Book Report: Public Health in the Town of Boston

Public Health in the Town of Boston: 1630-1822
by John B. Blake (Born: 1922, Died: 2006)
c. 1959, Harvard University Press, Cambridge, MA
Distributed in Great Britian by Oxford University Press, London
Relation to Author of this Blog: Grandfather-in-Law

John Blake received his Ph.D. in American history from Harvard University in 1954 and studied uner renowned historian Arthur Schlesinger. The book reviewed here was taken from his Ph. D. dissertation. This is the only book he published, going on instead to become chief of the History of Medicine Division of the National Library of Medicine.  

John Blake chose to study Boston for a time frame that spanned colonial, revolutionary, and post-independence and ending when Boston became a city. The town of Boston was, as other large towns and cities in the US and Europe were, dealing with epidemic illnesses like yellow fever and smallpox. At the beginning of the time period, the causes for these illnesses were unknown. We are therefore able to witness the public's attempts to figure out the causes and then debate solutions to protect the public from the illnesses. 

The book alternates between two aspects of public health - two types of solutions for the illnesses - at that time: quarantine and inoculation for illnesses that were thought to spread through contagion; and sanitation issues to deal with illnesses that were thought to be related to environmental factors.

Most readers will find the chapters covering the history of inoculation more captivating than sanitation issues (with my father being one possible exception). I was surprised to learn how early the idea of inoculation came out. And through the book we witness the intense debates over the safety of inoculation at a time when people didn't fully understand what it was really doing and why it was working. With hindsight, and helpful guidance by the book's author, we can see who was right. From there we can draw lessons about how we should think about similar public health issues in our time.

The sanitation issues, though not quite as captivating, are necessary for the discussion of public health. When the book starts, government is not very involved in daily life. However, we can see a shift as people realize that environmental factors can affect public health and therefore necessitate a public solution. The public solutions go so far as to regulate where butchers and tanners can operate and how private citizens are required to maintain their own property (gasp!).

Before I end this post, I want to take a small detour. Those of you who are reading this post likely knew John Blake - or are close to someone who did. So let's take a minute to think about the work he did to write this book. In order to tell this story, John Blake had to pour over town meeting minutes and local publications for all of the years the book covers. That is no small feat and I imagine requires a dedication that surpasses what other writers of history (thinking of the pop-history writers we know about today) endure. 

And I am grateful he did it. The result is an interesting book about the earliest examples of public health policy that changes from inactive government to more active government to deal with the very serious problems of the times.