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THE
NORTH CAROLINA HISTORICAL REVIEW
Volume XXI
Issued Quarterly
Numbers 1-4
JANUARY-OCTOBER, 1944
Published by STATE DEPARTMENT OF ARCHIVES AND HISTORY
Corner of Edenton and Salisbury Streets Raleigh, N. C.
Selling Agents: F. W. FAXON CO., 8S Francis St., Back Bay, Boston, Mass.
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THE NORTH CAROLINA HISTORICAL REVIEW
Published by the State Department of Archives and History
Raleigh, N. C.
Christopher Crittenden, Editor David Leroy Corbitt, Managing Editor
ADVISORY EDITORIAL BOARD Robert Digges Wimberly Connor Walter Clinton Jackson
Adelaide Lisetta Fries
STATE DEPARTMENT OP ARCHIVES AND HISTORY
Robert Digges Wimberly Connor, Chairman James Allan Dunn Mrs. George McNeill
Clarence Wilbur Griffin Gertrude Sprague Carraway
William Thomas Laprade Mrs. Sadie Smathers Patton
Christopher Crittenden, Secretary
This review was established in January, 192b, as a medium of publication and discussion of history in North Carolina. It is issued to other institutions by exchange, but to the general public by subscription only. The regular price is $2.00 per year. To members of the State Literary and Historical Associa- tion there is a special price of $1.00 per year. Back numbers may be pro- cured at the regular price of $2.00 per volume, or $.50 per number.
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The North Carolina Historical Review
Table of Contents
VOLUME XXI
Number 1, January, 1944
the formative years of the north caro- lina board of health, 1877-1893 1
Jane Zimmerman
THE SOUTHERN REFUTATION OF THE PRO- SLAVERY ARGUMENT 35
Kenneth M. Stampp
RECONSTRUCTION LETTERS FROM NORTH CARO- LINA, PART IX, LETTERS OF BENJAMIN FRANKLIN BUTLER [Concluded] 46
James A. Padgett
BOOK REVIEWS 72
Fries's Records of the Moravians in North Carolina, Vol. VI — By S. K. Stevens; Barry's Mr. Rutledge of South Carolina — By C. E. Cauthen; Shaw's William Preston Johnston — By Robert D. Meade; Farish's Journal and Letters of Philip Vickers Fithian, 1773-74: A Plantation Tutor of the Old Dominion — By Julia Cherry Spruill; Bettersworth's Confederate Missis- sippi: The People and Policies of a Cotton State in Wartime — By Cecil Johnson; Meade's, Fossan's, and Thomas's Calendar of Maryland Papers, No. 1, The Black Books — By Lester J. Cappon; Meade's Judah P. Benjamin: Confederate Statesman — By Bell Irvin Wiley; Warren's The Sword Was Their Passport. A History of American Filibustering in the Mexican Revo- lution— By John Tate Lanning; The Problem of Federal Field Office Records — By A. R. NewsomE; Johnson's British West Florida, 1763-1^783— By Lowell Ragatz.
HISTORICAL NEWS 88
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iv Contents
Number 2, April, 1944
william gaston and the supreme court
of north carolina 97
Joseph Herman Schauinger
DISLOYALTY TO THE CONFEDERACY IN SOUTH- WESTERN VIRGINIA, 1861-1865 118
Henry T. Shanks
THE CAPTURE OF A CONFEDERATE BLOCKADE RUNNER, EXTRACTS FROM THE JOURNAL OF A CONFEDERATE NAVAL OFFICER 136
Frank E. Vandiver
RECONSTRUCTION LETTERS FROM NORTH CARO- LINA, PART X, LETTERS OF JAMES ABRAM GARFIELD 139
James A. Padgett
NORTH CAROLINA BIBLIOGRAPHY, 1942-1943 158
Mary Lindsay Thornton
BOOK REVIEWS 165
Clarke's Parliamentary Privilege in the American Col- onies— By Hugh T. Lefler; Garrison's The United States, 1865-1900: A Survey of Current Literature with Abstracts of Unpublished Dissertations. Volume I, Sep- tember, 1941-August, 1942— By R. H. WOODY; AN- DREWS'S The Soul of a Nation: The Founding of Vir- ginia and the Projection of New England — By Robert E. Moody; Murphy's Edgar Gardner Murphy — By John Hope Franklin ; Allen's The Diary of a Voyage to China, 1859-1860 — By Charles S. Sydnor; Porter's Modern Negro Art — By John Hope Franklin ; Con- rad's Harriet Tubman — By John Hope Franklin.
HISTORICAL NEWS 175
Contents v
Number 3, July, 1944
public printing in north carolina, 1749-1815.... 181
Mary Lindsay Thornton
THE CORRESPONDENCE OF THOMAS HUGHES
CONCERNING HIS TENNESSEE RUGBY 203
Marguerite B. Hamper
POET, PAINTER, AND INVENTOR : SOME LETTERS
BY JAMES MATHEWES LEGARE, 1823-1859 215
Curtis Carroll Davis
RECONSTRUCTION LETTERS FROM NORTH CARO- LINA, PART XI, LETTERS TO SALMON PORT- LAND CHASE, PART XII, OTHER LETTERS: LETTERS TO LYMAN TRUMBULL ; A LETTER TO THADDEUS STEVENS; THREE LETTERS TO EDWARD MCPHERSON; AND A LETTER TO BENJAMIN FRANKLIN WADE 232
James A. Padgett
BOOK REVIEWS 248
Goerch's Down Home — By Hugh T. Lefler; Fries's The Road to Salem — By Eugene E. Doll ; Bagby's The Old Virginia Gentleman and Other Sketches by George W. Bagby — By A. P. Hudson; Wish's George Fitz- hugh: Propagandist of the Old South — By Joseph C. Robert.
HISTORICAL NEWS 257
vi Contents
Number 4, October, 1944
the north carolina department of
REVENUE 265
Allen J. Maxwell and William Oran Suiter
W. W. HOLDEN AND THE ELECTION OF 1858 294
Edgar Estes Folk
THE NEGRO POPULATION OF GUILFORD COUNTY,
NORTH CAROLINA, BEFORE THE CIVIL WAR 319
William Edward Farrison
REPORT OF THE BRETHREN ABRAHAM STEINER AND FRIEDRICH CHRISTIAN VON SCHWEINITZ OF THEIR JOURNEY TO THE CHEROKEE NATION AND IN THE CUMBERLAND SETTLE- MENTS IN THE STATE OF TENNESSEE, FROM 28th OCTOBER TO 28th DECEMBER, 1799 330
Adelaide Lisetta Fries
BOOK REVIEWS 376
Paschal's History of Wake Forest College — By Rosser H. Taylor ; Lanning's A Brief Description of the Pro- vince of Carolina — By Robert E. Moody; Corbitt's Addresses, Letters and Papers of Clyde Roark Hoey, Governor of North Carolina, 1987-191*1 — By R. H. Woody; Saye's New Viewpoints in Georgia History — By Philip Davidson ; Wiley's The Plain People of the Confederacy and Ramsdell's Behind the Lines in the Southern Confederacy — By R. H. Woody; Mott's Jefferson and the Press — By Culver H. Smith.
HISTORICAL NEWS 386
The North Carolina Historical Review
Volume XXI January, 1944 Number 1
THE FORMATIVE YEARS
OF THE
NORTH CAROLINA BOARD OF HEALTH
1877- 1893
By Jane Zimmerman
Many interesting phases of history often are neglected by those who write history. One phase which has too often been overlooked by historians in North Carolina is the story of the struggle for a state board of health. The average citizen of North Carolina knows today that his state has an efficient, well- organized Board of Health; yet, that same citizen knows noth- ing of the pioneer effort which brought that Board of Health into being. He knows nothing of the difficulties which the early leaders of the health movement in North Carolina faced; nor does he know anything of those leaders.
North Carolina was one of the earlier states to work for a board of public health, and it is in an attempt to tell the story of that work that this study is made. I have attempted, in no sense of the word, to write a comprehensive history of the work of the Board of Health in North Carolina. My study is only a frag- ment of such a history. For the purpose of this article, it has seemed best to limit the discussion to the pioneer period in the Board's life, from 1877, the year of its establishment, to 1893. The latter date, 1893, is not chosen arbitrarily. It is chosen, first, because the years from 1877 to 1893 have been recognized as a pioneer period in the life of the State Board of Health. Dr. Robert Digges Wimberly Connor, speaking of the Board of Health, and especially the work of its first two secretaries, Doctors Thomas Fanning Wood and Richard H. Lewis, says that
To these two pioneers of public health work, Thomas Fanning Wood and Richard H. Lewis, North Carolina owes one of the most brilliant chap- ters in her history. In the face of widespread professional opposition and almost universal popular indifference these undaunted leaders placed public
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2 The North Carolina Historical Review
health work in North Carolina on a firm foundation. They procured legisla- tion for compulsory bacteriological examination of public water supplies, for strict quarantine of contagious diseases . . . but their greatest work during this pioneer period, beginning with the publication in 1877 of the Board's first bulletin — Timely Aid for the Drowned and Suffocated — was their educational activities.1
Archibald Henderson, in his recent North Carolina: The Old North State and The New, says :
The public health movement required pioneering. Public health is not a subject mentioned in the State Constitution. Health laws and regu- lations derive from the general "police power" of government. Very slowly and in the face of popular apathy rather than active opposition was the work of the Department of Health recognized and justified.2
Even more significant than the recognition given to the pioneer period by historians are the facts of history. In 1893 the legis- lature passed an act which was considered by the public, by the press, and by the medical profession as the best "health act" North Carolina had ever had. In April, 1893, the North Carolina Medical Journal stated that both the medical profession and the laity were beginning to appreciate the work of the Board of Health.3 That appreciation helped to assure the Board of Health a permanent place among the institutions of the state.
It was not until the period following the Civil War that the people of North Carolina became actively interested in a state board of health. During the years of the war, men and women were brought face to face with the horrifying conditions of health and sanitation which came as a result of the conflict. As soldiers advanced into new territories, they carried with them typhoid fever, smallpox, and other perilous diseases, scattering them throughout the country. Many soldiers returned to their homes and unwittingly became carriers of typhoid. North Carolina was visited by the invading armies, who left behind them an after- math of disease. A traveler in Wilmington in 1862 tells of a yellow fever epidemic which descended upon the town and "raged with terrific effect for two or three months."4 One of the victims of the devastating scourge was Doctor James H. Dickson, of Wilmington, who had ministered night and day to the sufferings of his townsmen. Doctor Dickson was a member of the North Carolina Medical Society, and his death from yellow fever greatly affected his fellow members who began to realize
1 Robert Digges Wimberly Connor, North Carolina Rebuilding An Ancient Commonwealth, II, 569-570.
2 Archibald Henderson, North Carolina: The Old North State and the New, II, 445.
3 North Carolina Medical Journal, XXXI, 179 (April, 1893). * Alfred Moore Waddell, Some Memories of My Life, p. 55.
The Formative Years of N. C. Board of Health 3
that North Carolina needed to provide better means to protect the people from dangerous diseases.5
The end of the war in 1865 did not make less acute the prob- lems of health and sanitation. In addition to the soldiers who returned from service, great masses of the f reedmen flocked to the towns.6 The outbreak of smallpox, which had started in the early months of the war and had increased as the four years rolled by, reached its culmination in 1866. In Wilmington, by October, 1865, the disease had begun to wear the appearance of an epidemic. According to the report of the City Smallpox Hos- pital, from October 10, 1865, until July 7, 1866, seven hundred sixty-one persons were admitted to the hospital. Most of those afflicted with the malady were Negroes.7
The Civil War also brought forth a leader for public health work in North Carolina. Among the Confederate soldiers who, at the end of the war, returned to North Carolina to find a place in the new order which the war had brought, was a young doctor — Thomas Fanning Wood, of Wilmington. Before the war, young Wood had worked in local drug stores and studied under local apothecaries until he had learned a great deal about drugs ; then he had become the private pupil of various physicians in the town. But it was the war that gave him his chance. Having volunteered for service, he entered the war as a private in the Eighteenth Regiment, North Carolina Infantry. He was later made a hospital steward in the North Carolina Hospital in Rich- mond. During his time "off-duty" he was detailed by the Secretary of War to attend lectures at the Medical College of Virginia. With this preparation, he was able to pass a medical examination, and as a result, in February, 1863, he was appointed Assistant Surgeon and assigned to the Third Regiment, North Carolina Infantry, Jackson's Corps. On April 9, 1865, he was with General Lee's army at the surrender of Appomattox.
Returning to Wilmington at the end of the war, Doctor Wood began the practice of medicine. He soon discovered that the Northern armies had left in their wake an epidemic of small- pox. The epidemic became so intense that Doctor Wood estab- lished a hospital for the sick and indigent Negroes who were
B "Minutes of the Proceedings of the Thirteenth Annual Meeting of the Medical Society of the State of North Carolina," Transactions of the Medical Society of North Carolina (1866), p. 9. (Hereinafter cited as Transactions.)
6 James Garfield Randall, The Civil War and Reconstruction, p. 726.
7 J. B. Purcell, Wilmington in Health and Disease, p. 15. Of the total number afflicted with the disease, 114 negroes and 3 whites died.
4 The North Carolina Historical Review
flooding the town. In this hospital he cared for over thirteen hundred cases.8
This work with men without means of support and unable to care for themselves doubtless gave the young doctor his forward-looking vision of the possibilities of public health work in North Carolina. Just how completely he grasped the far- reaching results of his idea, or how clearly he saw the ever- increasing number of lives saved as a result of his vision and inspiration, we shall never know ; but that the movement became inextricably tied up with his life, that the vision never left him, and that under its sway he worked until his influence reached the people of his state, we do know.
He worked through the North Carolina Medical Journal, which he, with Doctor Moses John De Rosset, edited, through the North Carolina State Medical Society, through a little group of doctors in his own city, and through a greater group of friends throughout the state, until the General Assembly passed an act which brought the North Carolina State Board of Health into being.9
One has only to read the Transactions of the North Carolina Medical Society to feel that the State Board of Health was a child of the Medical Society. As early as May 16, 1872, this body was discussing the possibility of establishing a state board of health. On that date, at a meeting in New Bern, a committee, appointed to consider and suggest special subjects deserving legislative action, proposed:
... a committee to solicit at the hands of the Legislature the passage of an act providing for a Board of Public Charities, etc., so as to have such a Board not one of charity alone, having supervision as now over the penal and charitable institutions of the State, but one of health and vital statistics; also embracing in its scope of duties, investgations of the causes effecting [sic] the health and lives of the people . . .10
When the proposal was presented to the general meeting of the Medical Society, there was a great deal of debate as to the wisdom of sending a lobbying committee to the General Assembly. Doctor Charles O'Hagan, of Greenville, forcibly expressed his opposition, saying that it would not only be a
8 "Autobiographical Sketch of Thomas Fanning Wood" (written in 1892), Southern Medicine and Surgery, XC, 794 (December, 1928). See also Edward Jenner Wood, "Thomas Fanning Wood," Dictionary of American Medical Biography; and George M. Cooper "The Woods — Father and Son," Southern Medicine and Surgery, XC, 787-794 (December, 1928).
9 Laws and Resolutions of the State of North Carolina, Passed by the General Assembly (1876-1877), p. 156. (Hereinafter cited as Laws of North Carolina.)
10 Transactions (1872), p. 6.
The Formative Years of N. C. Board of Health 5
futile gesture, but that the task of awakening the General Assembly to the needs of the people was a task for the press and pulpit; and besides, he was unwilling to make martyrs of a committee from the Medical Society by sending members of that body as suppliants to the North Carolina General Assembly. Doctor O'Hagan's opinion prevailed, and the lobby- ists were not sent to Raleigh.11
In December, 1875, the Eastern Medical Association, at a meeting in Wilmington, decided to renew the fight for a board of health, and to try to arouse more enthusiasm within the State Medical Society in such a board. The Eastern Association believed that it would be impossible to secure a board of health for the state unless the State Medical Society brought pressure to bear on the General Assembly.12
In the fight for a board of health, a little group of physicians in Wilmington led the offensive. In February, 1875, a bill providing for the appointment of a superintendent of health for the city of Wilmington was sent to the General Assembly, along with a petition expressing a keen desire for a medical officer to look after the sanitary conditions of the city and see that public health regulations were adopted and carried out. This petition bore the signatures of eleven physi- cians of Wilmington.13 The bill was passed.14
At the next annual meeting of the Medical Society of North Carolina, the members turned with great interest to the idea of some system of public health work for the state. Doctor S. S. Satchwell, of Rocky Mount, presented a paper on "State Medi- cine and Preventable Diseases."15 The paper was described in the Minutes of the meeting as "a clear and forcible argument in favor of the establishment of a State Board of Health." As a result of this paper, a committee was appointed to memorial- ize the legislature on the subject. The members of the committee were Doctors S. S. Satchwell of Pender County ; R. L. Payne, of Davidson County; M. Whitehead, of Rowan; and George A. Foote, of Warren.16 With the next meeting of the General Assem- bly, this committee went to Raleigh and remained there much
11 Transactions (1872), p. 21.
12 Transactions (1876), p. 19.
13 Unpublished Legislative Papers for 1874-1875, State Department of Archives and History, Raleigh.
^Laws of North Carolina (1874-1875), p. 586.
15 Transactions (1876), pp. 29-52.
18 Transactions (1876), p. 6.
6 The North Carolina Historical Review
of the winter, lobbying for a state board of health. This com- mittee was joined by Doctors Eugene Grisson and N. J. Pittman,17 who, on February 12, 1877, helped to secure the passage of the bill establishing the North Carolina State Board of Health.
The Board of Health as established by the General As- sembly was to consist of all the members of the North Caro- lina Medical Society. The duties of the Board were two-fold: first to make sanitary investigations and inquiries with respect to the people, the causes of diseases, the sources of mortality, the effects of localities, employments, conditions, and circumstances on the public health; and second, to diffuse information on questions of health and sanitation among the people. The members of the Board were to become the medical advisers of the state, and, as such, to give advice to the gov- ernment "in regard to the location and sanitary management" of public institutions. They were to call the attention of the state to such sanitary matters as in their judgment affected the "industry, prosperity, happiness, health, and lives of the citizens of the state." And finally, they were to make to each regular session of the General Assembly, through the governor, a report of the work, investigations, and discoveries of the Board, together with suggestions for further legislative action which the Board believed to be necessary. The act provided an annual appropriation of $100 to defray the necessary expense of the Board.
From the beginning, the need for local organizations was recognized, and the "Act to Establish Boards of Health in the State of North Carolina" specified that county medical societies should constitute county boards of health, and that they should cooperate with the State Board in carrying out public health functions. The county boards were to look to the legal authori- ties of the counties and incorporated towns for their executive duties and powers and to act with those authorities in drawing up any rules and regulations that the two parties might deem expedient.18
On May 23, 1877, at Salem, North Carolina, during the annual meeting of the North Carolina Medical Society, the first machin- ery for organizing the State Board of Health was set in motion. Doctor S. S. Satchwell was elected president, or chairman of the
17 Transactions (1877), p. 73.
18 Laws of North Carolina (1876-1877), pp. 154-156. In its composition, the North Carolina Board of Health was modeled after the Alabama Board, which included the members of the Medical Association of Alabama.
The Formative Years of N. C. Board of Health 7
Board of Health; and Doctor Thomas Fanning Wood, secretary and treasurer. At this organization meeting the committee appointed to frame the by-laws and make regulations for the action of the Board of Health recommended that the duties imposed upon the State Medical Society, by the act which had authorized it to act as the State Board of Health, be performed by an executive committee. The Medical Society would appoint this committee and make a report of its appointments to the governor at the next meeting of the General Assembly. The following committee was named to assume these responsibilities : Doctors S. S. Satchwell, Thomas Fanning Wood, Charles Duffy, Jr., Peter E. Hines, and George A. Foote. It was also ordered that the one hundred dollars appropriated by the legislature for the State Board of Health be deposited with the treasurer of the State Medical Society, subject to the order of the treasurer of the Executive Committee of the Board of Health.19
The act as passed by the legislature was not all that those who had fought for the passage of such a bill desired; but it was accepted because advocates of public health supervision believed it to be a beginning of the work they advocated. Doctor Wood expressed the attitude of the Medical Society when he wrote that the act was considered by the great majority of the members of the Society an insult to the intelligence of that body. Yet, said he :
Some of the members willing to undertake it, with not more money from the State than enough to pay the stationery bills, it was accepted with a very bad grace. A great deal of work has been attempted with a view of organizing and putting all strings in readiness for the future day when the Legislature will have learned wisdow Enough [sic} to make an appro- priation adequate to the necessities of the case.20
Doctor Satchwell showed a similar spirit of hopefulness in his address entitled, "Board of Health," before the North Carolina Medical Society in 1877. He said that the appropriation for the newly established board was small because the state treasury was in a depleted condition. His belief was, however, that if the Society was careful in carrying out its required duties and in electing competent persons to assist in its work, then each successive legislature would increase the amount allotted.
19 Transactions (1877), p. 9.
20 "Sketch of the Medical Society of North Carolina," MS in the papers of Doctor Thomas Fanning Wood, now in the private possession of Doctor George M. Cooper, Raleigh, North Carolina. This manuscript is undated and unsigned, but Miss Jane Wood, daughter of Doctor Wood, has sworn that this was written by her father.
8 The North Carolina Historical Review
With adequate funds the state could have a useful health depart- ment with perhaps a full-time commissioner as a state officer.21
Interest in the newly created Board of Health was not limited to the members of the North Carolina Medical Society or to the medical profession. The press became an instrument for express- ing public sentiment favorable to the Board. In 1877 an editorial in the Wilmington Weekly Star invited the special attention of physicians, legislators, and others interested in health and vital statistics to the work of the infant State Board of Health. The Star referred regretfully to the parsimony of legislators who had appropriated only one hundred dollars to work of such vital significance. It then added: "We believe that an appropriation of $2,000 would not have been more than enough to carry out successfully and efficiently the very important end in view."22
The work of the Board of Health, as established by the law of 1877, was very inefficient and unsatisfactory. The fact that it consisted of the one hundred and fifty members of the North Carolina Medical Society, with no definite organization, would lead one to believe that it had only nominal existence. With only one hundred dollars for correspondence with members in ninety-four counties, Doctor Wood started putting the machinery in motion; and, during the first twelve months, he sent out an average of about two hundred letters per month.23
From the beginning, Doctor Wood was conscious of the inade- quacy of the State Board of Health as established in the original act ; at the same time, however, he was hopeful that the General Assembly would see the possibilities of the work that had been started and improve the legislative provisions that made the work possible. In June, 1878, he made the following appeal for further legislative action:
But we need not pursue this argument further to convince thinking people that the State will save thousands of dollars by vitalizing her Board of Health. Gentlemen of the Legislature should not expect too much gratuitous aid from the medical profession of North Carolina. They are already overburdened with the care of the hundreds of indigent people the State cannot provide for, and it will be shameful if they allow them to struggle on without help to carry out that which in other states, has achieved such results. Vitalize your already existing Board of Health or wipe it off the Statute Books!24
21 Transactions (1877), p. 75.
22 Issue of November 2, 1877.
23 Transactions (1878), p. 16.
24 North Carolina Medical Journal, I, 410 (June, 1878).
The Formative Years of N. C. Board of Health 9
The sustained effort to place the Board of Health on a higher plane continued; and on January 20, 1879, a com- mittee from the North Carolina Medical Society met in Raleigh. After having weighed the temper of the legislature, the committee drew up a bill which would not only change the membership of the State Board of Health as established, but would also change the general method of organization and the functions of the Board. The bill, although considered a step forward by those who wanted to vitalize the existing Board, was not at all what the committee desired. It was actually little more than a compromise measure with a few moderate innovations which the committee thought might be acceptable to the General Assembly. To have asked more probably would have meant defeat for the whole matter.25
The bill which the committee from the Medical Society proposed was sent to Governor Zebulon Baird Vance, who gave it his personal approval. On January 25, 1879, the governor sent the "Report of the Secretary of the State Board of Health of North Carolina" to the General Assembly with the following communication: "I commend it and the sug- gestions it contains to your careful attention. The great im- portance of the subject and the eminent source from which the report emanates, claim an earnest degree of your con- sideration."26
Despite Governor Vance's approval of the desired plan, the bill from the Medical Society was changed drastically before it passed the two houses of the General Assembly ; but on March 14, 1879, the "Act Supplemental to An Act Creating the State Board of Health" was passed.27 This Board, with many modifications and changes, has functioned ever since.
The Board of Health as reconstituted in 1879 was to con- sist of nine members, six of whom were to be chosen by the Medical Society from its active members, and three to be appointed by the governor. One of the members appointed by the governor was to be a civil engineer. The law provided that the members elected by the Medical Society should serve two for six years, two for four years, and two for two years; whereas those appointed by the governor would all serve only
25 North Carolina Medical Journal, III, 43-44 (January, 1879).
26 Public Documents of North Carolina (1879), Document No. 20, p. 5.
27 Laws and Resolutions of the State of North Carolina (1879), p. 219.
10 The North Carolina Historical Review
two years. All vacancies were to be filled by the Board of Health.
The officers of the Board of Health were to be a president and a secretary-treasurer, the latter to be paid for his services, the amount to be fixed by the Board. The other members of the Board were to receive compensation of two dollars per day plus travel expenses while on actual duty at meetings, or while making investigations of matters pertain- ing to the health of the people.28
The general duties which had been written into the original act were included in the "Supplemental Act" of 1879.29 In addition to these functions, provision was made for issuing bulletins at the outbreak of epidemic diseases, designed to disseminate to the public information on how to prevent and check the spread of dangerous diseases; for the chemical examination and analysis of water; and for the organization of auxiliary boards of health in the counties. The county boards were to be composed of all the regular practicing physicians in the county, the mayor of the county town, the chairman of the board of county commissioners, and the city or county surveyor. From this group, one physician was to be elected to serve for two years as county superintendent of health.
The new health law of 1879 provided for a threefold pro- gram of disease control: this program included inland quar- antine, the abatement of nuisances, and vaccination. Inland quarantine was placed in the hands of the county boards of health, with the county superintendents responsible for the quarantine and isolation of inland cases of smallpox, yellow fever, scarlet fever, and other diseases "dangerous to the public health." Failure on the part of county superintendents to carry out their duties in regard to quarantining diseases made them subject to a fine of twenty-five dollars or imprison- ment in the county jail. This marked the beginning of com- pulsion in the laws.
As a means of further protection against diseases, nuisances considered "dangerous to the public health" were to be abated by the parties occupying the premise on which the nuisance existed, according to the means prescribed by the county superintendent of health. Failure to give warning of the
28 Laws of North Carolina (1879), p. 214.
29 See above, page 9.
The Formative Years of N. C. Board of Health 11
nuisance, or to carry out the directions of the superintendent, was to be a misdemeanor, subject to a fine or imprisonment.
The third means of disease prevention was vaccination. The law took cognizance of this by specifying that the secretary of the State Board of Health should keep on hand a supply of fresh smallpox vaccine, to be sent to the county superin- tendents in case of a threatened outbreak of smallpox. The county superintendents were also required to vaccinate all persons applying for such service, all persons admitted to jails, workhouses, and poorhouses, and also all public school children free of charge.
The most important innovation in the new act was the creation of auxiliary boards of health in the counties. Certain important functions were left to the county superintendents of health. For instance, they were to be responsible for the important tasks of gathering and registering vital statistics; of performing the medico-legal post-mortem examinations for coroner's inquests; of attending prisoners in jails and inmates of poorhouses, workhouses, and other county institutions; of making regular reports to the secretary of the State Board of Health; and of carrying out all work as directed and suggested by the State Board. For these services, the county superintend- ents were not granted any fixed salaries, but were to receive such amount as was spent in the year 1878 for medical attendance on the jails, poorhouses, and workhouses, plus the amount paid to the county coroners for medico-legal examinations. Some coun- ties paid nothing for these services, and others, a very small amount.30
A meeting to reorganize the North Carolina Board of Health was held on May 21, 1879, at the old McAdoo House in Greens- boro. The following doctors, members of the Medical Society, were elected to the Board of Health: S. S. Satchwell, of Rocky Point ; Thomas Fanning Wood, Wilmington ; Charles J. O'Hagan, Greenville; M. Whitehead, Salisbury; and R. Lt Payne, Lexing- ton. The governor appointed A. R. Ledoux, Professor of Chem- istry at the University of North Carolina, Chapel Hill ; William Cain, civil engineer, Charlotte; and Doctor Henry G. Woodfin. Doctor S. S. Satchwell was re-elected president of the State Board of Health and Doctor Wood, secretary and treasurer.
™Laws of North Carolina (1879), pp. 215-217.
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At this meeting, Doctor A. R. Ledoux proposed that the secre- tary of the State Board of Health be entrusted to work out and to execute the details of the legislature provisions. The pro- posal was accepted, and Doctor Wood, as secretary, became virtually the "Board of Health."
All public health laws of the state having been placed un- equivocally in his hands for enforcement and execution, Doctor Wood began his efforts to make the newly established Board of Health a vital force in the life of the state. From the beginning, however, his work was fraught with many difficulties. Counties found it easy enough to organize boards of health, but more difficult to carry out the program suggested by Doctor Wood. County superintendents were not enthusiastic about performing many services for almost no compensation; and the Biennial Reports of the early years show a constant turnover of county superintendents. Some commenced their work earnestly, but when they discovered that their work depended upon the coopera- tion of every physician in the county, and that "reports from these gentlemen were fitful and uncertain," they gladly aban- doned their work to others.31
Perhaps the greatest handicap to the success of the program was the lack of funds; but Doctor Wood had so much faith in the ultimate success of the work he had undertaken that in the biennium, 1879-1880, he spent $831.99 instead of the $400.00 appropriated for the two-year period, or $431.99 from his own private funds.32 In explaining this to the General Assembly, Doctor Wood said that he had done this in "order to keep the machine in running order until help would come."33
Miss Jane Wood, daughter of Doctor Thomas Fanning Wood, has attested to her father's great benevolence:
From early childhood, I understood that the health of the State came first in our household. My father was the first secretary and in those days no funds were provided either for salary or expenditures. The office was my father's medical office, the supplies were part of his private equip- ment, and it was out of his own pocket that the enterprise lived until it could get the support of the legislature. At that time we rather disliked the sacrifices this financial burden entailed, but when we [Miss Wood and two small brothers] grew old enough to realize what my father's efforts meant to the State, we were glad and proud to cooperate.34
31 First Biennial Report (1879-1880), pp. 2-3, 9.
33 "Cash Book — Board of Health," MS in Wood Papers, now in the private possession of Doctor George M. Cooper, Raleigh.
33 First Biennial Report (1879-1880), pp. 22-23.
34 Miss Jane Wood, Wilmington, North Carolina, to the author, July 11, 1941.
The Formative Years of N. C. Board of Health 13
Despite attempts to bring about a more effective public system, for six years the General Assembly did nothing to change the organization of the Board of Health. Bills designed to revise the State Board of Health as established by the 1879 act were introduced in 1881 and 1883,35 but both times failed to pass. The North Carolina Medical Society, disappointed by the lack of interest in the health work of the state on the part of legis- lators, nevertheless continued its fight for a more efficient Board of Health.
In May, 1884, at a conjoint meeting of the State Board of Health and the North Carolina Medical Society held in Raleigh, Doctor Wood gave a very pessimistic report on the work of the Board of Health. He said quite frankly that he was discouraged. He pointed to the measly two hundred dollars a year handed out by the legislature and said that the interests and objects of the Board seemed to be in retrograde condition in North Carolina while other states went forward in the opposite direction. He believed a crisis was imminent in the history of the Board. Influenced by Doctor Wood's report, Doctor Satchwell offered a resolution to the effect that the Medical Society appoint a com- mittee to beseech the legislature in behalf of the Board. The resolution requested also that all of the local superintendents from the counties and the members of the State Board come to Raleigh when the legislature met, in an effort to impress that body with the need for changes in the laws and for more ade- quate funds with which to carry out the work of the Board. The Medical Society finally adopted a resolution requiring the president of the Medical Society to appoint a committee to go before the legislature and request an adequate appropriation to be used by the Board in behalf of the "high and humane objects of the Board."36
The persistent efforts of a few enthusiastic supporters of the Board of Health evidently impressed the legislators, for the General Assembly which met in 1885 not only amended the laws so as to make the county boards more efficient, but also increased the annual appropriation from two hundred to two thousand dollars. The General Assembly further set up a contingent fund of two thousand dollars to be expended in pursuance of the pro-
35 Unpublished Legislative Papers, 1881 and 1883. State Department of Archives and History, Raleigh.
89 Transactions (1884), pp. 31-32.
14 The North Carolina Historical Review
visions of the act, when rendered necessary by a visitation of cholera or any other pestilential disease.
The act of 1885 also expanded the duties of the county superin- tendents to include the examination of lunatics for commitment, the sanitary inspection of the jails and poorhouses in their respec- tive counties, and the filing of monthly reports to the boards of county commissioners. In case there was no county superin- tendent of health, then it was the duty of the county commis- sioners to employ a member of the board of health to perform the necessary duties. The county superintendents, or those assigned the work of the county superintendents, were to be paid regular salaries, the amount to be fixed by the county commissioners.37
Commenting on the new act which the General Assembly had just passed, the editor of the News and Observer wrote:
By the recent act of the legislature the powers of the board have been greatly enlarged. An appropriation was made specially for the use of the board. The main object of the meeting yesterday was to organize and take steps looking to the prevention of cholera. The scourge is expected to visit the United States the coming summer, and North Carolina is but falling into line with her sister states in taking these most necessary precautions.38
For eight years the Board of Health functioned under the act of 1885, and the people of North Carolina looked more and more to the State Board of Health for protection against diseases. Health officials, nevertheless, remained dissatisfied with pro- visions of the law, especially those pertaining to vaccination. By 1892 superintendents of health were convinced that vaccina- tion laws could be made effective only if compulsory, and that the existing requirements were practically worthless. The North Carolina Medical Society decided to ask the Board of Health to send a committee to Raleigh during the next meeting of the General Assembly to work for a mandatory vaccination law.39
Realizing that the vaccination laws were not the only weak- ness in the Health Act, but that the entire act needed to be changed, the Board of Health decided to call a general health conference to convene in Raleigh on January 24, 1893. Invita- tions to attend were sent to six hundred and fifty officers of the state government, members of the General Assembly, county superintendents of health, mayors of towns, county commis- sioners, physicians, lawyers, merchants, and other prominent
37 Laws of North Carolina, (1885), pp. 459-463.
38 News and Observer (Raleigh), March 24, 1885.
39 Transactions (1892), p. 52.
The Formative Years of N. C. Board of Health 15
men in the state. This conference drew up a bill which was pre- sented to the General Assembly.40
When the General Assembly met, Governor Thomas Michael Holt spoke in the interest of