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Indiana HistorianTheA Magazine Exploring Indiana History

Public Health in Indiana

2 The Indiana Historian, March 1998 © Copyright Indiana Historical Bureau 1998

Focus

The Indiana HistorianMarch 1998

ISSN 1071-3301Order Number 7043

EditorPamela J. Bennett

Lead ResearcherPaula A. Bongen

DesignerDani B. Pfaff

Contributing EditorsCarole M. Allen, Janine Beckley,

Alan Conant, Dani B. Pfaff,Virginia Terpening

The Indiana Historian provides re-sources and models for the study of localhistory to encourage Indiana’s citizens ofall ages to become engaged with the his-tory of their communities and the state ofIndiana.

The Indiana Historian (formerly TheIndiana Junior Historian) is issued quar-terly from September through June.

It is a membership benefit of the Indi-ana Junior Historical Society. One compli-mentary subscription is provided to Indi-ana libraries, school media centers, andcultural and historical organizations.

Annual subscriptions are available for$5.00 plus tax. Back issues are availableat individual and bulk pricing.

This material is available to visuallyimpaired patrons in audio format, cour-tesy of the Indiana History Project of theIndiana Historical Society. Tapes are avail-able through the Talking Books Program ofthe Indiana State Library; contact the Talk-ing Books Program, 317-232-3702.

The Indiana Historian is copyrighted.Educators may reproduce items for classuse, but no part of the publication may bereproduced in any way for profit withoutwritten permission of the Indiana Histori-cal Bureau.

This issue of The IndianaHistorian examines the early yearsof public health science in the latenineteenth and early twentiethcenturies.

Below on this page are a fewsuggestions about using this issueas a springboard for furtherinvestigation: “You be the histo-rian.”

On pages 3 and 4, there is abrief history of medicine andpublic health issues from a na-tional perspective. The timelinethroughout provides a broadcontext for the topic.

Indiana’s efforts and progressin fighting disease and educatingthe public about health are re-viewed on pages 5-7. Especiallyimportant was the creation of theIndiana State Board of Health in1881.

Dr. John N. Hurty’s leader-ship of the State Board of Health

from 1896 to 1922 is reviewed onpages 8-9. Hurty’s energetic andconfrontational style in the war ondisease is evident in some of thematerials reproduced in thisissue.

On pages 10 and 11, the coreproblem of obtaining pure water isaddressed. The drawing on theback cover relates to this topic.

Indiana’s fight for healthymilk is briefly reviewed on page12.

On page 13, the life andaccomplishments of Dr. HarveyWashington Wiley are reviewed.Wiley was crucial in the passageof the first federal Pure Food andDrugs Act in 1906.

The present state of publichealth science is briefly consid-ered on page 14.

Page 15 contains the bibliog-raphy and sampling of resources.

There are many difficult words in thisissue. Have a dictionary on hand tohelp.• Explore the public health historyof your area–town or county, for ex-ample. Use county histories, newspa-pers, public records in the court-house, cemetery records, etc. Createa timeline of that history.• Select an important event or per-son in your public health history andmake a marker–see page 13 of theissue–as a commemoration.• Contact public health officials inyour area and the Indiana Depart-ment of Health for resources to helpunderstand more about public healthissues today.• Dr. John N. Hurty and the StateBoard of Health conducted publicrelations campaigns against healthhazards using posters and otherprinted materials. Survey how suchcampaigns are conducted now; gathersample materials. Identify a currenthealth hazard and produce a cam-paign to alert others.• Investigate the water supply for

your community. Arrange a tour ofthe water treatment facility and/orinvite engineers to make a presenta-tion in your classroom.• Explore how your family and yourcommunity make sure your food issafe. Invite a teacher, nutritionist,extension agent, or other food-relatedprofessional to discuss food safety–and other food-related health issues.• Explore how milk and other dairyproducts are produced and marketedtoday.

• Talk to older persons in yourarea. How was milk bottled anddelivered ten, twenty, thirty, or fortyyears ago?• What is pasteurization? Is it aprocess only for milk?

• Invite a physician, health care pro-fessional, or scientist to talk withyour class about medical and scien-tific advances and challenges.• Collection of “vital statistics” be-gan in Indiana under Dr. Hurty. Whatare they? How are they collected?Why are they so important?

You be the historian

Cover illustration: This proclamation byIndiana Governor Noah Noble (1831-1837) has been reproduced from theOctober 27, 1832 issue of the IndianapolisIndiana Journal. It illustrates well thebelief that disease was caused by an“overruling Providence.” The proclamationwas first published in the Indiana Journal,October 20, 1832, but the available copywas not clear enough for reproduction.

© Copyright Indiana Historical Bureau 1998 3The Indiana Historian, March 1998

Progress in public health

Hippocrates, a Greek,founds profession ofphysicians, developsHippocratic oath, andencourages separation ofmedicine from religion;earns title “Father ofMedicine” (Hellemansand Bunch, 34).

The Canon of Medicinewritten about this time byAvicenna (Ibn Sina) is a fivevolume treatment of Greekand Arabic medicine thatdominates the teaching ofmedicine in Europe until the17th century (Hellemansand Bunch, 72).

King John of Englandproclaims the firstEnglish food lawprohibiting adulterationof bread withingredients such asground peas or beans(“Milestones,” 1).

Paracelsus argues thatmedicine should bebased on nature and itsphysical laws; he is firstto suggest the use ofchemical substances,such as mercury andantimony, as remedies(Hellemans and Bunch, 106).

Lady Montagu bringsto England theTurkish practice ofinoculating childrenwith smallpox. Shehas her two childrenvaccinated(Hellemans andBunch, 179).

Zabdiel Boylstonintroducesinoculationagainst smallpoxinto Americaduring theBoston epidemic(Hellemans andBunch, 181).

First Americanmedicalsociety isfounded inNew London,Connecticut(Hellemansand Bunch,215).

391 to 400 BC 1000-1009 1202 1530 1717 1721 1763

Life free from disease is anadvantage that many people in theUnited States take for granted.Most people have confidence thatfood, water, and medicines aresafe, and that waste products andgarbage are disposed of properly.Local, state, and federal laws existto protect citizens from food anddrug adulteration and waterpollution and to require immuni-zation against certain contagiousdiseases. Extraordinary health

challenges remain, but scientistsnow have sophisticated tools andknowledge to fight diseases andhealth hazards that occur.

In the seventeenth, eigh-teenth, and nineteenth centuries,the situation was very different.Diseases of the earliest colonistsin North America included small-pox, malaria, diarrheas anddysenteries, respiratory prob-lems, measles, mumps, scarletfever, diphtheria, and others

(Duffy, 10). Typhoid, yellow fever,and cholera also killed manypeople.

Until the last half of thenineteenth century, doctors knewalmost nothing about the realcauses of diseases. Bleeding,purging, vomiting, and blisteringwere standard treatments for manyillnesses (Ibid., 20). There weremany dangerous patent medicines,including compounds such ascalomel containing mercury whichis poisonous (Janssen, 17).

As the population grew beforeand after the American Revolution,the number of people affected withdiseases also increased. Peopleknew that many diseases werecontagious. Doctors did not knowhow diseases were spread. Onepopular theory was the “miasma”theory, which stated that diseasewas caused by the gaseous sub-stances coming from stagnantwater or decaying matter (Duffy,24, 21-22, 41). Doctors and localofficials could find many areas thatfit the “miasma” theory.

During the first half of thenineteenth century, street cleaningand garbage removal was theresponsibilty of individual citizens.In addition, hogs, cattle, andhorses were allowed to roam thestreets in cities and towns. An-other major problem was thedisposal of human waste. Somelarger cities employed people toempty privies, but most smalltowns had no such provisions.Drainage from overflowing privies

This chart demonstrates the dramatic reduction of early childhood deaths in Indianarelated to all people who died in Indiana (Indiana statistics).

This chart documents causes of death over time. In the later years most leadingcauses of death are no longer from infectious diseases. These statistics demonstratethe effect of advances in science and medicine. Statistics for 1850 and 1991 are forthe United States.

tuberculosis

fever

typhoid fever

pneumonia

dropsy

accident

croup

scarlet fever

cholera

dysentery

tuberculosis

pneumonia

typhoid fever

casualtycerebrospinal meningitisbronchitis

diphtheria

whooping cough

smallpox

scarlet fever

tuberculosis

pneumonia

violence

cancer

typhoid fever

influenzacerebrospinal meningitisdiphtheriapuerpural septicemia

diarrheal diseases

heart/circula- tory diseasecanceraccidentspneumonia/ influenzamotor vehicle accidentstuberculosisdiabetesnephritis/ nephrosiasuicidediarrhea/ enteritis

cancer

heart disease

cerebrovascular diseasespulmonary diseases

accidentspneumonia/ influenza

diabetes

suicide

homicide

HIV

Leading Causes of All Deaths for Selected Years

1850 1905 1991U.S.statistics

Indianastatistics

infectious diseasenon-infectious disease, accident, or violence

1882 1950Indianastatistics

Indianastatistics

U.S.statistics

Deaths of Children Age Four and under as a Percentage of All Deaths in Indiana

1850 1905 19911882 1950

39.4% 34.3% 29.3% 7.4% 1.9%


1765 1785 1789 1793 1795 1796 1800 1808

Massachussettsenacts firstgeneral foodadulteration lawin the UnitedStates (“Mile-stones,” 1).

Life expect-ancy of maleinfants at birthin Massachu-setts and NewHampshire is34.5 years(Cummings,[238]).

An epidemic ofyellow fever inPhiladelphiakills about10% of thepopulation(Hellemansand Bunch,243).

John Morganfounds firstmedical schoolin America atthe College ofPennsylvania(Hellemans andBunch, 217).

Napoleon offers prize forpractical method of foodpreservation. Francois Apperteventually receives prize byintroducing process of bottlingor canning, heating, and thensealing (Hellemans andBunch, 245).

English physicianEdward Jennerperforms firstinoculationagainst smallpoxby infecting a boywith cowpox(Hellemans andBunch, 245).

BenjaminWaterhouse isfirst U.S.physician to usenew smallpoxvaccine—on hisson (Hellemansand Bunch, 251).

August 20Vincennes Western Sun,August 20, 1808, statesthe cause of diseasesaffecting town are to befound in the decayinggrasses growing alongthe river.

Progress in public healthcontinued

and accumulating garbage oftencontaminated community watersupplies (Ibid., 69, 71, 73, 75).

Rapidly growing population,new technology, and increasedmanufacturing in America’s citiesin the nineteenth century broughtadditional health problems. Insmall towns, citizens safely grewand produced most of their ownfood. In larger cities, milk, meat,and canned foods were generallysupplied to people by dairies,meat packers, and food proces-sors. As early as the seventeenthcentury, New York and Massachu-setts had laws regulating specificfoods (Young, 33-34). Massachu-setts, in 1785, passed what “is

generally considered the firstcomprehensive food adulterationlaw . . . in the United States”(Janssen, 17).

American pharmacists andphysicians were also concernedabout the purity of drugs andmedicines. This concern helpedestablish the first two schools ofpharmacy in the U.S.—in Phila-delphia in 1820 and in New YorkCity in 1828. By the 1840s, therewas enough concern about drugadulteration that the U.S. Con-gress passed the Drug Importa-tion Act of 1848. This law re-quired all drugs entering the U.S.through its six major ports to beanalyzed for “quality, purity, and

fitness for medical purposes”(Young, 7, 6, 10, 14).

Throughout the rest of thenineteenth century, more statespassed pure food and drug legisla-tion. The Pure Food and DrugsAct of 1906 was the beginning offederal regulation of food anddrugs in the U.S. (Young, 3).

During this same period,public health evolved as a medicaldiscipline and a governmentalfunction. Reviewing public healthin Indiana in 1916, Dr. William F.King, assistant state healthcommissioner, provided hisdefinition of the field of publichealth:

Public health is synonymous withpreventive medicine, and preventivemedicine had its real beginning withthe discoveries of Pasteur . . . .Pasteur proved that so-calledcontagious diseases were due togerms . . . and he said, “It is within thepower of man to drive all contagiousand infectious diseases from the earth”(King, 272).

The life expectancy of a maleinfant at birth in Massachusettsor New Hampshire in 1789—just afew years after the AmericanRevolution—was 34.5 years(Cummings, [238]). The life ex-pectancy of a white male born in1990 was 72.9 years (StatisticalAbstracts of the U.S.). The dra-matic increase in life expectancycan be traced to the efforts ofscientists in private businessesand government agencies toprotect and improve the publichealth of American citizens (Duffy,134, 148-49).

This chart demonstrates how the flu—an infectious disease—spread in1918 and how it COULD spread in 1998. The short time today for a

disease to spread globally presents major challenges for public healthscientists. What is a pandemic? What other pandemics have

there been in history? Are there any pandemics today?

Ada

pted

from

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3, 1

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p. 6

3.

Flu Pandemics: Then and NowYear

WorldPopulation

Primary mode oftransportation

Time for virus tocircle the globe

Preventivemeasures

Treatments

Estimated dead

What COULDhappen in1998

5.9 billion

Jets

4 days

Vaccines

Someantiviral drugs

60 million?

What happenedin 1918

1.8 billion

Troop ships,railroads

4 months

Gauze masks,disinfectants

Bed rest,aspirin

20+ million


Health of Hoosiers

1816 1817 1832 1843 1844 1847

ThéophileRenéLaënnec ofFranceinvents thestethoscope(Hellemansand Bunch,265).

Pandemic ofcholeraspreads overIndia, EastAfrica, andAsia(Hellemansand Bunch,265).

October 18Cholera epidemicprevails throughoutIndiana. Governor Nobleproclaims secondMonday in November asday of fasting and prayer(Indianapolis IndianaJournal, October 27, 1832).

Oliver Wendell Holmes ofMassachusetts advisesdoctors to prevent childbedfever (puerperal fever—common to mothers afterchildbirth at the time) bywashing their hands andwearing clean clothes(Hellemans and Bunch, 311).

The Commission forEnquiring into Stateof Large Townsestablishes aconnection betweendirt and epidemicdisease in England(Hellemans andBunch, 311).

AmericanMedicalAssociation isfounded(Hellemansand Bunch,315).

1849 1850

IndianaMedicalSociety isfounded inIndianapolis(Russo, 40).

4.5% of Indiana’spopulation lives intowns of more than2,500; by 1880 thisnumber had risen to19.5% of Indiana’spopulation(Thornbrough, 555).

Early settlers in Indianaendured the hardships of estab-lishing homes, towns, and farmsin the wilderness. In addition,these settlers faced seasonalfevers, frequent epidemics, andmany other devastating illnesses.

People did not know whatcaused these terrible diseases.Doctors, with little or no training,treated patients using primitivemethods and unregulated medi-cines, and hoped for the best. Afew people believed that stepscould be taken to help improve thehealth of the public. One such

In 1832, Dr. DanielDrake of Cincinnati,Ohio explained howpeople could helpthemselves survivethe cholera epidemic(excerpted from theMadison IndianaRepublican, October18, 1832). Drakewas a well-knownphysician of theperiod.

Elihu Stout, editor of the Vincennes Western Sun, used his newspaperon August 20, 1808 to encourage people to help improve healthconditions. He warned against the dangers of decaying grasses by theWabash River, the source for drinking water. He also advocatedcleaning up the town’s streets, especially removing carcasses of deadanimals which were allowed to rot where they lay. Note the use of an“f” for an “s” in many words; it is an early writing style.

person was Elihu Stout, editor ofthe Vincennes Western Sun, whoseeditorial from 1808 is reproducedon this page.

By the 1830s, some Indianatowns had established boards ofhealth (Thornbrough, 668). Townofficials also enacted laws regulat-ing sanitation and providing forquarantine. The success of theseattempts was limited. “Disease wasstill pretty much considered to bea result of sin, and pestilence wasusually regarded as a dispensationof Providence” (Rice, 48). Theproclamation, on the cover of this

[. . .]

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1850 1856 1860 1862

Californiapasses apure foodand drinklaw(“Mile-stones,” 1).

Englishman, JohnSnow, shows thatprohibiting use of wellcontaminated withsewage reducesincidence of cholera inthe vicinity of the well(Hellemans andBunch, 325).

A city ordinancegives theIndianapolisBoard of Healthbroad powersover vaccinationagainst smallpox(Thornbrough,572-73).

1854 1854

Massachusetts lawprohibitsadulteration of milk,and three yearslater prohibits thefeeding of distillerywaste to cows(Cummings, 55).

Englandenacts aFood andDrugs Act(Grun, 425).

President Lincolnappoints a chemist toserve in the newDepartment ofAgriculture—thebeginnings of theBureau of Chemistry(“Milestones,” 1).

18681865

Joseph Lister ofEngland introducesphenol as adisinfectant insurgery, reducingsurgical death ratefrom 45% to 15%(Hellemans andBunch, 337).

January 16A patent for arefrigerator car isgranted to WilliamDavis, Detroit, Michigan.Davis also designs firstrefrigerated railroad carwhich is built 1869(Carruth, 299).

Health of Hoosierscontinued

issue, by Governor Noah Nobleabout the 1832 cholera epidemicprovides a good example of thatwidespread belief.

The cholera epidemics in1832 and 1849 encouraged at-tempts by Indiana physicians toorganize crusades against dis-eases. In June 1849 in Indianapo-lis, the Indiana State MedicalSociety was created. It noted thattreatment of disease was impor-tant, but it promoted the relativelynew idea that prevention of dis-ease was vital. In its first years,the society requested the IndianaGeneral Assembly to pass a lawrequiring registration of births,marriages, and deaths so thatdata could be collected to help indisease prevention. In 1851, asociety committee lobbied theGeneral Assembly to enact legisla-tion requiring drug manufacturersto reveal the exact ingredients oftheir compounds (Russo, 40-41).It took decades to accomplishthese valuable measures.

In 1852, the General Assem-bly did pass legislation giving citygovernments authority to estab-lish boards of health and toprevent pollution of streams withsewage, rubbish, and dead ani-mals. Cities could “destroy putridanimal or vegetable matter” andcompel building owners to cleanup dirty buildings. Cities were alsoauthorized to establish quarantineregulations. However, sanitaryand public health regulations

seem generally to have beenignored (Thornbrough, 571).

Luther D. Waterman, M.D.,president of the Indiana StateMedical Society, chastised theGeneral Assembly and encouragedhis fellow doctors in his 1878address:

We must not cease our labors, as abody, until the citizens of this Statehave pure air to breathe, pure water todrink, unadulterated food andmedicines, live in buildings that are notsources of infection to themselves ortheir neighbors, and have an intelligentbody of agents to warn and protectthem from preventable, indigenous,and importable causes of disease(ISMS, Transactions, 1878, p. 3).

In the 1870s, the IndianaState Medical Society began to

These excerpts from the Indianapolis Star illustrate the effect of the 1918 worldwide flupandemic in Indiana. How did this pandemic affect your community? Are there senior

citizens who remember it, and can you talk with them about their memories?

promote the idea of a state boardof health. Finally, the GeneralAssembly passed legislation onMarch 7, 1881 creating the Indi-ana State Board of Health. Fivethousand dollars per annum wasappropriated for the work of theboard for two years (Rice, 56, 61).

The early years of the IndianaState Board of Health were notvery productive because of lack offunds and changes of personnel(Ibid., 61-64). It worked to estab-lish local boards of health incounties, cities, and towns of thestate. It devoted much time toorganizing a system of registrationof vital statistics. It tried to edu-cate physicians and local health

India

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1874 1878 1878

Illinoispasses firstgeneralstate foodlaw(Cummings,97).

President of theIndiana State MedicalSociety emphasizescontaminated water,adulterated food, and“air impregnated withnoxious gases” ascauses of disease(Thornbrough, 668-69).

Survey of Indianaphysicians shows thatthere is generalacceptance amongthem that typhoid,malarial fever andcholera are caused bygerms (Thornbrough,667-68).

1880 1880

LouisPasteurdevelops thegerm theoryof disease(Hellemansand Bunch,355).

By this time all majorIndiana cities havesome sort of sewers,mainly to carry off rain.No more than 10% ofprivate houses inIndiana have indoorplumbing (Thornbrough,572).

1881

New York,New Jersey,and severalother statespass purefood laws(Cummings,97).

1881

IndianaGeneralAssemblyvotes toestablish aState Board ofHealth(Thornbrough,668).

officers about the causes andcontrols of diseases (ISBH,Monthly Bulletin, 35:11 [November1932], 163, 164). Many Indianaphysicians and citizens did not yetbelieve in the germ theory ofdisease (Phillips, 470).

In 1896, John N. Hurty, M.D.was elected secretary of the Indi-ana State Board of Health, aposition he held until 1922. Underhis leadership, the effectiveness ofthe Indiana board was rankedsixth in the nation in an AmericanMedical Association study in1914-1915 (Madison, 309).

According to Madison, “Bythe 1920s, the professional physi-

cian had achieved wide, though notcomplete, acceptance as the pri-mary source of medical care” (308).By that time also, the State Boardof Health had made advances incontrolling “diseases transmittedby impure water, milk, and food”(309). But the work of the board—and others—was needed, especiallyin the area of impure water:

Lakes, rivers, and streams were grosslypolluted by domestic waste and byindustrial wastes from canneries, oilrefineries, meat-packing plants, andfactories. Perhaps the most obviouslyoffensive sources of pollution were themany city and town sewer systemswhich simply discharged raw wastedirectly into the closest river (310).

Dr. John N. Hurty had a veryconfrontational style in his waron disease. According to Rice

(253), this is “A typical HurtyPoster of this Period [circa

1911-1915] Grim, Morbid andTerrifying.” Look at health andmedical advertisements today.

How do they comparewith Hurty’s?

One campaign of the IndianaState Board of Health under Dr.John N. Hurty focused on thecare and health of newbornbabies. The board distributedThe Indiana Mothers’ BabyBook, pictured in this poster.“The book was reprinted for anumber of years and literallythousands of copies weredistributed.” The poster wasoriginally printed in the ISBHBulletin, October 1915 (Rice,310, 312).

1882

Robert Kochdiscovers bacteriumthat causestuberculosis, the firstdefinite associationof a germ with aspecific humandisease (Hellemansand Bunch, 359).


1883 1889

Dr. Harvey W.Wiley of Indianabecomes chiefchemist of theU.S. Departmentof Agriculture(“Milestones,” 2).

Indiana StateBoard of Healthofficially endorsesgerm theory in itspublished report(Phillips, 470).

March 5Dr. John N. Hurty iselected to thesecretaryship of theIndiana State Boardof Health (Russo, 44).

1898

June 2Paul-Louis Simond, fightingthe bubonic plague pandemicin Bombay, India, realizesthat fleas on rats transmit thedisease to humans(Hellemans and Bunch, 391).

1899

Indiana GeneralAssemblypassescomprehensivefood and druglegislation(Phillips, 471).

1896

Hurty leads the fightDr. John N. Hurty was ap-

pointed head of the Indiana StateBoard of Health in 1896. Onehistory of public health inAmerica, cites Hurty as one of six“civic health leaders who influ-enced health reform at the stateand national levels” (Duffy, 222).

John Newell Hurty was bornon February 21, 1852 in Lebanon,Ohio. When he was fourteen, hisfamily moved to Paris, Illinois.Here he met Colonel Eli Lilly.Hurty later recalled, “Col. Eli Lillybeguiled me into the drug busi-ness. . . . shaped my life work”(Rice, 10).

Lilly was part owner of theBinford and Lilly Red Front Drug-store. From 1869 to 1871, Hurtywas Lilly’s apprentice. Encouragedby Lilly, Hurty attended thePhiladelphia College of Pharmacyand Science for one year, return-ing in 1872 (Ibid., 17, 18-19).

In 1873, Lilly left Paris forIndianapolis, where he opened apharmaceutical laboratory withDr. John Johnstone, a dentist. AtLilly’s request, Hurty joined themas their chief chemist. In 1879,Lilly and Johnstone ceased theirpartnership. Lilly went on tofound Eli Lilly and Company, theIndianapolis pharmaceuticalcorporation (Ibid., 19).

In 1879, Hurty opened hisown drugstore at the corner ofOhio and Pennsylvania streets. Inthe basement, he set up one of thefirst analytical laboratories in the

state. He tested the purity ofwines for local hotels, paints andlubricants for the railroads, coalfor the power company, and waterfor the Indianapolis Water Com-pany. He also created cosmeticsfor local theatre troops (Ibid., 19-20, 30-31).

Over the next ten years,Hurty began his long associationas a faculty member with both theIndiana Dental College and theMedical College of Indiana. In1884, he established, and for atime taught at, the School ofPharmacy at Purdue University. In1891, Hurty earned his medicaldegree from the Medical College ofIndiana (Ibid., 38-39, 25, 36).

Hurty fought for andachieved many advances in thetwenty-six years he led the StateBoard of Health. The chart of lawspassed on the next page showsthe broad range of daily life andbusiness that was connected tothe public health of citizens.

In 1922, he resigned to runfor the Indiana General Assembly.He was elected in 1922. His majorgoal was passage of legislation tostrengthen the State Board ofHealth. His efforts were defeated,(Ibid., 370, 373-376). He died onMarch 27, 1925.Sources: See Justin E. Walsh, gen.ed., A Biographical Directory of theIndiana General Assembly, Vol. 2,1900-1984 (Indianapolis, 1984), 209-210, for specific biographical informa-tion.

This cartoon honors Dr. Hurty’s service toIndiana. It expresses the positive effectthat Hurty’s bill in the Indiana GeneralAssembly could have for Indiana. Hurtyhad resigned from the State Board ofHealth and been elected to the GeneralAssembly in 1922. The cartoon appearedin the Indianapolis Times, January 11,1923. The bill was defeated in February(Rice, 376).

Ric

e, 6

9.

Dr. John N. Hurty in 1896.

1890

Life expectancyof white males atbirth in the U.S.is 42.5 years(StatisticalAbstracts of theU.S.).

1883

Robert Kochdiscovers bacteriumthat causes choleraand shows thatcholera can betransmitted by foodand drinking water(Hellemans andBunch, 361).


1902 1906

Congress passeslaw organizing U.S.Public Health andMarine HospitalService thusestablishing for thefirst time a federalrole in public health(Duffy, 240-41).

June 30Pure Food and DrugsAct is passed byCongress; on same day,Meat Inspection Actpasses requiring federalinspection for all plantsin interstate commerce(Carruth, 402, 404).

1907 1912

Indiana GeneralAssembly revises itsfood and druglegislation, alignedmore closely withfederal Pure Food andDrugs Act (OutdoorIndiana, September1970, 33).

Dr. John Hurty,Indiana StateBoard of Health,is electedpresident of theAmerican PublicHealth Associa-tion (Russo, 46).

19201902

U.S. Congressappropriates funds toestablish foodstandards and to studythe effects ofchemicals on digestionand health (“Mile-stones,” 2).

October 10Due to influenzaepidemic, Indiana Boardof Health issues orderbanning all publicgatherings in the stateuntil October 20(Indianapolis Star,October 10, 1918, 1).

1918

1899 - Pure Food and Drug Law

1903 - Quarantine Law

1907 - Sterilization Law

- Anti-toxin Law

- Drug Sample Law

- Pure Food and Drug Law,amended in 1911

1909 - Sanitation of Food ProducingEstablishments Law

1911 - Prevention of InfantBlindness Law

- Hydrophobia Law

- Renovated Butter Law

- Cold Storage Law

1913 - Vital Statistics Law

- Sanitary Schoolhouse Law

- Medical School Inspection Law

- Anti-Rat Law

- Public Water Supply Law

- Weights and Measures Law

- Clean Milk Can Law

- Public Playgrounds Law

- Establishment of SanitaryDistricts

- Housing Law

- County Hospital Law

- Sanitary Mattress Law

- Fertilizer Reduction Plant Law

- Mausoleum Law

- False Advertisement Law

- Cigarette Law

- Transportation of SchoolPupils Law

- Schoolhouse Civic andRecreation Center Law

- Child Neglect Law, amendedin 1915

1915 - Anti-Tuberculosis Law

- Full Sized Sheet Law

- Drainage, Sanitary andReclaiming District Law

- Sanitary Packing and Shippingof Rags and Paper Stock Law

- Cutting Weeds Along PublicHighways Law

Some achievements in Indianaunder Hurty’s administrationat the State Board of Health

Source: J. N. Hurty, “Review of Public Health Work inIndiana,” in Lee F. Bennett, ed., Proceedings of the IndianaAcademy of Science 1916 (Indianapolis, 1917), 233-35.

The danger of flies—as carriers of “filth-borne diseases” such as typhoid fever—wasa major campaign of the Indiana State Board of Health under Dr. John N. Hurty. A:This health poster “in true Hurty style” shows and tells the dangers of flies (Rice,140). B: This vivid image was on a State Board of Health postcard with a messageabout filth to “Dear Citizen” from “A Housefly and Family” (Rice, 143). C: Thenewspaper clipping gives some indication of statewide inaction in 1909.

Guard against flies

India

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5,

1909.

A.

B.

C.

Life expectancyof white malesat birth in theU.S. is 56.34years; all othermales, 47.14(StatisticalAbstracts of theU.S.).


1928 1930 1930 1932 1935 1935

AlexanderFlemingdiscoverspenicillin inmolds; it is notused clinicallyuntil the 1940s(Hellemans andBunch, 451).

The PostumCompanybeginsmarketingfrozen foods forthe first time(Hellemans andBunch, 457).

Slicedbread isintroduced(Hellemansand Bunch,457).

Domagk uses Prontosilon his daughter toprevent infection; itssuccess makesProntosil famous as thefirst “wonder drug”(Hellemans and Bunch,469).

Congress passesSocial SecurityAct whichimmediatelyprovides millionsof dollars forpublic healthservices (Duffy,258).

German chemistGerhard Domagkdiscovers firstsulpha drug—Prontosil(Hellemans andBunch, 461).

1927

A separate lawenforcement agency isformed—the Food,Drug, and InsecticideAdministration. In 1930its name is changed tothe Food and DrugAdministration(“Milestones,” 3).

1925

Indiana GeneralAssemblypasses lawrequiringpasteurization ofmilk ortuberculintesting of cattle(Madison, 314).

Obtaining pure waterA supply of pure water was

one of the crucial elements forIndiana’s earliest settlers. Oftenthat supply was a pure spring orstream, or—if necessary—a wellhad to be dug.

As towns grew, water had tobe provided and regulated. Forexample, in 1814, Jeffersonville,Indiana trustees passed thefollowing ordinance to protect thetown’s public wells:

if any person or persons, after the datehere of shall let the Bucket go downthe well without supporting it by thehandle or windlass or shall wrench[rinse] clothes at the well, or waterhorses with the buckets, he or she sooffending shall on conviction thereof befined fifty cents with costs for eachoffense (BROADSIDES: Indiana, TheEarly Years, Resource Guide[Indianapolis: Indiana HistoricalBureau, 1987], p. 226).

Throughout the nineteenthcentury, the population of Indiana

grew—and so did its industries.City and town officials found itmore and more difficult to provideclean water and to deal withaccumulating waste and garbage.Physicians and scientists werealso beginning to understanddiseases and connect them withsanitary conditions.

The Indiana State Board ofHealth under Dr. John N. Hurtyemphasized testing of watersupplies throughout the state. Theboard’s laboratory was finallyauthorized by the General Assem-bly in 1905; it was opened in 1906(Rice, 179, 180). The board alsoeducated the public and officialsabout the need for controllingwater pollution.

In its Annual Report for 1906,the board reported on the publicwater supply in the first annualreport of its laboratory of hygiene:

The water supply, furnishing as it doeswater for drinking and domesticpurposes, becomes an important factorin determining the health of acommunity. Indeed it is the mostimportant of all the agents whichadminister to healthful life. Certaindiseases are largely water borne,particularly diseases of the intestinaltract, such as cholera and typhoidfever, and the quality of water suppliedto perhaps 90 per cent. of a town’spopulation, is of first importance. Thisis realized more and more and theconsumers today refuse to drink waterthat a few years ago was used withoutthe slightest fear. . . . Water suppliesshould be constantly subjected to rigidinspection.

In 1911, the State Board ofHealth undertook a major surveyof the part of the Ohio River thatborders Indiana. Scientists trav-eled the Ohio River in a houseboatoutfitted with testing equipment.

The principal object of the survey wasto ascertain the suitability of the riveras a source of domestic water supplyand . . . to detemine to what extentIndiana cities and manufacturingconcerns are responsible for thepollution of the water (Annual Report,1911, p. 335).

A major conclusion of the1911 survey was

that, in its raw state, the river water iscontaminated and unfit for drinkingpurposes at any point along the survey.. . . river water should not be used, asis now the case at several cities,without purification. It can only bemade safe by filtration and chemicaltreatment (ISBH, Annual Report, 1911,pp. 400-1).

In 1913, the State Board ofHealth was authorized by theGeneral Assembly to enforce purewater supplies in cities or towns(Indiana Laws, 1913, pp. 63-64).

The houseboat used in the Indiana State Board of Health Ohio Riversurvey in 1911 (Jay Allen Craven, “A Sanitary Survey of the Ohio

River Bordering Indiana” [Thesis submitted to the faculty of PurdueUniversity for degree of civil engineer, June 1912], frontispiece).


1936 1938 1939 1939

MarchA special session ofthe Indiana GeneralAssembly passes alaw enabling the stateto receive monies fromthe federal SocialSecurity Act of 1935(Madison, 325).

After a 5 yearbattle, Congresspasses the Food,Drug, andCosmetic Act, amajor revision ofthe 1906 law(“Milestones,” 3).

Birds Eyemarkets firstprecookedfrozen foods(Hellemansand Bunch,479).

First foodstandards areissued—cannedtomatoes,tomato puree,and tomatopaste(“Milestones,” 3-4).

Howard Floreyand Ernst Chaindevelop penicillinas an antibiotic inEngland(Hellemans andBunch, 483).

Freeze drying,developed firstfor medicine, isused for foodpreservation inthe U.S.(Hellemans andBunch, 483).

Study by theAmerican PublicHealth Associationfinds Indiana farbehind most statesin providing publichealth services(Madison, 328).

Fluoridation of thewater supply toprevent dental decayis introduced into theU.S. (Hellemans andBunch, 489).

1940 1940 1942 1945

Clean Water Testing Dates of tests

1906 1911 1916Private water suppliesdeep wel ls tes ted 150 205 442

good 111 166 353bad 25 18 75doubt fu l 14 21 14

shal low wel ls tes ted 342 559 706good 125 252 263bad 177 232 426doubt fu l 40 75 17

Public water suppliesdeep wel ls tes ted 57 88 135

good 42 76 124bad 10 2 11doubt fu l 5 10 0

shal low wel ls tes ted 40 14 66good 11 13 52bad 20 1 14doubt fu l 9 0 0

The Indiana State Board ofHealth obtained its firstlaboratory in 1906. It immediatelybegan testing water suppliesfrom throughout the state. Thischart illustrates the results oftesting wells over an eleven yearperiod. In 1906, there were anestimated 351,000 private wellsserving 1,757,000 citizens. Therewere 141 towns with public watersupplies serving 891,000 citizens(ISBH, Annual Report: 1906, pp.136-37, 143, 145; 1911, p. 315;1916, pp. 96, 98). Shallowwells—like the one on the backcover of this issue—are at highrisk of pollution; does this chartsupport that statement?

This chart resulted from the 1911 survey of the river by the Indiana State Board ofHealth (Annual Report, 1911, p. 355). Are there still companies manufacturing theseproducts today? How do they address the problems of waste pollution?

Manufacturing Concerns in Indiana Discharging Waste into the Ohio River, 1911


1946 1949 1952 1953 1959

U.S. agency tocontrol malaria inwar areas becomesCommunicableDisease Center,known today [1990]as the Center forDisease Control(Duffy, 279).

X-rays from asynchrotron areused for the firsttime in medicaldiagnosis andtreatment(Hellemans andBunch, 509).

Polio epidemicstrikes U.S.affecting47,665persons(Hellemansand Bunch,513).

Jonas Salkdevelops vaccineagainst polio;used for massinoculationsstarting in 1954(Hellemans andBunch, 515).

Evarts Grahamand ErnestWydner show thattars from tobaccosmoke causecancer in mice(Hellemans andBunch, 517).

In U.S., deepfreezerscapable offreezing freshfood go on sale(Hellemansand Bunch,521).

Three weeks beforeThanksgiving, U.S.cranberry crop isrecalled to test forpresence of a weedkiller(“Milestones,” 5).

1952 1955

Fighting for healthy milkEarly in his administration at

the Indiana State Board of Health,Dr. John Hurty took on the fightfor healthy milk. As the cartoonand caption on this page suggest,children were the most frequentvictims of impure milk.

Hurty had the law behindhim to fight against bad milk, buthe lacked money and staff toenforce it. His recommendationsfor costly pasteurization andbottling of milk brought protestsfrom many dairymen. Hurty andothers urged that pasteurizationof milk be carried out at home tokill germs (Rice, 162, 167).

The State Board of Healthhad the power to close dairies anddid so. Sometimes the sanitaryconditions at the dairy—not theadulteration of milk—caused theclosure. In a paper presented at aconference of health officers inJune 1899, Dr. A. W. Bitting,Purdue University outlined fourinspection elements:

A complete milk and dairyinspection . . . the milk as to quality . . .the presence of adulterants . . . theexamination of the cattle for diseases . . .and of the surroundings (ISBH, AnnualReport, 1899, p. 185).

In addition to assuring purity ofmilk at the start of the supply

line, delivery steps also needed tobe controlled. According to Rice(161),

The milkman in the city distributed milkfrom door to door, dipping it from anopen can—and sometimes drinkingfrom the dipper himself . . . . The milkwas left on the doorstep in a pan ofsome sort. If the pan was not taken inpromptly it is likely that the cat mightbeat the housewife to it.

An April 1900 Bulletin of theState Board of Health, mentions“sticks, hairs, insects, blood, pusand filth in milk. The same Bulle-tin says that by careful measure-ment the citizens of Indianapolisconsume over one ton of manure ina year’s time” in milk (Rice, 162).

The most serious adultera-tion of milk—especially for chil-dren—was the use of formalde-hyde as a preservative. As early asJuly 1899, the Indianapolis Newsreported prosecutions of dairymenwho added formaldehyde to milk.Many children—including infantsat the Indianapolis OrphansHome—died from contaminatedmilk (Ibid., 164).

Regardless of prosecutions,better knowledge, and the coop-eration of many dairymen whowanted pure milk, the fight wenton for many years (Ibid., 168). By1909, however, dairymen andhealth officers were carrying outtheir second annual convention“To Study Sanitary Milk Produc-tion and Distribution . . .” (Con-vention Program).

According to Rice (161) “in1896 it was a very seriousmatter indeed if a mothercould not nurse her own

child. . . . few such childreneven lived to adult life. . . .The biggest reason for allthis was . . . the very poor

quality of the milk whichwas available for baby

feeding and for use by thepublic in general.” This

cartoon by Gaar Williamsvisualizing the situation

appeared in theIndianapolis News (date

unknown, circa 1900). Thecaption reads, “It looks like

a tough battle for the littlefellow” (Rice, 163). Williams

was a famous Hoosiercartoonist.

1950

Life expectancyof white malesat birth in theU.S. is 66.31years; all othermales, 58.91(StatisticalAbstracts of theU.S.).


1763 1965 1968 1970 1970 1972

Kefauver-Harris DrugAmendments passCongress requiring drugmanufacturers, for thefirst time, to prove to theFDA the effectiveness oftheir products beforemarketing them(“Milestones,” 5).

Drug Abuse ControlAmendments areenacted to regulateproblems caused byabuse of depres-sants, stimulants,and hallucinogens(“Milestones,” 6).

AprilJames L. Goddard,commissioner of U.S. Foodand Drug Administration,refuses to permit canned hamthat has been radioactivelysterilized to be used by theU.S. Army (Hellemans andBunch, 561).

December 2Environmental ProtectionAgency begins its work.Established by PresidentRichard Nixon in July,the EPA’s first director isWilliam D. Ruckelshausof Indiana (Carruth, 674).

December 31National Air QualityControl Act calls forninety percentreduction inautomobile exhaustpollution by 1975(Carruth, 677).

1962

October 18Over President Nixon’s veto,Congress passes the WaterPollution Control Act requiringindustry to stop wastedischarges into water by 1985(Carruth, 689).

Indiana’s champion in WashingtonIndiana also provided a

champion for public health in thefederal government. HarveyWashington Wiley was crucial inthe passage on June 30, 1906 ofthe federal Pure Food and DrugsAct. Federal law is still necessaryto regulate food and drugs ininterstate commerce, which is notprotected by state laws.

Wiley was born on October18, 1844 on a small farm nearKent, Jefferson County, Indiana(Wiley, 13). In 1868, he appren-ticed with Dr. S. E. Hampton inMilton, Kentucky to learn therigors of being a country doctor.He studied at the Indiana MedicalCollege in Indianapolis and re-ceived his M.D. in 1871 (Ibid., 91-93, 95, 97).

Wiley was elected chairmanof chemistry at the Indiana Medi-cal College in 1872. He attendedHarvard University, 1872-1873,and received a bachelor of sciencedegree. He became professor ofchemistry at Purdue University,Lafayette, Indiana in 1874 (Ibid.,98, 112n, 122).

During a visit to Europe in1878, he met with some of theworld’s best chemists: “I foundmyself more and more interestedin chemistry and the science ofnutrition.” After returning toPurdue, his research was focused:“I carried back a passion forexamining food products, espe-cially sugars.” By the spring of1883, Wiley notes, “My investiga-

tions of food adulterations had ledme to believe that tremendouschanges had to be brought aboutbefore there would be anythinglike the protection the publicneeded from impure and danger-ous substances” (Ibid., 138, 150,154).

On April 9, 1883, Wiley wassworn in as chief of the Division ofChemistry of the U.S. Departmentof Agriculture (Ibid., 159). Heremained with the departmentuntil 1912. He is best rememberedfor the “vital role . . . [he] playedduring the long fight to extendfederal protection to the consum-ers of food and drugs” (Anderson,1).

Wiley continued the fight forpure food through his writingsand as director of the Bureau ofFoods, Sanitation, and Health ofGood Housekeeping Magazine. Hedied on June 30, 1930 (Ibid., 259,278).

This Indiana statehistorical marker

honoring Wiley wasinstalled in 1981. It is

located at SR256and CR850 West,

Kent, JeffersonCounty.

Dr. Harvey Washington Wiley.

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1763 1981 1982 1990 19971977

December 3The FDA approves the use of irradiation to killbacteria such as E. coli in beef. The processis already in use for poultry, fruits, vegetables,and spices. Interest in irradiation increasedafter meatpacker had to recall 25 millionpounds of contaminated hamburger(Christian Science Monitor, Archives wwwpage, December 3, 1997, p. 2).

Last recorded case ofsmallpox found in thewild is in Somalia.Smallpox thought tobe extinct except inresearch laboratories(Hellemans andBunch, 581).

U.S. Centers forDisease Controlrecognizes AIDS forfirst time(Hellemans andBunch, 587).

In the aftermath of poisoning ofTylenol capsules, the FDA issuesregulations requiring tamper-resistant packaging. FederalAnti-Tampering Act of 1983makes it a crime to tamper withpackaged consumer products(“Milestones,” 7).

Nutrition Labeling and EducationAct passes Congress requiringall packaged foods to havenutrition labeling. All healthclaims for foods must meetstandards defined by theSecretary of Health and HumanServices (“Milestones,” 8).

Public health challenges continueThe centennial anniversary of

Indiana’s Pure Food and Drug Lawof 1899 will be in 1999. An issueof The Indiana Historian on thetopic of public health seemed tobe an appropriate tribute.

Current practices and wide-spread articles about publichealth concerns—three of whichare illustrated here—present anopportunity to look at and con-sider changes over time in publichealth.

The items reproduced on thispage—as well as items on thetimeline—indicate the continuingchallenges for agencies and indi-viduals seeking to maintain thehealth of the world’s population.

As the diagram on page 4 indi-cates, health and disease must beglobal concerns, especially be-cause of the quick and easyaccess provided by air travel.

In the nineteenth and earlytwentieth centuries, public healthpioneers worked with minimalknowledge and tools fightingignorance and poverty. There wasa constant need to balance eco-nomic and political interests withprogress in public health.

After mid-twentieth centuryadvances in medicine and sanita-tion, scientists believed that theyhad defeated infectious diseases.Recent outbreaks have demon-

strated the error of that belief.Populated areas continue to

increase, and their demands onthe environment grow as well.Today, for example, many sourcesof water for cities and townsremain the same as they were forIndiana’s early settlers. Obtainingpure water from those sources,however, is a much more complexoperation.

Although they have advancedknowledge and tools, scientistsare still facing extraordinarypublic health challenges. As thetwenty-first century approaches,public health scientists are stillpioneers.

US

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, 1998.

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Selected ResourcesA Note Regarding Resources: Items are listed on this page that enhancework with the topic discussed. Some older items, especially, may includedated practices and ideas that are no longer generally accepted. Resourcesreflecting current practices are noted whenever possible.

Bibliography

• Anderson, Oscar E., Jr. The Healthof a Nation: Harvey W. Wiley and theFight for Pure Food. Chicago: Univer-sity of Chicago Press, 1958.

Provides a detailed and balancedassessment of the contributions ofWiley.• Carruth, Gorton. The Encyclopediaof American Facts and Dates. NewYork: Harper Collins Publishers, 1993.

Comprehensive, easy-to-readtimeline of American history.• Cummings, Richard Osborn. TheAmerican and His Food: A History of FoodHabits in the United States. Chicago:University of Chicago Press, 1940.

A general history of food and itsphysical and social impacts on America.• Duffy, John. The Sanitarians: AHistory of American Public Health.Urbana: University of Illinois Press,1990.

Comprehensive history of thegrowth of public health in America.• Grun, Bernard. The Timetables ofHistory. New York: Simon andSchuster, 1991.

Comprehensive, easy-to-readtimeline of world history.• Hellemans, Alexander, and BryanBunch. The Timetables of Science. NewYork: Simon and Schuster, 1988.

Contains chronology of mostsignificant achievements in sciencehistory.• Indiana State Board of Health (nowIndiana State Department of Health).

The Indiana State Library has anextensive collection of annual reports,monthly bulletins, health brochuresand flyers, and other materials datingfrom 1881 to present. The IndianaState Archives has the official recordsof the agency.• Janssen, Wallace F. “America’sFirst Food and Drug Laws.” FDAConsumer, 9:5 (June 1975), 12-18.

A brief introduction to the history ofthe first food and drug laws.• King, W. F. One Hundred Years inPublic Health in Indiana. Indianapolis:

Indiana Historical Society, 1921.This interesting survey was origi-

nally delivered as a speech in 1916.• Madison, James H. Indiana throughTradition and Change: A History of theHoosier State and Its People, 1920-1945. Indianapolis: Indiana HistoricalSociety, 1982.

Contains a very informative chapteron public health.• “Milestones in U.S. Food and DrugLaw History.” <http://vm.cfsan.fda.gov/milestone.html>. August 1995.

A Food and Drug Administrationtimeline of the history of food anddrug regulation in the United States.• Phillips, Clifton J. Indiana inTransition: The Emergence of anIndustrial Commonwealth, 1880-1920.Indianapolis: Indiana HistoricalBureau and Indiana Historical Soci-ety, 1968.

Chapter on public health is veryinformative.• Rice, Thurman B., The HoosierHealth Officer: A Biography of Dr. JohnN. Hurty. Collected reprints of articlesappearing in the Indiana State Boardof Health Bulletin, 1939-1946.

The articles are by a colleague ofHurty. A mixture of primary documen-tation and personal opinion, they giveinsight to the personal and profes-sional sides of Hurty.• Russo, Dorothy Ritter, ed. OneHundred Years of Indiana Medicine,1849-1949. [Indianapolis]: IndianaState Medical Association, 1949.

This book was published in connec-tion with the centennial of the IndianaState Medical Association. It is acompilation of articles which givesgeneral overviews of aspects ofIndiana’s medical history.• Thornbrough, Emma Lou. Indianain the Civil War Era, 1850-1880.Indianapolis: Indiana HistoricalBureau and Indiana Historical Soci-ety, 1965.

Informative chapter examinespublic health issues.• Wiley, Harvey Washington. Harvey

W. Wiley: An Autobiography. Indianapo-lis: Bobbs-Merrill Company, 1930.

A well-written, easy-to-read, andenjoyable account of Wiley’s life fromhis childhood on a southern Indianafarm to his public health career.• Young, James Harvey. Pure Food:Securing the Federal Food and DrugsAct of 1906. Princeton, New Jersey:Princeton University Press, 1989.

A detailed history of the origins ofand politics behind the Pure Food andDrugs Act.

Suggested student resources

• Fradin, Dennis Brindell. Medicine:Yesterday, Today, and Tomorrow.Chicago: Childrens Press, 1989.

A brief history and the currentstatus of medicine are surveyed inthis work for intermediate readers.• Kalman, Bobbie. Early Health &Medicine. New York: Crabtree Publish-ing Company, 1983.

The work provides an easily readsurvey of health and medicine forintermediate readers.• Ritchie, David, and Fred Israel.Health and Medicine. New York:Chelsea House Publishers, 1995.

An excellent resource for intermedi-ate readers, with an emphasis onpublic health. Part of Life in America100 Years Ago series.• Senior, Kathryn. Medicine: Doctors,Demons & Drugs. New York: FranklinWatts, 1993.

This work provides a concise over-view of the history of medicine for anylevel reader. Part of Timelines series.

Additional Resources

• Indiana State Department ofHealth.

Literature and videos are availablethrough the Health Promotion Centerby calling 317-233-7257. Its addressis 2 North Meridian Street, Indianapo-lis, Indiana 46204.

Indiana Historical Bureau140 North Senate Avenue • Room 408 • Indianapolis, Indiana • 46204-2296 • 317-232-2535 • TDD 317-232-7763

IndianaHistorical

BureauServing Indiana

Since 1915

This illustration in black and white was the first image to be used in an Indiana State Board of Health MonthlyBulletin (1:4 [October 1899], 7). It shows the pollution of a shallow well by a privy and a trash pile. The house onthe right labeled “typhoid” indicates the result of the pollution. In the middle of the illustration is a funeral partygoing from the house to the cemetery on the left (Rice, 89). Image enhanced by The Indiana Historian.

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