 20 feet above the ground surface, and the water flowed to the old 
infiltration well below the pumping station, which was used as a suction well 
for high-service pumps. The engineers recommended the installation of 
three more wells to be equipped with pvuups for discharging the water into 
a new storage reservoir. In 1892 a 1 ,000.000-gallon concrete storage reser- 
voir was built, and during that year and the following year four or five new 
wells ending in St. Peter sandstone were drilled. 

In a further effort to increase the supply, all wells were equipped with 
air-lift in 1895. 

In 1896 the so-called shaft-and-tunnel system was installed which con- 
sisted of a central shaft about 80 feet deep from which tunnels connected 
to the tops of the several wells. Pumps located at the bottom of the shaft 
drew water from the wells and discharged into the reservoir and suction 
well at the ground surface. This development yielded about 6,800,000 gal- 
lons of water a day and proved more or less adequate for about a dozen 
years. River water had been used more or less frequently since the original 
waterworks were installed. 

In 1897 the sixth artesian well was drilled. By 1900 the water con- 
sumption for the population of about 31,000 was about 84 gallons per capita. 

In 1910 a second engineering commission consisting of J. W. Alvord, 
D. H. Maury, and D. W. Mead, leading consulting engineers then practicing 
in the Middle West, were engaged to make a thorough investigation of water 
resources and the waterworks system because the supply was again proving 
inadequate. These engineers recommended the establishment of a new cen- 
tral station on the west side of the city with some wells in that vicinity ex- 
tending into Potsdam sandstone and other wells at scattered points in the 
city, from which water could be pumped directly into the distribution system. 
The first result of this report was the installation of two separate well sta- 
tions, one in the northwest and one in the southwest part of the citw and a 
second 1,000,000-gallon storage reservoir near the main station on the river 
bank. Before these wells were available in 1911 river water was again used. 
In 1913 three of the wells locally known as the Peach Street wells because 
of their location in that street near the main pumping station, were tempor- 
arily abandoned because they were suspected as one possible source of con- 
tamination of the public water supply that had caused a water epidemic the 
preceding year, and these wells were not again used except for short periods 
in 1916 and 1920 but are still maintained as a second reserve supply. In 1913 
the use of the old infiltration well as a suction well was also abandoned and 



292 DOWN-STATE MUNICIPALITIES 

re|)aii"s made to the (irii,'inal sttirage reservoir, as result of the water-borne 
typhoid- fever investigation. 

In 1921 the new west side pumping station recommended by the con- 
sulting engineers in 1910 was started, together with four drilled artesian wells 
and a 5.000,(X)0-gallon storage reservoir. At the close of the period covered 
by this history the water supply was being obtained from the drilled wells 
near the west side station, the two isolated wells installed immediately after 
the engineer's report in 1910, and the Peach Street wells and the others near 
the old station along the river bank are held as a reserve source of supply. 

The sanitary quality of the original water sup]:ly obtained by tile lines, 
tapping springs and an infiltration system was of questionable character. 
Also the river connection subjected the supply to contamination even though 
there was no city sewer outlet that entered the river above the dam, which 
dam is below the waterworks station, until 1883 or about nine years after 
the original waterworks installation. Although there is no record of a water- 
borne epidemic being caused by the public water supply previous to 1912, 
it probably was at all times of doubltful sanitary quality and may have been 
responsible for some scattered cases of typhoid and other intestinal diseases, 
especially when river water was definitely being admitted into the system. 

The typhoid-fever epidemic in 1912 was undoubtedly caused by the 
public water supply. The investigation made at the time of the epidemic 
showed that the supply may have been contaminated in any of three ways 
or a combination of them, namely : — pollution of the Peach Street wells near 
which a city sewer was located, pollution of the water in the original 
1 ,000,000-gallon reservoir when the water in that reservoir was drawn down 
in order to fight a fire, and pollution through cross connections with polluted 
river and creek supplies at factories. Later data showed that although the 
Peach Street wells and reservoir leakage may have added to the contamina- 
tion, that the main pollution and cause of the epidemic was the pumpage 
into the city mains of polluted river water by operation of fire pumps at 
one factory in order to help supply water for fighting a big fire at another 
factory. 

The city passed an ordinance in l'*12 prohibiting the further mainte- 
nance of dangerous cross connections, but no special efifort was made to 
enforce this ordinance until 1922 when the danger of the cross connections 
was brought by the State sanitary engineer to the attention of Dr. N. O. 
Gunderson, who had recently become commissioner of health. A chlorina- 
tor was obtained for emergency use at the main station in 1922 and through 
the efforts of Doctor Gunderson the cross connection ordinance was 
enforced, and since that time the water as pumped into the distribution 
system has been of safe sanitary quality. .\t times the chlorinator has been 
operated to take care of any contamination introduced when working on the 



ROCK FORD 293 

wells or when analyses have indicated slight contamination. Some improve- 
ments at the waterworks, including drainage of well pits and repairs to the 
reservoir top in accordance with recommendations made by Health Commis- 
sioner Gunderson and endorsed by the State sanitary engineer, remained to 
be carried out at the close of the period covered by this history. 

Since Doctor Gunderson became commissioner, very careful local ana- 
lytical control supplemented by occasional analyses in the State sanitary 
engineering laboratories have been maintained. With similar continued 
control and the carrying out of the recommended improvements mentioned 
ab()\e, the supply should continue to be of safe sanitary quality. 

The first record of an analysis is in 1878 when the sample was sent to 
some laboratory at Bridgeport, Conn., and was reported back as "good". In 
1912, 515 samples of water, including many from the public water supply, 
were analyzed at the city laboratory, and the laboratory control as noted 
above has been further extended since 1922. 

The original distribution system of about ten miles of mains was 
planned by Engineer Birdsall Holly. For several years the next additions 
included extensions of laterals so that eventually the larger mains became 
inadequate. Since then larger feeders have been installed and the distribu- 
tion sxstem now serves practically all of the built-up territory in the city and 
the ])ublic water supply is in general use throughout the city. 

Sewerage. 

In 1875 an ordinance relating to plumbers was passed, and in 1880 an 
ordinance relating to sewerage and drainage. In 1880 the drainage system 
consisted of surface gutters leading to the river. 

In 1886 there began the development of a system of sewers b\ the 
installation of two sewers, each about one mile long, with an outlet to the 
river. There were then about 3,500 dwellings in the cit\' and nearh- 1,000 
cesspools. These original sewers were recorded as being for sanitar\- sewage 
only, surface drains and gutters being relied upon to carry storm water to 
Rock River, on the banks of which the city was developing, or to Kent and 
Keith Creeks, tributaries of Rock River, which furnished natural outlets for 
storm waters as the city expanded away from the main stream. 

It was reported that by 1887 only about 235 houses were equipped w ith 
water-flush toilets, and that one-half of these drained to cess-pools. About 
24 out of every 25 houses still had privies. 

As the city continued to grow, additional sewers were installed with out- 
lets to the river or the two creeks that are tributary to the river at Rockford. 
It was reported that shortly before 1900 a rather comprehensive plan for 
sewerage for the city was prepared, but this plan was not followed. 



294 DOWN-STATE MUNICIPALITIES 

By l'J18 there were 2,142 privies in the city, whicli indicates that the 
installation of sewers and plumbing had not kept up with the growth of the 
citv. By 1921 the number of privies had been reduced to 1,345 and there has 
been a further reduction every year since that time. 

At llie close of the period covered by this history there were a total of 
50 or more public sewer outlets, one-half of which discharge into Rock River 
above the dam in the southern portion of the city, another one-fourth into 
the river below the dam, and the remaining one-fourth into Kent Creek. 
The city has developed so that there were about equal areas on the east and 
west sides of Rock River, which flows southerly through the city. Near the 
close of this period additional sewerage facilities were urgently needed to 
take care of subdivisions that had developed fairly rapidly and also to abate 
and prevent stream pollution. Consequently, in 1926 Rock ford took advantage 
of the sanitary district law enacted by the legislature in 1917 and organ- 
ized a sanitary district which included the entire city and some surrounding 
territory. Just before the close of the period covered by this report Pearse, 
Greeley & Hansen, consulting engineers for the district, had submitted a 
report on a sewerage project which included main intercepting sewers on 
both sides of Rock River to pick up the sewage from the main existing out- 
lets and to carry this sewage to a suitable treatment-plant site south of the 
city where the sewage will be treated by progressive steps to abate any exist- 
ing pollution and prevent any objectionable stream pollution in the future. 
This report has been approved by the State Department of Public Health 
and also by the board of trustees of the sanitary district, and plans for carry- 
ing out the project are under way. 

With the carrying out of the Rockford Sanitary District project and 
some additional lateral sewerage work which is also planned, all built-up 
territory within the city and district will be provided with sewerage facilities 
and the collection and disposal will conform to modern sanitary standards. 

Milk Control. 

For forty _\ears milk control has been a subject of jealous public con- 
cern in Rockford and the efforts to provide the cit\- with an adequate, safe 
and otherwise satisfactory supply have culminated in giving to the munici- 
pality a system of sanitary milk supervision that is far superior to that pre- 
vailing in most other ci immunities of Illinois. 

The first official step toward municipal control of the milk supply took 
place in 1888 when an ordinance was adopted requiring all dealers to procure 
a license. The main reason for this step was probably for revenue but it 
enabled the city to dictate conditions upon which a license would be issued, 
providing a splendid means of enforcing sanitary or other standards that 
mieht be deemed wise. 



ROCKFORD 295 

At first the chief concern was for chemically satisfactory milk. The 
public wanted a product free from water and with a butter fat content no 
less than the cow prescribed. It wanted milk without manure and other 
barnyard filth that frequently finds its way into the milk pail of careless 
producers. Still it was recognized that milk has some close relation to health 
because the jurisdiction over milk supplies was placed under the health 
ofticer. 

Thus in 1902 a special milk inspection service was undertaken by the 
health department and in 1904 this was extended to include dairy farms. 
Chief emphasis was placed upon chemical standards and ordinary cleanli- 
ness for its own sake. This attitude was disclosed by the number of samples 
analyzed for chemical contents. In 1907 more than 1200 samples were 
collected and chemically analyzed. 

In 1912 came the first movement toward controlling the bacterial qual- 
ity of the city's milk supply when an ordinance requiring the cooling of milk 
and the routine inspection of dairies was adopted. This ordinance vv'as re- 
vised a year later and amended in 1914, each time prescribing more stringent 
sanitary requirements and giving the health authorities more extensive 
control powers. In 1924 a complete new ordinance which practically re- 
quires the pasteurization of all milk except that produced and handled under 
very high sanitary standards was adopted. The ordinance gave the health 
officer power enough to carry into effect a thoroughly modern control 
SNstem, 

A rather unique feature of the system so far as the producing farms 
are concerned, is what Dr. Gunderson calls remote control practice. Daily 
bacterial and reductase tests are made at the milk-receiving stations of city 
dealers. When the results suggest insanitary or other undesirable conditions 
at the farm an inspector is dispatched promptly to the point in question. 
This method appears to have worked out very sastifactorily in Rockford. 
Certainly few cities enjoy a more satisfactory supervision over this most 
important and easily contaminated food supply. 

Health Conditions. 

What appears to be the earliest historical reference to prevailing health 
conditions in Rockford is found in a history of that citv, covering the period 
of 1834 to 1861, by Charles A. Church. He says: 

"The year 1S4G was sigualleil by much sickness. Nearly every 
family living on low land had malarial fever, and the doctors were busy 
people. At one time Dr. Catlin, who settled in Rockford in 1839 could 
get but four or five hours sleep out of the 24, and he would become so 
exhausted that he frequently slept while riding from house to house. 
One day in 1S46 he made "0 calls, and prescribed for GO patients. 



296 1X)\V.\'-STATK MUNICIPALITIES 

'■Durins this season, Dr. Goodhue was asked what to do tor the 
sick. To this grave question the doctor made this characteristic reply: 
i (ion't know, unless we buy a big smoke house and cure them.'" 

No otiicial iiKirtaliiy records were kept in those earl_\- (la_\s but statis- 
tics taken from sexton and cemetery registers indicate an annual death rate 
of something more than 12 per 1.000 population. The rate fluctuated from 
year to year with the rise and fall of epidemics but no statistics are available 
to show how wide the margin of variation was. An annual mortality rate 
of 12 per 1,000 people suggests favorable health conditions, but it must be 
remembered that settlers in a new country ordinarily constitute a sturdy 
groui), free from any considerable number of those in the very early and 
very late age periods of life. Since the highest mortality prevails among 



TEN PRINCIPAL CAUSES OF DEATH 

ROCKFORD ILLINOIS 


1 — 

< 


IZ 
10 

a 

6 
i 
2 













1 HEART DISEASE 6 TUBERCULOSIS 

2 CANCEO 7 PNEUMONIA 

3 BBIGMTS DISEASE 9 PREMATURITY 

4 STROKE 9 CONTAGION 

5 ACCIDENTS 111 DIABETES 


- 














- 


' 


1 














1 




* 


_ 












# 


|J 


* 


[* 


^ 




1 




1 


'M 














n 


CAUS[ 


1 


I 


3 


4 


5 


6 


] 


fl 


9 


10 


PAT[ 


\U 


00 


/] 


].l 


6.0 


1 


5.4 


M 


4.8 


16 



For Year 1926. 



persons under one and over fift_\- it is clear that a rate (.if 12 or more in a 
population without many of these is not indicative of so healthful a condition 
as might be surmised at first impression. The annual death rate in the 
United States Army in times of peace, for example, is ordinarily less than 
5 i^er 1.000 men. 

An epidemic wave of cholera appeared in the United .States in 1849 and 
it appears rather certain that this outbreak reached Rockford in 1853. No 
authentic records about it have been preserved but tradition informs us that 
public alarm reached ;in altitude sufficient to lead officials to procure the 
use of a new barn i>n ihc outskirts of town for housing and caring for 
patients. It is probable that this unhappy experience led directlx to the 
first efforts in the cit}' toward organizing a public health service. 



297 



The next epidemic disturbance of sufficient magnitude to inspire notice 
on the permanent records of the city took place in 1877 when 399 cases of 
scarlet fever occurred. That was a terrible experience for a community of 
less than 14,000 souls. Such wide-spread prevalence of so dangerous an 
infection is enough to justify a pronounced public demand for every official 
service that might reasonably be expected to prevent or favorably modify 
recurrences of that character. It followed very naturally therefore that 
public sentiment in Rockford resulted in the adoption of various ordinances 
requiring general cleanliness in the city, sewage disposal and the naming 
of a committee to form a new and active board of health. No less could be 
expected frum an intelligent people. 

Table 1. 
AIoKTALiTV From Certain Causes, 



YE.\R 


i 
6 


3 
P 


1 


6 


s 


b, 


1 

6 
5 


5<S 


1 


5 


1? 


'c 5 
5_ 


1886 


158 


2 












3 






15 




1887 


228 


22 








' i 




3 






29 


' 8 


1888 


















i 






1889 


























1890 


340 










"4 


i 


',54 






'46 


24 


1891 


355 


"g 








4 




12 


'ii 




33 




1892 


389 


23 






' i 


5 




8 


14 




43 


■38 


1893 


409 


16 








12 


2 


1 


6 




40 


22 


1894 


298 


4 








10 


3 


1 


4 




45 


14 


189.3 


350 


6 






' 6 


1 


8 


6 


8 


' 8 


30 


21 


1896 


283 


.") 






2 


1 




15 


3 




23 


25 


1897 


335 


10 






... 




1 


52 


3 


... 


46 


15 


1898 


272 


1 












26 


4 


30 


24 


1899 


272 


3 






" -2 




i 


10 


4 1 


42 


20 


1900 


300 


1 








' (i 


1 


r, 


2 


... 


36 


20 


1901 


429 


3 








1 


3 


1 


4 




56 


47 


1902 


403 


3 








IS 




11 


2 




48 


33 


1903 


433 


1 










"e 


4 


6 




37 


30 


1904 


460 


11 








3 


... 


2 


5 




55 


33 


190.-) 


739 


6 








1 


1 


5 






62 


43 


1906 


416 


4 












4 


"2 




39 


39 


1907 


498 


6 








' 's 


' a 


10 


1 




28 


75 


1908 


450 


4 








2 




3 


7 






39 


1909 


503 


2 






"3 


2 


'.'.'. 


4 


1 




55 


36 


1910 


610 


11 






2 


2 




8 


2 




50 


39 


1911 


720 


11 








1 




10 


2 




46 


67 


1912 


582 


42 












f, 






45 


58 


1913 


593 


15 








' i 


3 


10 


2 




41 


54 


1914 


562 


4 






i 


2 


2 


6 


2 




60 


44 


1915 


603 


4 






1 


4 


.5 


6 


6 




49 


58 


1916 


061 








Ti 


8 


1 


2 


1 




43 


83 


1917 


723 


' 6 






4 


g 


7 


3 


1 




60 


101 


1918 


1087 


2 






2 


1 


1 


13 


323 


'.'.'. 


68 


88 


1919 


702 


1 






6 


1 


1 


7 


4 




52 


89 


1920 


835 


3 






3 


4 


4 


9 


97 




61 


88 


1921 


697 


1 






1 


3 


3 


12 


1 




50 


49 


1922 


708 


1 








4 


1 


3 


2 




48 


79 


1923 


755 


1 






' '9 




s 


9 


26 




24 


81 


1924 


672 


2 






4 


1 




2 


7 




33 


37 


1925 


681 


2 






3 


2 


i 


1 


2 




23 


42 


1928 


836 


3 






3 


1 


1 


1 


25 


"i 


38 


43 



* For Enteric fever for years 1886-99. 
Note: Slight disi.*repancie.s exist between 
different nietliotls employed and areas iiicliided 



table and th( 
:he conipilatio 



298 



DOWN-STATK MUNICIPALITIES 



Table 2. 
Mortality Rates From Certain Causes. 



YEAR 


O 


B 


s 


m 


s 
s 


> 

1 


6 

1 

is 


%s. 

Jo 
3 " 


1 




11 


If 


1886 
1887 
1888 
1889 
1890 
1891 
lS»-i 
1803 
1894 
1895 
1896 
1897 
1898 
1899 
1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
1908 
1909 
1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 


8.1 
11.1 

liii 

H.6 
1.").5 
15.8 
11.2 
12.8 
10.0 
11.6 
9.2 
8.9 
9.6 
13.2 
11.8 
12.3 
12.5 
19.3 
10.4 
12.1 
10.5 
11.4 
13.4 
14.5 
11.2 
11.1 
10.1 
10.5 
11.1 
11.7 
17.1 
10.7 
12.3 
10.0 
9.9 
10.3 
8.9 
8.8 
10.5 


10.3 
107.6 

3219 
91.7 
(2.3 
15.0 
21.9 
17.7 
34.7 
3.4 
9.9 
3.2 
9.2 
6.3 
2.8 
29.7 
15.6 
10.0 
14.4 
9.2 
4.5 
24.2 
22.1 
79.8 
27.9 
7.2 
6.8 

h'.e 

3.1 
1.5 
4.4 
1.4 
1.4 
1.4 
2.6 
2.6 
3.9 


'.'.'. 

'.'.'. 
'..'. 




1.5.9 
2i!9 

8'.4 
4.4 

i!8 

1.7 
8.5 
6.4 
3.1 
9.0 
4.4 
1.4 

12!2 
5.2 
3.4 
3.9 


16.9 
10.5 
19.9 
45.6 
37.6 
3.6 
3.5 

19!2 
3.1 

52 . 2 
5.6 
8.1 
2.6 

19!2 
4.6 
4.5 
4.4 
2.0 

i.'g 

3.6 
6.8 
13.6 
12.8 
1.6 

li 

5.6 
1.8 
1.3 

2.6 
1.3 


4.2 

V.e 

11.4 
29.6 
7.1 
3.5 

3.3 
3.2 
9.2 

16.8 

2!6 

7!2 

::: 

5.6 
3.6 
8.5 
1.7 

11.2 
1.6 
1.6 
5.9 
4.2 
1.4 

10.9 
2.6 
1.3 
1.3 


15.4 
14.5 

229!o 
49.4 
31.8 
3.8 
3.8 
21.9 
53.1 
179.9 
88.4 
32.9 
16.0 
3.1 
31.9 
11.2 
5.4 
13.0 
10.0 
24.3 
6.9 
4.6 
17.6 
20.1 
9.5 
18.6 
10.8 
10.2 
3.4 
4.8 
20.4 
10.5 
13.3 
10.8 
4.2 
12.2 
2.6 
1.3 
1.3 


45. '2 
59.5 
22.8 
15.0 
29.6 
10.5 
10.4 
13.8 
13.2 

6.<k 
12.3 

6.3 
16.8 
13.5 

"s'.b 

2.4 
16.1 
2.3 
4.4 
4.0 

'3. '7 
3.6 
10.2 
1.7 
1.6 

507.1 
6.0 

143.6 
1.4 
2.8 

35 . 4 
9.1 
2.6 

31. 5 


2 


^3 


77.0 
141.8 

loo.'o 

135.6 
171.4 
152.0 
169.3 
109.8 
80.5 
159.2 
102.0 
138.2 
115.2 
171.9 
139.2 
103.6 
148.5 
161.2 
97.5 
68.0 
126,5 
124.9 
110.0 
92.5 
85.5 
76.3 
108.0 
83.3 
73.1 
96.0 
106. S 
78.0 
90.3 
70.0 
66.7 
32.6 
42.9 
29.7 
48.3 


38^4 

loiis 

... 

151.5 
83.6 
.52.3 
76.1 
87.6 
51.9 
81.6 
65.8 
64.0 
144.3 
95.7 
84.0 
89.1 
111.8 
07.5 
182.3 
89.7 
81.7 
85.8 
134.7 
110.2 
100.4 
79.2 
98.6 
141.1 
161.0 
138.2 
133.5 
130.2 
68.6 
109.8 
110.2 
48.1 

54^6 



NoTK : 1 

•For Enti 

Slif^ht discrepancies 

methoils emplu\"etl .iiid .i 



rate from All d 



per 1,000 population; all others per 100,000 population. 

in Rockford due to different 



For the next four years nothing of extraorchnary significance in the 
health of the city transpired hut in May of 1881 smallpox was introduced 
from Milwaukee and smouldered in the community for fifteen months. Some 
23 cases and 3 deaths therefrom are recorded. This experience in itself is 
not particularly noteworthy except for the fact that Rockford appears to 
have escaped smallpox prior to that time and the further fact that the out- 
break led to the construction of a "pest house" without the walls of the city. 
Added to the public anxiety created by another visitation of scarlet fever the 
experience with smallpox stimulated another reorganization of the health 
department and very likely had to do with the passage of the ordinance in 
1884 that required the health officer to be a qualified resident physician. 



299 



Another experience that instilled into many hearts an earnest desire for 
protection against the ills which best humanity was that involving 135 cases 
of diphtheria in 1890. Those were the days before antitoxin had been dis- 
covered when diphtheria ran its dreadful course without stop or hindrance. 
This particular outbreak resulted, therefore, in 54 deaths, giving a fatality 
rate of 30 per cent. The number of deaths amounted to about 180 per 
100,000 people, a rate nearly two hundred times greater than that which 

usually prevails now. In 1926 Rockford 
lost but one life to diphtheria and that 
gave a rate of slightly more than one per 
100,000 population. 

About 1900 typhoid fever and tuber- 
culosis began to attract attention in Rock- 
ford because of general agitation on these 
bjubjects which had found birth in the 
minds of sanitarians familiar with the 
new born science of bacteriology. Both 
diseases had preyed upon the local citi- 
zens for years. Indeed they were looked 
upon rather as an evil habit or pernicious 
consuming sin that could neither be 
avoided nor compensated for because 
they were endemic or chronic in the com- 
niunit} . 

The general agitation concerning the 

preventable character of tuberculosis and 

typhoid fever provoked an examination 

of the mortality statistics in Rockford. 

This study revealed that the mortality 

from tuberculosis was 169 per 10(J,000 

population in 1901 and that this disease 

was the most frequent cause of all deaths. 

Typhoid fever had created no little 

ciiiicern in 1892 when a severe outbreak 

had resulted in 23 deaths. Another epidemic involving upwards of 100 cases 

occurred in 1904 and then came a frightful experience in 1912 and 1913 

when 512 cases carried 57 persons to their graves. 

Repeated epidemiological studies by local health officers. State health 
officials and an epidemiologist from the University of Chicago incriminated 
both water and milk supplies at various times. The outcome of these investi- 
gations together with the propaganda for tuberculosis eradication resulted 
in the establishment of services that gave to Rockford milk and water supplies 




300 



DOWN-STATE MUNICIPALITIES 



of the highest sanitary quality and a s])li.-iuli(l program against the great white 
plague. The phenomenal reduction in t_\ pht)id fever, scarlet fe\er and tuber- 
culosis all point to the splendid improvements in milk and water Mipplies and 
to the effectiveness of the anti-tul)erculosis work. 

Table 3. 
Cases of Cicktain Diseases Reported. 



1916 


1917 


1918 


1919 


1020 


1921 


1922 


1923 


1924 


1925 


1926 


1927 


Tvphoid Fever 


12 


19 


10 


S 


11 


16 


16 


5 


9 


16 


8 


13 


Smallpox 


30 


36 


9 


38 


149 


391 


1 


1 




9 


32 


1 


Measles 


863 


394 


420 


452 


120 




212 


931 


833 


397 






Scarlet Fever 


216 


127 


64 


lis 


208 


413 


237 


67 


28 


66 


179 


247 


Wlioiip. CouRh 




206 


68 


21 


02 


261 


39 


223 


146 


364 


68 




Diphtheria 


57 


42 


46 


131 


97 


279 


124 


58 


51 


22 


25 




iTiflueiiza 










99 


2 


29 


30 


10 


13 


82 


23 


P..li.imvelitis 


1 


1 


4 


1 




2 


4 


1 


3 


11 


3 


26 


MeliiriKitis 




4 


6 


1 


2 


4 


2 


2 


1 


2 


2 


7 


Tul.en-iilosis* 


118 


94 


71 


68 


99 


37 


2.56 


178 


135 


185 


285 


180 


Pneumonia* 












•^0 


115 


163 


86 


121 


129 


130 


Svphilis 












67 






38 


35 


45 


58 














17r> 






91 


106 


96 


87 


Chancr„i,l 












20 












3 



*A1I forms. 
NoTF. : Case reports are never complete, but tliey h:ive been much more so since 1920 than before in 

Illinois. Rockford is one of the cities where notification has reached a reasonably satisfactory status. 

Slight discrepancies exist between this table and the illustration made in Rockford due to different 
methods employed and areas included in the compilation of data. 



Table 4. 
jIRTIis and Infant Deaths. 



YK.\R 












Number 


Rate** 


Nuniber 


Rate* 


1906 


757 


IS. 4 






1907 


830 


19.5 






was 


la-i 


17.9 






1909 


706 


15.6 






1910 


850 


18.1 






1911 


924 


18.6 


105 


113.6 


1912 


932 


18.0 


7S 


83.7 


1913 


1069 


20.0 


94 


87.9 


1914 


1189 


21.0 


S4 


70.6 


1915 


1084 


18.9 


90 


83.0 


1916 


1276 


21.0 


127 


100.0 


1917 


1273 


20.(1 


127 


09.8 


191S 


1329 


20.9 


164 


123.4 


1919 


1420 


21.0 


127 


S9.0 


1920 


1539 


22.8 


124 


80.6 


1921 


1588 


23.2 


SI 


51.4 


1922 


1477 


20.8 


io.-> 


72.6 


1923 


1501 


19.9 


126 


83.9 


1924 


1595 


21.3 


89 


55.8 


1925 


1600 


21.0 


S2 


52 . 


1926 


1664 


21.1 


101 


60.7 



*I)eaths of infants under 1 

**Per 1,000 population. 

Notb: Slight discrepancies exist between 

different methods emploi'ed and areas included 



f age per 1000 births reported. 



is table and the ilhi.stri.ti 
the compilation of data. 



Rockford due to 



ROCKFORD 



301 



A! INUAI - CpNTA MIO US DISEASt ^ R ATE 




1913 1914 1915 1916 1817 1918 1919 1920 1921 Mi 1023 1924 I9?5" 



place: 



ISS\\\S\\\V^ 



O F" 



BIRTH 



YEflR|Nyi>IBM|PCBC[h% 



REIRCEIMTA&E 



10 ?0 30 40 50 60 70 



1911 



I9I9F 



i920F 



1921 



.\\\!\\\k\\\\\^ 



Sfi 



\\\\\\\i 



\\\\\\\\\\\\\\v^ I 



\\\k\\\\V\\\\'\\'d^^ 



\\\'\\\T\\^ V\\'\\\\\ M 




302 DOWN-STATE MUNICIPALITIES 

l\()ckford fared far better than many other communities in the State 
diirins,' the 1918 pandemic of influenza. Deaths charged against that infec- 
tion amounted to 265 per lOO.CXX) population while most of the other com- 
munities suffered rates above 300 and n(jt a few above 500. The combined in- 
fluenza-pneumonia rate in Rockford in 1918 was 640 per 100,000 people 
whereas eight or ten other municipalities experienced losses that amounted 
to from 650 to 1.139 per 100.000 population. 

Reference to the statistical tables and the illustrations will show that 
Rockford is now enjoying a freedom from communicable diseases that results 
in mortality rates both specific and general which compare favorably with 
those of any comparable cit\' an_\ where. 

References. 

\hnii,l I:. Ill, ,jf the City of Uockford, 1S97 to date. 

I i ill II iM furnished bv Dr. N. O. Gunderson, Health Commission of Rockford, Illinois. 
1' , I I, 1 l.y Miss Pearl Hixson, Public Health Nurse of Rockford, Illinois. 

ell It ihl liaiirams drawn by Mr. E. L. Johnson, quarantine officer. Department of Health, Rockford. 
Itepoit nf engineers to make a survey and recommendations for an adequate water supply, Rockford, 
1910. 

Reports of the State Board of Health, John H. Rauch, Secretary, 1883-1888. 

History of Rockford, Charles H. Church, Rockford, 1900, 

History of Medical Practice in Illinois, Vol. 1, Lucius H. Zeuch, Chicago, 1927. 

Appraisal of Health Service in Fifteen Illinois Cities in 1925, Illinois Health News, Ma\-June. 1926. 

Social statistics of Cities, U. S. Census, Report 1880, Vol. XIS, 1888. 



Rock Island 

The island in tlie jNIississippi River from which Roclc Island takes its 
name was first occupied in 1816 when Fort Armstrong was erected on its 
lower end. 

In 1835, the commissioners of Rock Island County entered at the Galena 
land office a fractional quarter section of land, in what is now the central 
part of the city and laid out a town called Stephenson. By an act of the 
legislature passed in March 1841, the name was changed to Rock Island, and 
it was incorporated as a town. In 1849 it was incorporated as a city. The 
population according to the U. S. Census of 1850 was 1,711. 

The city stands on a level plateau which is for the most part 10 to 25 
feet above the high water mark of the Mississippi River. From one-half 
to a mile back from the river, rise bluffs generally about 200 feet above high 
water. 

The soil is rich loam, with some deposits of clay, sand and gravel with 
an underlying bed of magnesium limestone from 3 to 10 feet below the sur- 
face of the ground. 

A strip of low, marsh}- land about 500 feet wide extends from the center 
southwest through the city, and one mile beyond to Rock River. In times 
of high water, this land in the early eighties was covered to a depth of from 
6 to 14 feet of water. 

This marsh was formerly a prolific breeiling place of malaria carrying 
mosquitoes, but after the sewer was built draining this slough, malaria prac- 
tically disappeared from the city. 

Rock Island is now a city of 35,177 people (1920 census) being separat- 
ed from Moline by nothing more obvious than the middle of a street and 
from Davenport, Iowa, by the Mississippi River across which a bridge facil- 
itates close communication. Settlement began during the first half of the 
nineteenth century. 1850 finding the community with a population of 1,711. 
In 1920 the 35,177 inhabitants included 29,064 or 82.6 per cent, native born 
whites, 5,352, or 15.2 per cent foreign born whites and 754 or 2.1 per cent 
negroes. The age distribution showed 4,258, or 23.3 per cent, to be 45 or 
more years of age. 

Health Machinery 

The first ordinance of public health significance was adopted in 1857. 
It provided for a board of health and stipulated a sanitary code of sufficient 
breadth to give the board plenty of room to perform any justifiable program 
which it might have deemed wise to undertake. 

(303) 



304 



DOWX-STATE MUNICIPALITIES 




G. G. Craig, Sr., M. D. 

First Health Commissioner, 

1S80-18S7 



But the board did little or nothing and per- 
hap.s one paper organization succeeded another 
until 1880, when the city was organized under the 
general law. At that time a new board of health 
iiiilinance was adopted which provided for six 
members, the mayor and cit\- clerk being ex- 
oflicio. The first board appointed under this 
new ordinance included three physicians on its 
membership. 

Under this ordinance it at once became the 
practice to designate some local physician as 
health commissioner who acted as the executive 
officer of the board. He received a small salary 
while board members got two dollars each for attending meetings. At first 
the board manifested considerable interest in its duties and functions, making 
periodic tours of inspections and scrutinizing alleged nuisances, etc. This 
ardor soon weaned, however, as had been usual and matters were left more 
and more in the hands of the health commissioner. 
This practice continued until 1911 when Rock 
Island adopted the commission form of govern- 
ment. The most significant change that the 
transition brought to the health department was 
that the health commissioner now had to serve 
one master instead of half a dozen. At any rate 
there appears to have been no pronounced differ- 
ence in the character or volume of the work 
imdertaken. 

In \'>24 the commission form of government 
was given up and another board of health made 
up of the mayor, the city ph3'sician, as the health 
commissioner now came to be called, and the 
health officer (sanitary inspector) came into 
being. This system still prevails. 




George L. Eyster. M. D. 
Health Commissioner, 
1SS9-1S91; 1893-1895 



Health commissioners who have served Rock Island inclu( 



Dr. G. G. Craig, Sr. 1880-1SS7 

Dr. Sanuiel Plummer 1887-1889 

Dr. G, L. Eyster 1889-1891 

Dr. C. B. Kinyon 1891-1893 

Dr. G. L. Eyster 1893-1895 

Dr. E. M. Sala 1895-1897 

Dr. Joseph P. Comegys 1897-1899 

Dr. Joseph de Silva 1901-1903 

Dr. George G. Craig, Jr. 1903-1905 

Dr. James F. Meyers 190,5-1907 



Dr. Ralph Dart 

Dr. Albert N. Mueller 

It. George G. Craig, Jr. 

Dr. Albert N. Mueller 

Dr. C. T. Poster 

Dr. Albert N. Mueller 

Dr. Harry Prey 

Dr. J. R. Hollowbush 

Dr. Albert N. Mueller 



le: 
1907-1909 
1909-1911 
1911-1914 
1914-1915 
1915-1919 
1919-1923 
1923-1927 
May-Oet. 1927 
1927 to date 




First Infant Welfare Clinic, opened in Rock Island, September 5, 1914. 




■'irsi (iiMii Air Si licKil for Tnlierculous Children, opened in Rock Island, 1925. 



306 



DOWN-STATE MUNICIPALITIES 




George G. Craig, Jr.. M. D. 
Health Commissioner, 
1903-1905: 1911-1914 



Money appropriated to and spent Ijv the health department increased 
as the demands of the city grew. New functions have been added from 
time to time while voluntary agencies have arisen to supply services not pro- 
vided by the city. 

Rock Island was the second city in the State 
to establish a municipal tuberculosis sanitarium. 
It was voted in April, 1910. The institution 
was opened in 1916 and continued to function 
as a city project until April 1927, when its oper- 
ation was taken over by the county as a result 
of an election in 1920. 

\'oluntary agencies began infant welfare work 
in 1914 when the West-end Settlement House 
and the Visiting Nurse Association opened a 
station. Mrs. John Hanberg, Mrs. W. B. 
Barker, Dr. Albert N. Mueller, Edna Flannagan, 
R. N., and Sophia Rosene, R. N., were the mov- 
ing spirits in bringing this service into action. 
The school board l)egan to participate in health work in 1918 when a full 
time nurse and a part time physician and dentist were employed. 

A social hygiene clinic was operated in the city 
by the county f<;)r a number of vears following 
the World War. 

Developments and growth in health work were 
accompanied by ordinances of various character 
providing ample authority for the health officials 
to exercise their full resources in giving the com- 
munity sanitary and hygienic supervision. 

An appraisal of the public health facilities in 
the city in 1925, made by the State Department of 
Public Health, gives a rather accurate notion 
of conditions at that time and they remain much 
the same. Excerpts from the report of that 
study read : 

"With a score of 469, Ronk Island stands eleventli from the top 
among the fifteen cities in which the public health activities were 
appraised for adequacy in extent and character. 

"The city health department, consisting of a part-time health officer, 
a full-time inspector (another inspector was added in 1926). and a part- 
time clerk, undertakes vital statistics work, communicable disease 
control and supervision over milk supplies and sanitary conditions. 
The board of education employs a part-time dentist, a part-time phy- 
sician and a nurse for school hygiene service. Nurses on the Visiting 
Nurse Association staff do bedside and public health work. In the 




Cyrus T. Foster, M. D. 

Health Commissioner, 

1913-1919 



ROCK ISLAND 



307 



field of tuberculosis a special tax levy by the county provides sanitarium, 
clinical and nursing facilities. 

"Excluding funds appropriated for tuberculosis sanitarium service, 
in order to eonforni with the policy followed in eomputiug costs else- 
where, the city spent about 13.5 cents per capita for public health pro- 
tection last year. Other agencies contributed about 22.5 cents per capita, 
making the grand total about SB cents. Expenditures in Danville were 
the same per capita, no other of the fifteen cities spending so little for 
this most basic governmental function. 

"Practically no tabulations or analyses of vital statistics are at- 
tempted. This permits the city to lose all of the benefits that, might 
accrue from these valuable records. 

"No communicable disease nurse is employed nor is there provided 
a physician to visit all cases of contagion. The sanitary inspector pla- 
cards premises and releases from quarantine. 

"Sanitarium care of tuberculous patients is up to standard with the 
disease incipient only on a goodly percentage of admissions. No open- 
air classrooms or preventoria for children predisposed to tuberculosis 
are provided. 

"The prenatal, infant and preschool child hygiene program is 
limited largely to a field nursing service provided by the Visiting Nurse 
Association. While excellent in character the volume of this work is 
not commensurate with the needs of the city. A total of 7'OS visits 
were made to the preschool age clinic last year. 

"The health of the public school children is receiving careful con- 
sideration. Under the supervision of school physician and dental sur- 
geon, assisted by the school visiting nurse, the children of the grade 
schools are given periodic physicial ex- 
aminations, defects listed and parents noti- 
fied. Contagious diseases are promptly de- 
tected and the patients removed from 
school. Twelve hundred and sixty-five 
(1265) dental defects were corrected by 
the school dental surgeon during the past 
year. Records of the findings of the school 
l)hysician are tabulated but similar records 
of corrections of physical defects are not 
availalile. 

"The curriculum of the public schools 
|)rovides for health instruction in all 
grades from the first to the sixth inclu- 
sive. 

"The public water supply is adequate 
and meets fully all sanitary requirements 
but only 80 per cent of the dwelling houses 
utilize it. Likewise 20 per cent of the 
homes have no toilet facilities other than outside privies. 

"An inspector spends part of his time making sanitary investiga- 
tions. Some of the food handling establishments are required to hold 
license and are inspected from time to time. 




Albert N. Mueller, M. D. 

Health Commissioner, 1909 

1911; 1914-1915; 1919- 

1923; 1927 to date 



308 



DOW N -STATK M U N IC 1 PA I.ITI ES 



"About GO per cent of the milk supply is pasteurized. Laboratory 
examination of samples is not systematically practiced, no inspection of 
produciuK farms is attempted and the insiiection of pasteurizing plants 
is inadequate." 



Watmr Supply 

W'aterwork,'^ were first in.-^talled in Rock Island in 1870. Water was 
drawn from the Mississippi River below the sewer outlets and pumped to 
the mains without treatment. 

In 1878 Mr. I'. 1.. Cable donated the lands and funds for a new plant 
to be located about two miles upstream. The 
intake was to be above the sewer outlets and ex- 
tend into the main channel of the river. This 
plant delivered a somewhat better water, but 
it was still contaminated b}' sewage from cities 
further upstream. Sedimentation was the only 
form (jf treatment until the early 90's when j\Ir. 
Cable donated funds for a filtration plant. 
\\ooden tub filters of the Jewell gravity type 
were installed. These filters did not prove satis- 
factory, but were used for about ten years. 

In 1899 a new filtration plant was built by the 

city. The new plant included sedimentation and 

three slow-sand filters of one-half acre each. 

This plant was built up on the bluff in the highest part of the city. The 

slow-sand filters were not very satisfactory treating such a turbid water 

and soon became inadequate. 

A new rapid-sand filter plant replaced the slow-sand plant in 1911. 
This plant was modern and adequate, and is still in use. 




P. L. Cable 



Sewerage 

A s_\-stem of sewerage had been started in 1885. About one-tenth of 
the city was served and there were four outlets discharging into the ^lissis' 
sippi River below the city. 

The system has been extended and outlets have been added, until at 
present the cit\ is well sewered and there are many outlets scattered along 
the river. Tlu-re are three small treatment plants on sewers emptying into 
a small creek tributary t(i the rixer. 

^lississippi River is \i;\(\\\ pcillutcd at this point b\- sewage, part of which 
comes from Rock Island. 

The city is in nee<l of ade(|uate interceptors and treatment plants. 



ROCK ISLAND 



309 



ROCK I3LAMD 

l%1 '1° 'f 'f 'T - 



"P 'f 



-¥ 1 




VITAL 3TATI5TIC50 
conn. DIS. COMTROLS 
Vm DIS. COnTROL««l 
TUB. COMTROL 
HEALTH CHILD 
HEALTH 5CH.CHILD^ 
SANITATION 
MILK COMTROL 
LABORATORY 
POP. HEALTH INSTH 



PERCCMT OF STANDARD SCORE 
FOR EACH OF TEM riAJOR HEALTH ACTIVITIES 

I92g 




This graph ilhi-strates the strong and weak points in Roclv Island's 
public health service, oflficial and voluntary, as it existed in 1925. It is 
based upon a personal survey and rated upon the standards evolved by the 
American Public Health Association. The total efficiency rating in Rock 
Island was 47 per cent of the standard perfection requirement. 



Health Conditions 

The first statistics regarding diseases and deaths are those for the gar- 
rison located at Fort Armstrong dm'ing the seven years that followed its 
establishment in 1816. 

During this period the ratio of intermittent fevers was 17 per cent and 
remittents 10 per cent. The relation of diseases of the respiratory organs 
to all other diseases, exclusive of accidents and venereal infections was 1 to 
3.8. The ratio in all military posts at the time was 1 to 7 or less than half 
as great as at Fort Armstrong. 

During the Black Hawk war in 1832, the fort was a special place of 
interest and seciu-ity. Here the early pioneers used to rendezvous when 
Indian attacks threatened. 

It was here that General W'infield Scott met with Governor Reynolds 
to conclude the treaty of peace with Black Hawk and his warriors. 



310 



DOW N-STATK M U X I C 1 PA LITI ES 



Governor Reynolds in "i\Iy Own Times" says: 

"While arrangements were being made to hold the treaty at Roclv 
Island, the cholera appeared in its worst form in that section of the 
State and amongst the Indians. This disease was a stranger in the 
country at that day and spread terror and panic wherever it went. 

"We were compelled to disperse the Indians while the disease 
raged at Fort Armstrong on Rock Island some distance from the fort 
so as to be more healthy. 

"After waiting a month or more for the cholera to subside, we con- 
cluded the treaty on the loth of September, 1831.'." 

It is probable that cholera was again prevalent in Rock Island during 
the general epidemic that swept the country during the middle of the nine- 
teenth century although there are no records to substantiate this conjecture. 
On the other hand the health commissioner declared in 1885 that cholera, 
and a few other diseases, had not been epidemic since the organization of 
the health department in 1882, This implies that the memory of an epidemic 
still lingered in the minds of public officials. 

Such mortality records as are a\ailable suggest that smallpox nevef 
appeared in epidemics of large magnitude in Rock Island. An outbreak 
of 15 cases is recorded in 1882 and a few cases at a time have been registered 
periodically since that date. Posting a police guard at the entrance of pre- 
mises to insure the rigid quarantine of patients seems to have been the method 
of controlling smallpox prior to 1900. This, of course, was in addition to 
vaccination which was nrade compulsory, so far as school children were con- 
cerned, bv ordinance. 




Fort Armstrong, the nucleus around wbirh tlie Tri-eities have been built. 



ROCK ISLAND 



311 



Table 1. 
Mortality From Certain Causes. 















_ 










































o 








0^ 


g 


p. 




1 


.2 




YEAR 


i 


b 




X 




fc! 





.2 3 


g 




11 


.2 " 










a 






id 


tS 


c 


£ 




t5 







^ 


i; 




"^ 


s 




ic-c 


3 




fe^ 




= 


P 


s 


1 


s 


g 

x 


1 


iS " 


w 


e. 


Is 




1881 


288 


15 


6 




7 


14 


2 


10 






39 


8 


18S2 


225 


15 


2 


"2 




4 


i 


14 






33 


10 


1883 


134 


5 






4 











! !! 


26 




1884 


161 


9 


2 






' '4 


2 


21 






24 




1S85 


... 
























1895 


148 


3 


... 








2 


6 






10 




1907 


211 


4 








3 




10 


7 




17 


21 


1908 


188 




















... 




1909 


298 


' ii 








' i 




i 






28 


'26 


1910 


350 
























1911 


356 


'io 






















1912 


312 
























1913 


366 


10 






1 


i 


" 


13 






'24 




1917 


482 








... 








2 








1918 


561 


5 






7 




' '4 


s 


•84 




46 


74 


1919 


347 


1 










1 


2 


19 




39 


21 


1920 


407 


2 








2 


7 


1 


18 




41 


32 


1921 


356 


2 








1 


3 


1 


2 




30 


19 


1922 


335 














4 


6 




31 


18 


1923 


315 


' i 






3 




5 


8 


8 




25 


14 


1924 


343 


2 






2 1 1 




4 


1 




30 


10 


1925 


325 


3 






... 1 1 




2 


13 


i 


13 


14 


1928 


404 


1 






. . . f 1 


1 


^ 


10 


1 


22 


20 



Table 2. 
^loRTALiTY Rates Fro.m Certain Causes. 



YE.VE 


(3 




j2 


ft 


1 


1 


6 

c 


.So 

5 "^ 


c 
% 


1 


■3 ^ 


£2. 


1881 


24.7 


125.0 


50.0 




42.7 


116.6 


16.6 


83.3 






325.0 


66.6 


1882 


19.2 


125.0 


16.6 






33.3 


8.3 


116.6 






275.0 


83.3 


1883 


13.2 


41.0 






33!3 






75.0 






208.3 


75.0 


1884 


12.9 


75.0 


leie 






33]3 


leie 


175.0 






200.0 


66.6 


1885 


























1895 


8.9 


17.6 










11.7 


35.2 






58.8 




1907 


9.2 


17.4 








13.1 




43.7 


30.5 




74.2 


91.7 


1908 


9.7 


... 






















1909 


12.4 


37.7 








4'i 




i.\ 






117.4 


83 . .8 


1910 


14.3 
























1911 


14.0 


39.. 3 






















1912 


11.7 
























1913 


13.2 


36!2 






a'.e 


S.6 


■ih'.i 


i-i'.i 


... 




86.9 




1917 


15.09 
















6.2 






169.1 


1918 


16 9 


15. i 


3.'6 




21.5 




12^3 


24 '. 6 


258.4 




141 is 


227.6 


1919 


10.2 


2.8 








ii'.S 


2.8 


5 7 


54.2 




111.4 


60.0 


1920 


11.4 


5.5 






s'o 


5 5 


19.4 


2.7 


50.0 




113.8 


88.8 


1921 


9.8 


5.5 


2!7 






2.7 


8.2 


2.7 


5.5 




82.1 


52.0 


1922 


8.9 














10.7 


16.0 




82.8 


48.1 


1923 


8.2 


2.'6 






7.'8 




13.1 


21.0 


21.0 




65.7 


36.8 


1924 


8.8 


5.1 






5.1 


2 .;") 




10.2 


2.5 




76.9 


25.6 


1925 


8.1 


7.4 








2.5 




5.0 


32.4 


2.5 


57.3 


34.9 


1926 


9.9 


2.6 








2.6 


2!6 


12.1 


26.0 


2.4 


53.6 


48.9 



The rate from .\11 Cau.ies 



lOn.OOO popuhiti. 



312 



I)()\V.\ -STATE MUiXICirAI.ITlES 



Table 3. 
Cases of Certain Diseases Reported. 



1 

1 1916 

1 


1917 


191S 


1919 


1920 


1921 


1922 


1923 


1924 


1925 


1920 


1927 


Typhoid Fever 


16 


14 


30 


9 


11 


6 


20 


2 


- 


12 


6 


2 


Smallpox 


7.5 


30 


9 


142 


173 


57 




16 


41 




1 


4 


Meiisles 


23 


75 


436 


14 


580 


32 


7 


881 


456 


88 


368 


687 


Scarlet Fever 


7.> 


31 


1)4 


16 


47 


65 


22 


19 


18 


19 


44 


48 


Whoop. Cough 


9 


69 


118 


21 


405 


88 


21 


224 


41 


243 


108 


313 


Diphtheria 


37 


37 


66 


43 


16 


47 


54 


109 


87 


57 


57 


34 


Influenza 






298.5 


•? 


497 


2 


18 


« 


1 


11 


16 


9 


Poliomveliti-s 


4 


9 






1 


4 








3 






Meninpritis 




1 


2 






3 


3 


1 






1 


1 


Tuberculosis* 


13 


13 


10 


20 


34 


79 


88 


31 


48 


38 


39 


57 


Pneumonia* 




... 


2(9 


9.5 


129 


61 


69 


30 


31 


45 


76 


66 


S.vphilis 




... 






... 


124 






22 


45 


11 


12 


Gonorrhea 




... 


' 




... 


166 






44 


52 


43 


22 



•.Ml forms. 
Note: Case reports are ne\er complete, but thev ha\ 
Illinois. This table indicates improvenient i 



Table 4. 
Births axd Infaxt Deaths. 





1 










YK.\R 


1 




1 








1 Number 

1 


Rate*' 


Nutnber | 

! 


Rate* 




1881 






- 1 


616.6 




1882 






02 1 


516.6 




1883 






43 1 


358.3 




1884 






41 1 


341.6 




1916 


490 


10. 1 


56 1 


112.9 




1917 


432 


13.5 


52 


120.3 




1918 


460 


13.9 


58 


126.1 




1919 


475 


13.9 


39 


82. 1 




1920 


481 


13.5 


62 


128.5 


, 


1921 


494 


13.4 


41 


83.0 




1922 


466 


12.3 


24 






1923 


420 


11.0 


33 


78.6 




1924 


450 


11.5 


24 


53.3 




1925 


399 


10. n 


30 1 


75.2 




1926 


410 


10.0 


20 i 


48.8 





per 1000 births reported. 



It was different with typhoid fever. That disease lia.^ cost the city 
dearl}' in both life, suffering and money. Statistics for the early eighties 
indicate that 44 deaths resulted from typhoid fexer in the four years ended 
with 18S4. Tliat number of fatalities suggests the occurrence of some four 
or five humlred cases, a severe experience for a community of about 12,000 
souls. 

It is probable that the disease had fallen upon the inhabitants during 
earlier years witii no less disastrous results. .'subsequently to that period 
epidemics varying from a dozen to 5tX) cases have occurred. In l')0o there 



ROCK ISLAND 313 

were about 500 cases and there were about 1150 in 1911. An outbreak of 
12 cases in 1890 was confined to the pupils in Augustana College. As late 
as 1922 there were 20 cases reported from Rock Island. These statistics 
show what remarkable progress has been made against typhoid fever. In 
the whole state of Illinois there were but 1,286 cases reported in 1927. l-i-ock 
Island had two in that }ear. 

Diphtheria, Hkewise, has si)illed its wrath upon Rock Island from time 
to time. In 1889, for instance, this infection began to spread and continued 
until 222 cases had been reported, resulting in 45 deaths. Again in 1923 
there was a rather peculiar epidemic that seemed to follow and complicate 
an outbreak of measles. Case reports ran up to 109. Between these two 
there has been the constant seasonal incidence that hasn't ceased to arrive 
with the autumn of each succeeding year. 

Tulierculdsis was once the chief cause of tleath in Rock Island as it was 
elsewhere in Illinois and the country. In 1881 the number of deaths attrib- 
uted to tuberculosis in Rock Island gave a mortalit}' rate of 325 per 100,000 
population. In 1926 the rate was 53.6. The most pronounced period of 
improvement began in 1918 when the rate was 141.5. 

Influenza and pneumonia struck Rock Island but lightly in 1918. The 
combined mortality rate was only 486 per 100,000, a figure lower than from 
influenza alone in many municipalities. Only four or five other places in 
the State escaped with such small losses. 

The general death rate in Rock Island suggests good health conditions. 
It is unusuall\- low. It may be that hospital facilities across the river in 
Davenport attract enough of the sick to be no small factor in the low death 
rate. 

References. 

Am III] 1.1, iN ,if the City of Rock Island, Itock Island, Illinois, various dates. 

(h.ii . I ilia furnished b.v Dr. Albert N. Mueller, Health Commissioner. 

Ainu ! MI !i, ,,f the StateBoard of Health, .lohn H. Raueh, Secretary. .Springfield, variovis dates. 

Ml iiAii I I ., Governor John Reynolds, lSo.5. 

Report ot iin Appraisal of Health Service for 192.5 of Fifteen Illinois Cities, Dr. Isaac I). Rawlings, 
Director of Public Health, Illinois Health News, May-June, 192G. 
U. S. Census Reports, Washington, D. C, various dates. 



Springfield 

The first settlement on the present site of Springfield was made in 1818, 
the _\ear Illinois entered the Union. At first it was called "Calhoun," in 
honor of the threat nullifier of South Carolina, hut the name proved to be 
un])opular and few peo])le used it. They preferred Springfield, the name 
given to the postoffice in the embryo city of Calhoun. 

Early in the career of Springfield, the municipality began acquiring 
political honors, a habit which it showed no tendency to forsake. In 1821, 
two years before it was officially laid out, it accjuired the title of county seat 
of Sangamon County. 

In 1837, as the result of a rather strenuous political contest, it became 
the State capital and the first session of the legislature to meet there assembled 
in 1839. Abraham Lincoln, as a member of the long-nine, had much to do 
with the removal of the State capital from Vandalia to Springfield. Among 
the many rumors of reasons for removing the capital from \'andalia to 
Springfield are two that relate to health. 

One is that the legislature had gmwn tiretl of the preponderance of 
venison, wild turkey, wild duck, and other game meats supplied them at 
Vandalia, and they moved the capital to Springfield where they could get 
more pork and beef. 

Another is that the Kaskaskia bottoms around \'antlalia made the 
location so highh malarial that the legislature wanted a healthier site for the 
State House. 

The village government in .^pringlield consisted of a president and a 
board of trustees of five members. In 1839, Abraham Lincoln was elected 
a member of the board to fill a vacancy, and was re-elected in the following 
year. 

-Springfield is located near the .Sangamon l\i\'er in the ver_\- heart of a 
rich coal mining and agricultural region where the terrane is so flat that 
adequate drainage of residential districts depends upon unusual engineering 
skill in the construction of sewer mains. In 1920 it had a population of 
59,183, the fifth largest city in Illinois. The number of inhabitants in 1840, 
the earliest year listed in the United States census returns, was 2,579. Sub- 
sequent to that time two decades, 1850-1870, witnessed ver\- rapid growth, 
the increase amounting to 96 per cent during the twenty \ears, but later the 
population has grown more gradually. ( U' tin- 1920 population 84.7 per 
cent were native liorn whites. 10. (i foreign born whites and 4.7 negroes. 
Nearly 24 per cent were in the 43 and o\'er age grouj). 

(314) 



SPRINGFIELD 



315 



Health Machinery 

Among the books and papers of the late Dr. A. \V. French, a dentist 
of Springfield, was found an old note book, the binder's title on the back 
of which reads "Minutes of Springfield, Illinois 1832-1840." On the fly 
leaf of the book is written: "jXIinutes of Board of Trustees of the Village 
of Springfield, Illinois, of its meetings from April 1832 (first meeting) to 
the org-anizing of a city in 1839.'"^ 

These minutes show that on Jul\- 19, 1832, at an extra meeting of the 
board, the following preamble and resolutions were read and passed : 

"Whereas, we have information that the Asiatic cholera is now pre- 
vailing in Chicago, and whereas, it becomes the duty of the trustees 
to guard the town from infection from tliat source." etc. 

The usual orders were then made as to cleaning up the town. On Novem- 
ber 14, orders were given out that the court house be fitted up as a hospital 
in case it was needed for the cholera patients. 

The next event of importance to the health machinery of the city took 
place in 1840 when the community was incorporated as a city under a special 
charter granted by the legislature. This charter provided for the annual 
appointment of a board of health consisting of three or more commissioners, 
over whom the mayor was designated as the presiding officer and the city 
clerk as clerk. Broad powers relating to public 
health were vested in the board. The charter 
required, among other things, that physicians 
should report all cases of communicable diseases 
and that the health officer visit patients suffering 
from such diseases and report his opinions rela- 
tive thereto to the city clerk. There is no evi- 
dence that any of these provisions were carried 
out with any degree of regularity or completeness. 
Doubtless the board of health became active 
during epidemic emergencies but for the most 
part it sank into a dormant or inactive status over 
long periods of }ears. In 1877, when public 
health ideas filled the air about the capital build- 
ing, due to the legislative act creating the State Board of Health, the council 
in Springfield adopted an ordinance requiring the isolation of persons 
sick with contagious diseases and giving the board of health power to 
quarantine premises upon which communicable diseases existed. It also 
prohibited slaughtering in the city and regulated food and milk supplies. 
Moreover there was an ordinance making vaccination against smallpox 
compulsory. 




George Thomas Palmer, M.D 

Superintendent of Health 

1909-1913 



1 Journal Illinois Historic-al Society, Vol. 2. 



DOWN-STATE MUiNlClPALITIES 



In 1S80 the board of health was made up of six members, one from each 
waiil, besides the mayor and city clerk. It appears that annual expenditures 
amounted to about $300 during ordinary times and that this went largely to 
inspectors, employed during jileasant weather in order to stimulate general 
civic cleanliness. 

In 1SS2 a new ordinance introduced the police department into the board 
of health. It pri)\iileil that the board should consist of seven members 
.'ippointed l)y the mayor, and the mayor, superintendent of police and 
city clerk as ex-offlcio members. From this time forward over a number 
of years the mayor appointed a member of the police force to act as health 
officer. It seems to have been the practice from the start to select physicians 
for members of the board and not infrequently all members except the ex- 
officio were doctors. 

Subsequently to 1882 the growing demands of a growing city caused 
a gradual increase in the appropriations made 
til the health department and these were expended 
for the employment of persons who varied in 
number with epidemic emergencies, for the 
operation of a "pest house", the removal of dead 
;inimals, etc. It soon became customary to em- 
pldv a full time inspector working directly under 
the board of health and by 1903 there were two 
or three inspectors, one acting as health officer. 

A distinct change came in 1909 when Dr. 
George Thomas Palmer was appointed superin- 
tendent of health in Springfield. He was the 
fn^t physician to fill the chief executive position 
of the board of health in Springfield. Since that 
date a doctor has always filled the office, sometimes on a full time basis, 
sometimes on part time duty. The health department staff in 1909 consisted 
of the superintendent, an assistant, a meat inspector, two health officers, a 
plumbing inspector and the matron of the "pest house." 

The next important change came in 1911 when the city adopted the 
commission form of government. This disposed of the board of health, 
placing its duties and responsibilities upon the shoulders of the commissioner 
of public health and safety and bringing closer to political power the office 
of superintendent of health. The staff of the health department was changed 
but little, a secretary-clerk replacing the assistant superintendent. 

.\liout this time there occurred a pronounced wave of public interest in 
health and social welfare matters that resulted in an exhaustive sanitary, 
social and educational study of the city, put on by the Russell Sage Found- 
j^lion in 1''14. This stiuh- reduced information concerning the health and 




B. B. Griffith, M. D. 

Superintendent of Healtli 

1914-1918 



SPRINGFIELD 



317 




Albert E. Campbell. M. D. 

Superintendent of Health 

191S-1924 



sanitary conditions of the community to a report which detaileil all possible 
shortcomings, featuring infant mortality and other statistics, and offered 
some very definite recommendations for improvement. 

Sh(.)rtly after the survey the voluntary agencies became active. The 
study had indicated an unnecessarily high infant mortality rate so in Feb- 
ruary 1916, the first infant welfare clinic was opened through the initiative 
of the Springfield Improvement League. This was the beginning of what 
proved to be a very important factor in the health 
machinery of the cit_\-, growing in size from one 
to seven infant welfare stations with a nursing 
staff of four. 

In 1918 a full time ph\sician in the person of 
Dr. A. E. Campbell, was employed as superin- 
tendent of health and since then the office has 
iieen rated as a whole time position. 

One improvement followed another until at 
the close of 1925 the health department together 
with the quasi-public and voluntary agencies, were 
doing a very creditable volume of work. A good 
summary of the nature and adequacy of the mach- 
inery at that time, which continues to be the case, 
is found in a report of a survey made early in 1926 by the State Department 
of Public Health. From it we read : 

"With a total score of 667, Springfield stand.s fourth among the 
fifteen cities in which the public health activities were appraised. This 
is in itself a very creditable record ; but the striking fact is the recent 
development of improvements in health service, some of which were 
inaugurated too late in the year to be credited in this survey, which is 
based on the 192.5 record. These improvements, set forth in another 
section of this report, have been due to (1) the hearty cooperation of 
the local medical profession, (2) the active interest of the citizens, and 
(3) the initiative of the full-time health officer. 

"Springfield takes first! place in its venereal disease control pro- 
gram, an important feature of which is the clinical service conducted 
at St. John's Hospital and financed jointly by the State and county. In 
vital statistics and health measures for children under school age, 
Springfield ranks second and third in communicable disease control. 

"This city expends $21,110 or 3:! cents per capita through its health 
department. Expenditures by other agencies bring the grand total to 
$16,991 or 7.3 cents per capita. 

"The school hygiene work Is under the direction of the board of 
education, which employs a part-time dentist and four nurses. Last 
year, upon request of the local medical society, the city health offlcer 
was appointed director of hygiene for the public schools. The parochial 
schools employed a nurse early in 1925. There is no medical examina- 
tion of school children, although the nurses make physical inspections 



318 



DOWN-STATU MUNICIPALITIES 



and home visits. Healtli education in tlio scliools is not as thorougiily 
carried out as is desiralile. Springfield is one of tlie seven cities in this 
group, all of them much smaller than Springfield, which does not have 
medical supervision for its school children. Playgrounds are conducted 
in connection with many schools and in the several parks throughout 
the city under a well organized recreation commission. 

"The most striking fact in connection with Springfield's public 
health status is the marked improvement which began with the reor- 
ganization of the health department in 1924. This improvement has 
been manifested (1) by the hearty co- 
operation of the county medical society 
with the health department, (2) by the 
substantial support of the council of social 
agencies In promoting the health depart- 
ment program, (3) by the coordination of 
the infant welfare and school hygiene pro- 
grams with the health department, and 
(4) by the confidence of the dairy interests 
expressed in their petition to the city com- 
mission requesting supervision of their in- 
dustry by the health department. 




Raymond V. Brokaw, M. D. 

Superintendent of Health 

1924-1927 



"The county medical society endorsed 
the new isolation hospital project soon to 
be opened as an integral unit of St. John's 
Hospital; and also the child guidance 
clinics which are now conducted in this 
city by the Institute for Juvenile Research. The society formerly re- 
quested the board of education to appoint the city health officer as 
supervisor of hygiene in the public school system, to establish an open- 
air school, and to provide facilities for mentally defective children, all 
of which requests met with favorable action. 

"The Council of Social Agencies, representing a large group of in- 
fluential and interested citizens, has materially advanced Springfield's 
public health program by raising the standards of social service; by 
financing the new $100,000 isolation hospital project; by contributing in 
part the salary of the health officer, and in full the salary of a director 
of nurses: by sponsoring the child guidance clinics, and financing a 
social service worker in this connection; and more recently by promot- 
ing a mental hygiene educational program, which is being conducted by 
the Illinois Society for Mental Hygiene. 

"The coordination of the public health nursing activities has pro- 
vided for direct supervision by the city health department of the com- 
municable disease nurses, the infant welfare nurses, the public school 
nurses and the county school nurses. A new director of nurses has 
been added to the staff of the city health department to develop this 
program." 



SPRINGFIELD 



319 



SPRIMGHELD 



VITAL 5TATI5TICSi^ 
conn. DIS. CONTROL}^ 
VEh. DI5. CONTROLS 
TUB. COMTROL ^ 
HEALTH CHILD 
HEALTH 5CH. CHILD 3§ 
S^MITATJOh 
MILK COMTR0L[S 
LABORATORY @ 
POP. HEALTH IN5T^ 




PERCEMT OF STANDARD SCORE 
FOR EACH OF TEN MAJOR HEALTH ACTIVITIES 

1923 



This graph illustrates the strong and weak points In Springfield's public 
health service, official and voluntary, as it existed in 1925. It is based upon 
a personal survey and rated upon the standards evolved by the American 
Public Health Association. The total efficiency rating in Springfield was 
67 per cent of the standard perfection requirement. 

The physicians who have served Springfield as superintendents of health 

George Thomas Palmer. M. D. 1909-1913 

0. H. Deichmann, M. D. 1913-1914 

B. B. Griffith, M. D. 1914-191S 

A. E. Campbell, M. D. 1918-1924 

R. V. Brokaw. M. D. 1924-1927 

H. H. Tuttle, M. D. 1927 to date 



Water Supply 

The public water supply was installed about 1868. The water was 
pumped direct from Sangamon River and consequently was at times turbid 
and not safe for drinking purposes. At that time a majority of the inhabit- 
ants depended on wells and cisterns for their drinking water. 

In order to secure a cleaner and safer water a large well was constructed, 
in 1884, on the bank of the river. The well soon proved inadequate and in 
1888 an infiltration gallery was constructed near the well. 



320 



DOWX-STATE MUNICIPALITIES 



In IS'K) tlic su[)i)l\- asjain became inadequate and a connection was made 
between the ri\er and the inliltration gallery to supplement the well water 
with riser water. 

The use of river water created much dissatisfaction and several wells 
were drilled to make the continuous use of river water unnecessary. 

In 1918 a chlorinator was installed to make the water safe, Init it was 
still turbid at times. 

From time to time additional wells were drilled and the infiltration 
gallerv was enlarged, but in general the water was rather unsatisfactory. 

In 1926 a modern water-purification, iron-removal and water-softening 
plant was completed. A combination of well and river water is still used 
but the treatment plant makes the water desirable for all household uses. 

The construction of a dam to form Lake Springfield is being considered. 
When the lake is formed it will be used as a source of suppl\- and will furnish 
a better supply than the river water. 

Table 1. 
Mortality From Certain Causes. 



1S73 
1876 
1877 
1878 
1879 
1880 
1881 
1882 
1883 
1884 

1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
1908 
1909 
1910 
1911 
1912 
1913 
1914 
1915 
1916 
1917 
1018 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1920 



605 


12 


674 


9 


040 


11 


598 


18 


801 


15 


750 


16 


831 


34 


764 


17 


851 


17 


866 


27 


867 


15 


866 


23 


994 


17 


902 


17 


995 


17 


976 


s 


979 


17 


1223 


12 


965 


:) 


1002 


8 


903 


5 


976 


2 


1049 


3 


969 


4 


1121 


4 


1094 


4 



(! 




12 




' 




3 




1 


4 


10 


... 


1 


3 

1 



103 


92 


94 


94 


73 


111 


71 


105 


93 


145 



•Prior to 191)0 for Enteric Feve 



SPRINGFIELD 



321 



Table 2. 
Mortality Rates From Certain Causes. 



YEAR 


6 

5 




1 


1 


i 

3 


> 





1" 


i 


1 


o'l 


E>2 


1875 




26.5 


-^.7 








5.3 


164.3 




. . 


275 . 6 


118.5 


1876 






26.6 


26.6 






37^2 


74 ".2 


26.6 


85.1 








190.8 


69.1 


1877 






78.0 


10.4 






5. 2 


88.4 


36.4 


26.0 








239.2 


94.3 


1878 






56.1 


15.3 








30.6 


10.3 


102.0 








265.2 


56.8 


1879 






30.0 


5.0 






.5! 6 


230.0 




65.0 








195.0 


101.8 


1880 






56.1 


10.1 






20.2 


153.0 


16. i 


45.9 








244.8 


116.4 


1881 






171.5 


29.4 






19.7 


9.8 


24 . 5 


24 . 5 








303.8 


78.9 


1882 






139.2 


9.0 








9.6 


... 


67.2 








27S.6 


62,5 


1883 






56.4 


4.7 








9.4 


9.4 


32.9 








211.5 


99.0 


1884 






39.6 








4.4 


4.4 


13.2 


61 . 6 








250.8 


58.1 


IHOO 


17.7 


35.1 








11.7 


17.6 


58 . 5 


26.3 




234.2 


99.5 


1!)01 


19.3 


25. S 


2 


9 




17.2 


8.6 


28.7 


74.6 


31.6 




307.1 


117.7 


1902 


18.0 


31.0 






22 is 




2.8 


8.4 


53 . 5 


16.9 




270.3 


11)4.1 


1903 


16.5 


49.7 






2.8 


2.8 


11.0 


19.3 


60.8 


5.5 




228.1 


127.0 


1904 


21.4 


40.0 


2 


7 


2.7 


10.7 


18.7 


16.0 


29.3 


21.3 




266.7 


208.0 


1905 


15.5 


33.7 






2.4 


2.4 


4.8 


4.8 


26.5 


12.0 




204.6 


103.5 


1906 


19.3 


41.1 


2 


6 




12.8 


2.6 


15.4 


53 , 9 


7.7 


'.'.'. 161.8 


125.9 


1907 


18.1 


73.9 


4 


3 






28.3 


10.9 


6.5 


45.6 


19.6 


... 221.7 


121.7 


1908 


17.3 


38.6 










6.3 


25.0 


9.1 


13.6 


15.9 




186.0 


102.1 


1909 


16.8 


33.6 


5 


9 






25.7 


2.0 


2.0 


5.9 


7.9 




179.8 


134.5 


1910 


16.6 


52.0 










5.8 


11.5 


3.8 


25.0 


9.6 




225.2 


127.0 


1911 


16.7 


28.2 


3 


8 








11.3 


11.3 


22.5 


7.5 




185.8 


142.6 


1912 


16.2 


41.8 










.5.5 




14.6 


41. S 


3.6 




136.4 


121.9 


1913 


18.4 


30.1 


3 


5 






31.9 


i.'s 


24.8 


24.8 


5.3 




161.2 


157.6 


1914 


16.4 


29.3 












8.6 


6.9 


17.2 


1.7 




177.6 


138.7 


1915 


17.8 


28.5 


i 


7 






36.9 


10.1 


1.7 


21.8 


10.1 




157.0 


157.7 


1916 


17.3 


13.1 










9.8 


6.5 


16.4 


29.5 


14.7 




124 . 1 


119.4 


1917 


17.1 


27.1 










1.6 


1.6 




9.6 


12.8 




113.4 


107.7 


1918 


21.1 


18.5 










IS. 5 


1.5 


(i.'i 


13.9 


370.3 




143 . 5 


223.7 


1919 


16.4 


8.5 


i 


7 






1.7 


1.7 




18,7 


115.2 




142. S 


147.4 


1920 


16.8 


13.4 


1 


7 








13.4 




10.2 


76.6 




100.7 


169.5 


1921 


14.9 


8.3 


1 


7 






sio 


11.6 


sis 


11.6 


11.8 




74.6 


102.8 


1922 


15.9 


3.3 










1.6 


0.5 


11.5 


3.3 


62.4 




95.0 


104.8 


1923 


17.0 


4.8 










16.1 




6.4 


12.8 


63.1 




92.1 


92.2 


1924 


15.5 


6.3 












i!.5 


4.7 


14.2 


49.2 




55 . 5 


90.4 


192fl 


17.5 


0.3 










i.s 


4.6 


3.1 


4.6 


86.0 


i.'.i 


87.5 


76.6 


1926 

1 


16.9 


6.0 

1 




" 1 




, 


3.0 


1.5 


16.5 


4.6 


67.5 


1.5 


80.3 


98.9 



Note: The rate from .\1I Causes is per 1000 population; all otiiers per 100,000 population. 



Sewerage 



In 1885 there was a sewerage system with about ten miles of sewers and 
three outlets discharging into Spring Creek. The system had been enlarged 
until by 1913 there were twelve outlets. 

In 1924 a report on sewage disposal was prepared by Pearse. Greeley & 
Hansen and Dawson & Walraven. It was recoiiiniended that interceptors 
and a treatment plant be constructed. 

\X present the interceptors are completed, and crinstiuction of the treat- 
ment has been started. 



322 



DOWN-STATE MUN ICII'ALITIES 



lir.ALTii Conditions 

I. ale in 1832 cholera was responsible for the Hrst grave public health 
l>ni])lcin that the officials of Springfield were ever called upon to meet. The 
disease liad been introduced into the mid-western territory by troops under 
the command of General Winfield Scott, moving westward to participate in 
the Black Hawk War, and spread quickly to Springfield because of close 
communications maintained between the military forces and the State officials 
at the Capitol. Lack of statistical records leaves to conjcclure an idea of 
how severe the epidemic prtjved to be in Springfield. 

Again in 1844 the redoubtable Daniel Drake, M. D., while enrcniU- up'>n 
one (jf his many observati(jn tours of the mid-western territory, fuund in 
Springfield some cases of intermittent fever declared by him to be as malig- 
nant as those ordinarily found upon the banks of the Tuscaloosa or Pearl 
Rivers, seven degrees latitude further south. He was informed moreover 
by John Todd, A. < 1. lliiu\v. William .Merriman and Gershom Jayne, four 
local physicians, that auiuiiuial fevers, probably typhoid and malaria, pre- 
vailed in the .Sangamon \ allc\-. Later history suggests that both typhoid 
and malaria were in; Iced prcwilcnt .and caused losses that today would be 
regarded with the greatest public .alarm. 

In 1849 another epidemic of cholera occunnl in (lie cit\ . 1 )r. ( iershoni 
Jayne, who came to Springfield in 1821 and wlm \\,as one ni the tn>l com- 
missioners of the lllin(jis and Michigan can.al. was in tlic thick (if tln' battle 
against this choler.a outbreak .and mnnindful of 
(l;in,i;<T. 

Cholera morbus w,as also very ])revalenl during 
this period. Accoi'ding to ] )r. ( icorge Noble 
Krcider. it w.as (hie to spoiled focjds. The means 
of preserving food in the summer time were very 
pool", .and the lue.at w.as often spoiled and un- 
doiililedl\ the milk too. Dr. George I'aslield re- 
poiled lli.al ii was nothing unusual to iind on a 
lioi Slimmer tli.il three or four citizens had died 
ol' cholera morbus during the night after only a 
few hours' illness. 

A pandemic of inlluenza occiined in 1849-1850. 
Not niiub reference was made to it in Illinois, possibly on .account of the 
cholera e|)idemics in the same ye.ais. which overshadowed it. The outbreak 
was widely diffused in the |i(jpiil,atioii of the Ciiited States, .and prob.ably 
more fatal than the statistical records wanild indicate. 

During a long i)eriod of its early history Springfield appears to have 
escaped the uncontrolled outbreaks of sniall])ox tb.at were attended with so 
mucli public .al.anu .and furor in other places. .\t le.isl there is scant record 




George N. Kreider, M. D. 



srRixciFiKi.n 



323 




George Pasfield, M D. 



of ail}' such experiences except fur a inilil rofrrcnce nf an epidemic in tlie 
early eighties. It must be renicnilicrcil in thi> i-dniu-otinn that vaccination 
was compulsory in the citv and that Si)rini;tield \\a^ tin- capital of the State 
dnrini;- thnsr early \ears iif ihe State Board of llcallh wln'u the or^aniza- 
tiiin ]iro)noted vaccinalinn with an overw hclniinc;' 
/(■al and rni])hasis. 

Kut C()m|)ulsory vaccinalinn was declared 
unconstilutional during the ninrlies and in 1901 
Springfield fell \ic(im lo an otiihreak of smallpox 
whicli seenicil lirnl npnn avenging itself against 
])enple who had enjoN'ed such a long-time inimun- 
itw Al any rate 527 cases were rec()rde<l in l''l)l 
and ,i.>5 in l'X)2. A "pest house" was constrncird 
in a desolate localit\ near the cemeler\ and con- 
siderahle ex[)enses were incurred in olhei' ways 
in efforts to conlrol the disease. I Ins epidemic 
aetuallv smouldeied in the cil\- for three or four 
years hut since that time smallpox has ne\ er ai;,ain appeared in a seriously 
embarrassing character. While vaccination is not and cannot he compulsory 
an alert health departnu-nt has managed to slimnlale a considerable degree 
of \accination on the one hand and on the other ha^ ]ndni]itly applied C(introl 
and i>reventive measures when smalljioN broke om in the cdniinnnity. 

Typhoid fever has had a long and ugly history in Springlield. Up to 
1918 the annual mortality from that disease rare- 
ly fell below 20 per 100,000 population and not 
infrecjuently the rate ascendeil to i)oints above 
40. The actual number or deaths ranged from 
5 to 35 indicating a very heavy prevalence. ll 
was ascertained through a house to house can- 
vass in 1910 that 7,000 shallow wells and 6,000 
privy vaults w ere in use in the city and very likely 
this condition h.id a close relation to the perpetual 
typhoid problem that cost the community so dear- 
ly. I!\ 1918 a big percentage of both privies and 
wells had been abandoned and subsequentlx to 
that date typhoid fever steadily declined. 

Springfield has suffered from its full share of dii)hlheria and scarlet 
fever although both diseases are at present insignificant causes of death com- 
pared with what they were up to 1916. Prior to that date both infections 
paid unwelcomed epidemic visits to the city at periodic intervals, while a 
kind of nonnal or residual prevalence prevailed constantly to plague a limited 
mnnlier of unfortunate victims. Diphtheria usually was the more fatal of 




Willinni .laviU'. M. 11. 



324 



IIOWN-STATK M L'NUII'AI.ITIKS 



the two and was rcsi)()iisil)k' for the hca\icr mortality. A particularly severe 
outbreak of scarlet fever occurred in 1879 when 46 deaths were attributed 
to it. The epitleniic stretched out over the next year carrying 30 more 
victims to their graves. Another widespread outbreak occurred in 1920 
and 1921 but it was milder and resulted in but 8 and 7 deaths, respectively. 
Diphtheria has been more strictlx seasonal, the average annual mortality 
being greater than that from scarlet fever with 31 deaths in 1875 being the 
greatest number ever registered for a single year. Other bad diphtheria years 
were 1878 with 20 deaths, 1901 with 26, 1903 with 22, 1906 and 1907 with 21 
each and 1912 with 23. The mortality is not always an accurate index to 
the prevalence, however, because the malignancy of the disease varies con- 
siderably from time to time. 

Table 3. 
Cases oi" Certain Diseases Reported. 



1 

1 liil9 

1 


1920 


1921 


1022 


1923 


1924 


1925 


1926 


1927 


Typhoid Fever 


13 


21 


43 


27 


18 


40 


24 


13 


18 


Malaria 








1 






4 






Smallpox 


27 


32 


50 


5 


3 


6 


2 




9 


Measles 


11 


2(10 


170 


43 


1203 


76 


300 


432 


1589 


Scarlet Fever 


73 


507 


638 


91 


79 


64 


130 


100 


187 


Whooping Cough 






120 


309 


207 


81 


58 


422 


25 


Diphtheria 


7.5 


41 


03 


100 


98 


134 


85 


36 


56 


Influenza 


573 


256 


1 


31 


47 


35 


51 


58 


34 


Poliomyelitis 


3 




18 


4 


2 


1 


1 


1 


3 


Meningritis 


1 


2 


1 


2 


3 


2 


3 




2 


Tviberculosis* 






74 


230 


273 


102 


108 


145 


94 


Pneumonia* 






70 


205 


223 


191 


146 


146 


169 


Syphilis 






270 






325 


257 


387 


280 


Gonorrhea 


V 




337 






379 


285 


453 


335 


Chancroid 






29 












12 



*.\11 forms. 








NOTK : Case reports are 


never complete, 


Im- 


thp\ 


lllin..is. This table 


in.licates that n. 


tih. 


Itinli 



The trend of tuberculosis has been distinctly downward since about 1900. 
Prior to that date the disease was very common in Springfield, as it was else- 
where, causing a very noticeably heavy mortality and incapacitating no small 
number of citizens. Happily this infection now causes less than a third 
of the mortality that it did in lOQO and .'Springfield has a death rate from it 
which is but slightly higher than that for the State. Mortality from tuber- 
culosis in Sangamon County remains high, however, due to the location 
of two large sanitariums to which patients come from many other counties. 

Influenza was moderate in Springfield in 1918 compared with the havoc 
it wrought in many other places. The deaths attributed to it numbered 240, 
giving a mortality rate of 370 per 100,000. compared with figures using above 
400 in a number of other municipalities. Even when combined with the 
mortality from pneumonia the deatli rate fell a bit short of 600 which was 
lower than tliat of a dozen other Illinois cities. 



SPRIXCFIELD 



325 



Table 4. 
Births and Infant Deaths. 





Birtlis 


Infant Deiiths 


YEAR 












Number 


Riite** 


Xuiiiber 


1 Riite* 


1871! 






64 




1S77 






64 




1S7S 






56 




187!) 






52 




1880 






85 




1881 


400 


19.7 


87 


217.5 


1882 


386 


18.5 


77 


199.4 


1883 


410 


19.2 


61 


148.7 


1884 


239 


10.9 


73 


305.4 


188.-, 


2117 


9.3 






I'lnn 






135 




1!H)7 






113 




l»in 






152 




11)11 






118 




1913 






171 




IHIJ 






132 




191.-. 






118 




101(1 






119 




1!)17 






104 


107.3 


1918 






136 


105.8 


1919 






117 




1920 


116.5 


19.6 


109 


92.7 


1921 


1350 


22.4 


120 


88.8 


1922 


1212 


19.8 


111 


91.fi 


192S 


1352 


21.9 


108 


79.9 


1924 


1412 


22.5 


98 


69.4 


1925 


1394 


21.8 


119 


85 . 4 


1928 


1317 


20.4 


99 


75.2 



* l)eath>( of infants iinde 
•* Per 1000 population. 



per 1000 births reported. 



The general mortality rate in Springfield appears to be a little high but 
an unfavorable influence comes from many factors that do not indicate a 
low level of general health. For one thing the city has hospital and medical 
facilities superior to those in many communities of much larger size. This 
attracts patients from a considerable outlying territorw Another is that 
the age distribution cif the population is unusual. Nearly 24 per cent are 
45 or more \ears old. .\ home for the aged is located there. Futhermore 
the fact that it is the capital city brings to it a considerable number of non- 
residents. Allowing for all of these factors, it is probable that the general 
mortality rate in Springfield would be no higher than that which obtains in 
any other Cdninnmity of gudd prevailing health conditions. 



Rl£FERENCI-:S. 

Data supplied by Dr. H. H. Tuttle, Superintendent of the Healtli liepartnient Sririnn-fleld 

Annual Reports of the City nf Sprinsrfleld. 

Frill? SrhnrMrr, ,lr . I'lil.iir II. .iltli in Springtiekl, Pepartment of Surveys and Exhibits 



Hisloi,\ ,,i Mfihral 1 
Report on an -Appra 
re. May-June, 1926. 
United States Census Reports, 



Mini..! ^1 H.. Unard of Health, various dates. 
i|ii \,ill. 1 . I'.niiel Drake, M. D. 

ttice m lliniois. Vol. 1, Lucius II. Zeuth. M. D.. Chiiago. 1927. 
1 of Health Service during 1925, in Fifteen Illinois Cities; Illinois Health 




Edmund S. Kimberly, M. D. 

Member of First Board of Health of Chicago, 1934. 

Other Member, Dr. William S. Clark. 




Daniel Brainard. M. D. 

First Health Officer and Member First Organized Board of Health of Chicago 

composed of Ma.vor Benjamin W. Raymond and 

Doctors Stephen B. Gay and Josiah 

T. Belts, 1S37. 



HISTORY OF THE DEPARTMENT OF HEALTH 
CITY OF CHICAGO* 

Organization 

The health department of the city of Chicago was established by an 
ordinance passed by the city council on July 19, 1876. 

This action was taken in jjursuance to an act of the legislature known 
as the Cities and \ illnges Act, passed in 1872, and adopted by the city in 
1875, in lien of the charter previously in force. This act provided for the 
appointment of a lioard of health and also gave the city council the power, 
by a two-thirds v(.ite, to create offices, and the mayor the authority to fill 
these offices, such aiipointnients to be made with the advice and consent of the 
city council. 

The ordinance creating the health department provided for the appoint- 
ment of a commis-iioner of health at a salary of $1500; an assistant commis- 
sioner of health at $1200; a secretary at $1200; an assistant secretary at 
$1000 per annum ; two meat inspectors and 13 sanitary policeman at a salary 
of $60 per month. The following year the salary of the commissioner was 
raised to $3000 per year. 

The newly established department of health was vested with all the 
powers and charged with the duties of the board of health, which had been 
in existence since 1867. 

Dr. llrockhurst L. .Mc\'ickar was appointed as the first commissioner 
of health, but resigneil the position before the end of the \car. < )n January 
29, 1S77. Dr. t iscar DeW'olf was appointed commissioner and held the office 
continuou.sly for a ]jeriod of 12 years. 

The population of the city at this time was approximately 407,660 in- 
habitants. The annual appropriation for the health department, excluding 
the amounts designated for scavenger service and dead animal removal, was 
$36,640, which represented an expenditure of a little less than nine cents i)er 
capita for general health work. 

The annual death rate from all causes was 21 per 1(X)0 inhabitants. The 
deaths under one year of age constituted 31.4 per cent of all deaths. The 
annual death rate from typhoid fever was 41.2 per 100,000 population, and 
the death rates from diphtheria and scarlet fever were 184.5 and 198.9 per 
100,000 population, respectively. The death rate from scarlet fever in 1876 
was the highest in the history of the city, and constituted the first big prob- 
lem confronting the newly established department of health. 



history prior to It^TC see Vol. I, p. 101, thi: 

(327) 



Pre'Bacteriologic Period 

: I'rc-W Grid's fair Period) 

The years 1876 lo 1892 may properly be called the pre-bacteriologic 
[K-riod of the health (le])artment. During' this time the office of commis- 
sioner of health was filled by Doctors lirockhurst L. Mc\'ickar for five 
months : Oscar C. DeWolf for 12 years ; Swayne Wickersham for two years 
and John D. Ware for two years, in the order as enumerated. 

Tlie reason for designating this period of activities of the liealth depart- 
ment as the pre-bacteriologic period is because it fell in the time before the 
germ theory of disease had been generally accepted. Tlie lilth origin of 
disease, as pronounced by Pettenkofer in Germany, and Chadwick, Simon 
and ]\Iurcheson in England, was still the basis of sanitation and disease con- 
trol when the department of health was established. 

In Chicago, Dr. John H. Kauch had given impetus to this theory with 
practicing physicians and the general public, during his work as superintend- 
ent under the board of health, and was continuously following its tenents 
as secretar}- of the State Board of Health, which position he then occupied. 
Consequently, there was every reason for the commissioners of health, upon 
whom now fell the responsibility for directing the public health work, to con- 
tinue along the lines, the effectiveness of which had apparently been so well 
established. 

During these early years of the department the practice of medicine 
was not yet subject to .State control, and the standard of medical education 
as a whole was very low. In addition to the physicians who had taken ad- 
vantage of medical education as offered at that time, there were a host of 
practitioners who lielil iheiiisclves out as doctors. These were followers 
of .some cull such as the i'lnnvnian. or Ilotanic School, or were quacks prey- 
ing upon a gullible public. 

Contagious Diseask Control 

During the pre-bacteriologic period disease ran rampant. The city 
was growing by leaps and bounds, and the older parts were becoming more 
and more congested. Chicago had become the metropolis of the West, and 
a great center of travel and immigration. 

It was. therefore, natural that communicable diseases should spread 
rai)idl\- with the efforts of control then in vogue. How futile it was to 
stop the >priad nf scarlet fever, diphtheria and other contagious diseases 
by overhauling plumbing and relaying drains, or by making efforts to con- 

( 328 ) 



330 CHICAGO 

trul the Stock Yards nuisance, is shown by the bills of mortality during this 
epoch. As a rule the records show that the death rates from these diseases 
were the highest in the history of the city. 

Scarlet fever was of epidemic proportion when the department of 
health was first established. The years 1876 and 1877 show the highest 
death rates from scarlet fever in the history of the city since 1869, as 
illustrated by the chart in Figure 2. 

The chart shows that the death rates from scarlet fever were 198.8 and 
190.5 per 100,000 population, respectively, in these two years. 

Diphtheria was also very prevalent between 1876 and 1881. It reached 
its height in 1880, when there occurred 290.7 deaths from the disease for 
every 100.000 jjopulation. This represents the highest annual death rate 
from diphtheria in the history of the city, as shown by the chart reproduced 
in Figure 3. 

From 1880 to 1891, the death rates from measles were very high. The 
years 1882, 1884 and 1887 were especially bad in this respect. In 1885, 
the death rate for measles was 50.6 per 100,000 population, the highest in the 
history of the city. 

In 1876 whooping cough assumed ejMdemic proportir)ns and the deaths 
reached 53.8 per 100,00(J. This is by far the highest death rate from this 
disease on record. 

The great prevalence of these diseases caused the commissioner of 
health to require the reporting of contagious diseases by physicians. This 
v>'as first made effective in 1877. At the same time it was also required 
that cases of scarlet fever should be placarded. 

These new requirements, as was to be expected, brought on a protest. 
The views of the protesting physicians were reflected in an address, delivered 
by Dr. Henry M. Lyman, at the fifth annual meeting of the American Public 
Health Association, which was held in Chicago in 1877, in which he protested 
strongly against the placarding of scarlet fever cases, and deplored the waste 
of cards and tacks. He stated that the people revolted against the "yellow 
card nuisance." 

In 1888 the foundations were laid for the isolation of persons suffering 
from diphtheria, by a declaration issued by the conimissioiier of health to 
the effect that diphtheria is not a filth disease. Init a contagious disease, like 
smallpox. 

In 1881 and 1882. when scarlet fever and diphtheria had "burnt out" 
and again reached what in those days was considered normal portions, 
a severe out-break of smallpox occurred. It started among the immigrants 
that flocked to the city in great numbers in 1881. Altogether there occurred 
about 6,000 cases during the two vears. of which nunilier 2,472 died. The 



Scarlet Fever. 

Deaths Per 100,000 Population. 

Average Death Rates for Stated Decades. 



1667-76 1 
1877-86 I 
1887-96 1 
I697-06 i 
I907-I6 1 



" 21 I 

14 2 
• 19 6 





DEATH RATES BY YEARS 


YEARS 








50 lOO ISO 200 


1867 
1868 
1869 
1 I670 
1871 
1872 


i 










1 6 73 








IS7.<)- 
1675 
1676 








1877 
1 678 
1679 

laeo 

1861 
1 682 
1663 
1664- 
1665 
1886 
1S67 


















1666 










1 889 










1690 
IS9I 












1692 
1693 












1 694 


•m^ 










189 5 


B 










1 896 


■ 










1697 


B 








1696 


m 








1899 












I900 


^^ 










I90I 


^ 










I902 












1903 


^^^ 










I904 


^ 










190S 


■ 










1906 
I907 
I908 






















1909 


^^^ 










I9IO 


^^mm 










19 11 












1 912 
1 913 
1 914 












^ 










1915 


■ 










I9IG 


•m 










1917 












1918 












19 19 


m 










1 920 


^ 










1921 


IM 








1922 


■ 










1 923 


1 










1924 


■ 










1925 


■ 











332 CHICAGO 

death rate from smallpox was 218.3 per 100,000 population in ISSl. and 
230.2 in 1882. These were the highest death rates from this disease in the 
city to date. 

The reason that smallpox gained such headway seems to be that the two 
measures, always found effective in the control of this disease, were not 
carried out vigorously. In 1881, the cit\' council revoked the ordinance per- 
mitting the forcible removal of cases to the hospital. The smallpox hospital 
must have been quite unpopular even at that time. To improve this con- 
dition it was placed in charge of Catholic Sisters in 1882. 

\'accination was not carried on so vigorously at first as the situation 
demanded, the reports of the department of health showing that only 48,900 
vaccinations were performed in 1881, and 110,504 in 1882. The population 
of the city in 1880 was 501,185, according to the United States census. 

I'ollowing this there were no unusual outbreaks of disease, and the gen- 
eral death rate continued irregularly downward until 1891, when it suddenly 
increased to 24.16 per 1,000 population. This increase was principally due 
to an outbreak of influenza which started in January 1890, and which was 
followed by a high acute respiratory disease death rate during the three 
succeeding years. This reached its height in 1891. 

T_\phoi<l fever also became prevalent in 18'X). and continued so for three 
years. It reached its height in 1891, during which year the death rate from 
this disease was 173.8. per 100,0(i0, which is the highest mortality rate from 
typhoid fever in the history of the city. The rate remained high during 
the following year, nearl_\- 124.1 per 1(X).000 population. 

It is interesting to note the attitude of the health department in regard 
to the origin of this typhoid epidemic. In his annual report to the mayor 
for 1892, Commissioner \\'are commented on the origin of the txphoid out- 
break as follows : 

"The examination showed that in almost ever.v case where death 
had occurred, the plumbing was notoriously bad, the drainage worse 
and in many instances not the slighest effort had been made to keep 
the house and surroundings in sanitary condition; drains under houses 
had been broken into, the drain overflowed cellars, and the openings 
left for months until discovered by our inspectors; dwellings by the 
hundreds built on undrained ground and where it is impossible to dig 
twelve inches into the ground without finding water. Is it any wonder 
that typhoid should exist under such circumstances? * * * * We have 
tyi)hoid and always will have so long as there remains so much un- 
drained property. There are 40,000 old-fashioned privy vaults in the 
city. * * * * Never, in the history of Chicago, has the water supply 
been better. * • * * Chemists of reputation have made tests during the 
past year and the finding in every case demonstrated that Chicago has 
every reason to be proud of the results obtained." 



DlI'HTHKRIA AND CrOUP. 

Deaths Per 100,000 Population. 
AvKK AGK Death Rates for Stated Decades. 



1667-76 1 
1677-86 1 
1687-96 1 
I697-06 ' 
I907-I6 I 



YEARS 


DEATH RATES BY YEARS 


50 ICO ISO 200 250 300 


1667 
1666 
1869 
1670 
1671 
1872 
1 673 

ia7.+ 

1675 
1676 
1677 
1676 
1679 
1880 
1861 
1 682 
1663 
1664 
1665 
1666 
1667 
IS66 
1669 

laeo 

1891 
1692 
1693 
1 694 
1895 
1696 
1697 
1896 
189 9 
I90O 
I901 
I902 
1903 
I904 
I90S 
1906 
I907 
1906 
I909 
19IO 
19 11 
1912 
1 913 
1 914 
1915 

i9ie 

1917 
1918 

19 19 
1920 
1921 
I9Z2 
1923 
1924 
1925 














^^^^^"^ 


1 


1 


] 




















^^ 










^^^^^^ 


1 ^^1 "" 














1 




1 ^^^^ 




\ 








"■^^^^^^n 




1 1 


1 ^^^^1 


1 "^^^"^^^^^ 


^T"^^^^^ 










~ 












1 1 


^^^^"^^^ 








^^^ 












^ 







n 



334 CHICAGO 

The t\pli()i(l outbreak was of particular sif^nificance, not only on 
account of its severity, but also on account of the appruachini,'^ World's Fair, 
which was scheduled to open in the following ^ear. 

The State Board of Health took cognizance of the typhoid epidemic in 
Chicago, and made an investigation and report of the extent and apparent 
causes of the outbreak. This, together with the report previously made by 
Sedgewick and Hazen, and the observations of the Chicago department of 
health, hastened the improvement of the water supply, the bad condition of 
which appeared to be the cause of the epidemic. 

An ordinance was passed in 1892 adding diphtheria, typhoid fever and 
typhus fever to the list of reportable diseases, and the method of reporting 
contagious diseases by postal cards was inaugurated. 

General Sanitation 

Aluch attention was given to general sanitation during this period. This 
was to be expected in view of the fact that the diseases coming under the 
attention of the health department, on account of their epidemic or local 
appearance, were thought to be due to filth. 

Even in diphtheria, scarlet fever and erysipelas, there was a strong sus- 
picion that filth pla\ed a major rule in their development and spread. 
Where no visible filth could be found sewer gas and other effluvia were sus- 
pected as the causative agents. Plumbing and drainage of buildings con- 
sequently received a great deal of attention. 

In 1879 a survey of tenement houses was made by a volunteer corps of 
thirty-three physicians. An ordinance was passed, providing for the in- 
spection of all places of employment, and six inspectors were provided for 
its enforcement. 

On account of the threatened invasion of cholera from Europe in 1885, 
an appropriation of $100,000 was made for a general sanitary inspection and 
cleaning of the city. This was a part of the comprehensive general survey 
and cleanup campaign conducted by Dr. John H. Rauch, secretary of the 
State Board of Health, to ward off the invasion and spread of cholera. 

In 1881 a State law was passed which gave the health department full 
control over the plumbing, drainage, Hght and ventilation of tenements, work- 
shops and lodging houses, and required that plans must be submitted to the 
health commissioner for approval of any such buildings to be erected. 

Following the passage of this act, considerable attention was given to 
tenement house and workshop inspection. A total of 2,444 plans for tene- 
ments were approved in 1883, of which number 1.142 were for so-called 
"flat buildings." 

.\ moderate degree of phunbing control was exercised by the health 
department in the }ears ininiL'(liritely following the passage of this act. 



CHICAGO 335 

In 1889 following the failure of the legislature to pass the compulsory 
plumbing law, drafted in cooperation with the Illinois Association of Archi- 
tects and the Chicago Plumbers' Association, the health department promul- 
gated a set of rules governing the drainage and plumbing of new buildings. 

In 1890 an ordinance was passed prohibiting privy vaults on sewered 
premises, and in 1891 the council passed a comprehensive plumbing ordi- 
nance. 

The general housing conditions were bad. largely because no control 
had been exercised over building construction, plumbing, drainage, light and 
ventilation until the early eighties. The city passed the 500,000 mark in 
1880. and it was only in the \ear following that the building department was 
established and the health commissioner was given jurisdiction over the 
sanitation of tenements, workshops and lodging houses. 

The bad tenement house and workshop conditions, although primaril}- 
due to a lack of building control in earlier years, in the course of time became 
associated with the problems of poverty and the living conditions of the 
working classes. 

In the early eighties the conditions of the laboring people became acute 
and caused a class consciousness which was reflected in the efforts to 
organize labor and to improve the conditions of the laboring classes. 

It was, therefore, natural that the health department, in connection with 
the intensive efiforts that were being made to investigate and improve tene- 
ment house conditions, should also collect statistics in regard to conditions 
of employment, wages and cost of living. 

In 1883 the city council passed an ordinance requiring the commissioner 
of health to make such investigations and to report the findings annually. 
This work was at once undertaken by the department and continued for a 
period of 12 years. Even at this time the reports are valuable because they 
show the wages received and the working conditions of the laboring classes 
at a time when they were making vigorous efforts to improve their condi- 
tions through collective bargaining. 

The Citizens' Association, in a report issued in 1884, called attention to 
the wretched condition of tenements, and in 1889 this same condition was 
again pointed out in a report made by the City Homes Association. 

Although the health department paid more or less attention to these 
conditions, and at times paid especial attention to the inspection of work- 
shops, and made a study of employment conditions, not much improvement 
was accomplished except in the better construction and sanitation of new 
buildings. 

In 1891 and 1892, which was a period of great municipal development 
and growth, brought on by the oncoming World's Fair, the great increase in 
population resulted in overcrowding and congestion of existing tenements 



336 ciiuAGo 

and till- huildiii!,' nf luaiiy cluM]) structures, which afterwards proved to he 
nut only a tire hazard, but also a menace to heaUh and sanitation. 

( In account of the possibility (if tlie invasion of cholera from Hamburg 
and other European cities in l''n2. the .^uni of $30,000 was appropriated to 
clean the city. The cleanup order included even the woodsheds among the 
structures to be cleaned, "(ireat care was exercised to thoroughly clean 
the paved alleys ; nothing was left that could possibly become a breeding 
place for cholera germs, and each load of refuse removed was sprinkle<l 
with lysol after being dumped." 

The two outstanding sanitary problems for which Chicago had become 
famous, or rather infamous, namely, the Chicago River and the Stock Yards, 
loomed as large as ever when the department of health was organized. 

The board of health, which had been created ten }ears previously, was 
established largely with a view to dealing with these problems and, primarily, 
because the great fatality fnjm cholera in the previous year had stimulated 
the citizens, interested in sanitarx- reform, to action. The newly established 
board set out vigorously to study and to improve these conditions, but in 
1874, the year after Dr. Ranch resigned as sanitary superintendent, the 
annual report of the board of health states that "there is much nuisance 
from slaughter houses." Those in the neighborhood of Eighteenth Street 
and the Chicago River are particularly mentioned in this connection, on 
account of their location near the residential section. It was also reported 
that the South Branch of the Chicago River is a stagnant pool of abom- 
ination. 

In 1877 the Stock Yards nuisance became \ery acute. Prosecutions 
in the police court pro\ed unsuccessful. Tlie city then attacked the problem 
from a new angle. Attorney R. .^. Tuthill, later Judge Tuthill, prepared 
an ordinance providing for the licensing of slaughtering and rendering 
plants. X'igorous proceilures were now vmdertaken to rid the cit}' of the 
Stock Yards nuisance. In 1878, twenty-seven indictments were \oted by 
the grand jury against operators of slaughtering and rendering plants for 
maintaining public nuisances. 

The licensing ordinance was sustained in the supreme court, and it was 
this carefully drawn ordinance that brought the Stock Yards plants under 
control and laid the foundation for future licensing ordinances passed as 
sanitar}- control measures. 

The result of this movement was that all the slaughter houses were 
moved outside the city limits, but soon the cit\- grew and embraced their new 
location. 

The Chicago River also recei\e(l much attention by the department of 
health during this ])eriod. In 1879 the State Board of Health, after an 
investigaliiin of the canal in the DesI'laines \'alle\, recommended that the 



CHICAGO 337 

pumping works at Bridgeport be rebuilt and operated to cleanse the channel. 
These were completed and put in operation in 1884. 

In 1880 the Fullerton Avenue conduit was completed. This was twelve 
feet in diameter and served to supply fresh lake water to the North Branch. 
The water was forced through the conduit by two screw pumps. At times 
when the river was very bad, water was pumped from the river to the lake 
through this conduit. 

This ailditiunal supply of water, flowing down from the North Branch, 
and the increased velocity, caused by the operation of the pumps at Bridge- 
port, improved the condition of the river for a time ; but the rapid increase 
in population and in industrial development resulted in the discharge of in- 
creased amounts of waste material to offset the good effects of these mea- 
sures and the result was that the river was as bad as ever. 

The sewage-laden river was a constant menace to the water supply. 
The water pollution, resulting from the flow of the river into the lake, varied 
with the rainfall and the height of lake levels, but was always sufficient to 
contaminate the water near the short intakes of the water supply system. 
The typhoid fever death rates were high and rarely fell below 50 per 100,000. 

In 1885 a final and definite solution of this problem was suggested and 
taken up with avidity. A subcommittee of the Citizens' Association on drain- 
age and water supply, of which Messrs. Lyman E. Cooley, Ossian Guthrie 
and Dr. Frank W. Reilly were members, after a comprehensive survey, sug- 
gested that a new drainage canal be dug, so as to reverse the flow of the 
river. Dr. Rauch, the secretary of the State Board of Health in 1886. in 
a report based upon examinations made by Professor J. H. Long, recom- 
mended the diversion of the sewage from the lake into the river and canal, 
and the dilution of the same with an average of 24,000 cubic feet of water 
per minute for every 100,000 inhabitants. The board urged that a proper 
waterway to carry out this plan be constructed. 

In the following year the drainage and waterway committee. a|)pointed 
by the mayor, in accordance with a resolution of the city council, with 
Rudolph Hering as chief engineer, made a report recommending the con- 
struction of a new drainage channel. In the meantime, comprehensive exam- 
inations of the water in the Illinois and Michigan Canal and Illinois River 
were continued by Professor J. H. Long, and reported in 1888. 

In the following year the establishment of the Chicago Sanitary District 
was authorized by the legislature, following which the district was organized 
and the plans formulated for the digging of the canal. Actual work on the 
canal was begun on September 3, 1892. and thus the problem of sewage dis- 
]50sal and river and lake pollution was brought to what at that time seemed a 
favorable solution. 



338 ciiu'AGo 

( larbajic rcniowil and tither scaven^^cr work, such as the removal of 
(lead animals, was one of the principal activities of the health department 
durini,' this period. Approximately one-half of the already meagre appro- 
priations of the department were for this work. In 1885 the contract system 
of garbage removal was adopted. This cost the city $75,000, which was 
about one-third of the cost of the old system. In 1886 the sum of $176,196.34 
was set aside for scavenger service, out of a total appropriation of 
$258,356.34 made for the health department for this year. In 1887 a garbage 
furnace, capable of consuming 150 tons daily, was built at Seymour Street 
and C irand Avenue at a cost of $7.0(X). The cost of maintaining this crema- 
tory in 1888 was $11,643. Garbage receptacles of standard style were de- 
signed this year, but in spite of these improvements the garbage cjuestion 
was pressing, demanded much attention and was subject to considerable 
criticism. 

In 1890 garbage disposal was placeil un<ler the direction of a general 
sanitary officer in the department. A study was made of garbage removal 
in other cities. A survey showed that there was much nuisance from 
manure. It was found that there were about 100.000 horses in the city at 
that time. 

An odor division was also organized this year. Necessity being the 
mother of invention, it is to be presumed that there was an urgent necessity 
for such a division. 

In 1881 a smoke-control ordinance was passed by the city council, and 
its enforcement was assigned to the laboratory of the department. In 1884 
a smoke inspector, under the jurisdiction of the health department, was ap- 
pointed to handle this work. 

\V.\TKR, Food and Mii.k. 

The work of the health department in the control of water and milk 
during the years 1876 to 1892, inclusive, the so-called pre-bacteriologic 
period, was almost entirely based on chemical examinations and attention to 
chemical standards of purity. 

In reference to the condition of the water suppl\- the records show that 
a study was made of lake pollution in 1877, and that it was found to be 
due to two sources, namely, the Chicago River and the dumping of refuse. 

In 1881 typhoid and diarrheal diseases were very prevalent. There was 
also a high mortality of children under one year of age. Whether the in- 
creased prevalence of these diseases was due to polluted water, or infected 
milk, was not determined. 

In 1886 a report on the water supply of Chicago was made by Dr. 
Ranch of the State Board of Health. This showed that it was polluted, by 
sewage entering the lake throinjli numerous sewer outfalls, and the Chicago 
River. 



339 



SANITARY MAP OF CHICAGO : SHOWING TYPHOID-FEVER REDUCTION 



Between 1891 and 1894. 



above the horizontal lines show the 
proportion of deaths from Typhoid Fever 
per 1000 of population in 1891. 

Figures below the lines show the proportion 




PER 1000 OF Population ik the Ten 

Largest Cities of the 

United States. 

Per cent, of 
Cities. 1891 " "• " '■ 

Chicago 1-59 

Cincinnati . 
Cleveland . 
Philadelphia 
San Francisco . 
Baltimore 

Boston 

St. Louis 
Brooklyn 
New York 

Average redact 



36.1 per cent. Redaction for Chicago: 80.3 per cent. 
Figure 4. 



340 CHICAGO 

The Hyde Park water tunnel, one mile long, was completed this year. 
Before this the Hyde Park pumping station was supplied thr(]ugh an iron 
pipe extending 1,400 to 1,800 feet into the lake. 

A tunnel, 3,000 feet long, was completed in 1887 at the Chicago Avenue 
pumping station for emergency use in case of fire. This was used for the 
regular water supply at times, and especially in 1892. There was a similar 
shore intake for the Lake \'iew pumping station. 

The location of the water intakes to the sewer outfalls along the Lake 
Shore is shown in Figure 4. 

This map also shows the death rate from typhoid in the various sections 
of the city during 1891 and 1894. The typhoid rates in 1891 were highest 
in the territory supplied by the Chicago Avenue and the Fourteenth Street 
intakes. This was before the latter intake was extended four miles out into 
the lake in December 1892, after which there occurred a marked reduction 
in the territory supplied by the new Four Mile Crib and tunnel system. 

The Chicago health department reports for this period do not make any 
reference to any examination of water made by the department. The re- 
ports on the W'-ork of the laboratory, which was established in 1894, relate 
only to smoke inspection and later to examination of milk samples. 

Light on the condition of the milk supply which existed at the time 
the department was organized, is shown by investigations made in 1874 and 
1875. These showed 4,372 cows fed on distillery slops from the seven dis- 
tilleries in the city. A large amount of the milk supply, especially on the 
West Side, was obtained from cows fed on brewery slops. This milk sold 
for half the price of country milk. 

In 1877 an ordinance was passed regulating the sale of milk and pro- 
viding for the appointment of a milk inspector. Twenty-nine convictions 
of milk dealers for violations of the milk ortlinance were obtained during the 
year. 

Approximately one-half of the sixty-seven milk samples examined in 
1879 contained less than two and one-half per cent butter fat. The follow- 
ing year thirty-four per cent of 101 samples collected contained less than 
this amount of fat. 

In 187') a ."-^tate law was passed prohibiting the sale of adulterated milk 
and milk obtained from cows which were diseased or fed on distillerx- slops. 
In 1885 another hill was passed b\' the legislature regulating the productit)n 
and sale of dairy products. 

This year Professor J. H. Long made chemical examinations of the 
city's milk supply for the Chicago health department, and found half of the 
samples below grade. This work was started in a drug store on Cottage 



CHICAGO 341 

Grove Avenue near 39th Street, and was continued for a period of three 
)-ears. In 1886 efforts were made to stop the coloring,'- (jf milk, which was 
extensively practiced at that time. 

In 1892 a division of milk inspection was created b\- cil\- ordinance inde- 
pendent of the health department, and a comprehensive milk ordinance was 
passed requiring the licensing of milk dealers and the maintenance of sani- 
tary conditions in establishments handling milk. This ordinance also estab- 
lished chemical standards of purity for milk sold within the citv limits. 

It was found that, of the 500 samples of milk first examined, 75 per 
cent were below the standards set by the ordinance, while only 8 per cent 
of a similar lot taken from trains on arrival were below grade. 

Milk inspection was carried on only spasmo<lically during this period, 
and the results of analyses of samples reported in 1892, showed that no 
marked improvement of the milk supply resulted therefrom. 

The attitude of the department, as set forth in the report of the general 
;-anitary officer to Commissioner John D. Ware, in the 1891 annual report of 
the department, shows an attitude that was not provocative of remedying 
the bad conditions of the milk supply that had been previously pointed out 
by Professor John H. Long, when he served as city chemist. 

The report of the general sanitary officer of that \ear on milk and food 
inspection, read in part as follows : 

"The price per quart of niillv paid l).v tlie consumer is generally 
the best test as to quality; milk sold at three cents per quart is 
skimmed. Look at the can from which the milk is taken, and you will 
find it plainly marked 'skimmed'. The State says it must be so marked 
and it is. The city milk supply is all drawn within a radius of fifty 
miles. The railroads handling the milk take an interest in it. They 
have their own milk agent and he is alive to their interests. The milk 
leaves the farmer all right and gets into the hands of the dealer all 
right. 

"Ccnsuniers. it you pay a rood price for your milk and it is not 
satisfactory, change milkmen until you get value received. The poor 
man who purchases his milk at the corner grocery will say he receives 
no assurance that his milk is not adulterated. To him the department 
of health will say 'Bring your sample, and if it is supicious from the 
crude means of test at our command, the taste and microscope, the 
department will take the risk of error and dump the milk in the 
sewer.' " 

Other food inspection was almost entirclx limited to inspectinn of meat 
at slaughtering houses. Two meat inspectors were pro\i(led for this work 
when the department was first organized in 1876. In 1892 this number had 
been increased to nine. Three of these were assigned to inspection outside 
of the Stock Yards. 



342 CHICAGO 

The first comprehensive federal meat inspection hiw, applying to inter- 
state shipment of meat, was enacted by Congress in 1891. The institution 
of federal inspection had a salutary effect upon the meat inspection main- 
tained at the abattoirs located within the city. The city continued its service, 
and at times there were misunderstandings between the two corps of 
inspectors. 

In 1890 a dispute developed with the State Live Stock Commission 
in regard to bringing of diseased or condemned animals into the city and 
slaughtering them in establishments under city inspection. This controversy 
was adjusted by both parties agreeing that a special place should be provided 
for the slaughter of such animals. 

Period of Developvxent 

The years 1892 and 1906, inclusive, may well be designated as the time 
of development of health conservation and sanitation in Chicago. 

During this period the office of commissoner of health was occupied by 
Dr. Arthur R. Reynolds for two years, William R. Kerr for two years, Dr. 
Arthur R. Reynolds a second time for eight years, and Dr. Charles J. Whalen 
for two years. Dr. Frank W. Reilly who became associated with the depart- 
ment in 1894, was appointed assistant commissioner in January of the fol- 
lowing year, and served in this capacity through this entire period. 

Although the great discoveries in bacteriology were announced around 
the early eighties, such as the discovery and description of the anthrax 
bacillus by Pasteur and Koch in 1877, staphilococci by Pasteur, Billroth and 
others in 1880, typhoid bacillus by Eberth in 1880, tubercle bacillus by Koch 
in 1882, diphtheria bacillus by Klebs in 1883, cholera vibrio by Koch in 1883, 
they did not become generally applicable, either in the practice of curative 
or preventive medicine until the early nineties. 

In 1881, Koch made his epoch-making report, in which the method of 
using solid culture media for obtaining pure cultures of bacteria and the 
fundamental postulates for determining the specific pathogenicity of bac- 
teria, were first announced. 

The first course of lectures on the germ theory of disease was given by 
Dr. Henry Gradle in 1883, at the Chicago Medical College. Dr. Wm. T. 
Belfied also gave a course of lectures on this subject in the early eighties. 
Twelve j'ears later, Dr. Isaac D. Rawlings gave the first laboratory course 
in bacteriology at this college. 

Dr. Christian Fenger came to Chicago in 1878, thoroughly imbued with 
the European views in regard to the role of bacteria in surgical infections 
and began to teach and demonstrate these principles at his clinics at Cook 




OMMISSIONERS OF HEALTH 
CITY OF CHICAGO 
Afxd D^vfe of Appoirvtmcnf 





Commissioners of Health— City of Cliieago 
187G to 192S 



344 CHICAGO 

C'uunt\' Ilospital. Aiudiil; the students who clustereil around him were 
Ludvig Hektoen and others who hiler jilayed a prominent role in teaching 
the bacterial origin of disease to medical students and in popularizing these 
facts with the practicing physicians. 

It was natural that the older practitioners and the followers of other 
schools of practice, should he reluctant to accept the new theories and find- 
ings in regard to the origin of infectious diseases. Dr. N. S. Davis, who 
had taken such an acli\e part in imprtjving the health of the city and State, 
was one of the outstanding figures in the medical profession who refused 
to accept the germ theory of disease at this tin:e. 

In the 1884 edition of his lectures on the Principles and Practice of 
Medicine, he said : 

"If we adhere impartially to well ascertained facts, we must adtiiit 
that diphtheria often makes its appearance in families, asylums and 
schools, as well as at the beginning of epidemics, under such circum- 
stances that it is imjiossible to trace it to any form of communication 
with previous cases, either in the same localities or elsewhere. In other 
words, it is capable of spontaneous development, and consequently does 
not depend for production and spread upon any specific contagious germs 
or virus generated in the bodies of the sick." 

Such views were hard to dispel in the minds of the older practitioners. 
With but few exceptions, the germ theory of disease was, however, quite 
generally accepted in the early nineties. The same change in views were 
gradually being applied in preventive medicine. 

In 1888, Health Commissioner De Wolf had declared that diphtheria 
was not a filth disease, but an infectious disease, like smallpox. In 1885, Dr. 
Frank W. Reilly first called attention to flies as carriers of disease. The 
report of Sedgewick and Hazen had definitely called attention to the relation 
of the ])olluted water suppl\- to the prevalence of typhoid fever in the city. 

In 189v3, F. L. Dibble, in his book entitled The Vagaries of Sanitary 
Science, presented a scathing denunciation of the filth theory of disease and 
the methods previously in vogue for controlling diseases, and showed more 
or less accurately the futility of proceeding along these lines. 

This status of sanitary science, and the development and quite general 
acceptance of bacteriology, made it possible for Dr. Arthur R. Reynolds, 
when he was appointed commissioner of health in 1893, to direct the work 
of the health department along scientific lines. 

One of the first steps taken by him in this direction was the establish- 
ment of a laboratory. Tn 1804 Dr. .\dol])h (lehrman was a]jpointed 
director of the laboratory, which was e(|uipped to make analysis of 
milk and water. This avoided the necessity of sending such samples to 
private laboratories, as had been the custom. In September, examinations of 
diphtheria cultures were begun. The first W'idal tests were made in 1896. 



CHICAGO 345 

A total of 12,580 analyses of all kinds were made in the laboratories 
during 1894, 12,093 of these were of milk and cream, 239 were of the city 
water supply, 95 diagnoses of diphtheria were made, 26 of bread, 8 of air 
and various food products. In all 21 different things having a bearing on 
health were analyzed. 

The department's crusade to BOIL THE WATER during 1893 and 
1894 was very effective in reducing typhoid fever. Some of the daily papers 
carried the phrase — BOIL THE WATER — in large type on the front page. 

The first diphtheria antitoxin was issued by the health department on 
October 5, 1895. At the same time a corps of antitoxin administrators was 
appointed. The results obtained, when tabulated, showed a great lower- 
ing of the mortalit\- in the cases where this remedy was used. A circular 
of Informatiiin on the Antitoxin Treatment of Diphtheria was issued b\' the 
department, with a \ie\v t" pdiiularizing this form of treatment. 

IxFi-xTious Diseases. 

During the World's Eair which was held in Chicago in 1893, and visited 
by millions of people, there was much overcrowding in the city. The lodging 
houses were crowded, and the outbreak of smallpox among the lodgers led 
the department to inaugurate a vigorous campaign of vaccination, but in 
spite of this 140 cases of smallpox occurred, of which number 23 ended 
fatally. 

The next \'ear, during which there was much unemplo_\'ment, man\ labor 
disputes and strikes, smallpox assumed epidemic proportion. A total of 
2,332 cases and 1,033 deaths from the disease occurred during the year. 
A vigorous vaccination campaign, in fact, the most extensive of its kind in 
the history of the city, was carried on by the department, with a result that 
1,084,500 vaccinations were performed in the city during the year. The 
"vaccination creed" of the department, first issued at this time, was distri- 
buted in large numbers. 

Additional hospital accommodations had to be provideil for persons 
suffering from smallpox. The Msiting Xurse Association furnished the 
nursing service for these hospitals. 

Plans were made for the construction of a large municipal smallpox 
hospital, and the foundations laid for it, but in the following )ear, when 
smallpox had subsided, the plans were modified and the size reduced to 
about 125-bed capacity. The new hospital, located at 34th Street and 
Lawndale Avenue, was completed in 1896. 

The next increase in the smallpox incidence was in the years 1903 and 
1905. In 1905 there were 546 cases of the disease reported, with 61 deaths. 



346 CHICAGO 

A marked reduction in the incidence of typhoid was speet.lily accom- 
plished. The death rates from ty]ihoid fe\er in the \arious wards of the 
city during 1894, as compared with IS'M. are shown in tlie map, Figure 4, 
pajje 339, repro(hiced from annual rejjort of the department for 1894. 

This also shows the four water intakes and the sewer outlets ahjng the 
shore line. 

All of tlie other infectious diseases, with the exception of tuberculosis 
and pneumonia, were brought gradually under control during this period, 
and the only outstanding epidemics that occurred from these diseases, were 
a moderate outbreak of epidemic cerebrospinal meningitis in 1898. and an 
outbreak of typhoid on the West Side river wards, due to a pollution of the 
water supply in this district. A typhoid rate of 44.5 per lOO.OOO for the city 
was recorded that year. 

An extensive outbreak of scarlet fever occurred at the end of this period, 
affecting especially the North and West sides of the city, due to the infec- 
tion in the country of the milk supplied by a large dealer. This outbreak 
reached its height in January 1907, during which month 3,058 cases were 
reported. 

The disease, although widespread, was mild in character, and. therefore, 
many cases were not reported. These served as new sources of infection, 
and helped to augment and prolong the epidemic. 

During the }ear, a total of 718 deaths from scarlet fever were recorded, 
representing a death rate of 35.1 per 100,000 population. 

In 1903 the death rate from the acute respiratory diseases, was 313.4 
per 100.000 population, which was the high mark from this class of diseases 
during this period. 

A marvelous reduction was accomplished in the death rate from diph- 
theria and croup. This was reduced from 129 per 100,000 population in 
1892, to 27.1 in 1907. The reduction was especially marked after 1895, and 
followed the introduction of the use of antitoxin in the treatment of this 
disease. 

Diphtheria, for which the new science of bacteriology had found not 
only the causative genu and an accurate method of diagnosis, but also a 
curative and preventive agent in the form of an antitoxin, was especially 
amenable to preventive measures. It was the application of these that 
brought the death rate down as indicated. 

In 1896 the laboratory was equipped with an incubator to facilitate diag- 
nosis work. The following year four antitoxin and incubator stations for 
diphtheria cultures w-ere established in different sections of the cit\'. 

Better methods of disinfection were employed. In 1898 the use of 
formaldehyde for this purpose was introduced, first by the use of generators, 
and later in the \car, bv the sheet method. 



347 



In 1905 antituxin beciime very high priced, and in order to make it 
generally available, the department took a hand in lowering the price and 
also resumed the free distribution of this product. The next year these 
efforts culminated in an arrangement with the McCormick Memorial Insti- 
tute for Infectious Diseases whereby the Institute supplied antitoxin to 
physicians and the health department at cost. By this means the combine 
of manufacturers to hold up the price was broken. 

To overcome the objections to the placarding of premises on which a 
person suffering from a contagious disease was isolated, the department in 
1896 began to allow physicians to assume the responsibiHty of quarantining 
cases of contagious disease under their care. This procedure remained in 
effect until 1909, when it was rescinded because it was found that it retarded 
the reporting of cases and was a hardship on physicians who could not con- 
scientiously assume this responsibility. 

Following the death of Chief Medical Inspector Garrot, Dr. Heman 
Spalding was appointed to that position on May 1, 1899. He held the office 
continously until his death in 1926. Dr. Isaac D. Rawlings entered the 

department in March 1899, as a 
medical inspector and was appointed 
assistant chief medical inspector five 
vears later. These two officials 
played an important role in the 
development of communicable 
disease control and school inspec- 
tion in Chicago. 

Dr. .Spalding, ever reminiscent of 
his early experience in the smallpox 
epidemic of 1893 and 1894, special- 
ized in the diagnosis and control of 
this disease, and was an ardent 
advocate of vaccination at all times. 
Cpon Dr. Rawlings fell the re- 
sponsibility of attending to the end- 
less details necessary to carry on the 
measures required, to guard the in- 
habitants of a large and growing 
city against the inroads of contagi- 
ous disease. His careful planning 
and systematizing of the work' laid 
the foundations for the methods of communicable disease control now in 
effect in the City of Chicago and the State of Illinois. On February 3, 1921, 
he was appointed Director of the Department of Public Health of the State. 




Jleniun SiJiihliii,^, M I) 



348 CHICAGO 

An ordinance was passed in 1895 licensing and regulating undertakers. 
Dr. O. M. llcckar<l was appointed registrar of vital statistics this year. The 
same year funeral in>pecticin was inaugurated li\' the department. 

Efforts were also made to lower the high infant mortality that prevailed 
in the early nineties. The deaths of infants under one year of age then con- 
stituted about 30 per cent of all deaths. 

In 1894 the department started to distribute its circular on the hot 
weather care of babies. Tn 1896 rules were promulgated regulating the prac- 
tice of midwifer\'. In 1898 a system of reporting births by postal cards was 
inaugurated and remained in effect for three years. 

The first comprehensive step taken to combat the annual hot weather toll 
of infants was in the summer of 1899, when a volunteer corps of 73 physi- 
cians was detailed in the congested districts of the city to give instructions to 
the mothers on the care of babies. 

Medical inspection of schools was started b}- the department of health at 
the beginning of the school year, September 3, 1896, when eight of the ten 
medical inspectors in the service were detailed to this work. This w'ork was 
continued until January 8, 1900, when through the efforts of Dr. W. S. 
Christopher, SO medical inspectors were detailed by the board of education 
for this work, with the understanding that they would work under the direc- 
tion of the commissioner of health. They remained on duty until nearly the 
end (if the school term. ( )nly ten were reassigned to this work with the open- 
ing of schools in Septeml)er, and continued to visit the schools on emergency 
calls, and made inspection for contagious diseases. In the fall of 1900. the 
Compulsory Education Department assumed control over this corps of in- 
spectors. This led to duplication of work and misunderstandings, so that the 
commissioner of health in 1902 found it necessary to protest against this 
arrangement but not nnicli iniproxenient resulted therefrom. 

During the extensive outbreak of scarlet fever in the early part of 1907, 
250 school in.spectors were provided during the emergencx'. of which num- 
ber 100 remained after the epidemic was over until the end of that school 
year. 

The reductions in the death rates from contagious diseases, and efforts 
made to conserve the health of infants and children, reflected themselves in 
the decline of the general mortality rate during this period. During the first 
17 years following the establishment of the health department, the so-called 
pre-bacteriology period, the average annual death rate was 20.3 per 1,000 
population. During the last three years of this same period the average 
annual death rate was 21.9. showing that practically no inroad had been made 
on the ravages of disease, with the arniamcnturium u>ed during the pre- 
bacteriologic period. 



CHICAGO 349 

With more scientific methods, and a more accurate knowledge of the 
causes of disease, the death rate was reduced nearly 25 per cent in the first 
14 years of the bacteriologic era. In 1901 the annual death rate for the first 
time reached the low minimum of 13.9 per 1,000 and from there on averaged 
about 14.7 per 1.000 annually during the last six }-ears of this period. 

The average age at death in 1905 was 31 _\ears, 9 months and 18 days. 
as compared with 16 years, 2 months and 12 days in 1875, the \ear preced- 
ing the establishment of the health department. 

Sanitary Engineering. 

The completion and opening of the new drainage channel on January 17, 
1900, was a great accomplishment from a sanitary engineering standpoint. 
The object of the new canal, with the tributary branches which were to be 
dug subesequently, was to divert all of the sewage of Chicago and adjoining 
territory in Illinois from the lake. To do this for Chicago, north of the Calu- 
met district, it was necessary to intercept all of the sewers emptying into the 
lake, and then to divert the sewage from the interceptors, by great cross- 
town sewers, to the Chicago River and drainage channel. x\lthough a com- 
mission had been appointed in 1896 to prepare plans for diverting the city 
sewers to the river, the major portion of the intercepting sewer system was 
not ready when the drainage channel was completed in 1900. 

In 1898 the main sewers in Twelfth and Twenty-second streets had 
been changed in grade, so as to discharge into the river instead of into the 
lake. The Thirty-Ninth street intercepting sewer, diverting all sewage 
between Thirty-first and Seventy-fifth streets, was opened in December, 
1905, but the Lawrence avenue sewer, receiving the intercepted sewage from 
along the North Shore, was not completed until 1908. 

On the same day that the drainage channel was opened the State of Mis- 
souri started an injunction proceeding against the State of Illinois, seeking 
to restrain the sanitary district from discharging its drainage into the Mis- 
sissippi River, via the Illinois and Des Plaines Rivers. In anticipation of 
these proceedings. Doctor Reynolds, commissioner of health of Chicago in 
1898, inaugurated the work of stream examination for the Sanitary District 
of Chicago. 

No plan of water analysis of such broad extent and great magnitude had 
heretofore been undertaken. It covered the waters between Chicago and St. 
Louis and was national in its influence and significance. 

The reason for the work was a persistent rumor that the State of Mis- 
souri would take steps to enjoin the State of Illinois from opening the drain- 
age channel that was built to carry the sewage of Chicago, together with 
the waters of dilution, from Lake Michigan in its course to the Mississippi 
River. 



350 CHICAGO 

ThvL'L' laljoratories, making iiuli\iilual examinations, wx-re hrnutjht into 
the service. Dr. A. S. Draper, licad of the L'niversity of Illinois, appointed 
Professor Arthur W. Palmer and Dr. T. P. lUirrill for the work. Dr. W. R. 
Harper of the University of Chicago appointed Dr l-ldwin O. Jordan and 
Dr. Adolph Gehrman was appointed for the laboratory of the department of 
health of Chicago. 

These men organized the work, agreed u|)on niethoil.s. went o\er the 
streams from Bridgeport, where the drainage channel began in Chicago, to 
St. Louis, in Missouri. They selected the different points at which samples 
of water were to be taken, selected and instructed those who would collect 
the samples and ship the containers. The samples were collected in triplicate 
at stated periods and shipped one to each of the laboratories. 

A small laboratory was set up by Dr. Jordan at Grafton, Illinois, where 
determinations were made at once. It was presided over by Dr. E. E. Irons 
of Chicago, who was then an under-graduate in medicine. 

Dr. Reynolds alone held the conference with the trustees of the sani- 
tary district that secured their consent to undertake the work, and he is 
authority for the statement that the letter of the department of November 28, 
1898, urging the policy of making the examinations, and the letter of trans- 
mittal of the results in their literary excellence and final form, are the work 
of Dr. Frank W. Reilly. These two letters were considered by the depart- 
ment of health as its masterpieces as state papers. The full report was 
printed by the trustees of the sanitary district in 1902. 

This work was started in May, 1899, and continued until Jul\-, 1900, 
and showed that all of the pollution in the Illinois River from Chicago sew- 
age had disappeared before reaching Peoria, also that the water at the mouth 
of the Illinois River was purer on an average than that of the Alississippi 
above this junction. 

These findings were used, together with those obtaineil by Professors 
]. H. Long and F. R. Zeit. in another somewhat later comprehensive chem- 
ical and bacteriological examination of the Illinois, Missouri and Mississippi 
Rivers made in 1902, in the mjunction proceedings which were heard in 
St. Louis before a commissioner of the United States Supreme Court and 
finally decided by the United States Supreme Court against the State of 
Missouri in May, 1906. 

Following the extensive prevalence of t\phoid fever in the years just 
preceding the World's Fair, greater attention was given to the purity of the 
water supply. Owing to an unavoidable delay in extending the Hyde Park 
Crib, it was found necessary to purify all the water used on the World's Fair 
grounds by Pasteur filtration. An attempt was also made to la\- a pipe line 
from Waukesha, Wisconsin, to supply the Fair with spring water from that 
localitv. 



CHICAGO 351 

The Four-lNIile Crib off Fourteenth Street was put into operation in 
1893, and the use of the shore intakes at the Chicago Avenue and Lake 
View pumping stations was permanently discontinued. Doubtless the water 
from these sources played an important role in the high typhoid incidence in 
the city during the years 1890 to 1892. 

Extensive examinations of the city's water supply were inaugurated in 
the cit\- laboratory in 1894. The following year daily examinations were 
started, and after that the department published the results in the daily 
papers and inserted a warning notice and advice to BOIL THE WATER 
whenever the findings were especially bad. 

The H_\de Park intake was extended two miles in 1894. The North- 
western Lake and Land Tunnel System, supplying the Central Park and 
Springfield Avenue pumping stations, was completed in 1900.The use of the 
Rogers Park pumping station, which received its water through a short 
shore intake, was discontinued in 1906 and the territory was supplied from 
the Lake View Pumping station. 

A State law was passed in 1897 providing for the licensing of plumbers 
and inspection of plumbing by municipalities. Acting in accordance with the 
provisions of this statute, a city ordinance was passed providing for the 
licensing of plumbers by a board of examiners and also setting forth stand- 
ards for plumbing installations. 

The first free public bath house, the Carter H. Harrison at 759 ]\Iather, 
was established in 1893. From then up to 1907 the number was gradually 
increased to fourteen. 

General Sanitation. 

The scavenger service, the operation of which had given the health 
department so much vexation, was transferred to the department of public 
works in ^larch, 1893, but this did not settle the garbage problem. Com- 
plaints in regard to garbage accumulations on premises and in alleys con- 
tinued to come to the health department daily in large numbers, and the 
public had the same reasons for being dissatisfied with the service as before. 
In 1900 an ordinance was passed requiring the separation of garbage and 
rubbish. 

The wooden refuse receptacles, one side for ashes the other side for 
garbage, maintained in the alleys in the rear of every building, were usually 
in bad repair or, as often happened, wrecked by a passing vehicle. These 
receptacles were neither rat nor fly-proof and offered, especially when filled 
to overflowing, as was often the case, the best sort of habitation and food 
supply for such vermin. The garbage, after collection, was dumped in low 
places or in available holes or excavations. These "dumps" were the source 
of much nuisance in the summertime, and the odors from them often per- 



352 CHICAGO 

meatwl the surrouiulins,' neighborhood. Strange to say, they attracted liordes 
of women and chil(h"en from the poorer sections who picked over the refuse 
and garbage and carried or carted home anything that they thought was 
worth salvaging. 

This condition prevailed until I'Wi, when the first contract was made 
for the disposal of the city's garbage at a reduction ])lant. The storage 
and disposal of manure remained under the jurisdiction of the health depart- 
ment. The quantit}' of manure produced increased from year to year, and 
the nuisance created thereby presented a problem which became greater as 
the population of the city increased and its area was extended. 

The stud}- of typhoid fever, which was so prevalent among the troops 
during the Spanish-American War in 1898-1899, had demonstrated the role 
of flies in the transmission of this disease. In 1902 the relation of flies to the 
spread of typhoid was studied by Alice Hamilton in the epidemic of the dis- 
ease which occurred on the West Side. 

These and numerous other observations had established the danger of 
flies, so that in the early nineties cognizance began to be taken of their sani- 
tary significance, but it took nearly another decade to educate the general 
public sufficiently in regard to their danger so as to demand the enforcement 
of laws intended to prevent the breeding of flies in the city. 

The numerous privy vaults in the city were another matter that received 
closer attention when the role of flies as carriers of disease had been demon- 
strated. 

.\ census and canvass in 1907 showed that there were 66,(K)0 horses 
and 14,047 privy vaults in the city. 

In 1902 a comprehensive tenement house ordinance was passed, modeled 
after the New York law. At the beginning of this period women were added 
to the corps of sanitary inspectors, with the idea that they might be more 
alert in detecting and remedying insanitary conditions found in the inspec- 
tions of homes and premises. 

An ordinance prohibiting spitting in public places was passed in I'Wl. 
Smoke inspection, which had been under the jurisdiction of the health 
department since 1881, was transferred to the newly created department of 
boiler inspection in 1903. 

Food .\nd Milk Instection. 

The division of milk inspection, which had been organized as a separate 
department, was brought under the jurisdiction of the health department in 
1893, and operated in connection with the laboratory, which was established 
at the same time. Milk samples were now taken more or less regularly. 

A study of the milk supply of the city, made by the I'niversity of Illinois 
Agricultural Experiment Station in 1899, showed that much of the supply 
was of inferior grade. 



ciiuAco 353 

111 I'-'OO the health ileiiartmeiit lalioratory detected formaldehyde in 
293 samples, and a campaign was started to stop its use as a milk pre- 
servative. 

Dairv inspection was inaugurated in 1902. At first the Chicago Civic 
Federation paid the salaries and exi'enses of two dairy inspectors. More 
attention was alsn paid to city milk inspection. In 1904 the country dairy 
inspection was taken o\er 1)\ the health department. This work as first 
was large!)- educational and was princii)all\- CDUcerned with the feeding of 
wet malt, which was f(jund in about 20 jier cent of the farms inspected. 
An ordinance was passed re(|uiring milk cans to he sealed in transit. 

An independent examination of the milk supply, made by P. G. Heine- 
mann in 1904 for the Civic Federation, showed that 26.8 per cent of the 
samples were below grade in butter fat, 30.9 per cent in solids not fat, also 
that 15 per cent of the restaurant samples contained formalin. The average 
bacterial count of samples taken on May IS of that year was 942,000 per 
cubic centimeter. 

In 1905 the making of sanitary inspections of milk depots in the cit\' 
was inaugurated, also bacteriologic examination of samples. A total of 
5,838 samples were thus examined and most of the samples showed over 
500,000 bacteria per cubic centimeter, and some ran as high as 10,000,000. 
In the following year bacteriologic examinations were first made of milk 
samples collected on dairy farms, but only thirty samples were examined. 

The bureau of food inspection was established by an ordinance in 
1905, but the work of the bureau was performed at first under the super- 
vision of the director of the laboratory. The same year Commissioner 
Whalen concentrated on meat inspection at the Stock Yards, and gave 
much attention to the inspection of canned goods and of foods in cold storage. 

The Jungle, by Upton Sinclair, published in February, 1906, portraying 
the picture of a workman emplnxed at the Stock Yards, was embellished 
with incidents relative to insanitar\ cimditions of the slaughter houses and 
the laxity nf meat inspectinn which were so revolting that they received 
!.;eneral public consideration and ullimatelx lirnught about a federal inves- 
tigatinn. 

The report of this investigation, the so-called McNeil-Reynolds report, 
showed that the conditions depicted in The Jungle, although written as 
fiction, were indicative of the insanitary conditions and inadequacy of the 
meat inspection service of many of the slaughter houses investigated. The 
revelation of these facts and the iniblic attention they received caused Con- 
gress to pass a comprehensive meat inspection law, eiifective in 1906, regu- 
lating the .sanitary condition of plants and requiring the inspection and ap- 
proval of all meats and meat products pre|)arc(l in establishments shipping 
products via interstate commerce. 



354 CHICAGO 

In 19CKj the city council passed ;ui (in.linance proxiding for the licensing 
and control of restaurants. 

The ice suppl\' received attention in 18%. It was found that ice 
obtained from clayholes, the Chicago and Calumet Rivers, was unfit for 
domestic use. To prevent the sale of this ice for such purposes an ordinance 
was passed licensing ice dealers and regulating the production and sale of 
ice. Following this the department carried on a systematic inspection of the 
ice supply, sending inspectors to the sources of production each winter to 
make inspections and take samples. 

Publicity and Education. 

Publicity and education in public health work was given an impetus 
by the acceptance of the bacteriologic origin of disease. It was soon evident 
that in order to prevent effectively the spread of infection it was necessary 
that the public should be familiar with the simple facts in regard to the origin 
and spread of contagious diseases. Consequently, much attention was given 
to educational propaganda during this period. 

In 1894 the Monthly Statement of Mortality, published b\- the depart- 
ment, first contained notes by Commissioner Reynolds on health conditions in 
the city. Following the appointment in 1894 of Dr. Frank W. Reilly, a 
trained sanitarian with newspaper experience, there came from the depart- 
ment a series of circulars and bulletins, which were dignified by literary style 
and a conservative and accurate statement of the facts in simple language. 
The first of these publications was The Vaccination Creed and the cir- 
cular on the Hot Weather Care of Babies, issued in 1894, already referred 
to. These were followed the next year by circulars on the Prevention of 
Smallpox, The Anti-to.vin Treatment of Diphtheria and Advice to the Family 
in the Care of Contagious Disease. 

In the appointment of E. R. Pritchard as secretary in 1899, another 
newspaper man was added to the staff of the department. In 1901 the 
department started publishing the State of the 
City's Health every week in the newspapers, and 
discontinued the publication of the Monthly 
Statement of Mortality. 

The following year the State of Chicago's 
Health was published as a weekly bulletin. For 
the first time Fourth of .Inly Dont's were pro- 
mulgated by the department. 

In 1906 the Bulletin of the Department of 
Health was first issued as a weekly publication, 
and mailed to physicians and others interested in 
E. R. Pritchard public health work in the city. 




CHICAGO 355 

The Chicago health department was awarded a gold medal at the Paris 
Exposition in 1900 for an exhibit showing methods of work and results 
accomplished. The following year it received a medal at the Pan-American 
Exposition in Buffalo. At the Louisiana Purchase Exposition in St. Louis in 

1904 the department was given the highest award for the best and most com- 
prehensive display of public health methods. 

Quasi-Public Agencies. 

During this period the advances in preventive medicine came so fast, one 
after another, and the opportunities of the application became so numerous 
that it was impossible for the constituted authorities, with the funds avail- 
able, to do all the things that should be done to improve the public health. 

Although the population of the city increased from 1,253,022 in 1893 to 
2,047,690 in 1907, or in other words, nearly doubled in numbers and the 
area was increased nearly four-fold, the 1889 annexation alone adding 133 
square miles of territory to the 43.9 square miles which constituted the city's 
area prior to this annexation, the appropriation and personnel of the health 
department were not increased proportionate!}'. 

At the end of 1892 tlie health department report listed 101 emploves; bv 

1905 this number had been increased to only 160. Correspondingly, the 
expenditures, exclusive of scavenger service, increased from only $120,- 
596.87 in 1893 to $243,209.76 in 1905. 

It is for these reasons that this period is characterized by the organiza- 
tion of many societies interested in promoting certain fields of public health 
or social welfare endeavor, and in numerous instances, actuallv engaging in 
this line of work at the expense of private philanthropy. 

Among these institutions was Hull House, established in 1889. This 
was followed by the Chicago Lying-in Hospital and Dispensary in 1895, the 
Chicago Association of Day Nurseries, in 1897, the City Club in 1903, and 
the Juvenile Protective League, in 1904. The Chicago Visiting Nurse 
Association, founded in 1888, rendered valuable service during this period, 
especially during the smallpox epidemic in 1893 to 1895. 

In 1903 the city milk committee was organized for the distribution of 
modified and pasteurized milk, also the tuberculosis committee of the Visiting 
Nurse Association. In 1906 this was organized as the Tuberculosis Insti- 
tute. This group held a tuberculosis exhibit at the public library in 1905, 
which gave a great impetus to anti-tuberculosis work in the city. 

In 1904 Dr. T. B. Sachs published a report on the pervalence of tuber- 
culosis in the West Side Jewish district, which attracted considerable atten- 
tion. The next year the City Homes Association presented the results of its 
studv of tuberculosis in the citv. 



356 CHICAGO 

The Cliica,i;i;) Sucicty of Social Hygiene was organized in 1906. The 
Chicago Pediatric Society assisted in carrying on infant welfare work in 
the siunmers of 1905 and 1906. One feature of this work was the con- 
duct of improvised infant welfare stations in tents, erected in the poorer 
sections of the city, where pediatricians selected by the society gave advice 
to mothers on the care of babies during the hot weather. 

Period of Systematic Control 

Starting with the year 1907, the efforts of the health department have 
been directed towards the systematic control of the various preventable 
diseases. Likewise, the other activities of the department, such as the 
control of the milk supply, meat and food inspection, ventilation inspec- 
tion, and control of the purity of the water supply, have been undertaken 
on a comprehensive scale, in accordance with well understood principles 
intended to accom[)lisli the object in view, namely, the conservation of the 
I)ublic health. 

It is on account of these facts that this has been designated as the 
Period of Systematic Control. 

The commissioners of health who served successively during this time 
were Doctors William A Evans, four years ; George B. Young, four )ears ; 
John Dill Robertson, seven years ; Herman N. Bundesen, five years and 
from December, 1927, to date, Arnold H. Kegel. The term of the com- 
missioner was lengthened to four years in 1907, which gave the incum- 
bents a more nearly sufficient time to put into effect their policies. The 
salary of the commissioner was raised to ?8.00(» in 1907 and to $10,000 
in 1914. 

CoMMl'NirABLE DISEASE CoNTRGL. 

In 1907 the department for the first time had an adequate appropria- 
tion to carry on its activities. This amounted to $848,966 and represented 
an increase of nearly 200 per cent over the $288,733 available in 1905. This 
appropriation had been obtained by Commissioner Whalen, in part for 
increased activities in meat, milk and miscellaneous food inspection, and 
at the end of his term, for medical inspection of schools, quarantine service, 
and other activities in connection with the outbreak of scarlet fever, which 
occurred at that time. 

The communicable disease situ;ition th;it presented itself to Commis- 
sioner Evans at the beginning of his term in 1''07 was approximately 
as follows: There had been no substantial reduction in the death rates 
from tuberculosis and the acute respirator}- diseases. In fact, in recent 
\cars these diseases had shown a tendency to increase. The tuberculosis 



CHICAGO 357 

(all forms) death rate had reached 197.2 per 100,000 in 1907, which rep- 
resented the highest annual death rate from this disease since 1893. The 
deaths from the acute respiratory diseases stood at 282.1 per ltX),000, 
which was higher than the average annual death rate for the preceding 
three decades. 

All the other infectious diseases had been reduced in the preceding 
14 years, lint all were still far too prexalent. The typhoid death rate 
had (h'opped to 18.2 per 100.000 and even diphtheria, in the reduction of 
which such marvelous results had been obtained in the preceding decade, 
showed a death rate of 27.1 per 100,000 at the beginning of this period. 

The infant mortality, greatly decreased in the '90's, had shown a tend- 
enc\' to increase since 1901. It reached the figure of 3.2 per 1000 popu- 
lation in 1907. Births were only partially registered and consequently the 
onl\- fair wav of calculating the death rates of infants was in relation 
to the whole population. 

From the foregoing data, it is plain that the great problems confront- 
ing the health department at the beginning of this period were the con- 
trol of tuberculosis and the acute respiratory diseases and the reduction 
of infant mortality. 

Tuberculosis. 

Conditions were favorable from the outset for active measure to lower 
the tuberculosis mortality. The pulilic had been awakened to the gravity 
of the situation. A tuberculosis exhibit had been held at the public library 
in 1905. The Chicago Tuberculosis Institute had been organized in 1906, 
and in the following year opened seven dispensaries for the diagnosis and 
treatment of cases. 

The health department took immediate steps to enforce the reporting 
of cases. A definite pronouncement was made in 1908, adding tuberculosis 
and pneumonia to the list of reportable diseases. All cases of tuberculosis 
reported were entered on the records of a house hie. which was started 
in 1909 and continued by the health department until about 1920. 

Active anti-spitting crusades were conducted in the campaign against 
tuberculosis. After a trial at arresting and fining violators. Commissioner 
Evans in 1909 resorted to the use of a warning card as illustrated on page 
369 of Volume I. These cards, bearing a picture of a crusader with a 
red cross on the shield, were carried by all employes of the department, 
and politely handed to anyone seen spitting on the sidewalk or in public 
places or conveyances. 

After repeated efforts of the State Board of Health to pass a law 
providing for the establishment of a State tuberculosis sanitarium had 
resulted in failure the Glackin law. providing for the establishment of 



358 CHICAGO 

tiilicrculosis sanitariums by immicipalilies, passed the Legislature in 1908. 
The following year the city, by a referendum vote, decided to establish 
,'i sanitarium under the provisions of this act. The vote taken was 167,- 
230 for and only 39,410 against the proposition. Thereupon Mayor Busse 
appointed Harlow N. Higginbotham, Dr. Theodore B. Sachs and Dr. Wil- 
liam A. Evans as the first board of directors under the provisions of this 
act. This board elected Mr. Higginbotham president, and Dr. Sachs secre- 
tary, and proceeded at once to secure grounds, and to build a sanitarium, 
all to be paid for out of the succeeding annual tax levies of one mill on a 
dollar of the assessed valuation. This gave the board approximately a 
million dollars annually. 

In 1910 the board took over the operation of the seven tuberculosis dis- 
pensaries maintained by the Chicago Tuberculosis Institute. A nursing 
service was conducted in connection with the dispensaries, which served 
to supervise and care for persons infected with the disease. As far as 
possible restrictive measures were enforced in open cases in the home 
or industry. 

The sanitarium, located at Bryn Alawr and Crawford avenues, was 
completed and opened on March 9, 1915. This provided 380 beds for the 
isolation and treatment of early cases of tuberculosis, which were increased 
to 1,000 the following year. Thereafter only late cases were cared for at 
Cook County Hospital, and after December 1, 1910, also at the County 
Tuberculosis Sanitarium at Oak Forest. In this connection it should be 
noted that after the passage of the registration law in 1915, tuberculosis 
deaths at the Oak Forest institution were no longer included in the Chi- 
cago count. 

In 1916 a house-to-house survey was made by the Municipal Tubercu- 
losis Sanitarium in the district between Twenty-second Street and North 
Avenue, extending from the Lake to Ashland Avenue, comprising a total 
of approximately eight square miles. In 1917 this sui'vey was extended 
to embrace the territory south to Fifty-Fifth Street between Wentworth 
Avenue and the Lake. This territory had a total population of 371,259. 

A total of 165,700 persons in this area were examined and 8.6 per cent 
were found afflicted with tuberculosis. One result of this entire survey 
was that 14,282 unregistered cases of tuberculosis were found and brought 
under observation. 

In 1917 all physicians in the Municipal Tuberculosis Sanitarium dis- 
pensaries were placed on a full-time basis. A quarantine system was 
instituted and no open cases of tuberculosis were allowed to remain in 
contact with children in the home. Where cooperation on the part of such 
patients could not be obtained the premises were quarantined or the cases 
were hospitalized. 



CHICAGO 359 

As a result of the systematized efforts and others, to be referred to 
later, such as the pasteurization of the milk suppl.v and the attention to the 
health of children in the schools, the tuberculosis death rate was lowered 
from \ ear to \ear and reached a minimum of 78.3 per 100,000 in 1922, 
since which time it has sliown a sli,<,'ht tendency to increase. 

Acute Respiratory Diseases. 

The fight against the acute respiratory diseases, although also actively 
started in 1507. has not shown such good results as the campaign for the 
suppression of tuberculosis, largely owing to the fact that many of the 
factors in the transmission and the snsceptibilit\- to these diseases are still 
wrapped in obscurity. 

After pneumonia was added to the list of reportable diseases in 1907, 
the reporting of cases was by no means complete at once, and it was not 
until 1914 that the number of cases of pneumonia reported exceeded the 
number of deaths recorded from this disease. 

Much effort was expended in directing public attention to the neces- 
sit}' for adequate ventilation and ordinances were passed in 1910 requir- 
ing proper ventilation for places of public assembly, public conveyances, 
factories and workshops. Much attention was also given to the ventila- 
tion of theatres and street cars, with the result that the ventilation of these, 
even as early at 1917. was better in Chicago than in any other cit\' in the 
countrv. It was in this )ear that all street cars were equipped with proper 
ventilation appliances. 

During this time the acute respiratory disease rate began to drop, but 
in the spring of 1917 a sharp rise occurred and the death rate frc:m these 
diseases reached a total of 214.6 per 100,000 during the \ear. 

In November, 1917, the laboratory started typing pneumococci. In 
December the same \ear it was first required that cases of pneumonia be 
placarded. This action was taken none too soon, for in the following 
year, when Chicago was reached by the pandemic of influenza which encir- 
cled the globe, the death rate from the acute resjiiratory diseases jumped 
to 552.1 per 100,000. 

This pandemic of influenza reached Chicago .September 21, 1918, 
attained its maximum on the following October 17, on which day 381 
deaths from pneumonia and influenza occurred in the city. Following this 
it declined until the death rate frcmi ,ill causes fell to normal again during 
the week ending November 23. The t"tal number of deaths from influenza 
and pneumonia during the outbreak was 8,510. The total excess death 
rate during the 25 weeks following September 8, l')17. was 3.8 per 100.000, 
which was the second lowest increase in mortality recorded for any city 
in the United States with a population of 500,000 and over. 



360 CHICAGO 

\'if,r(ir()us measures were taken to combat this e])i(lemic. Inliuenza 
was made reportable on September U). I'ulilic funerals were prohibited 
on October 12. Smoking on street and elcvaicd railroad cars was pro- 
bibitcd un October 13. This order was not rescinded after the epidemic, 
with the result that smoking, together with the accompanying spitting nuis- 
ance on these cars, has been abolished in Chicago since that date. 

Theatres, skating rinks, night schools, and lodge halls were closed on 
Octol)er 15 and kept closed for 1.5 days. 

.\ nii.xed vaccine was prepared under the auspices of a laboratory com- 
mittee appointed to handle this phase of preventi\e work, and a total of 
313,028 do.ses were issued up to January 1, I'MO. 

.\ distinct recurrence of the influenza occurred from January- to March 
the following year, but Chicago was not as hard hit during this epidemic 
as some of the other communities. The death rate from the acute respira- 
tory diseases in 1910 reached 2(X).() per 100,000 population and 231.5 in the 
following }ear. 

-\. i^neumonia commission was appointed in the fall of 1''24, to study 
the prevalence of the acute respiratory diseases and recommend measures for 
their control. After a survey and detailed investigation of all the cases 
resported during a season and a review, reclassification and stud\' by Dr. 
William H. h'vans. of the reports of deaths from pneumonia during the 
same period, the commission made its recommendations which were em- 
bodied in a set of rules and regulations governing the handling of pneu- 
monia cases, issued b\' the .State Department of Public Health in Decem- 
ber, 1925. 

Ty/^lwid. 

\ mar!;ed reduction in the typhoid death rate was accomiilished during 
this periotl. The steps taken to bring this about were the pasteurization 
of the milk supply, which was first required by an ordinance passed July 
13, 1908, on the recommendation of Dr. William A. Evans, and the chlorina- 
tion of the water sui)i)l\-, started March 15, 1912, by Dr. George B. Young, 
and applied to the entire water supply of the city by Dr. John Dill Robert- 
son on October 6, 1916. On July 22 of the same year, during an outbreak 
of infantile paralysis, it was definitel}' required by Dr. John Dill Robertson 
that all milk and cream, except certified, be pasteurized at a temperature of 
145 degrees I'ahrenheit for 30 minutes. This executive order has not been 
rescinded to date, and as a result, no niilk-borne outbreak of txphoid fever 
has occurred in the city since that time. 

Previous to the a|)plication of these measures, local milk-borne epidemics 
of t\phoid h.ad been noted almost annually since the systematic inspection of 
t\i)hoid cases had been inaugin'ated in l'H).S. 



Typhoid Fever. 

Deaths Per 100,000 Population 

AviRACE Di-ATii Rates For Stated Decades. 



1667-76 I 
1877-86 I 
1887-96 I 
1697-06 I 



1907-16 


^ 10 7 








YEARS 


DEATH RATES BY YEARS 






50 lOO I50 


1667 
1666 
1869 
I670 
1671 
1672 
1873 
IS7-4 
1 875 
1676 
1677 
1878 
1679 
I860 
1881 




— 






1 882 
1683 
1864 
1665 
1886 
IS87 
I6S8 
1869 
1690 
169 1 
1692 
1693 
1694 
189 5 
1896 
1697 
IS96 
1699 




h- 















I900 










I90I 
I902 










1903 
I904 










I905 










1 906 










I907 










I908 


^^B 








I909 


^^m 








I9IO 


^BB 








1911 


■MB 








1 912 


^ 








1 913 


^m 








1 914 


■M 








1915 


B 








1916 


B 








1917 


1 1 <b 








1918 


1 14 








19 13 


1 1 2 








1920 


LI 








1921 


1.1 








1922 


1.1 








1923 


I 1 9 








1924 


1 IS 








1925 


1 1 5 









362 CHICAGO 

In this cniinecticin it is interestinsj' to note that the Annual Reports of 
the Health Department, prior to 1''07. record but one local outbreak of 
t_\phoid due to milk and that is the one reported by Commissioner Whalen 
in 1906. I'rom the history of typhoid as it is now known, it is safe to pre- 
sume that such outbreaks occurred frequentlx' but were ntjt recognized, 
because they occurred in the midst of a heavy tvphoid incidence due to 
polluted water or infected shell-fish, and were not separated from the sum 
total of cases that occurred. 

On January 26, 1916, an outbreak of typhoid fever occurred in the 
district supplied by the Sixty-eighth Street water pumping station. The water 
at this station became polluted by sewage getting into the pumping wells 
as a result of flooding of the basement of the pumping station during a 
general flooding of the territory drained by the South Side intercepting 
sewer system. A total of 105 cases developed, of which number eight died. 

More and more attention was paid to carriers to avoid contact infection. 
Persons afflicted with typhoid were ho-spitalized as far as practicable. Nurses 
were detailed to make periodic visits to cases isolated in the home. 

The effect of all these efforts was reflected in the lowering of the typhoid 
death rate from year to year. In 1917 it dropped to 1.7 per 100,000. This 
established a record for Chicago of a typhoid death rate lower than that of 
any city in the United States with a population of 100.000 or over. The fol- 
lowing year the rate was reduced to 1.4 and again Chicago held the record 
of the lowest rate in cities of the 100,000 population class and over. 

In 1922 the record was established for Chicago of having had the lowest 
typhoid death rate of any city in the country with a population of 500,000 
or over for six consecutive years. The rate this year and the preceding 
three years was 1.1 per 100,000. 

From October 13, 1923, to January 25, 1924, an outbreak of t\phoid 
occurred in the territory supplied from the Hyde Park Crib. A total of 
288 cases were reported, with 23 deaths. 

The waters along the South Shore had been, and at the time of the 
outbreak were, found contaminated with sewage from the Calumet River 
and the Thirty-ninth Street sewage pumping station, wdiich followed heavy 
rainfalls on October 17 and 18. 

The State Department of Public Health detailed Chief Sanitary Engi- 
neer Harry F. Ferguson to make an investigation. Based upon the results 
of his findings, it was concluded that the lake water carried more than 
average pollution at the critical period of reversal of flow of the Calumet 
River and the outflow of some sewage from the Thirty-ninth Street pump- 
ing station, and that the chlorine and analytical control was not adequate 
and sufficientl\' responsive to changing conditions in the lake water to 
assure<lly provide for a safe water as punipeil into the distribution system. 



CHICAGO 363 

The State Department thereupon made recommendations for the better sani- 
tary control of the public water supply of the city and urged the emplo\- 
ment of a sanitary engineer to supervise this work. 

On November 30, 1924, another outbreak of typhoid occurred and lasted 
until the following January 21. A total of 129 cases with 16 deaths occurred. 
The cases were reported mostly in the better residential districts of the city. 
A careful study of the cases, made by the health department, and later 
reviewed by Dr. L. L. Lumsden of the United States Public Health Service, 
showed the infection to be due to shell oxsters shipped from the Great 
South Bay region in Long Island, New York. 

After these outbreaks, the usual low t_\phoid record was again main- 
tained. 

Diphtheria. 

It was in the suppression of diphtheria, even more than in the control 
of typhoid and tuberculosis, that a full understanding of the disease made 
it possible to institute an almost perfect system of control. With the dis- 
covery by Von Behring of a method of active immunization against this dis- 
ease, and the perfection of a method by Schick for determining immunity 
against the infection, health officers were supplied with all the weapons 
necessary to control diphtheria effectively. 

How successfully these measures were used is shown by the course o'f 
the death rate from this disease during this period. From 1907 until 1917 
the rate remained practically stationary and averaged 33.3 per 100,000 
population. 

Early in this period it was first required that cases should be terminated 
only if these showed two negative cultures, and after 1908, that cultures 
from persons in contact with cases should be similarly negative. After 
1909 it was also required that such person should receive an immunizing 
dose of antitoxin. 

Police stations were made distributing depots for culture media and 
antitoxin in 1908, and were also designated as receiving stations for cultures 
for transmission to the health department laboratory. In order to make 
antitoxin generally available in the handling of diphtheria, the State Board 
of Health in 1909 established 28 free distributing stations in Chicago. 

At the same time the old smallpox hospital was converted into a munici- 
pal hospital for the reception and care of diphtheria cases. 

In 1917 diphtheria became very prevalent, especially in October and 
November. A total of 10,290 cases and 1,216 deaths from the disease 
occurred during the year, representing a mortality rate of 47.8 per 100.000 
population. 



364 CHICAGO 

Acli\f imnmnization a.yainst (li]>htlici'ia with toxin-anliloxin mixture 
was inaugurated in the |)uhhc schuuls, and in institutions carint; for infants 
and children. 

Since that time greater efforts were made from year to year to apply 
this method of immunization to all susceptible infants and children. In 1921 
such immunizations were offered at infant welfare stations in addition to 
ihe work carried on in the schools, with the result that within recent years 
an average of 40,000 injections of toxin-antitoxin have been given annually. 

In immunization with tuxin-antitoxin, an effective weapon has been 
found to wipe out this disease liut its apjilication is as yet far I'mm uni- 
versal. 

The death rate from diphtheria dropped from an average annual rate 
of 33.5 per 100,000 population to 7.3 per 100,000 in 1926, the lowest in the 
histtiry of the city. 

In 1927, diphtheria again became much more prevalent and more fatal. 
The death rate rose to 14.1 per 100,000, and the fatality rate among reported 
cases was 10.6 per cent, as compared with an average of 7.4 per cent in the 
preceding three years. 

Scarlet Fcirr. 

Scarlet fever remained fairly prevalent after the milk-borne outbreak 
in 1907 up to 1913. During that year a death rate of 38.5 per 100,000 
population was recorded. ( )nly once since then has mortality from this 
disease approached such a rate. That was during 1917, when a total of 
13,444 cases were reported with an annual death rate of 24.4 per 100,000 
population w'as recorded. 

Since that time the disease has not been very prevalent and the death 
rate from it has been \'ery low, especially in the years 1923 to 1927, inclu- 
si\e, during which the death rate reached the phenomenally low average 
figure of 2.8 per 100,(KX) population. 

SiiHiHpn.v. 

Xo epidemic of smallpox occurred during this period. -\ new sniallixix 
hospital was finished in 1908, -with a bed capacity of 40 but only on a few 
occasions has the hospital been filled with patients. 

The law requiring the compulsory vaccination of school children was 
held unconstitutional bv the Illinois supreme court in I'KJS, and following 
that the department was able to enf<.)rce vaccination only in the ])resence 
of an epidemic. 

The ruling of the court was gi\en rather broafl interpretation by the 
department until 1922, when in a case against the school Ixiard, which was 
appealed to the supreme coin't, the court held against the board. 



CHICAGO 365 

No deaths occurred from smallpox in the years 1908, 1909, 1915, 
1910 and 191'). 

The highest incidence of smallpox was in 1917 and 1918 when 296 
and 266 cases occurred annuallw 

Misccllaiicuiis Infectious Diseases. 

An extensive milk-borne outbreak of streptococcus sore throat occurred 
in December, 1911. and lasted until the following February, An investiga- 
tion showed that the milk responsible for the epidemic was improperly pas- 
teurized on a number of days. It was estimated that approximately 10,000 
cases, due to milk infection, occurred in the cit\' during the two months. 

An outbreak of infantile paralysis started on July 14, 1916. six weeks 
after an extensive epidemic in New York City. It lasted until November 
10, and resulted in a total of 254 cases with 34 deaths from the disease. A 
system of train inspection was inaugurated immediately after the disease 
occurred in New York. All cases were hospitalized, and children that had 
been in contact with cases were kept under observation. 

.\nother outbreak of infantile paralysis occurred in 1917, beginning 
Jul\- 1 and lasting until December 1 of that year. A total of 527 cases 
with 177 deaths were reported during this outbreak. 

Moderate outbreaks of infantile paralysis and meningitis occurred in 
1927, when a total of 148 cases and 29 deaths from the former, and 193 
cases with 92 deaths from the latter disease, were reported. 

Tetanus, which had occurred rather extensively after each old-fash- 
ioned Fourth-of-July celebration, was greatly eliminated as a cause of death 
in the annual bills of mortality by the passage of the "Sane Fourth Ordi- 
nance" in 1911, prohibiting the sale of fireworks. 

Beginning in March, 1919, cases of encephalitis lethargica began to 
occur as is usual after an epidemic of influenza. A total of h9 such cases 
with 25 deaths were reported during that year. 

Malaria contracted locally disappeared entirely from the mortality 
tables during the latter part of this period. 

General Measures. 

In addition to the s|iecific procedures instituted to control the various 
communicable diseases, certain general measures were inaugurated during 
this period which are worthy of mention. 

The first of these was taken in 1907, when the rules allowing physi- 
cians to assume responsibility for cjuarantining cases of contagious dis- 
eases were rescinded and the corps of disinfectors were detailed as cjuaran- 
tine officers to watch cases isolated in the homes. 



366 CHICAGO 

At the same time the policy of hospitalizing cases as far as practicable 
was adopted. At first, in addition to the old smallpox hospital made avail- 
alilc f(ir diphtheria cases, already referred to, the Count_v Hospital and the 
Durand Hospital, established in 1909, were used for the hospitalization of 
scarlet fever and other contagious cases. Typhoid cases were cared for 
in private hospitals or in Cook Count\' Hospital. 

On Januar\- 8, l''I7. the new Municipal Contagious Disease Hospital 
was opened at California lioulevard and Thirty-first street. The adminis- 
tration building and one ward building were completed at that time. Sep- 
arate cubicles enclosed with glass, and so arranged that visitors can see 
the patients from the visitors' aisle, were provided for all the patients in this 
hospital, and proved successful in popularizing the hospitalization of children, 
to which parents were so prone to object, especially when they were not 
allowed to visit their children while in the hospital. 

In 1921 another wing was added to this hospital, which gave a total 
bed capacity of 400. One ward, or approximately 60 beds, was set aside 
for the isolation of women infected with venereal disease, and the rest of 
the hospital was used principally for diphtheria and scarlet fever cases. 

In I'H.i a classified system of tjuarantine worked out b_\' Dr. Isaac D. 
Rawlings, head of the division of contagious diseases, was adopted for cases 
of diphtheria, scarlet fever and whooping cough, which modified the quaran- 
tine of the cases with a trained attendant, so as to place fewer restrictions 
on the other members of the family. This was kept in effect until 1915, 
when the health department rules on quarantine were superseded by those 
issued by the State Board of Health. These have been followed ever since 
and in a way have served to absolve the health commissioner from making 
any changes and concessions in the isolation of cases or maintenance of 
quarantine. 

In July, 1924, terminal gaseous disinfection was abolished and rules 
were promulgated requiring concurrent disinfection during isolation, and 
cleansing of the rooms after the termination of a case of communicable 
disease. 

In August, 1924, the department adopted a series of normals or expect- 
ancies for comparison with the number of cases of a given communicable 
disease reported each week in order to watch and pre-judge the trend of 
the disease. These were adopted after a thorough study by A. W. Hedrick 
of the long-time trends, seasonal cycles, epidemic occurrences and irregular 
movements of the principal communicable diseases occurring in Chicago. 

By this comparison, the ratio of reported cases to the normal or expected 
number, termed the epidemic index, is used as the basis of indicating the 
trend of any disease during a given period and serves as a standard in fore- 
casting epidemics. 



367 



Venereal Disease Control. 



The control of venereal diseases was a new activity, imdertaken by the 
health department during this period. The vice commission appointed by 
Mayor Busse in 1910 made certain recommendations in regard to it. 

Commissioner Evans was a member of this commission and helped to 
draft these recommendations, and this doubtless prompted him to start 
certain measures of venereal disease control by the health department at 
that time. 

In the same year advice in regard to the prevention of venereal disease 
was first published in the bulletin of the health department and pamphlets 
on the subject, published by the Chicago Society of Social Hygiene, were 
distributed in the lodging houses. An ordinance was passed requiring dis- 
pensaries to report cases of venereal disease. 

A few premises were placarded and quarantined in 1910 where cases 
were reported in houses of prostitution. Infected prostitutes convicted and 
sentenced to the Bridewell were held until cured. 

A municipal venereal disease clinic conducted by a volunteer staff was 
opened and maintained for about six months at the Iroquois Memorial 
Hospital. 

In 1911 the segregated vice district was abolished by State's Attorney 
John E. Wayman, following which efforts to control venereal disease lagged. 
Attempts made by Commissioner Young to have an ordinance passed by 
the city coimcil requiring the reporting of venereal disease remained unsuc- 
cessful. The laboratory began making Wassermann tests in 1911. 

In the meantime nothing further was accomplished until Commissioner 
Robertson, on June 29, 1917, had an ordinance passed much more compre- 
hensive in its scope than was formerly attempted. This ordinance was 
modeled after the South Australian law and required the reporting of cases 
without giving the name of the patient, required the patient to remain under 
treatment and provided that in cases where the patient failed to continue 
the treatment until cured his name and address should be reported to the 
health department. 

This ordinance served as a basis for man\- of the laws that were 
adopted subsequently during the ^^''orld ^^'ar by numerous states and cities 
of the country. 

A municipal venereal disease clinic was opened at the Iroquois Mem- 
orial Hospital in 1918. Prostitutes arrested by the police were examined 
for venereal disease, and if found infected, were hospitalized until free 
from infection. At first the old smallpox hospital, which had been used for 
diphtheria cases and had been vacated upon the opening of the new Con- 
tagious Disease Hospital, was used for this purpose and renamed the Lawn- 



368 CHICAGO 

dale Hospital. This hospital remained in use until 1920, when the patients 
were transferred to a ward of the new Contagious Disease Hospital. 

A tutal of 7,2.^r< cases of venereal disease were reported durint; the 
first _\ear that the ordinance was in effect. Within recent xears this num- 
ber reached approximately 25,000 annually, and is interpreted by the health 
department as indicating not that venereal disease is on the increase but that 
better reporting of cases has been attained. 

The control of venereal disease was systematized in 1922 when the 
State Department of Public Health promulgated rules and regulations apply- 
ing to this work. These were drafted in cooperation with an advisory com- 
mittee of the Chicago department of health. At the same time the State 
Department adopted standards of infectivity and approved methods of diag- 
nosis for the handling of venereal disease cases. 

In 1923 the four neighborhood venereal disease clinics were consoli- 
dated into a central clinic located at the Iroquois Memorial Hospital. Clinics 
for the diagnosis and treatment of venereal diseases were also established 
at the Cook County Jail and the House of Correction. 

A special edition of the bulletin prepared by Commissioner Bundesen 
dealing with prevention of venereal disease was distributed to 500,000 homes 
in the city during Decemlier. 1924. 

Child Hygiene. 

iluch consideration was given to conserving the lives of infants and 
children during this period. 

One hundred physicians were assigned to the congested districts in 
July and August, 1908, to instruct mothers in the care of babies. The 
following two summers the work was carried on by a corps of nurses mak- 
ing house-to-house visits under the direction of ]")r. Caroline Hedger. The 
campaign was conducted in cooperation with the United Charities and 
\'isiting Nurse Association. 

The Infant Welfare Society was organized in 1910 as a successor to 
the Chicago Alilk Commission and opened its first infant welfare station in 
December of this year. In May, 1911, a child welfare exhibit and confer- 
ence was held at the Coliseum under the auspices of the Infant Welfare 
Society, United Charities and Msiting Xurse Association. This helped a 
great deal to stimulate interest in infant welfare work. 

In 1913 foiu- infant welfare stations were established In the health 
department and in the following year a division of child h_\giene was created. 

Tlie lack of complete birth records was a great obstacle in carrying on 
infant welfare work during the early part of this period. In 1908 the health 
department ceased entirely to enforce liirth registration on account of inade- 



CHICAGO 369 

quate laws and the divided authority between the city and county. Follow- 
ing this the county clerk received the small number of birth reports pre- 
sented for registration. 

Dr. C. St. Clair Drake of the Chicago department of health was ap- 
pointed secretary of the State Board of Health in April, 1914, and proceeded 
at once to secinx a State registration law for births and deaths. At the fol- 
lowing session of the legislature the passage of such a law was secured and 
on January 1, 1916, when it went into effect, the health department again 
resumed the function of registering births. 

Efforts were made at once to enforce this law, with the result that 
47,760 births were registered during the year, which constituted appro.xi- 
matel}' 85 per cent of the number estimated as occurring in the city. 

A hearing board was appointed in July, 1920, to hear the cases of 
physicians and midvvives who had failed to report births. Since then much 
attention has been given to compelling the reporting of births with the 
result that during the last few years over 99 per cent of all births were 
reported. 

A fund of $50,000 was appropriated l)y the city council in 1922 for addi- 
tional infant welfare work. This was used in part for the establishment 
and maintenance of 18 infant welfare and five prenatal care stations. In 
1923 the total number of stations in the city was increased to 48, of which 
number 27 are operated by the Infant Welfare Society. 

Conferences for the attention to children of pre-school age were estab- 
lished at nine infant welfare stations during 1925. The practice of mailing 
a handsome certificate of registration to the parents of all children whose 
births were reported was begun in ]\larch, 1924. 

.V profusely illustrated baby booklet was prepared and subset|uent to 
October, 1925, a copy was delivered by the health department nurses to all 
mothers upon the report of a birth. This was followed by circulars of 
instruction mailed to the mother every month until the baby reached the 
age of one year. 

In November, 1925, the department began to enforce vigorously the 
provisions of the State registration law requiring births to be reported within 
10 days. This was found essential in carrying out the program of breast 
feeding, which had been started during the year. An illustrated booklet 
on the prenatal care of mothers has been distributed since 1926. 

The efforts to prevent infant mortality have proved highly successful. 
The rate declined steadily during this period reaching 62.7 in 1926 per 1,000 
births reported. The reduction of the diarrheal diseases in children under 
two years of age was even more pronounced. The death rate from these 
diseases was approximately only 20 per 100.000 population during the last 
three years as compared with 119.7 at the Ijeginning of this period. 



370 CHICAGO 

Since l'H6 the acute respiratory (lise.ises of infants showed a tendency 
to increase and since 1921 have caused more deatlis at this age period than 
the diarrheal diseases. 

School Inspection. 

School inspection was also systematized and greatly extended. The lOU 
school medical inspectors, left on the payroll after the scarlet fever outbreak 
in the early part of 1907 had subsided, were the first adequate force avail- 
able by the health department for this purpose. It was soon discovered that 
correction of the physical defects found in school children would not be cor- 
rected to any great e.xtent, unless a force of nurses were available to follow 
up such cases. 

Consequently a school nursing service was organized in 1908, under the 
supervision of the Visiting Nurse Association, for which this organization 
and the city each furnished part of the 100 nurses employed. In I'^IO this 
work was taken over by the city health department. 

In order to attack the tuberculosis problem as it affected children of 
school age, fresh air schools were established. In 1908 the health depart- 
ment established an open window room at the Graham School. This experi- 
ment proved so successful that it led to the establishment of the Elizabeth 
McCorniick Open Air School on the roof of the Mary Crane Nursery. The 
board of education was also persuaded to follow the example and established 
its first open air school, the .same year at the Harvard School. 

The school dental service was inaugurated by the Chicago Dental Society 
in 1910 and was taken over by tlie health department three years later. In 
1921 the Municipal Tuberculosis Sanitarium established dental clinics at 
eight of its dispensaries. 

In 1915 the Municipal Tuberculosis Sanitarium provided 50 school 
health officers and 50 field nurses for the school inspection and follow-up 
work, with the understanding that a certain portion of the time of the entire 
force would be devoted to the early diagnosis of tuberculosis and preventive 
treatment of school children found suffering from malnutrition and 
tuberculosis. 

At the beginning of the fall term of school in 1916 a doctor's certificate 
of health was required of all children for readmission to school. This was 
tried for a few- years, and discontinued because the parents seemed unwilling 
to pay private physicians the proper fee for making the necessary exam- 
inations. 

In September l'^22 the medical inspection of school chilch-en for con- 
tagious and parasitic diseases was transferred from the division of child 
hygiene to the division of contagious diseases, and combined with the work 



CHICAGO 371 

of the 150 field health officers. A corps of 10 school health officers was 
assigned to make physical examinations, Schick tests and immunize against 
diphtheria in the schools. 

lieginning with the opening of schools in 1924 the corps of ph) sical 
examiners assigned to the schools began making a thorough physical exam- 
ination of pupils in the kindergarten and primary grades. The records show 
that a total of 101,376 phj-sical defects were corrected during tlie year and 
an equally large number in the succeeding years. 

Air, W'ater, Milk and Other Foods. 

The reductions in mortality accomplished during this period were to a 
large extent due to efforts made to conserve the purity of the air, water, milk 
and other foods. Of these milk received the first and the most consideration. 

Milk. 

The condition of the milk supply of Chicago in 1907 may be visualized 
by the findings of John M. Trueman of the Illinois Agricultural Experiment 
Station. His examination of 325 samples showed 19 per cent below grade 
in total solids, and 88 per cent containing a visible dirt sediment. A bac- 
teriological examination of 1,271 raw milk samples made by the health de- 
;iartment in 1909, showed an average bacterial count of 5,547,502 per cubic 
centimeter. 

That the milk was bad was further indicated b_\- the high mortahty 
among infants from diarrheal diseases, and the frequent outbreaks of infec- 
tious diseases traced to the milk supply. 

The Hygienic Laboraton,- Bulletin No. 41 on Milk in its Relation to 
Public Health was issued by the United States Public Health Service in 
1908. In this comprehensive review of the subject, Trask listed 260 out- 
breaks of typhoid, scarlet fever, diphtheria, and streptococcus sore throat, 
traced to milk infection. The clinical and experimental evidence in regard 
to the frequency and dangers of tubercle bacilli of bovine origin in milk 
was presented by Mohler and Schroeder, and showed emphatically the 
necessity of dealing with this problem. Rosenau presented a review of the 
literature, and the results of some personal experiments on the thermal death 
point of bacteria, with special reference to the tubercle bacillus. The con- 
clusion arrived at from the facts presented was that it was relatively simple 
to kill the bacteria in milk by heating it to a temperature short of the boiling 
point, or so-called "pasteurization". 

Dr. Evans, soon after assuming the office of commissioner of health, 
became convinced that radical measures were necessary to improve the milk 
supply of the city. That tuberculin testing of the cattle would not solve the 



372 rnu'AGo 

l)r<)l)lt'in was sult-cviilcnl, and fuillif rninrc tliLTc was tlic Dppn.sition of the 
farmers to this procedure to contend with. When tlie State a few years 
previously had attempted to test some of the cows in McHenry County, the 
fanners drove the veterinarians from the farms with shot guns. 

In the meantime a milk commission was appointed by the commissioner 
to help solve the problem. Dr. G. Koehler was appointed chief of the bureau 
of food inspection in August, 1907. Efforts were made to improve the 
conditions b\' concentrating on inspection of milk plants and dairies. The 
score card s\stem of grading these establishments was adopted. 

i\n ordinance was also passed this year prohibiting the sale of bulk milk 
in stores. This helped materially to uphold the butter fat standards for 
such milk and eliminated the likelihood of contamination. 

A sediment test, showing the amount of dirt in the milk was developed 
by the chief of the bureau of food inspection, and extensively employed for 
the detection and exclusion of dirty milk. 

After a _\ear's study and investigation of the local situation, as well as 
of the milk supply and inspection methods of other cities. Commissioner 
Evans had an (ordinance passed on July 13, V)()S. recjuiring all milk to be 
pasteurized unless obtained from tulierculin tested cows. About 45.000 cows 
were tested in the following three years, and the milk supply from the 
remaining 75,000 cows had to be pasteiu"ized. 

Systematic bacteriological examinations of the milk supply and testing 
of pasteurizers were inaugurated in 1909. Rules were promulgated regulat- 
ing the pasteurization of milk. These were made the basis of the require- 
ments for pasteurized milk embodied in the milk ordinance passed in 1912. 

The small milk dealers, numbering about 1,800 at that time, were not 
prepared or, as in the case of the majority, unwilling to comply with these 
requirements. Consequently there developed considerable opposition to the 
ordinance. Numerous unsuccessful efforts were made to get it repealed. 
In 1910 a commission was appointed by the legislature upon the instigation 
of Speaker Shurtleff from Marengo to investigate the milk question. This 
commission, after lengthy hearings, made a report which advised against the 
tuberculin testing of cows but did not particularly condemn pasteurization. 

In the following year the legislature passed a law prohibiting munici- 
palities to require a tuberculin test for dairy cattle. 

It was held that this law invalidated the Chicago milk ortlinance, and 
after a year's investigation it was decided by Commissioner Young to draft 
an ordinance eliminating the tuberculin test requirement and embodying spe- 
cific requirements for two grades of milk, namely, pasteurized and inspected. 
The task of preparing this ordinance \vas assigned to Dr. Koehler, who after 
careful consideration of all the details to be covered, drafted an ordinance 
which was presented to the city council and passed August 14, 1912. 



This ordinance required all milk to be pasteurized by prescribed meth- 
ods, unless produced on approved, inspected farms and as an original feature 
contained a requirement for thermostatic control and recording of pasteuri- 
zation temperatures. It also required the refrigeration of milk in transit, 
established a standard of purity for each grade, including a requirement in 
regard to the maximum amount of visible sediment permissible, and pro- 
vided that all milk sold to the consumer must be contained in tightly closed 
receptacles, properly labelled and dated. 

The enforcement of this ordinance at first presented numerous difiicul- 
ties. The small milk dealers continued their opposition and sought to re- 
strain the cit_\' from enforcing it by an injunction, l:)ut on appeal to the 
Supreme Court in 1914 the health department was sustained and the ordi- 
nance was upheld. 

This occurred none too soon, because in the fall of this }ear a wide- 
spread outbreak of foot and mouth disease occurred among cattle. This 
epizootic started on October 15 at Niles, Michigan. In November cattle 
of the dairy show held in the Union Stock Yards became infected. It also 
spread to the dairy district in and around Chicago and during the following 
two years recurred in various localities. 

Additional safeguards to protect the milk supply were taken during this 
outbreak, but the pasteurization of the entire milk supply was not consum- 
mated until Commissioner Robertson issued the order on Jul\' 16, 1916, 
during an epidemic of infantile paralysis, that all milk and cream sold in the 
city unless certified must be pasteurized. This was directlv in line with the 
doctrine that Dr. Robertson practiced and preached during his term as com- 
missioner of health of the city for seven years, namely that the purity of 
the milk, water, and air must be insisted upon without fear or favor. This 
policy carried on in earnest meant difficulty for the non-progressive milk 
dealers and the consequence was that many had to go out of business. During 
his term of office their number was reduced from 1,260 to 545 and pasteuri- 
zation was universally adopted by those remaining in business. 

The chemical sterilization of milk bottles was permitted by the depart- 
ment in 1922, after an inquiry into this method had been made by a commit- 
tee of experts. 

Beginning in Alarch 1924 all restaurants were required to furnish milk 
in bottles or from approved urns. Following this the percent of low grade 
samples collected from restaurants dropped to 5.9 during the \ear, as com- 
pared with 24.8 percent in the previous year. The hand capping of milk 
bottles was also prohibited at that time. 

A rule requiring that the ice cream "mix" must be pasteurized before 
being frozen was promulgated in 1925. This was followed by a great im- 
provement of the ice cream sold in the city, as shown by the liacterial con- 
tent of the samples examined. 



374 CHICAGO 

That the cainpaij;!! to inijirnvc the pastcuri/.aticju of the milk supply was 
Miccessful is shown by the haderiological examiiiatinn of milk samples col- 
lected during recent years. 

Only 33.6 per cent of the pasteurized milk samples examined in 1925 
showed bacterial counts above the legal number. The 4,360 samples of 
pasteurized milk collected during the year showed an average count of 
194,000 bacteria per cubic centimeter. The significance of this is most 
striking when these counts are compared with the count of 2,350 samples 
of raw milk examined in 1910, which showed an average count of 11,574,000 
per cubic centimeter. In 1910 only SO per cent of the entire milk supply 
was pasteurized. The raw milk was largely sold in the poorer sections of 
the city. 

The legislature in 1''25 enacted a comprehensive law, providing for the 
tuberculin testing of cattle, the establishment of accredited herds and the 
enrollment of counties under the accredited plan. An appropriation of two 
million dollars was also made by the State for the eradication of bovine 
tuberculosis. 

Other states, notably Wisconsin, had made great progress in the eradi- 
cation of bovine tuberculosis. In Illinois not much had been accomplished 
in the dairy district in the northern section of the State from which Chicago 
received its milk supply, although certain breeders and cattle raisers' associ- 
ations were strongly advocating the eradication of bovine tuberculosis in the 
State. 

The tuberculin testing of cattle was given a great impetus in the latter 
part of 1925 when Commissioner Bundesen announced that after April 1, 
1926 all milk and cream sold in Chicago must be derived from herds free 
from disease and under federal and State supervision. On December 23, 
1925 the city council passed an amendment to the milk ordinance embodying 
such a requirement. 

This order met with much opposition from the dair^inen with untested 
herds who tried to stop its enforcement In' a temporary injunction obtained 
in the circuit court of Kane County but which was later dismissed. On 
April 1, 1926, when the order went into effect and was strictly enforced by 
the department, the milk supply from a large number of farms m northern 
Illinois was excluded from the Chicago market and the city reached out 
into new territory and especially into Wisconsin for milk from accredited 
farms, the supply of which was found ample to meet all needs and which 
could readily be brought into the city with refrigerated t.ank cars that had 
come extensivel}' into use within recent times. 

In order to insure the safety of the milk suppl\- and especially of that 
derived from the territory which had not licen subject to periodic dair\' 
inspection by the department, as had been done in the old dairy district for 



CHICAGO 375 

over 20 years, special attention was given to the efficiencs' of pasteurization. 
A sanitary engineer was put in charge of milk and dairy inspection, who at 
once undertook a survey of pasteurizing plants, with a view to eliminating 
the by-passing or imperfect pasteurization of the whole or part of the milk, 
as had been found in the experiments made at Endicott, New York, and 
reported in Public Health Bulletin No. 147. 

The conditions found such as leaky valves, dead ends in pipes, forma- 
tion of foam, spashing and short circuiting, were largely corrected by the 
end of the year and the equality of the milk as shown by the bacterial count 
was improved. 

iratcr. 

The qucbtiun of the purity and safet}- of the water supply was also taken 
up systematically during this period. By 1909 it was found after investiga- 
tion of the reported cases of typhoid fever that aside from infected milk 
there remained a large percentage of cases apparently due to other causes. 
At the request of Commissioner Evans, Dr. L. L. Lumsden of the United 
States Public Health Service, in 1909 made an intensive study of the typhoid 
situation in Chicago and found that aside from carrier and contact infec- 
tion the water supply was responsible for a large per cent of the cases. This 
directed attention, first of all. to lake dumping, which was carried on rather 
extensively at that time. 

In 1910 a federal law was passed prohibiting the dumping of refuse in 
the lake within eight miles of the shore. In 1912 the city council passed an 
ordinance prohibiting such dumping within four miles of any water intake. 

In the following year an ordinance was passed pi-ohibiting the discharge 
of any refuse or sewage from boats within four miles of any water intake. 

Finally in 1914 an ordinance was passed prohibiting dumping in the 
lake within 10 miles of the corporate limits of the cit)- which meant 13 miles 
from shore. 

The enforcement of these provisions unfortunately did not eliminate the 
"water typhoid." The Calumet River remained as a source of infection, as 
was shown by the preponderance of typhoid from year to year in the south- 
ern section of the city. In addition there occurred periodic reversals of the 
Chicago River and much shore pollution, beside the wash-off from dump 
scows or the (luni[:iing in violation of the ordinances, as constant sources of 
water pollution. 

In the meantime, work had hc-en dune by C. -\. Jennings in 1908, that 
later served as a temporary remed_\- for these ills. Jennings, in attempting 
to purify and render potable the effluent from an experimental sewage treat- 
ment station, used for the treatment of Bubbl}- Creek sewage, had found 
that the application of a solution of calcium li\ pochlorite (chloride of lime) 



376 CHICAGO 

was most efficient in sterilizing the effluent, and at the same time was entii"el_v 
harmless. Subsec|uently, this i)rocedurc was applied to water supplies by 
sanitary engineers. 

On March 15. VJlZ Commissioner Young applied this treatment to a 
portion of the Chicago water supply, mainly in an experimental way at the 
E. F. Dunne water intake. On July 16 in the same year, this treatment was 
extended to the Hyde Park Crib, on August 15, 1913 to the Lake View Crib 
supply and used when the wind was offshore. The treatments were dis- 
continued during the winter months on account of the sohui(jns freezing in 
the temporar\- installations. 

On September 16, 1916 the use of licpiid chlorine was started at the 
Chicago Avenue pumping station, and next at the 22nd Street pumping sta- 
tion on December 15 during the same year. Dr. Herman N. Bundesen was 
assigned to supervise the application of chlorine at these stations and kept a 
close watch over the effects of the treatment on the incidence of typhoid in 
the districts supplied b\' the treated water. The results obtained were so 
striking that they led Commissioner Robertson to recommend that liquid 
chlorine be applied to the entire water supply of the city. This was accom- 
plished on October 6, 1916, with the completion of the installation at the 
Springfield Avenue station. 

This chlorination of the entire water supply was an important factor in 
reducing the typhoid death rate in Chicago to the low minimums that have 
been recorded annually since 1916. Only one outbreak of typhoid due to 
infected city water occurred since October 6. lOld, and that was the one 
that developed in the winter of 1923-24 in the territory supplied from the 
Hyde Park Crib, already referred to. 

Following this additional precautions were taken. In January l')24 a 
sanitary engineer was placed in charge of the application of chlorine and the 
control of the safety of the water supply. Since then hourly tests were made 
for residual chlorine in samples taken from the discharge mains at each 
pumping station and the total amount of chlorine applied was practically 
doubled. A total of 23,000 samples of water were examined in 1924; only 
0.3 per cent of 9,638 samples of chlorinated water examined showed colon 
bacilli in 10 cubic centimeters and none showed them in 1.0 of 0.1 cubic 
centimeter portions. 

In 1921 the supervision of lake dumping and dredging was placed under 
the jurisdiction of the department of health, and thus the approval of the 
department was required for all such undertakings. 

The constantly increasing magnitude of lake shore improvements which 
have been going on during recent years has demanded a continual vigilance 
on the part of the health department to prevent gross pollution of the water 



CHICAGO 377 

In Fehruary, 1924 the policy was adopted by Commissioner Bundesen 
of having all dredged material deposited behind tight bulkheads. During 
this year a total of 3,479.700 cubic yards of lake bottom material and 
1,273,800 of dredged and excavated materia! were deposited behind bulk- 
heads in connection with the lake shore improvement projects. 

A sanitary survey of Lake Michigan was begun in July, 1924, in con- 
junction with the United States Public Health Service and the Sanitary 
District. Thirty-six modern water chlorinators were purchased this year at 
a cost of $250,000 and their installations at the pumping stations were com- 
pleted in 1925. 

This same year a survey was started to tind and break all cross connec- 
tions between the city and other water supplies, which resulted in the finding 
and abolishing of approximately 500 such connections. 

In Februar}-, 1926 the supervision over the application of chlorine and 
the control of the safety of the water supply system was transferred to the 
departments of public works. 

The excessive quantities of chlorine required whenever the water was 
badly polluted has, during the last three years, given rise to much complaint 
about the bad taste of the water. This was especially notable when the pollu- 
tion consisted of industrial wastes, containing phenol and other soluble coke- 
oven products. To abate this condition Mayor William Hale Thompson, on 
January 3, 1928, upon the recommendation of Health Commissioner Arnold 
H. Kegel, appointed a commission consisting of five city officials with the 
health commissioner as chairman, to take steps to prevent the pollution of 
the lake with such industrial wastes. The matter was taken up at once with 
the officials of the Indiana cities and the industrial plants concerned and it 
was agreed that all would work together to correct the condition as soon as 
possible. 

Air. 

Inasmuch as serious efforts were made during this period to reduce the 
prevalence of tuberculosis and the acute respiratory diseases it was natural 
that much attention should be given to the purity of the air. 

A comprehensive smoke abatement ordinance was passed in 1907 and its 
enforcement was placed under the newly created department of smoke inspec- 
tion with Paul Bird, a competent combustion engineer, in charge. 

In the same year an ordinance was passed providing for the ventilation 
and heating of street cars. 

Conynissioner Evans in 1910 appointed a commission on ventilation 
which made an intensive investigation of the ventilation of school buildings 
and assisted in drafting a ventilation ordinance embodying for the first time 
definite standards of ventilation for public buildings, conveyances, factories. 



378 CHICAGO 

and workshops. This ordinance was passed by the city council this same 
year and has been a big factor in bringing about better ventilation. Its 
application to theatres and similar places of assembly was especially timely, 
in that it was applied to the construction of the numerous moving picture 
theatres, which began to be built at that time, and which have since become 
such a big factor in the cit\ 's amusements. 

In 1912 a ventilation division was created in the bureau of sanitation 
fur the enforcement of the ventilation ordinances. Dr. \'. li. Hill was 
appointed as head of this division. The division proceeded to make an 
exhaustive .study of street car ventilation on the basis of which a new ordi- 
nance was formulated and enacted, following which its enforcement was 
gradually accomplished. By 1917 all street and elevated railroad cars were 
equipped with proper ventilation and thus another source of danger from 
bad ventilation was largely eliminated. 

Continued progress was made in the installation of ventilation equip- 
ment in existing theatres and places of assembly. A survey- in 1915 showed 
that nearly all were thus equipped. When the wave of acute respiratory 
diseases and influenza struck the city in 1917. 1918 and 1919 the places of 
public assembly were found well ventilated, and this condition doubtless 
helped to save many lives. 

In October, l'M9, smoke inspection was again transferred to the health 
department, following which a railroad smoke abatement board was appointed 
b\- the commissioner with the object of obtaining the cooperation of the rail- 
roads in abating the smoke nuisance. 

The smoke inspection was carried on by the health department until 
July. 1927, when it was transferred to the department of boiler inspection. 

Foods. 

The inspection of foods was directed into channels tending to conserve 
the public health. Early in 1907, an agreement was made with the State 
Food Commission whereby the cit\- was to direct its efforts to food inspec- 
tion as related to liealth and the State to control measures relating to 
fair trade. 

After the L'nited States Bureau of .\ninial Industry had assumed con- 
trol of meat inspection, in accordance with the iirovisions of the Federal 
Meat Inspection law of 1906, the city passed an ortlinance requiring all meat 
sold in the city to be inspected and passed b\' some governmental authority. 

The city's power to seize and condemn foods was cjuestioned by the 
operators of cold storage warehouses and the case was taken to the United 
States Supreme Coint. In 1907 this court rendered a decision completely 
upholding the city in its contention. This established the city's power to 



CHICAGO 379 

control food supplies veiy decisively, and it was not again questioned there- 
after until 1911. 

The health department had in the previous year attempted to prohibit 
the sale of ice cream containing an excessive number of bacteria. Because 
the State standard did not contain any reference to the number of bacteria 
permissible the city's right was questioned, but the State supreme court in 
passing upon the case in 1911 ruled that the city's food regulations may 
be more stringent than those of the State, provided that they are not other- 
wise in conflict therewith. This established another principle which tended 
to aid the health department in its efforts to prevent the sale of unwhole- 
some food. 

The only food establishments or purveyors of foods that were subject to 
control by licensing at the beginning of this period, were slaughter houses, 
milk dealers, ice dealers, restaurants, butcher shops, fishmongers and poul- 
terers. This list has been gradually extended until now all classes of food 
establishments or purveyors of food or food products are subject to licensing 
and regulation. 

In 1910 the manufacturers of carbonated beverages were added to this 
list. Following this a survey of the industry showed that quite a per cent 
of samples of carbonated beverages examined contained lead derived from 
lead stoppers or from piping in the plants. The correction of this condition 
was required immediately. 

All other meat food products establishments were required to be licensed 
and were subjected to control b_\- an ordinance passed in 1914. By an ordi- 
nance passed in 1919 all groceries, delicatessen stores, butcher shops and 
meat food products establishments were reclassified for licensing purposes 
into two classes of food establishments, namely, wholesale and retail, and 
uniform sanitary requirements were adopted for the same. 

A comprehensive and definite food covering ordinance was passed in 
1915 after repeated unsuccessful efforts had been made to secure this desir- 
able legislation. 

Egg breaking establishments, which had been the source of consideralile 
complaint, were in 1917 brought under State control by an act requiring 
the licensing of this class of establishments. 

The cold storage warehouse problem was finally settled in ihe same way 
when the State in 1917 assumed control of this industry. 

Retail beverage dealers were required to be licensed by an ordinance 
passed in December 1920. 

The proper disinfection with heat or chemicals was required of utensils 
in public eating places by an order issued in November, 1926. 



3<S0 



H0U.S1X(; AND Gl-'.NiCRAI. SANITATION'. 



I'lxiii the appointment of Charles B. I'.all as chief of the bureau of 
sanitation in 1907 the work of this bureau was to a large extent directed 
toward improving housing ccjnditions and to securing better light and air in 
places of employment. 

In this connection the underground bakeries, of which there were 581 
in the cil\ in 1907, rccei\ed first attention. An ordinance requiring their 
abolishment and maintenance of so-called "daylight bakeries" was passed 
in 1907. Its enforcement met with bitter opposition, but after eight years 
of concerted effort practically all of the underground bakeries were moved 
into approved quarters. 

.V policy of strict enforcement of the provisions relating to light and 
air in the new building and tenement house code was adopted and carried 
out against considerable opposition on the part of speculative builders for a 
period of approximately ten years, after which time they were more or less 
educated to the new requirements. 

In VJll a revised and comprehensive building code was passed. Ad- 
vanced housing and ventilation standards were embodied in this code upon 
the solicitation of the department of health. 

Early in 1907 the drastic requirements in regard to the disposal of night 
soil were revised so as to allow its deposit properly diluted with water in 
the cit\' sewers. 

Common drinking cups were abolished by an ordinance passed in 1911. 
The same year common roller towels were also prohibited. 

.Screening against flies in tenement houses and the screening of stables 
were required by ordinances enacted in 1917. 

Adequate heat in dwelling apartments and places of employment was 
required by an ordinance passed June 10, 1922. Since then the department 
has devoted considerable time each winter to the enforcement of this 
provision. 

A comprehensive ordinance licensing and regulating laundries was 
passed in 1920. This prohibited the establishment of laundries in tenement 
houses and sleeping in laundries. 

r)n June 28, 1921, an act was passed by the legislature authorizing cities 
to adopt a comprehensive zoning plan, following which Mayor William Hale 
Thompson on July 22 appointed a commission to study the problem and 
prepare a zoning ordinance for the city of Chicago. A comprehensive zon- 
ing ordinance was drafted and was adopted b\- the city council on April 
5, 1923 

Building operations in the city dropped off considerably during the 
war but were actively resinned in 1021 when 10,309 building permits were 
issued. This ;ictivit\- has continued and reached a climax in 1''25 and 1926. 



CHICAGO 381 

In the summer of 1923 the department began the inspection and sanitary 
supervision of summer outing camps for children. 

The various general sanitary activities of the department were reorgan- 
ized and placed in a bureau of sanitary engineering which was established 
in January, 1923. 

After this the policy was adopted of giving more attention to matters 
of public health significance in carrying out the sanitary inspection and food 
stores inspection work of the department. All public toilets were subjected 
to periodic inspection since 1924. 

Sanitary Engineering. 
Water Siipl^ly. 

The extensions of the water works system during this period were 
made for the purpose of keeping up with the rapid growth in population. A 
new intake, known as the E. F. Dunne Crib, was completed in 1912, oppo- 
site the Hyde Park Crib. The Southwest Land and Lake tunnel supplying 
the Roseland pumping station was completed in 1911. By these works the 
far southwest side was for the first time adequately supplied with water. 

A large intake, known as the Wilson Avenue Crib, on account of its 
location four miles out in the lake opposite Wilson Avenue, was completed 
in 1918 with a tunnel to the Mayfair pumping station in the northwestern 
section of the city. Following this the use of the Lake View intake was 
abolished and the Montrose .\venue pumping station supplied from the 
new crib. 

In August, 1927, the W'illiam Hale Thompson pumping station on 
Western Avenue and 57th Street was opened. This is supplied by the Hyde 
Park and the E. F. Dunne intakes and serves to supply a section of the near 
southwest side of the city, which was badly in need of additional water. 

Since the two w-ater-borne typhoid epidemics in 1916 and 1923 sur- 
veys have been made of all the old tunnel s\stems and changes made to pre- 
vent the contamination of the water enroute to the pumping stations. 

Garbage. 

In 1913, when the cit}' refused to renew the contract with the Chicago 
Reduction Company, the health department was once more charged with the 
disposal of the city's garbage. Pending the rehabilitation of the old reduction 
plant which the city purchased a temporary garbage disposal station was 
maintained at Grace Street and the Chicago River until August, 1914, when 
the municipal plant was completed. 

A waste commission was appointed by the city which employed Engi- 
neers J. T. Featherstone and J. S. Osbom to make a technical sun^ey and 
recommendations for handling and disposing of the city's wastes. 



382 CHICAGO 

I'roni January 15, 1''14, the health dupartnient npcratcd the reduction 
plant located at 39th and Iron streets, after which time it was transferred 
to the department of public works. 

A garbage incinerator with a daily capacity of 30 tons was completed 
on the House of Correction grounds in 1915. 

Comfort Stations. 

Two i)uhlic comfort stations were opened by the health department in 
1916, another in 191'), and since 1925 the West Park Board has established 
a number in convenient locations in the park and boulevard system under 
its control. 

Publicity and Education. 

Publicity and education of the public in matters relating to health and 
sanitation were relied upon extensively to accomplish the prevention of sick- 
ness and deaths that was attained in the last two decades. 

Three of the commissioners who held office during this period were 
masters in the art of publicity and the other. Commissioner Young, carried 
on the educational work of the department in a reserved yet persistent man- 
ner, so that substantial results were deri\ed therefrom. 

Under Commissioner Evans the publicity work of the department was 
greatly extended, especially along the lines of infant mortality and respira- 
tory disease prevention. Much attention was given to pure milk and fresh 
air. A weekly foreign language and neighborhood press service was estab- 
lished. A lecture bureau was established and some lecturers were made 
available to give talks in foreign languages. 

In 1907 the health department bulletin was issued as the "Bulletin of 
the Chicago School of Sanitary Instruction," which had been organized in 
the department. This made it possible to enter the bulletin as second class 
matter and to greatly extend its circulation. 

E. R. Pritchard succeeded Dr. C. St. Clair Drake as editor of the bulle- 
tin in April, 1914, and continued as editor until 1924. 

The use of mo\ing [)ictures was first introduced for health educational 
work in 1910. 

Little ]Mothers' Clubs, for the practical education of girl pupils in the 
care of babies, were first organized in the public schools in 1912. 

Commissioner Robertson during his term of olfice relied largely on 
the newspapers to transmit a health story, knowing that in that way millions 
could be reached instead of thousands by a pamphlet or bulletin. 

By giving wide newspaper publicity to such health demonstrations as 
the diet squad, which was conducted in 1916, for the twofold purpose of 



383 



showing how to reduce in weight and also how to live on a daily bill of fare 
costing not over 30 cents, millions were reached where a pamphlet or report 
on the experiment could have reached only thousands. 

He conceived the idea of holding a large health show and succeeded in 
holding such a show at the Coliseum in November, 1920. which was attended 
by thousands of people. In the succeeding two years this health show was 
merged with the Pageant of Progress held on the Municipal Pier. 

He also established a school of home nursing in August, 1919, which 
was largely an educational feature. An eight weeks' course was given on 
the home care of the sick and hygiene to approximately 10,000 women dur- 
ing the first two years of its existence. 

Beginning with the issues in August, 1923, a change was made by Com- 
missioner Bundesen in the bulletin published by the department. The num- 
bers were made more attractive by the use of cartoons and neat illustrations. 
Larger type was used and only one subject was treated in each issue. Posi- 
tive health has been stressed. The circulation of the bulletin was also greatly 
increased. A number of special editions of the bulletin have been issued 
and widely distributed. In addition to the one on venereal disease preven- 
tion already referred to, one was issued on diphtheria prevention in Decem- 
ber, 1923. in an edition of 400,000 copies. 

Another special number was issued in April, 1924, featuring milk, and 
sent to every home in the city. At the end of the school term in 1924 a 
special bulletin relating to physical defects was distributed to 500,000 school 
children. In June. 1925, one featuring ice cream was distributed to every 
household in the city. 

A series of very complete annual reports were issued by the department 
during this period. Beginning with the octennial report for the years 1911-18, 
which is in fact a 1,540-page handbook, the reports have been compiled and 
edited by Dr. G. Koehler, who following the death 
of Dr. Frank W. Reilly on December 16, 1909, 
was appointed assistant commissioner of health 
February 25, 1910. 

Functions and Appropriations. 

In the 20 years since 1907, the department 
of health showed a tremendous growth and was 
almost completely transformed. From a depart- 
ment occupying d few rooms on the first floor 
of the old city hall it had developed into one of 
the major branches of the city government oc- 

G. Koehler, M. D. cun\ing nearlv the entire seventh floor of the 

Assistant Commissioner of i . ^ 

Health. 1910 to date new city hail. 




384 CHICAGO 

Thf total appropriations for tlic department increased from $848,966 in 
lyU7 to $1,560,157 in 1922, and reached the grand total of $2,291,240 in 
1927. The expenditure for health department activities in 1907 was 22.6 
cents per capita, from which time tliey have gradually increased and in 
1926 amounted to $1.22 per capita, including the expense of maintaining 
the Municipal Tuberculosis Sanitarium. The number of emploxes has 
also increased annually, reaching 976 in the 1927 Inidget, as compared 
with 403 at the lieginning of this period in 1907. 

The work of the department has been s\stematized and routine pro- 
cedures have been adopted for all the major activities. Following the 
administration of Commissioner Evans, during which the work of the 
department was greatly expanded and inspection and other services were 
rendered more efficient by the introduction of report forms and office pro- 
cedures for the keeping of records, the time arrived under Commissioner 
Young when it was advisable to outline definitely all of these methods of 
procedure in department and bureau orders. Such orders were issued dur- 
ing a period of three years. In 1914 and 1915 they were codified and 
issued as department and bureau handbooks of rules and regulations. 

A control system of handling and filing correspondence was estab- 
lished during this period. 

In the meantime a comprehensive efficiency survey of the department 
was made. The findings of this and other studies of department pro- 
cedure served as a basis for Dr. Koehler, the assistant commissioner of 
health, to make the following recommendations in 1014 for the improve- 
ment of the service : 

1. The establishment of a central stenographic division. 

2. The liolding of hearings by a board preliminary to starting suits, for 

violation of sanitary regulations. 

3. The re-arrangement of the department office space and the establish- 

ment of a central stock room. 

4. The establishment of a statistical division to handle the statistical 

work of the entire department, and the use of machines for compil- 
ing all statistics. 

5. The unification of the insi>ection service so as to combine the food. 

sanitary and quarantine inspection work, to be handled by one in- 
spector in a district. 

The first two recommendations were made effective by Commissioner 
Robertson and the others by Commissioner Bundesen, during their respec- 
tive terms of office. 

Their adoption and further perfection has helped materiall_\- to improve 
the admitiistration of the department and served to make it function more 
efficienth". 



CHICAGO 385 

Numerous changes in the organization and personnel occurred during 
this period, especially in the last five years. 

The bureau of food inspection was split off from the laboratories in 
1908, and handled all food inspection until 1926, when it was divided into 
the bureau of dairy products and the bureau of food inspection. 

The Iroquois Memorial Hospital, donated to the city by the Irocjuois 
Memorial Association, was opened as an emergency hospital and first aid 
station in 1910. The bureau of ambulance service was transferred to the 
health department in 1907 and transferred back to the police department 
in 1910. 

A bureau of hospitals was established in the health department in 
1912 which lasted until 1922, when it was abolished. 

The Municipal Lodging House, which the health department had oper- 
ated since 1908, was transferred to the department of public welfare 
in 1917. 

From 1913 to 1918. the department of health was charged with the 
disposal of the city's wastes and the building and operation of the garbage 
reduction plant. 

The operation of the public bath houses and comfort stations was 
transferred to the bureau of small parks of the department of public works. 
An advisory staff of 100 members was appointed in 1922. 

In January, 1921, a bureau of water safety and typhoid control was 
established, the functions of which were transferred to the division of 
sanitary engineering and bureau of medical inspection in 1924. The water 
safety control and direction of the chlorine applications was exercised by 
the division of sanitary engineering until January 1, 1926, when this 
activity was transferred to the bureau of engineering of the department 
of public works. The bureati of medical inspection was divided into the 
bureaus of communicable diseases and child welfare in January, 1923. 

In May, 1924, the health department was divided for administrative 
purposes into medical and technical sections, with an assistant commis- 
sioner in charge of each section. In 1927 an assistant commissioner and 
executive officer was appointed and the secretaryship was abolished. 

A bureau of inspection was organized in July, 1924, under the juris- 
diction of which were consolidated all the quarantine and non-technical 
inspection work of the department. In 1925 the bureau of sanitation was 
reorganized as a bureau of sanitar)- engineering. 

In October, 1919, the health department was again charged with the 
smoke inspection and handled this work until 1927, when it was merged 
with the department of boiler inspection. The same year an ordinance was 
passed transferring the inspection of plumbing and ventilation installation 
in new buildings to the department of buildings. 



386 CHICAGO 

'IIk- IlliiKiis suprcnu- cmirt. in tlie case of People ex rel. Jennie lUv- 
morc vs. Jolui Dill Robertson, et al, rendered a decision in 1922 which had 
a far-reaching effect on the department of hcahh. Although the case was 
taken up primarily on the right of the commissioner of health to quaran- 
tine carriers of typhoid, the question of the legal powers of the commis- 
sioner was raised and the cnurt held that the cities and villages act, under 
which the department nf lu-alih was organized, provided for a board of 
health and that therefore the commissioner of health had no power to 
make rules and regulations. 

In the crisis which resulted when the commissioner issued the order 
in 1925 that all milk must be derived after April 1, 1926, from healthy 
cows under governmental supervision, an ordinance was passed January 
13, 1926, providing for the appointment of a board of health consisting of 
five members. Mayor Dever appointed five members of his cabinet as 
members of the board. 

In ilay, 1926, the legality of the health commissioner's appointment on 
the board nf directors of the Municipal Tuberculosis Sanitarium was ques- 
tioned and F. X. Rusch. corporation counsel, and member of the board of 
health, was appointed to take the place of the health commissioner on the 
board of directors of the sanitarium, because it was held that the health 
commissioner was ineligible to the appointment because he was not a mem- 
ber of the board of health. 

( )n November 30, 1927 Dr. Arnold H. Kegel was appointed commis- 
sioner of health and on January 3, 1928. he was appointed a member of the 
board of health and also a member of the board of directors of the Munici- 
pal Tuberculosis Sanitarium. 

Rmduction of Death Rate. 

A review of the mortality records for the city shows that the syste- 
matic repressive measures against the various preventable diseases, during 
this period resulted in the lowering of the death rates from all the diseases 
towards which they w-ere especially directed. 

Principally on account of the control and prevention of the communi- 
cable and diarrheal diseases that was accomplished during this epoch, as 
chronicled in this article, the death rate from all causes was lowered 24 
per cent, or 3.5 per 1000 population. 

During 1''06 and the three following years the average annual death 
rate from all causes was 14.8 per 1000 population. This was gradually 
reduced, e.xcept during the influenza years, to an annual average of 11.4 
for the seven years ending in 1925. This represents a saving of approxi- 
mately 10,500 lives in each of these years over the number that would 
have occurred if the death rate prevailing at the beginning of this period 
had continued. 



CHICAGO 387 

The records also show that heart disease and cancer for the preven- 
tion of which no special efforts were made showed a marked increase as 
a cause of death. For example, the annual death rate from heart disease 
in 1906 was 109.8 per 100,000 population, from which it steadily rose, reach- 
ing 210.6 in 1925. Similarly the cancer death rate climbed from 66.5 in 
1906 to 107.5 in 1925. In other words, the annual number of deaths from 
these two diseases nearly doubled in the twent}' years. 

Inasmuch as heart disease and cancer are a frequent cause of death 
this increase in the rates alone represented 3,250 more deaths in 1925 
over the number that would have occurred if the death rates from these 
two diseases had remained as low as it was in 1906. 

This increase and others such as apoplexy, nephritis and violence have 
counteracted the lowering of the total death rate, brought about by the 
prevention of the communicable and diarrheal diseases, and must there- 
fore be taken into consideration in estimating tlie total saving of lives 
accomplished in this period. If this is done then it is found that the 
actual saving of lives within recent years amounts to nearly 14,000 annually, 
as a result of the systematic application of disease preventive measures 
instituted and carried on during the last two decades. 

Water Supply. 

The original water supply was installed in 1840 and was taken over 
by the city in 1854. The supply was obtained from Lake Michigan and 
pumped to the mains without treatment. 

As the demand increased pumps and intakes were added and the mains 
were extended. 

Before the direction of flow of Chicago River was changed, in 1900, 
the lake not only supplied water for Chicago, but received all of its sewage. 

During 1893-94 everyone was advised to boil the water and the result 
was a reduction in typhoid fever. 

Exten.sive examinations of the city's water supply were inaugurated 
in the city laboratory in 1894. The following year dail\- examinations 
were started and the results were published with a warning to boil the 
water whenever it was especially bad. 

In the past, many outbreaks of typhoid fever have been traced to the 
cit\ water supply, the most recent of which was in the winter of 1922-23. 

Chlorine has been in use as a sterilizing agent since 1912, and since 
that time there has been a marked reduction in typhoid. 

Investigations and experiments are now being made on the possiliility 
of filtering the lake water. 



Table 1. 
Mortality Statistics — City of Chicago 1850 — 1926 











1 












YEAR 


■S 


3 




3 




g 










s 


s 








3 




s 






















a> 










a. 








s 


.b. 










>, 


rt 










z^ 


■< 


« 


6- 


cs 


X 


« 


a 


K 


1850 


29,963 


1,467 


48.9 














1831 


34,000 


927 


27.2 


10 


29.4 


2 







6.0 


1852 


38, 734 


1,809 


46.7 


48 


123.7 


9 


23!3 


17 


40.5 


1853 


59, 130 


1,325 


22.4 


35 


59.2 


19 


32.1 


31 


52.5 


1854 


65, 872 


4,217 


64.0 


86 


130.5 


12 


18.2 


46 


70.0 


1855 


80, 023 


2,181 


27.3 


43 


53.7 


30 


37.5 


9 


11.2 


1856 


84, 113 


2,086 


24.8 


66 


78.5 


16 


19.0 


16 


19.0 


1857 


87, 600 


2,414 


27.6 


82 


93.6 


10 


11.4 


39 


44.5 


1858 


90, 000 


2, •.!55 


25.1 


49 


54.4 


5 


5.5 


22 


24.4 


1859 


93. 000 


2.008 


21.6 


51 


44.0 






10 


10.8 


1860 


109, 200 


2, 204 


20.7 


46 


42.2 


S 


2^7 


15 


13.7 


1861 


120, 000 


2.279 


19.0 


74 


61.6 


5 


4.1 


26 


21.7 


1802 


138, 180 


2. 835 


20.5 


85 


62.0 


5 


3.6 


38 


27.7 


1863 


150, 000 


3.875 


25.8 


149 


99.3 


115 


76.6 


28 


18.7 


1864 


169, :).o3 


4.448 


26.3 


192 


113.3 


283 


167.4 


135 


79.9 


1865 


178, 492 


4.029 


22 . 6 


190 


100.7 


57 


32.0 


20 


11.2 


1866 


200,418 


0. 524 


32.6 


203 


102.5 


9 


4.4 


160 


83.0 


1867 


225,000 


4,773 


21.2 


165 


73.3 


123 


54.7 


88 


39.1 


1868 


252, 054 


5,984 


23.7 


200 


79.3 


140 


57.9 


107 


42.5 


1869 


280, 000 


6,488 


23.2 


183 


65.3 


17 


6.1 


109 


38.9 


1870 


306, 005 


7, 323 


23.9 


268 


87.4 


15 


4.9 


95 


31.0 


1871 


334,270 


6, 976 


20.9 


204 


61.0 


73 


21.8 


1.56 


46.7 


1872 


367, 396 


10,156 


27.6 


524 


142.6 


055 


178.3 


37 


10.1 


1873 


380,000 


9.657 


25.2 


272 


71.0 


517 


136.1 


105 


27.6 


1874 


395,408 


8. 025 


20.3 


211 


53.4 


90 


22.8 


15 


3.8 


1875 


400, 500 


7.899 


19.7 


207 


51.7 


10 


2.5 


117 


29.2 


1876 


407,061 


8, 573 


21.0 


168 


41.2 


29 


7.1 


15 


3.7 


1877 


430,000 


8, 026 


18.7 


159 


37.0 


43 


10.0 


59 


13.7 


1878 


436.731 


7, 422 


17.0 


146 


33.4 


21 


4.8 


36 


8.2 


1879 


491,516 


8.614 


17.5 


208 


42 . 3 


1 


.2 


51 


10.4 


1880 


503, 185 


10,402 


20.8 


171 


34.0 


43 


8.5 


129 


25.6 


1881 


540, 000 


14,101 


26.1 


568 


105.2 


1180 


218.5 


110 


20.4 


1882 


560. 693 


13,234 


23.6 


402 


82.4 


1292 


230.2 


244 


43.5 


1S83 


580, 000 


11,555 


19.9 


301 


62.2 


46 


7.9 


44 


7.6 


1884 


629, 885 


12,471 


19.8 


354 


56.2 


2 


.3 


319 


50.6 


1885 


605, 000 


12,474 


18.8 


496 


74.6 


8 


1.2 


76 


11.4 


1S80 


703,715 


13, 699 


19.5 


483 


08.0 


2 


.3 


126 


17.9 


1887 


760, 000 


15. 409 


20.3 


382 


50.3 


2 


.3 


341 


44.9 


1888 


802, 051 


15. 772 


19.7 


375 


46.7 






151 


18.8 


1889 


935, 000 


16.946 


18.1 


453 


48.4 


2 


.2 


204 


21.8 


1890 


1, 099. 850 


21.869 


19.9 


1008 


91.6 






67 


6.1 


1891 


1, 148, 795 


27. 754 


24.2 


1997 


173.8 


'■'■ 




265 


23.1 


1892 


1, 199,730 


26.219 


21.9 


1489 


124.1 


2 


':2 


185 


15.4 


1893 


1, 253, 022 


27.083 


21.6 


670 


53.5 


23 


1.8 


234 


18.7 


1894 


1,308.082 


23,892 


IS. 3 


491 


37.5 


1033 


78.9 


182 


13.9 


1895 


1.306,813 


24, 219 


17.7 


518 


37.9 


160 


11.5 


156 


11.4 


1896 


1, 427, 527 


23, 257 


10.3 


751 


52 . 6 






73 


5.1 


1897 


1.490.937 


21, 809 


14.0 


437 


29.3 


2 


.1 


139 


9.3 


1898 


1, 557. 164 


22,793 


14.0 


636 


48.0 






55 


3.0 


1899 


1.020.333 


25, 503 


15.7 


442 


27.2 


i 


.'i 


168 


10.3 


1900 


1. 698. 575 


24,941 


14.7 


337 


19.8 


2 


.1 


194 


11.4 


1901 


1.751,968 


24,406 


13.9 


509 


29.x 


4 


.2 


158 


9.0 


1902 


1,801,255 


20, 455 


14.7 


801 


44.0 


5 


.3 


123 


6.8 


1903 


1, 850. 542 


28. 914 


15.6 


588 


31.8 


47 


2.5 


276 


14.9 


1904 


1,899,829 


20.311 


13.9 


373 


19.0 


29 


1.5 


47 


2.5 


1905 


1,949,116 


27. 212 


14.0 


329 


16.9 


61 


3.1 


231 


11.9 


1906 


1,998,403 


29. 048 


14.5 


370 


18.5 






128 


6.4 


1907 


2,047,090 


32,198 


15.7 


372 


18.2 


i 


' '. 05 


262 


12.8 


1908 


2,096,977 


30, S88 


14.5 


3S2 


15.8 






169 


8.1 


1909 


2,140,264 


31,296 


14.6 


271 


12.6 






165 


7.7 


1910 


2, 196,238 


33. 241 


15.1 


300 


13.7 


i 


'.'6 5 


191 


8.7 


1911 


2,249,303 


32. 571 


14.5 


241 


10.7 


3 


.1 


129 


5.7 


1912 


2,301,946 


34.034 


14.8 


175 


7.6 


7 


.3 


128 


5.6 


1913 


2, 354, 529 


35. 298 


15.0 


249 


10.0 




.04 


292 


12.5 


1914 


2.410.800 


S3, 952 


13.9 


107 


0.9 




.04 


75 


3.1 


1915 


2,464. 189 


34, 894 


14.2 


132 






... 


240 


9.8 


1916 


2.517,172 


30.304 


14.4 


128 






... 


131 


5.2 


1917 


2, 569, 755 


38. 027 


14.8 


43 


i'.e 




.07 


243 


9.5 


191S 


2, 022, 338 


44. 005 


17.0 


38 


1.4 




.15 


03 


2.4 


1919 


2,674,921 


33.494 


12.5 


31 


1 .2 






197 


7.4 


1920 


2,728,022 


34.841 


12.8 


SO 


1.1 




';64 


89 


3.3 


1921 


2, 780, 055 


30. 819 


11.1 


30 


l.l 




.14 


127 


4.6 


1922 


2,833,288 


31,700 


11.2 


31 


1.1 


15 


.53 


152 


5.4 


1923 


2,886.971 


33, 771 


11.7 


57 


1.9 




.03 


206 


7.1 


1924 


2. 939. 005 


32, ,918 


11.2 


45 


1 .5 




.03 


72 


2.5 


1925 


2. 995, 239 


34, 318 


n.5 


44 


1.5 


12 


.4 


116 


3.9 


1926 


3, 048, 000 


35, 623 


11.7 


24 


.8 


2 


.06 


58 


1.7 



The r.ite from All Ca 



per 1000 poimlatii 



all others per 100,000 populatic 



Table 2. 

JMoRTALiTY Statistics — City of Ciiicaco. 





•2^ 




















YEAR 


d i2 

■5 C 




1 








-" 0) 




s 






H<2 


s 


i 


s 


I 


S 


S i 


S 




S 




n-< 








n 






rt 










M 


i. 


« 





« 


a a 


a 


a S 


K 


18")! 


42 


123.5 


s 


23.5 


1 


3.0 




... 


3 


8.8 


1852 


116 


300.0 


30 


77.5 


2 


5.1 








3 


7.7 


18r,3 


176 


298.3 


28 


47.5 


4 


6.8 








-y 


8.5 


1854 


216 


327.3 


35 


53.1 


;", 


7.6 








.5 


22.7 


1855 


162 


202.5 


47 


68.7 


3 


3.8 








19 


23.7 


1856 


288 


342 . 9 


40 


54.8 


2 


2.4 








7 


8.3 


1857 


255 


291.1 


50 


57.0 












12 


13.7 


1858 


334 


371.1 


77 


85.5 


'4 


'4.4 








17 


19.0 


1859 


256 


275.3 


53 


57.0 


5 


5.4 








17 


18.3 


18G0 


276 


252,8 


48 


44.0 


.") 


4.6 








22 


20.2 


18B1 


320 


266.6 


55 


45.8 


7 


5.8 








32 


26.7 


18B2 


348 


252.2 


88 


64.2 


3 


2.2 








26 


19.0 


1803 


283 


188.7 


126 


84.0 


1) 


6.0 


2 


lis 


32 


21.3 


18G4 


410 


242.6 


163 


96.2 


11 


6.4 


4 


2.3 


52 


30.8 


1865 


340 


190.5 


150 


84.0 


16 


S . 9 


7 


3.9 


39 


21.8 


1866 


406 


203.0 


1S7 


93.3 


30 


18.0 


3 


1.4 


01 


30.5 


18G7 


541 


240.4 


171 


76.0 


45 


20.0 


8 


3.6 


05 


28.9 


1868 


026 


248.4 


341 


135.3 


82 


32.5 


n 


10.7 


121 


48.3 


1869 


754 


269.3 


313 


111.8 


C3 


22.5 


37 


13.2 


130 


46.4 


1870 


863 


281.5 


314 


102.4 


87 


28.4 


30 


9.8 


140 


45.6 


1871 


829 


248.0 


. 386 


115.5 


68 


20.3 


28 


8.4 


133 


39.8 


1872 


1009 


274.6 


462 


125.7 


75 


20.4 


54 


14.7 


169 


46.0 


1873 


930 


244.7 


435 


114.5 


107 


28.2 


52 


13.7 


179 


47.1 


1874 


804 


218.5 


377 


95.4 


109 


27.6 


50 


12.0 


189 


47.8 


1875 


880 


219.7 


493 


123.1 


122 


30.5 


50 


14.0 


213 


53.2 


1S76 


886 


217.3 


364 


89.3 


122 


29.9 


84 


20.0 


189 


46.4 


1877 


913 


212.3 


345 


80.2 


130 


30.2 


SI 


18.8 


183 


42.6 


1878 


856 


196.0 


377 


86.3 


177 


40.5 


97 


22 2 


302 


69.2 


1879 


854 


173.7 


460 


93 . 6 


177 


30.0 


131 


26.7 


354 


72.0 


1880 


981 


195.0 


633 


125.8 


163 


32.4 


179 


35.6 


303 


60.2 


1881 


1191 


220.0 


707 


130.9 


217 


40.2 


161 


29.8 


335 


62.0 


1882 


1183 


211.0 


829 


148.0 


220 


39.2 


184 


32. S 


374 


66.7 


1883 


1150 


198.3 


094 


119.7 


232 


40.0 


223 


38.4 


421 


72.6 


1884 


1185 


188.1 


713 


113.2 


265 


42.1 


233 


37.0 


388 


61.0 


1885 


1289 


193.8 


736 


110.7 


249 


37.4 


235 


35.3 


400 


69.2 


1886 


1377 


195.7 


880 


125.1 


230 


32.7 


300 


42.6 


453 


64.4 


1887 


1540 


202.6 


1008 


132.6 


301 


39.6 


320 


42.1 


549 


72.2 


1888 


1610 


201.3 


1105 


137.7 


361 


45.0 


330 


41.1 


619 


77.1 


1889 


1692 


181.0 


1170 


125.0 


379 


40.5 


373 


39.9 


664 


71.0 


1890 


2221 


201.9 


2073 


188.5 


461 


41.9 


509 


46.3 


816 


74.2 


1891 


2400 


208.9 


2898 


251.8 


545 


47.4 


594 


51 . 7 


927 


80.9 


1892 


2383 


198.6 


2397 


199.8 


539 


44.9 


610 


50.8 


1058 


88.2 


1893 


2647 


211.2 


2457 


196.1 


609 


48.6 


753 


60.1 


1100 


88.3 


1894 


2499 


191.0 


1520 


116.1 


639 


4S.8 


680 


52 . 


1038 


79.3 


1895 


2463 


180.2 


2359 


172.6 


682 


49.9 


701 


51.3 


1304 


99.8 


1890 


2667 


186.8 


2149 


150.0 


734 


51.4 


818 


57.3 


1289 


90.3 


1897 


2574 


172.6 


2152 


144.3 


742 


49.8 


937 


02.8 


1365 


91.0 


1898 


2829 


181.7 


2477 


159.1 


791 


50.8 


1051 


o7.5 


1399 


89.8 


1899 


2910 


178.9 


3438 


211.4 


890 


54.7 


1180 


72.6 


1492 


91.7 


1900 


2953 


173.9 


3389 


199.5 


986 


58 . 


1117 


65.7 


1893 


111.4 


1901 


2874 


164.0 


3127 


178.5 


1003 


57.2 


1016 


57.9 


1947 


111.1 


1902 


2979 


165.4 


3433 


190.6 


1074 


59.6 


1258 


69.8 


2098 


116.5 


1903 


3377 


182.5 


4629 


250.1 


1063 


57 . 4 


1510 


81.9 


2092 


113.0 


1904 


3543 


186.5 


4138 


217.8 


1124 


59.2 


1848 


97.3 


2043 


107.5 


1905 


3674 


188.8 


3582 


184.1 


1191 


61.1 


2017 


103.5 


2110 


108.3 


1906 


3837 


192.0 


4047 


202.5 


1328 


66.5 


2128 


106.5 


2195 


109.8 


1907 


4039 


197.2 


4753 


232.1 


1538 


75.1 


2496 


121.9 


2338 


114.1 


1908 


3915 


186.7 


3511 


167.4 


1571 


74.9 


2138 


102.0 


2086 


128.1 


1909 


3885 


181.0 


4713 


219.6 


1646 


76.7 


2273 


105.9 


3163 


147.4 


1910 


3908 


177.9 


5286 


240.7 


1804 


82.1 


2500 


113.8 


3323 


151.3 


1911 


3726 


105.6 


4929 


219.1 


1799 


80.0 


2460 


109.4 


3546 


157.6 


1912 


3763 


103.5 


4892 


212.5 


1778 


77.2 


2377 


103.3 


3488 


151.5 


1913 


3866 


164.2 


4871 


206.9 


2004 


85.1 


2325 


98.7 


3460 


147.2 


1914 


3908 


162.1 


4077 


169.1 


2115 


87.7 


2006 


83.3 


3900 


161.8 


1915 


4204 


170.6 


3800 


156.6 


2081 


84.4 


2168 


88.0 


4195 


170.2 


1916 


3734 


148.3 


3862 


153.5 


2267 


90.1 


2069 


82.2 


4524 


179.7 


1917 


3800 


147.9 


5018 


195.3 


2256 


87.8 


2293 


89.2 


4767 


185.5 


1918 


3827 


145.9 


7000 


266 . 9 


2407 


91.8 


2340 


89.2 


4936 


188.2 


1919 


3244 


121.3 


3353 


125.3 


2534 


94.7 


2125 


79.4 


4140 


154.8 


1920 


1 2652 


1 97.2 


3815 


139.8 


2573 


94.3 


2218 


81.3 


4909 


179.9 


1921 


2325 


83.6 


2216 


79.6 


2663 


95.8 


2122 


76.3 


4730 


170.1 


1922 


2220 


78.3 


2779 


98.1 


2S00 


98.8 


2313 


81.0 


5498 


194.1 


1923 


2335 


80.8 


3745 


129.7 


2949 


102.1 


2737 


94.8 


5547 


192.1 


1924 


2434 


82.8 


2892 


98.4 


3177 


108.1 


3232 


109.9 


r.en 


191.1 


1925 


2489 


83.1 


3075 


102.7 


3219 


107.5 


3092 


103.2 


6309 


210.6 


1926 


2530 


83.0 


3238 


106.2 


3283 


107.7 


3691 


121.1 


0547 


214.8 



liales per 100,000 populatic 



Table 3. 
Mortality Statistics — City of Chicago. 



1851 
1852 
1853 

1854 
1855 
1856 
1857 
1858 
1859 
1860 
1861 
1802 
1863 
1864 
1865 
1866 
1867 
1868 
1869 
1870 
1871 
1872 
1873 
1874 
1875 
1876 
1877 
1878 
187!) 
1880 
1881 
1882 
1883 
1884 
1885 
1886 
1887 



1890 
1891 
1892 
1893 
1894 
1895 
1896 
1897 
1898 
1899 
1900 
1901 
1902 
1903 
1904 
1905 
1906 
1907 
1908 
1909 
1910 
1911 
1012 
1913 
1914 
1915 
1916 
1917 
1918 
1919 
1920 
1921 
1922 
1923 
1924 
1925 
1926 



206 

811 

819 

133 

389 

339 

187 

200 

400 

354 

279 

220 

190 I 

184 

185 



143 

79 
493 
718 
410 
369 
404 
474 
620 I 
906 
228 

78 



61.0 
36.4 
6.2 
17.9 
85.6 
259.0 
272.0 
114.7 
37.5 
244.5 
270.0 
41.4 
49.9 
63.5 
44.9 
72,. 2 
204.6 



20.6 
51.4 
198.9 
190.5 
30.5 
79.1 
67.4 
34.6 
35.7 
69.0 
56.2 
41.1 
31.3 



43.4 
31.8 
26.3 



4.3 
32.8 
13.3 



53 . 3 
23.7 
10.7 
22. S 
21.1 
12.9 
22.0 
20.0 
19.7 
60.7 
11.2 

8.4 
91.8 
27.6 
25.0 
46.8 
29.7 
18.8 
33.8 
40.8 
27.1 
20 . 5 
32.6 
12.1 
53.8 

6.7 
13.0 
29.1 
18.0 
15.9 
17.8 
14.1 
15.9 
13.9 
22.8 
10.3 
18.3 
16.9 
13.7 
16.8 
10.0 

8.9 
13.1 
10.7 
13.4 

4.7 
10.8 
11.8 
14.8 
14.6 

5.9 
18.4 

8.4 
12.0 

0.4 

6.5 

7.9 

2.5 



164 
190 

169 I 

279 

236 

175 

314 



1463 

1009 

753 

817 

905 
1012 
1303 
1405 
1297 
1509 
1261 
1358 
1548 I 
1467 
1406 
1642 
1098 

774 

680 

917 

840 

515 

627 

637 

409 

433 

554 

555 

555 

680 

822 

877 

940 

952 

764 

679 

787 
1228 

720 

592 

030 

676 

561 



18 
25. 
196 
119.4 
209.3 
178.3 
231.3 
144.0 
79.1 
77.4 
91. S 
139.3 
73.6 
97.2 
62.1 



135.8 
120.2 
196.9 
290.7 
186.9 
134.3 
140.9 
143.7 
1.52.2 
135.2 
184.9 
161.6 
161.4 
114.7 
118.2 
129.0 
117.1 
107.4 
120.1 
76.2 
1.1.9 
43.7 
56.4 
49.5 



40.8 
40.4 
31.9 
27.7 
31.3 
47.8 
27.4 
22.1 



72 
85 
117 
287 
404 
202 
6971 
1757 
2037 
114 
317 
428 



1.2 

1.0 

18.0 

19.1 

9.4 

403.4 

416.8 

495.9 

454.3 

424.3 

436.8 

479.4 

407.6 

416.1 

433 . 1 

400.6 



351.4 
330.8 

362.8 I 
098.2 

327.9 I 

328.8 I 

179.9 1 
200.2 I 
237.8 I 
190.4 
203.8 I 

12.1 I 



465 
224 
110 
101 



122 
137 
143 



64 I 
121 I 
103 I 
133 I 
136 I 
100 I 
54 I 
07 I 



39 I 
01 I 
47 I 
51 I 



Rales per 100,000 iiopuKitii 



Table 4. 
Mortality Statistics — City of Chicago. 











M 








.^ 










V3 




'^ 




■^ 




^ 






















VEAK 


i. ^ 




>. 




g± 




Eg 






111' 


01 


1 


« 


fa 


» 


l~ 


% 






















^ '- — 


















O T^ 


K 


— 


£S 


— H 


a 


i-K 


— 


1S.31 






... 




18 


53.0 


1 


.1 


1S.".2 


'.'.'. 














51 


131.8 


1 


.05 


18.",3 


... 


; ; ; : 










31 


52.5 


1 


.08 


18r,4 


... 














210 


319.7 






1855 
















92 


115.0 


i 


" ! 05 


1836 
















07 


79.9 


6 


.29 


1857 


i 


'i!i 












63 


71.9 


33 


1.37 


1858 


3 


3.3 












17 


18.9 


47 


2.11 


185!) 


2 


2.2 












37 


39.8 


33 


1.04 


1800 


1 


.9 












37 


33.9 


10 


.44 


1861 
















31 


25.8 


3 


.13 


1802 


1 


.7 












44 


32.1 


10 


.35 


1803 


1 














49 


32.7 


10 


.26 


1864 


2 


1^2 












77 


45.6 


20 


.58 


1805 


20 


11.1 












85 


47.6 


10 


.27 


1860 


12 


0.0 












12o 


62.3 


18 


.30 


1867 


22 


9.8 












147 


65.3 


29 


.02 


1868 


44 


17. o 












184 


73.0 


39 


.05 


1869 


39 


13.9 












229 


81.8 


60 


.92 


1870 


31 


10.1 












260 


84.7 


35 


.75 


1871 


42 


12.6 












109 


50.0 


OS 


.97 


1872 


300 


81.7 










202 


71.3 


131 


1.29 


1873 


129 


34.0 












288 


75.8 


133 


1.38 


1874 


89 


22.5 












223 


56.4 


64 


.79 


1875 


85 


21.2 












252 


63.0 


57 


.72 


1870 


115 


28.2 












160 


39.2 


49 


.57 


1877 


102 


23.7 












227 


52 . 8 


43 


..54 


1878 


111 


25.4 












153 


35.0 


58 


.78 


1S79 


104 


21.2 












215 


43.8 


59 


.08 


1880 


70 


15.1 












147 


29.2 


69 


.66 


1881 


320 


59.3 












317 


56.9 


144 


1.03 


1882 


120 


21.4 












242 


43.2 


107 


.81 


1883 


108 


18.6 












219 


37.8 


152 


1.32 


1884 


89 


14.1 












244 


38.7 


108 


.86 


1885 


142 


21.4 












171 


25.7 


107 


.80 


1886 


103 


14.0 












130 


18^5 


126 


.92 


1887 


81 


10.7 












102 


21.3 


149 


.91 


1888 


138 


17.2 












148 


18.4 


186 


1.18 


1889 


110 


11.8 












167 


17.9 


137 


.81 


1890 


142 


12.9 












245 


20.4 


160 


.76 


1891 


301 


26.2 












375 


30.0 


176 


.63 


1892 


223 


18.6 












223 


15.5 


174 


.66 


1893 


388 


30.9 










145 


9.1 


181 


.67 


1894 


249 


19.0 












136 


8.7 


214 


.89 


1895 


8 


.58 












110 


0.9 


140 


.58 


1890 




.14 












150 


9.3 


IJO 


.63 


1897 

















37 


2.3 


143 


.66 


1898 


17 


1.6 












701 


40.8 


114 


.50 


1899 


18 


1.1 












788 


48.4 


143 


.56 


1900 


6 


.35 












804 


50.8 


101 


.40 


1901 


9 














832 


47.5 


113 


6.4 


1902 


4 


!22 












713 


39.5 


108 


5.9 


1903 


1 


.05 












720 


38.9 


105 


5.6 


1904 


3 


.15 












1702 


89.0 


131 


6.9 


1905 


16 


.8 












2180 


111.8 


142 


7.3 


1900 


6 


.3 












2236 


in. 9 


133 


6.7 


1907 


*15 


.7 












2451 


119.7 


197 


9.6 


1908 


♦12 


.57 












3070 


140.7 


179 


8.3 


1909 


* 3 


.14 












3116 


145.2 


189 


8.8 


1910 


43 


2.0 












3511 


159.9 


178 


8.1 


1911 


40 


1.8 












2983 


132.6 


204 


9.1 


1912 


41 


1.7 


22 


.95 


3050 


132.4 


124 


5.3 


1913 


61 


2 . 5 


4 


.17 


3214 


136.4 


95 


4.0 


1914 


48 


2.0 


10 


.41 


3029 


125.6 


119 


4.9 


1915 


51 


2.1 


10 


.40 


2023 


107.1 


72 


2.9 


1916 


53 


2.1 


49 


1.9 


3429 


137.9 


99 


3.9 


1917 


198 


7.7 


187 


7.2 


2845 


111.7 


69 


2.6 


1918 


93 


3.5 


25 


.95 


2960 


114.0 


75 


2.8 


1919 


46 


1.7 


17 


.63 


2536 


94.8 


54 


2.0 


1920 


37 


1.4 


8 


.29 


2203 


80.7 


76 


2.8 


1921 


31 


1.1 


14 


.50 


1755 


63.1 


68 


2 3 


1922 


27 


.9 


21 


.73 


1245 


43.9 


56 


2.0 


1923 


32 


1.1 


4 


.13 


1095 


37.9 


91 


3.2 


1924 


19 


.« 1 2 


.00 


876 


29.8 


131 


4.5 


1925 


31 


1.01 7 


s.s 


887 


29.6 


SO 


2.7 


1920 


29 


.9 3 


1.0 


600 


16.4 


102 


3.4 



* Encephalitis. 

*R:ites for puerperal septicemia percentage^ of total 
Other rates per 100,000 population. 



Table 5. 
Mortality Statistics — City of Chicago. 



YEAR 


.2 

S 


1 


Reported 
Uirths 


s 


Infant 
Deaths 
Under 1 yr. 


o 
o 

S.S 


1851 


17 


50.0 










1852 


38 


98.1 










1863 


34 


57.5 










1854 


70 


100.3 










1855 


30 


37.5 










1858 


22 


20.1 










1857 


47 


53.0 










1858 


16 


17.7 










1859 


10 


10.7 










1860 


24 


22.0 










1801 


15 


12.5 










1862 


19 


13.8 










1803 


27 


18.0 








'.'.'.'. 


1864 


32 


18.8 










1865 


43 


24.1 










1860 


74 


30.9 










1867 


39 


17.3 










1868 


29 


11.5 






2.330 


lit'.b 


180!) 


32 


11.4 






2251 


8.0 


1870 


49 


15.9 






2709 


8.8 


1871 


35 


10.4 






2475 


7.4 


1872 


57 


15 . 5 






3431 


9.4 


1873 


03 


10.5 






S570 


9.4 


1874 


31 


7.8 






3308 


8.4 


1875 


45 


11.0 






3024 


7.0 


1876 


62 


15.2 






2094 


0.0 


1877 


20 


4.8 







2432 


5.7 


1878 


59 


13.5 






2465 


r> (i 


1879 


49 


9.9 






2549 


5.2 


1880 


71 


14.1 






3147 


0.3 


1881 


124 


22.9 






4374 


8.1 


1882 


80 


15 . 8 






4059 


7.2 


1883 


95 


10.3 






3850 


0.0 


1884 


!)S 


15.5 






4179 


6.6 


1885 


111 


16.6 






4000 


0.02 


1880 


118 


16.7 






4081 


5.8 


1887 


87 


11.4 






44S3 


5.9 


1888 


96 


11.9 






4718 


5.9 


1889 


105 


11.2 






5008 


5.4 


1890 


121 


10.0 


'.'.'.'. 




0630 


0.0 


1891 


143 


11.4 






800S 


7.0 


1893 


139 


9.0 






7.574 


0.3 


1893 


83 


5.1 






8125 


0.5 


1894 


34 


2.1 






7336 


5.6 


1895 


56 


3.5 






6817 


5.0 


1890 


32 


2.0 






6512 


4.6 


1897 


24 


1.5 






5735 


3.9 


1898 


27 


1.7 


2S, 009 


ik'.s 


5415 


189.2 


189!) 






29, 065 


17.8 


5620 


189.9 


1900 


32 


'i!9 


29, .568 


17.4 


5341 


180.6 


1901 


21 


1.2 


26.048 


15.2 


5044 


189.2 


1902 


16 


.9 


27.343 


15.1 


5144 


188.1 


1903 


IS 


1.0 


29. 033 


15.0 


5316 


183.1 


1904 


9 


.5 


27, 803 


14. G 


5025 


180.7 


1905 




.9 


20,092 


13.3 


5831 


223.4 


1906 


9 


.4 


25,171 




6114 


242.8 


1907 


S 


.3 


25, 702 




0699 


260.6 


1908 


11 




27, 533 


13^1 


6888 


250.1 


1909 


9 


.4 


t54,729 


25.5 


0334 


116.6 


1910 


11 




155, PI 4 


25^4 


6841 


122.3 


1911 


S 


;4 


t56. Ill 


24.9 


0293 


112.1 


1912 


4 


.2 


156,379 


24.4 


6089 


118.0 


1913 


7 


.3 


t56, 626 


24.0 


6928 


122.3 


1914 


9 


.4 


t36, 895 


23.5 


6880 


120.9 


1915 


9 


.4 


t57, 045 


23.1 


6205 


108.7 


1916 





., 


47, 760 


18.9 


6007 


144.6 


1917 


4 


.2 


49, 5.56 


19.2 


0057 


134.3 


1918 


4 


.2 


51, 255 


19.5 


0036 


129.4 


1919 


7 


.3 


47, 853 


17.9 


5739 


119.9 


1920 





*> 


55, 720 


20.1 


5674 


112.8 


1921 


4 


'.I 


00, 902 


21.9 


5051 


89.3 


1922 


-, 




50, 724 


20.0 


4850 


85.5 


1923 


4 


!i 


55.935 


19.4 


4883 


87.3 


1924 


7 


. 2 


5S; 900 


20.0 


4528 


76.9 


1925 


4 


.1 


60, 155 


20.0 


4457 


74.7 


1926 


1 


.03 

1 


60,200 


19. S 


4007 

I 


00.6 



• Per 1000 population. 

t E.-tiiiintcd. 

Hirtli r.ile.s per 1000 population. 

iTif.nit deaths under 1 year, period 1808 to 1S97 

Infant deaths wider 1 .year, period 1.S98-1920, r;i 

Other rates per 100.000 population. 



393 



Sewerage. 



The first sewers were designed with outlets (hrect to Lake Michigan 
and into Chicago River, then a tributar\' of the lake. It was obvious that 
the lake could not be used both for a water supply and as a means of 
sewage disposal. As no other source of supply was available it necessitated 
the disposal of sewage in some other manner. 

The Chicago Sanitary District was organized in 1889 under a special 
law enacted b\- the legislature in that year. When the district was organ- 
ized it included 18.^ square miles and served 1,150,000 people. Now the 
district co\ers j7 square miles, serves 3,465,000 people and includes part 
or all of 57 suburbs. 

Construction of the main channel of the drainage canal was started 
in 1892 and completed in 1900, reversing the flow in Chicago River. Dur- 
ing that period and the following few years interceptors were constructed 
to carry the sewage to the river. 

Due to the amount of sewage and restrictions on the amount of 
diluting water that could be taken from the lake it became necessary to 
consider treating the sewage. 

In order to treat the sewage the district was divided into various 
treatment projects. At present the Calumet and DesPlaines River projects 
are in operation, the North Side project is nearly finished, the West Side 
project is started and small treatment plants are being operated at JMorton 
Grove, Glenview and Northbrook. 

References. 

Annual Reports of the Chicago Health Department, various dates. 
Monthly Statement of Mortality, Chicago Health Department, 1894. 
Principles and Practice of Medicine, N. S. Davis, M. D., 18S4. 
Vagaries of .Sanitarv Science, The, F. L. Dibble, 1893. 
Jungle, The, Upton Sinclair, 1906. 
Hygienic Laboratory Bulletin, No. 41, 1908. 
Public Health Bulletin, No. 147. 



THE SANITARY DISTRICT MOVEMENT 

Drainage for sanitary as well as agricultural purposes is a subject that 
has bewildered the inhaliitants df Illinois from the time when a desire to 
till the soil and esca])e frum malaria first burned in the hearts of early 
settlers. For more than a hundred years the thought of satisfactorily 
solving this problem has agitated the minds of pulilic officials and private 
citizens. 

I'lefore a State government was organized a number of comnumities 
were either moved or abandoned outright because of difficulties in draining 
the original sites. The settlers at Cahokia abandoned the place in favor 
of Belleville in 1813 and the original community that ultimately grew into 
Peoria was moved a mile and half further up the river at an e\en earlier 
date. 

In 1810 the first legislature to meet after Congress had fomially admit- 
ted Illinois to the Union passed a law legalizing lottery for the purpose 
of raising funds with which to drain the American Bottoms. About the 
same time a voluntary organization, the Illinois Agricultural i\ssociation, 
specified as one of its functions the promotion of drainage for sanitary 
and agricultural purposes. 

Then followed a long period when local governments managed in 
one way or another to get rid of communit}' sewage and drain the com- 
munit\ grounds in a manner that made the places habitable, if not sanitary. 

At length the lack of drainage facilities in Chicago, coupled with the 
rapid growth of that municipality, created sanitary problems that demanded 
solution by some extraordinary means. This led to the beginning of what 
ma\- be called the sanitary district movement in the State, which bids fair 
to give to the drainage problem the most satisfactory solution of any 
method yet devised. 

This movement began when Chicago, in 1889, persuaded the legislature 
to pass a law authorizing that city to create a sanitary district with power 
to levy taxes, build sewers and drainage channels and participate otherwise 
in relieving the community of its problem of sewage disposal. 

The next step in the movement took place in 1911, when the legislature 
authorized the creation of the North Shore Sanitary District. Then in 1917 
a law was passed which authorized the creation of sanitary districts gen- 
erally in the State wherever citizens manifested an interest sufficient to get 
the names of 100 voters attached to a petition. ]\Iore detailed account of 
the development of the sanitary district movement is presented hereafter 
in this chapter. 

(394) 



THE SANITARY DISTRICT MOVEMENT 395 

Even more recently, in 1925, the general sanitary district movement 
idea was enlarged when a law granted local communities the privilege of 
creating by popular vote what are known as river conservancy districts. 
These districts or organizations have many powers and functions similar to 
those of the sanitary districts. 

Sanitary District of Chicago 

The Sanitary District of Chicago was formed primarily to cope with 
the sewage disposal of the city of Chicago. Before the opening of the 
sanitary channel the sewers of Chicago emptied direct into Lake Michigan, 
the Chicago River and into its north and south branches. The pumpage 
into the old canal from the river was never sulTicient to prevent the periodic 
flow (if its sewer-laden contents into the lake. 

The fouling of the river became greater from \ear to \ear, as the 
population of the city increased and the industries on its banks and tribu- 
tary sewers developed. The nuisance from the river became the subject 
of continual public complaint, with increased emphasis during each succeed- 
ing summer season. This condition and the nuisance from the stock yards 
were outstanding features associated in that day with the name of Chicago, 
and were commented on disparagingly b}- the press of the country and 
travelers from other lands. 

\\'hile the greasy, bubbling scum and the nauseating odor from the 
river were the ponderable evidence of pollution and the subject of comment, 
the real danger lay in the discharge of t\phoid-laden sewage into the lake 
from the numerous sewer outlets along the lake shore. In time of freshets 
from heavy rainfalls, the contents of the river were also swept into the 
lake and materially added to the pollution of the water supply. 

ILvRLY Efforts to Purify the River. 

When the Illinois and Michigan Canal was completed in 1848, the 
Summit level was eight feet above the low level of the lake. Pumps were 
installed at Bridgeport which fed the canal from the South Branch of the 
Chicago River to furnish the needed water to make the canal navigable 
during the dry season. 

In 1849 a crude system of drainage with heavy box sewers, discharg- 
ing into the river was installed in the territory between State Street and 
Fifth Avenue, frcim Randolph .Street to the river. The project proved 
unsuccessful because, when most needed, the drains were below the level 
of the water in the river. 



396 Tin-; samtakv distkict .mdviimknt 

In 1855 a board of sewerage commissioners was created by an act of 
the legislature, and Mr. E. S. Chesbrough was appointed cliief engineer. 
A system of sewers was designed to discharge intd the ri\er l)y gravity. 
This necessitated the raising of the grade in the central business district. 

Mr. Chesbrough also presented a plan fur purifying the river <le|)endent 
uiKjn the introduction of water pumped from the lake through a covered 
canal in Sixteenth Street. 

In 1X65, the condition of the Chicago River and the measures necessary 
to reduce the pollution, were studied by a commission of engineers with the 
result that a recommendation was made that the Summit level of the canal 
be lowered so as to create a continuous flow of water from the lake. An 
amendment to the city charter gave the board of public works power to exe- 
cute this project for the cleansing of the Chicago River. 

Between 1866 and 1871, the city deepened the canal at a cost of 
$3.300,88,1. The pumps at Bridgeport were considered of no further use 
niiw. After two years of idleness, they were sold for $2,500 and the site of 
llie piniiping station was leased to private parties. 

.\fter a few \ears, the city deplored the sale of the pumps because, due 
to fluctu.-itic.ins in lake levels, it was soon found that the flow in the river was 
insutVicient to prevent its fouling. 

The Sag feeder, which had been constructed to feed the canal below the 
Summit level by water drawn from Stony Creek, a branch of the Little 
Calumet at Blue Island, and from the swamiis, known as the "Sag Slough", 
was dammed four miles west of Blue Island in order to increase the flow 
of water through the C'hicago River. 

The Ogden-W'entworth Canal was completed in 1872 as a private under- 
taking for the purpose of draining ]\lud Lake. This established a communi- 
cation between the West Fork of the Chicago River and the Des Plaines 
River. The additional water thus supplied through the West Fork had the 
effect of lessening" the flow in tlie main channel of the river. 

In 1877, a dam w'as built in the branch of the DesPlaines River, com- 
municating with the Ogden-Wentworth Canal, after the city had filed a com- 
plaint that the flow of water through this channel had the effect of lessening 
the current in the South Branch of the Chicago River. 

The foul condition of the canal and tlie DesPlaines River at Joliet, were 
brought to the attention of the State Board of Health in 1878. Investiga- 
tions made under the direction of Dr. John H. Ranch, secretary of the board, 
showed that a low stage of water was already accompanied b_v increased 
offensiveness of the canal and river. It was estimated that from 60,000 to 
100,000 cubic feet of watei" per minute would be required to cleanse the 
canal. 



THE SANITARY DISTRICT MOVEMENT 397 

As a result of these investigations, and in view of the serious complaint 
of the citizens of JoHet, the secretary of the State Board of Health made a 
recommendation to the city of Chicago in 1879 that the pumping works at 
Bridgeport be rebuilt. 

After some dela} , during which time the Chicago River became worse 
from year to year, new and more powerful pumps were installed by the city 
of Chicago at a cost of $250,177 and put into operation in 1884. 

In order to supply the North Branch with a flow of fresh water, the 
l'"ullerton Avenue conduit, 12 feet in diameter, was completed in 1880. By 
means of two screw pumps, water was forced through it from the lake, and 
at times the water from the north branch was pumped lakeward, with a 
view to cleansing this part of the river. The net result of all these efforts 
was that the river and shore of the lake remained foul. Professor John H. 
Long made a series of chemical examinations for the State Board of Health 
from September 5, 1885 to August 28, 1886, of the water supply of Chicago, 
H\-de Park, Lake View and Evanston. The sewage of the river had been 
flowing into the lake for nearly a month when the examinations were begun. 
The analysis of the Chicago supply taken from a hydrant showed .0105 parts 
per million of free ammonia, and .085 parts of albuminoid ammonia. The 
greatest contamination was found during the week ending Februar}^ 27 when 
thawing weather had set in, with light rainfalls and the pumps at Bridgeport 
were not operated. The best results were obtained between May and August 
when the operation of the pumps promoted the outward flow of the river. 

The city was increasing in population beyond all expectations, and the 
rather desperate situation was a constant source of discussion and even dis- 
may until the celebrated downpour of August 2, 1885 when it rained with 
violence for nearly two days. The Chicago River, augmented by a large 
overflow from the DesPlaines through the Ogden-Wentworth Canal, rushed 
in a torrent into the lake, and its foul contents were swept out as far as the 
Two Mile Crib off Chicago Avenue, which was the sole source of the city's 
water supply at that time. 

The people were aroused and the Citizens' Association appointed a com- 
mittee consisting of Mr. Ossian Guthrie, Mr. Lyman E. Cooley, and Dr. 
Frank W. Reilly, then assistant secretary of the State Board of Health, to 
inquire into the situation and report. Evidently no time was wasted for the 
committee reported on August 27 and recommended the construction of a 
ship canal substantially as the drainage channel exists today. The report 
was promptly adopted, was given wide publicity by the press and the agita- 
tion for the construction of the canal was continued until results were ulti- 
matel\' obtained. 

In January 1886, the city council provided for the appointment of a 
watcr-.^upply commission. ]\lr. kudolf Hering of New York, a celebrated 



398 



TH1-: SANITARY DISTKICT .M( >Vi:.MF.XT 



en,<,'iiH'iT. Mr. Samuel d. Artingstall, city engineer, and j\Ir. Renezette 
Williams, also an engineer, were appointed as members of this commission. 
They made a preliminary report in January 1887. No final report was ever 
made, hut all three, in their individual capacity, rendererl valuable aid in 
linally securing the passage of the Drainage District ]>ill. 



Sanitary District Ckkated. 

The efforts to improve the drainage system of Chicago finally culminated 
in an effort to secure the necessary enabling legislation during the legislative 
session of 1886-1887. Two bills were introduced to provide for an adequate 
drainage system for the city. The one, known as 
the Winston Bill, proposed to raise money, by 
special assessment, to construct an outlet through 
the DesPlaines Valley . The other, the Hurd Bill, 
proposed the creation of a metropolitan district 
with power to issue bonds and levy taxes. 




Murry Nelson 
I-'irst President, 1890 



The Hurd liill. as amended, was reported 
favoralily but the questiijn developed such broad 
relations that a general conviction prevailed that 
the problem should be fully considered before 
legislative action was taken. Consequently, a 
joint resolution was passed which provided for a 
committee of five to consider "the subject of the 
drainage of Chicago and its suburbs" and to report to the next legislature. 
The committee consisted of Mayor John A. Roach of Chicago, two senators, 
B. A. Eckhart of Chicago and Andrew J. Bell of Peoria, and two repre- 
senatives, Thomas C. McMillan of Chicago and Thomas H. Riley of Joliet. 
Mr. John P. \\'ilson of Chicago was employed as counsel and Mr. L)man 
E. Cooley as engineer. The report of this committee was submitted to the 
General Assembly on February 1, 1889, in the form of a bill which pro- 
vided for the creation of the Chicago Sanitary District. 

After many hearings and amendments, the bill was tinall}- passed and 
received the signature of the Governor on May 29, 1889. It became a law 
in force and effect on the following July 1st. 

In accordance with the provisions of the act a petition was made to the 
county judge of Cook County in which it was requested that he appoint two 
judges of the circuit court to act as commissioners with him for the purpose 
of fixing the boundaries of the district. The commissioners fixed the orig- 
inal boundaries of the district as shown in Figure 1. It comprised about 
IS.S s(|uare miles. 



400 Till-: SANITAKV DISTRICT MOVE.M iIXT 

The matter of organizing the district was then submitted to the voters 
at the general election held November 5, 1889, with a resulting vote of 
70,958 for, and only 242 against the proposition. This vote showed the 
sentiment that prevailed in favor of the project in the city of Chicago. 

The press had played an important part in crystalizing this sentiment. 
Dr. h'rank W. Reill\'. who spoke as a represcntati\e of the press, at the cere- 
monies inaugurating the tligging of the channel said : 

"The Sanitary District is essentially and distinctively the creation 
of the public press of the city of Chicago and of the Illinois Valley. The 
egg from which it was hatched was laid in a newspaper office, a little 
over seven years ago. It was incubated by the newspapers and the 
newspapers did the proper and necessary cackling at the various stages 
of its evolution. * * * * Xo one subject has been given so much space 
in the columns of the daily press as this enterprise." 

Dr. Reilly was in a position to speak knowingl}- on this subject for it 
was he who had inaugurated this publicity campaign and as a newspaper 
man and a sanitarian, had inspired its continuation until the object sought 
was obtained. 

On December 12, 1889, at a special election, the first board of trustees 
of the Sanitary District was elected. Dr. Arnold P. Gillmore was a member 
of this board. Soon afterwards the validity of the act was tested in two 
suits and sustained by the Illinois su])reme court. 

Surveys and estimates of the cost of the channel were ordered made. 
After several changes of engineers, and the consideration of various courses, 
a plan was finally agreed upon by the new and reorganized board of trustees 
elected November 3, 1891. 

Frank Wenter was chosen president of this board and trustee Lyman E. 
Cooley, former chief engineer, was made chairman of the committee of engi- 
neering. Benezette Williams was appointed chief engineer. 

The route of the ch.innel, between \\ illow Springs and Lockport, was 
agreed upon and contracts for its construction were awarded on July 13, 
1892. The route from Bridgeport to Willow Springs was reported by the 
engineers on June 7, 1892. 

The work on the main drainage channel was begun on September 3, 
1892. No sanitary undertaking of such magnitude had been undertaken 
previously in the State or Nation. It provided for the digging of a canal 
thirty miles long, 202 feet wide in the earth section, 161 feet wide in the 
rock section, and 24 feet deep. It cut across the divide that separated the 
St. Lawrence watershed from the Mississippi Valley and renewed the flow 
of water from Lake Michigan to the Mississippi, as it had flowed in pre- 
historic times. 



MEMBERS HRSTBOAI^D OF TRUSTEES ' 
The Sajvfoj'y Dic/'fv^cfof Clyic^qo ^ 




Twu other Mienilieis of the tirst boaril were Arnol.l 1'. (aihuorc. M. I)., ami \V. II. liussell. 



402 THE SANITARV DISTRICT MOVEMIIXT 

riie purpose of the canal was to furnish an outlet for tlie drainage of 
the cit} of Chicago and aid toward a waterwav or shi]) canal from Lake 
Michigan to the Mississippi. 

Isham Randolph was appointed chief engineer on July 7, 1893, and 
served until 1907. 

Sanitary Channel Completed. 

During the World's Fair of 1893 in Chicago, a trip to witness the blast- 
ing and the new and successful cantilever cranes removing the rock and earth 
from the channel to the spoils banks was one of the sights shown to visitors. 
The work- was finally finished and the waters of Lake Michigan turned into 
the channel to flow by gravity in its course toward the Gulf of Mexico at 
11 :15 A. M. on January 17, 1900. The cost of the project was $45,220,588. 

Continued expansion of the drainage channel system was marked by the 
completion of the North channel in 1910, and the Sag channel in 1922. 

When the work on the Sag channel was first started in 1906, the Sani- 
tary District made application to the War Department for the necessary 
diversion of water from the lake, to reverse the flow of the Calumet River. 
This was refused and litigation was started, which was finall}' adjudicated 
in an injunction proceeding in the L^nited States District Court, seeking to 
restrain the Sanitary District from withdrawing more than 4,167 feet per 
second of water. After a lengthy hearing, in a decree issued on June 18, 
1923, the Court rendered a decision against the Sanitary District and required 
it to hold to the provisions of the 1901 permit, allowing the diversion only 
of the aforesaid quantities of water. 

The district appealed from the decision to the United States Supreme 
Court. This Court affirmed the injunction of the district court on January 5, 
1925, and ordered the decree to go into effect in sixty days, without preju- 
dice to any permit that might be issued by the Secretary of War, according 
to law. 

In the meantime, the district had gone ahead with a program of sewage 
treatment. The first of the proposed sewage treatment plants was the one 
in the Calumet district, designed to treat the sewage from 42j4 square miles 
in that territory, with an estimated cost of $17,360,000, including the con- 
tributory sewers. This was started in 1920, began treating sewage in 1922, 
and was completed recently. 

The construction of the Howard Avenue sewage treatment plant was 
started in 1923. This will serve an area of 62 square miles and will be the 
largest activated sludge plant ever built. The estimated cost is $27,433,000, 
of which $11,(X)0,000 is for the contributing and intercepting sewer system. 

The 95th Street sewage pumping plant was completed in 1925. The 
total estimated volume of sewage and industrial wastes of the Sanitary 



THE SANITARY DISTRICT MOVEMENT 



403 



District was 835,000,000 gallons daily in 1925, with an average of 147 parts 
per million of suspended matter and .176 parts per million of bio-chemic 
oxygen demanded. 

A bill was introduced in Congress permitting the district to withdraw 
10,000 cubic feet of water per second, on which hearings have been held, but 
which has not been passed. 

Upon making application to the Secretary of War. after the United 
States Supreme Court decision, it was agreed on March 3, 1925, that a 
permit would be issued to the district to withdraw an annual average of 
8,500 second feet, and an instantaneous maximum of 111,000 second feet for 
a period of five years, provided that the district would construct sewage 
treatment plants to provide for the complete treatment of wastes from 
1,200,000 persons within that time, and that the universal metering of the 
water supply of the city of Chicago would be undertaken at the rate of 
10 per cent annually. 

The Sanitary District's definite construction program for sewage treat- 
ment works, which was approved by the War Department, conditioned on 
issuing the permit, contemplates the expenditures of $73,419,000 for such 
plants and allied works during the }ears 1925-29 inclusive. 



Extensions and Sewage Interception. 

The Sanitary District act was amended in 1903 by providing for the 
annexation of the North Shore and Calumet regions and authorizing the 
development of water power. 

The 39th Street sewage pumping station was completed by the city of 
Chicago in December 1904 and a part of the sewage from the south side 
was diverted from the lake. In the following year, the south side inter- 
cepting sewer system was completed as far south 
as 75th Street. 

The main channel extension was completed 
in 1907 at a cost of $4,489,913. It was con- 
structed in order to preserve navigation after the 
Illinois and Michigan Canal was cut by the Sag 
channel. The project is 4.25 miles long, extend- 
ing from the Lockport controlling works to the 
upper basin in Joliet. 

The north-side intercepting-sewer system, 
and the Lawrence Avenue pumping station were 
completed by the city in 1908. The pumping of 
flushing water from the lake was started on 
November 28, this year. 




T. J. Crowe 
Present President 



404 'IIII-; swiTAin' distkut m(i\'k.m::n't 

Tlif upcration of llic 3''tli Strcut ami 1-awrencf Awniie sewage and 
lliisli-vvater ijuniping stations was tiiincil nver to tlie Sanitary District in 1910. 

This \'ear the North Shore cliaiiiiel \\a^ completed, and a conduit was 
constructed in Western \\eniie to lhi--h the wcNt arm of Bubbl}' Creek. 

On .September Id. I'Ml, ihc eoiislriRtion of tin- Cahimet-Sag channel 
was begun with ,i view to diverting llie flow of the Calumet River, through 
a channel f)i>ni the Little Calumet in the neighborhood of Blue Island to 
the main (lr,iin;ige channel at the Sag. In the meantime, dredging was begun 
in tlu' main channel, between Robey Street and i-^ummit. to enlarge this 
section. 

The diversion of the I-lvanston sewage by the completion of the inter- 
cepting sewer system in that city in 1921, and the completion of the Calumet- 
Sag supplementary channel in 1922. completed the main dilution and diver- 
sion projects of the district. 

Si;wAi;i-: Tkk.\tment. 

The refusal 1)\ the federal government of a permit to divert additional 
water from the lake, for the creation of a flow in the Calumet-Sag channel, 
emphasized the importance of sewage-treatment jirojects in the disposal of 
the sewage handled b_\' the district. 

Study of the sew'age-treatment problem was first inaugurated in 1909, 
when an experimental sewage-testing station was established at the .VJth- 
.Street pumping station. In 1912 the studies were extended to the stock 
yards sewage. .\ sewage-treatment plant, handling the sewage of Morton 
Grove, was completed in U'Lv I'.xperimental testing and treatment stations 
were maintained in l'*2ll for the purpose of studying the disposal of tannery 
wastes, and the wastes from the corn products ])lant at .\rgo in the follow- 
ing year. 

In the meantime. Mr. Langdon Pearse, the sanitary engineer of the 
district, made studies and ol)servation of sewage-treatment plants in all parts 
of the country, ami the trustees accompanied by the sanitary engineer, made 
numerous annual inspection tours with a view to keeping in touch with the 
results of the \arious treatment projects in all parts of the United States. 

The first large sewage-treatment project undertaken by the Sanitary 
District for the treatment of Chica.go sewage was the Calumet .sewage treat- 
ment ])lant. This was started in 1^20. It is located at 125th Street and 
Cottage Grove Avenue and is designed to treat the sewage of the territory 
of approximately 52 sc]uare miles in the city south of 87th .Street. 

The initial installation was designed for a population of 225,CXX), and 
an a\erage sew.'ige flow of 36 million gallons per day. The treatment is by 
Imhoff tanks. Experimental activated sludge units and trickling filters were 
installed in connection with the plants. 




CHIEF ENGINEERS 
.The S 8VT\if 2v.ry Dr^^ricJ^ of Chic^lgo I 





406 TIIK SANITARY DISTK:lT .MArMKiVV 

Underdrained sand beds are provided for drying the sludge, covering 
an area of 3.5 acres. A part of the bed is covered with a green-house type 
of construction. 

The plant cost $6,601,120, and was put into operation in .September 1922. 

A large intercepting sewer, with pumping stations at 95th and 125th 
Streets, delivers the sewage to this plant from the Calumet district and from 
the territory as far west as Halsted Street. 

The DesPlaines River sewage-treatment works was also completed in 
1922. This is an activated sludge plant and serves for the treatment of the 
sewage of Elmwood Park, River Foi-est, Melrose Park, Maywood, Forest 
Park, Bellwood, the Speedway Hospital and a portion of Oak Park. The 
plant, which is located in Broadview, is designed for a population of 45,000, 
and an average sewage flow of 4.5 million gallons per day. The total con- 
struction cost was $1,136,044. 

LlTICATION OVKR WITHDRAWAL OF WaTER. 

The hearing on the litigation, which started in 1906, when the Sanitary 
District w-as refused a permit by the Secretary of War for the necessary 
diversion of water from the lake to reverse the flow of the Calumet River, 
was finally adjudicated in an injunction proceeding in the United States 
District Court, seeking to restrain the district from withdrawing more than 
4,167 cubic feet of water per second. On June 18, 1923, the Court rendered 
a decision against the Sanitary District, requiring it to hold to the provisions 
of the 1901 permit, which allowed only for the diversion of the aforesaid 
quantities of water. 

The district appealed from this decision to the United States Supreme 
Court. In 1922, the state of Wisconsin filed a suit in the United States 
Supreme Court, also seeking to restrain the district from diverting more 
water from the lake than that allowed by the aforesaid permit. 

The average diversion of water by the Sanitary District in 1924 was 
9,465 cubic feet per second. The Sag channel carried normally about 700 
cubic feet per second of this amount. 

In a decision, handed down by the United States Supreme Court on 
January 5, 1925, the injunction of the district court was affirmed, the decree 
to go into effect in sixty days, without prejudice to any permit that might 
be issued by the Secretary of War, according to law. 

In the meantime, a bill had been introduced in Congress, permitting 
the district to withdraw 10,000 cubic feet of water per second. Hearings 
were held on this bill, but to date it has not been passed. 

Upon making application to the Secretary of War, after the United 
States Supreme Court decision holding the district to the terms of the orig- 
inal permit, it was agreed (jn March 3. 1925, that a permit would be issued. 



THE SANITARY DISTRICT MOVEMENT 407 

allowing the district to withdraw for a period of five years, an annual average 
of 8,5fX) second feet, and an instantaneous maximum of 11,000 second feet, 
provided that the district would construct sewage-treatment plants, to pro- 
vide for the complete treatment of wastes of 1,200,000 persons within that 
time, and that the universal metering of the water supply of the city of 
Chicago could lie undertaken at the rate of ten per cent annually. 

The Sanitary District was required to submit a definite construction 
program before the permit was issued. The program that was submitted 
and accepted contemplates the expenditure of $73,419,000 for sewage treat- 
ment plants and allied projects during the years 1925-29. 

.\n ordinance providing for the metering of the water supply in accord- 
ance with the term^ of this agreement was passed liy the cit_\- council on 
September 1. 1925. 

The same vear the states of Ohio, Pennsylvania, Minnesota, and later. 
New York, were permitted by the United States Supreme Court to join with 
the State of Wisconsin in its suit seeking to restrain the Sanitary District 
from withdrawing an excess of 4.167 second feet of water from Lake 
Michigan. Subsequently, this case was referred to Justice Charles E. 
Hughes, as master, to hear the evidence for the court and submit his findings. 

After a lengthy hearing, he found against the states praying for the in- 
junction. On account of this litigation, the district appropriated $419,540 
for legal expenses in 1926, and $499,940 in 1927. 

In 1928. an appropriation of $294,270 was made for a health depart- 
ment, with a director at a salary of $15,000 per annum. 

Work O.n Sewage Treatment Projects Continued. 

The trend of the litigation over the withdrawal of water made it more 
apparent that the treatment of the sewage discharged into the channel was 
imperative. 

In 1925, the legislature increased the bonding power of the district to 
four per cent of the assessed valuation of the property in the district. This 
helped to provide the funds necessary to carry out the construction program' 
agreed to with the Secretary of War. 

A new and larger sewage laboratory was established at the main offices 
of the district in 1924, after which the one at 39th Street pumping station 
was discontinued. 

The Glenview sewage treatment plant was completed in 1924. This is 
an Imhoff tank trickling filter plant, costing $70,783. and designed to serve 
a population of 1,200. A similar plant was completed in 1925 to handle the 
sewage of Northbrook. designed for a population of 1.500. Its cost was 
$71,065. 



408 Tlir. SAMT.'.KV DISTRICT M'lVK.M I'.NT 

Wdrk was started mi the North Side trcatnu-iit works and its suppk-- 
meiital-intcrccpting-sewer s_\stcm in 1923. This plant is being built to treat 
the sewage from Chicago, north of F"ullerton Avenue, and from Evanston, 
Wilmette, Kcnilwurth. (Ilcncoe, Xik's Center and Xiles. an area of about 87 
square miles. 

Tile pkaiit iv loeated at Howard Street west of the North Shore channel. 
It i> of the actixaled-skidge t\pe and designed to handle the sewage of a 
population of SOO.OOO, with an average sewage flow of 175 million gallons 
per day. 

The total cost of the project is estimated at $17,500,000. 

In 1926 the first contract was let for the construction of the \\'est Side 
treatment works. This is located in the village of Stickney at the intersec- 
tion of West Pershing Road and 52d Avenue. It is being built to treat the 
sewage from the part of Chicago between Fullerton Avenue and the Chicago 
River, the Loop district, limited areas south of the river, and communities 
along the lower DesPlaines River and Salt Creek. 

The plant W'ill be essentially of the Imhoff tank t\pe and is designed to 
digest the waste sludge from the north side plant and will be provided with 
extensive sludge-clr\ing beds. 

The plant, when completed, will serve a population of 1,850,000 and an 
average flow of 400 million gallons of sewage a da\-. The estimated cost 
is $19,500,000. 

The total volume of sewage and industrial wastes of the sanitary district 
in 1925 was estimated at 835,000,000 gallons dailv. The estimated concen- 
tration, including industrial wastes, was 147 parts per million of suspended 
solids, and 176 parts per million of hio-cheniical oxygen demanded. The 
industrial wastes were estimated at ec|ui\alent to a population of 1,500,000. 

The figures show the magnitude of the problem that confronts the Sani- 
tary District in attempting to treat and render innocuous and nonputrescible 
the wastes in llie territory where it assumes jurisdiction over this disposal. 
The area of the district is now 437.4 s(|uare miles, 207 square miles of which 
are i:i the city of Chicago. The |iopulation of the district is estimated at 
3.465,000. 

In 1926 there were 314 sewer outlets into various streams in the district, 
as follows: Into the Chicago River and its branches, 221 ; into the Calumet 
River and Sag channel. 34; and into the DesPlaines River and Salt Creek, 
59. NearU- all the sewers in the ?7 municipalities, wholly or partly within 
the territor\ of the <listricts, are constructed on the conihined plan, that is, 
they are designed to carry both the storm water and the domestic and indus- 
trial sewage and wastes. The- per capita consuni;ition of water in the city of 
Chica.go is about 280 gallons daily. 

The averasre annn.al rainfall in the C/hicago area is 33.11 inches. 



THE SAXITAKY DISTRICT MOVEMENT 409 

These factors render the problem of treating the sewage more difficult 
and exceedingly expensive, it being estimated that the total cost of the sew- 
age-treatment plants and intercepting sewer systems necessary to handle all 
the sewage and storm water of the district, will excel the amount of 
$150,0(X),00(). the largest sum ever expended for any sanitary project and in 
comparison with which the amount originally expended for digging the sani- 
tary channel seems small. 

North Shore Sanitary District. 

The North Shore Sanitary District in Lake County was organized in 
pursuance to an Act of the legislature passed in 1911. This Act provides 
that "whenever any area of continuous territory within the limits of a single 
countv shall contain two or more incorporated cities, towns or villages own- 
ing and operating * * * and procuring a supply of water from Lake 
Michigan, the same may be incorporated as a sanitary district." In accord- 
ance Vi'ith this law, a part of the territory along the lake shore in Lake County 
was organized as a sanitary district in I'M 4. It has since been expanded 
to include all the territory from the Cook County line which is contiguous 
with the Chicago Sanitary District line, northward to the Illinois-Wisconsin 
state line, which is the northern boundary of Lake County. 

The district embraces the cities and village of Deerfield, Highland I'ark, 
High wood. Lake Forest, Lake Bluff, North Chicago, Waukegan and Zion 
City. The population of the district was 36,000 in 1920 and estimated at 
38,000 in 1927. Sewage-treatment plants have been built at Highland Park, 
Highwood. Deerfield, Lake Rluff and Waukegan. The plant at Lake Forest 
was remodeled. Some of the plant sites are in high-class residential districts 
and. therefore, the plants represent especially good design and also archi- 
tectural appearance. 

The management of the district is vested in a board of five trustees ap- 
pointed by the county judge and two circuit court judges. The district is 
divided into five wards and one trustee is appointetl for each, they elect a 
president from among their number. 

With popular approval the board of trustees is authorized to issue bonds 
not to exceed five per cent of the valuation of the taxable property in the 
district. This power has not been exercised. All the treatment works thus 
far constructed, costing $350,000. have been paid out of current and accumu- 
lated taxes. The Board is not vested with authority to construct sewers or 
otlici" works by special assessment. 

Sanitary Districts Organized L'nder Act of 1917. 
In 1917 an Act was passed by the legislature providing for the estab- 
lishment of sanitary districts, generally throughout the State, upon petition 
of 100 legal voters, to the county judge of the county in wliich the major 



^10 THE SANITARY DTSTKKT M I iVK.M I'.NT 

portion of the proposed district is located. Upon such petition the county 
judge and two judges of the circuit court fix the boundaries of the district 
and the proposition is submitted to the legal voters for approval. Xo terri- 
tory located more than three miles from the corporate limits of any city, 
town or village can be included in such a district but it max include con- 
tiguous territory of one or more incorporated communities. 

The management nf such districts is vested in a board of three trustees 
appointed by the county judge. The trustees elect one of their members to 
act as president. The salary of the truslc-cs was originally fixed at not to 
exceed $100 ]ier annum and by legislature in \'>27 was increased to $300 per 
annum. In addition to providing for the treatment and disposal of sewage 
of the district, the trustees are empowered to preserve the purity of the water 
supplied to the inhabitants and to this end are given power to prevent the 
pollution of any waters from which a water supply is obtained 13\ an\ com- 
munity within the district within a radius of fifteen miles from the intake or 
source of such water supply. 

The districts are authorized to levy and collect taxes not to exceed one- 
third of one per cent of the assessed valuation of the taxable property and 
upon vote of the people to levy an additional one-third of one per cent tax and 
to issue bonds not to exceed five per cent of the assessed valuation. 

In 1923 the law was amended so as U> give the trustees power to con- 
struct and pay for sewers, drains, laterals and appurtenances b\- special 
assessments, in accordance with the Local Improvement Act of 1897. 

The first sanitary district established under the Act of 1917 was organ- 
ized at Decatur in August, 1917. The districts that have been established 
under this Act are given in the accompanying table : 

Sanitary Districts Established Under Act of 1917. 



Location 


Date established 


Arm 8q. Miles 


Decatur 


1917 


o3 


Bloomington-Normal 


1919 


8.3 


El Paso 


1919 


2.3 


Champaign-llrbana 


1921 


8.5 


Downers Grove 


1921 


5.6 


Elgin 


1922 


8.3 


Taylorville 


1923 


3.5 


Springfield 


1924 


36.2 


Galesburg 


1924 


17.2 


Wheaton 


1925 


15.5 


Clinton 


1925 


l.G 


Aurora 


1925 


10 


Lincoln Highway 


1925 


10..-) 


Hinsdale 


1926 


13 


Rockford 


1927 


44.5 


Beardstown 


1927 


11.6 


Peoria 


1927 


28.0 



THE SANITARY DISTRICT MOVEMENT 411 

The establishment of the sanitary districts has and is making possible 
the abatement of nuisances and protection of water supplies and fish life. 
The remedy applied is the interception of the sewage, and delivery to a 
treatment plant for purification. 

In the communities with combined storm and sanitary sewers, intercept- 
ing sewers are built with a capacity of 400 gallons per capita in 24 hours, 
with overflows into the nearby streams. In Springfield, where four com- 
bined sewers discharged ten miles above a proposed waterworks impounding 
dam, the intercepting sewer system was constructed so as to carry up to 
325 gallons per capita per 24 hours to the treatment works at a point below 
the proposed dam and to chlorinate any overflow at the pumping station 
before allowing it to discharge into the stream higher up. This was found 
necessary because the cost of diverting the entire flow during storms to below 
the dam was estimated at $2,250,000, which was a prohibitive expense under 
the limited taxing and bonding powers granted to the district under the 
general statute. 

Other districts were also compelled to retrench, on the expenditures for 
treatment or intercepting works on account of lack of available funds. At 
Decatur, where the cost was increased by the large volume of industrial 
wastes, that from the starch works amounting to about 4,500,000 gallons per 
day, the first funds available covered but little more than half the necessary 
total expenditures. The total flow of sewage is over 10.000.000 gallons per 
day, which is over 25 per cent of the voted capacit\- of the plant. At this 
rate of flow the displacement period in the Imhoff tanks is about 1.15 hours, 
but the tanks have reduced the suspended matter about 75 per cent by weight. 
This, however, leaves a heavy burden on the sprinkling filters. Pre-aeratioii 
units have been added in order to make possible increased filtration rates. 

Sewage-treatment plants operated by sanitary districts formed under 
the Act of 1917 are: 

Date first iniils 
District comiJlrted 

Downers Grove 1921 

Decatur 1922-1924 

Champaign-Urbana 1923-1924 

Elgin 192o-192fi 

W'heaton 1925 

All of these plants include tanks and sprinkling filters except W'heatfjn, 
which has intermittent sand filters. Decatur also has pre-aeration units. 

In three other districts, namely, Bloomington-Normal, Taylorville and 
Springfield, major construction work on sewage treatment plants is under 
way. Up to 1926, the total bonds authorized to cover the cost of sewage- 
treatment pumping and intercepting works in the various districts of the 



412 THE SANITARY DISTRICT .MGVE.MICNT 

State, organized under the law of 1917, amounted to $4,504,000. In addi- 
tion the C(jst of part of some works was defrayed out of accumulated taxes. 
The ]HT c;ii)it;i cnsl of the sewage-treatment plants constructed thus far 
\arii(l from ^'».4() in Decatur to $12.17 in Elgin for the basis capacity 
of ihf plants. 

I\i\i:k C'onsi'.kvamv Distrkts. 

The establishniL-nt of River Conservancy Districts was provided for 
ii\ an .\ct of the legislature passed in 1925. Such districts are authorizetl 
to provide for sewage-disposal, development of water supplies, roads and 
sanitary policing. Provisions are contained in the law providing for the 
transfer of sewage works from existing municipalities or sanitary districts 
upon a favorable referendum \(ite and the compensation of such communi- 
ties for works constructed and transferred. 

The Fox River Conservancy District is the only one organized under 
this law. The Fox River confederation was organized in 1923, with the 
object of preventing the pollution of the Fo.x River, regulating the flow, and 
restoring it for recreation purposes. .\lso with a view to securing a pure 
water supply for the communities located on the river. To carry out this 
program, the confederation secured the passage of the River Conservancy 
Act. under which a district was approved by the voters in 1926, and organized 
to C'lrry dut the general provisions of the law. 

]\i:it:ri:nci:s. 

Some projects for Se\va^'e-Tle:itment Works under the niinois Sanitiiry District .\ct of 1M17. Snmuel 
A. (ireele.\'. 

Transactions of American Societj of Civil Engineers, Vol. 51, p, 441. Dec. 1027. 



THE PUBLIC TUBERCULOSIS SANITARIUM 
MOVEMENT 

Strike a match, lisht the fuse of a t^iaiit firecracker, watch the nervous 
spark that hastens along the full length of the fuse cord, listen to the ear- 
splitting explosion and you have the story of the public tuberctilosis sani- 
tarium movement in Illinois. Back in the nineties somebody struck the 
match w hen an agitation about tuberculosis control was started. That agita- 
tion sputtered along, like the nervous spark in the fuse cord, mostly in the 
form of legislative bills providing for a State sanitarium or system of sani- 
tariums, for about ten years. 

Then in 1908 the movement took on new life when the General Assembly 
enacted a law that authorized cities to construct and maintain tuberculosis 
sanitariums where popular favor expressed itself through the ballot box. 
Four cities, Chicago, Rock Island, Peoria and Rockford, in the order named, 
took advantage of this law and actually acquired sanitariums which were 
placed in operation. Two of these, Rockford and Rock Island, were later 
transferred to the county tuberculosis sanitarium board when the counties in 
which these cities arc located undertook to maintain sanitariums. 

This municipal sanitarium law of 1908 was a sort of preliminary burst 
that kept the fuse cord spark alive and gave it a fresh start sufficiently strong 
to carry it over seven more years of agitation. During this period the idea 
of a State sanitarium was definitely abandoned and in its place grew u]) the 
county sanitarium idea. 

This new notion found favor with the legislature so that in 1915 a 
law was enacted which reposed in counties the same privileges extended to 
cities under the 1908 sanitarium law. The next year eight counties took 
advantage of the law and then the major explosive outburst occurred in 1918 
when 33 counties decided by popular vote to levy upon themselves the tax 
provided for under the sanitarium law. Since that time only six additional 
counties have adopted the tuberculosis sanitarium proposition. 

Observation of the table reveals the fact that sentiment in favor of the 
sanitarium project prevailed in eight counties. Rock Island County later 
(1920) voted favorably on the question but Greene has steadfastly refrained 
from adopting the measure. The vote cast on the sanitarium proposition in 
these ten counties trailed a trifle behind that cast for United States President 
in the same election. 

(413) 



Against 


Total 


7,263 


21,357 


5,576 


17,231 


2,907 


5,089 


9,192 


29,422 


5,893 


21,287 


4,337 


12,212 


2,335 


9,706 


7,714 


17,375 


4,284 


9,382 


18,370 


24,701 



414 THI-: TUIil'.KCULOSIS SANITARIU^t MOVEMENT 

111 \'H(i the tulxTciilosis [jrojcct was vol(,-<l (in in ten eounties. These 
inchideil ; 

Votes Cast. 

For 

Adams 14,094 

Champaign 11,655 

Greene 2,182 

Kane 20,230 

LaSalle 15,394 

Livingston 7,875 

Morgan 7,371 

McLean 9,661 

Ogle 5,098 

Rock Island 6,331 

For tlie big-, popnlar explosive outburst of favor that occurred in 1918 
sentiment had broadened considerably in volume. This was manifested by 
the size of the vote and the favorable majority. The election was cleverly 
timed and the campaign ingeniotisly conducted. Under the strain of war 
activities health was a subject greatly stressed by the Government. People 
had reached the point where they fell whole-heartedly in line with anything 
the Government favored. Not only so but markets were good, wages were 
high and the people were getting accustomed to the sound of big figures 
when public appropriations were talked of. Forty or fifty thousand dollars 
sounded like a family budget schedule compared with the gigantic sums 
that Congress prodigiously appropriated daily for war activities and yet the 
tuberculosis people asked for amounts of that character for sanitariums. 

Furthermore, people had come to respond quickly and generously to the 
"drive" method introduced by the Government in connection with the sale of 
loan securities. The tuberculosis people were not slow to recognize the im- 
portance of the drive and they utihzed this campaign methotl effectively in the 
thirty-three counties. 

Thus we find a jiroponent of the measure enthusiastically observing: 

*"The table shows the result of the election in thirty-three Illinois 
counties where the county tuberculosis sanitarium measure was sub- 
mitted to a popular referendum. 

"It was a landslide. 

"The sanitarium proposition carried by an overwhelming majority 
in every county. In nine counties more votes were polled on the sani- 
tarium measure than were cast for United States Senator. There were 
four issues, including the sanitarium proposition, on the little ballot, 
and in twenty-one counties the sanitarium project led the entire ticket. 

•niinois .\irow, December 1918. 



THE TUBERCULOSIS SANITARIUM MOVEMENT 



415 



"There are 102 counties in Illinois. The majority of votes on the 
sanitarium proposition in the thirty-three counties where the measure 
was submitted to the people was 101,209, or nearly twice the majority 
given the successful candidate for United States Senator in the entire 
State. The sanitarium measure polled a larger majority in these thirty- 
three counties than any other issue on the little ballot polled in the 
entire State. 

"This result astounded even the most sanguine of our enthusiastic 
sanitarium boosters— and it was accomplished in the face of a series 
of handicaps, the like of which is seldom encountered in any campaign." 

Counties included in this "landslide" were: 



Boone 


Grundy 


Marion 


Bureau 


Henry 


Piatt 


Christian 


Jackson 


Pike 


Clark 


Jefferson 


Randolph 


Clay 


Kane 


Scott 


Coles 


Lee 


Stephenson 


Crawford 


Livingston 


Tazewell 


DeKalb 


Logan 


Vermilion 


DeWitt 


McDonough 


Whiteside 


Douglas 


Macon 


Will 


Fulton 


Madison 

Woodford 


Winnebago 



Subsequently the project was voted on in six other counties. It was 
carried in each. The counties and vears of election were : 



Alexander* 


1921 


Knox 


1920 


Menard 


1922 



Montgomery 


1920 


Sangamon 


1922 


Shelby 


1920 



Sanitariums have not been constructed in all of the counties which levy 
taxes for sanitarium purposes. The law does not make the acc[uisition of 
a sanitarium mandatory but it does specify that the funds collected shall be 
used for no purpose except to combat tuberculosis. Accordingly most of the 
counties have seen fit to hire sanitarium care for their tuberculous citizens 
rather than to construct and operate sanitariums of their own. 

Thus at the close of 1927 there were 46 counties collecting taxes under 
the provisions of the tuberculosis sanitarium law, commonly known as the