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During the Revolutionary War, according to military historians, approximately 90% of deaths among soldiers were the result of the spread of smallpox. As a result, Washington decided to mandate the vaccination of the troops – a process more dangerous and complicated in that era than our public vaccination campaigns today.

In this letter, Thomas Jefferson describes how the yellow fever is harming countless people, even those in the government, yet no one seems to know what can be done. Alexander Hamilton is ill, others are sick or dying, and Jefferson writes about avoiding the appearance of “panic” for the public.

This primary source reflects the incredible help that African Americans provided during Philadelphia’s yellow fever epidemic of 1793. Those who helped recount speaking with the mayor about what could be done and working with the government of the city in order to help those in need. Later in the document, the writers recount that they asked for pay for their many services given during this time of illness and need, yet some citizens turned against them.

The federal government left Philadelphia in 1793 to avoid the yellow fever epidemic; the federal  government’s response to the health concern was to leave the city. This letter is from Secretary of War Henry Knox and relates to the government weighing whether or not it was safe for them to go back to Philadelphia (students may need to be reminded that before Washington, DC, the federal government met in Philadelphia).

Known as the Shattuck Report and done with the Massachusetts Sanitary Commission in 1850, this was the first in-depth look at public health. It focused on health and living conditions in Boston but had far-reaching impacts in bringing public health to the forefront of important national issues. According to many, this was the first attempt to get a public health code in place in a major American city. Shattuck’s report came at a time when the government was doing little to help immigrants arriving to the US, low-wage workers were living in unsanitary conditions, the working poor received almost no government help, and healthcare was nearly nonexistent for those living in poverty. The report revealed the need for public health codes and government intervention; according to LSU Biotech Law, “This report is one of the fundamental documents in public health in the United States. It is the first systematic use of birth and death records and other demographic data to describe the health of a population. Its recommendations became the foundation of the sanitation movement in the United States. . . “ This report also outlines technology as a necessity for government intervention in public health, mentioning everything from sanitation systems to sanitation laws.

This book outlines health advice for soldiers; it was published by the federal government under the US Sanitary Commission during the Civil War, at a time when the Union Army needed government assistance to keep soldiers healthy. The work also discusses everything from diet to sanitation.

This photograph shows a Union Civil War hospital in June 1862. This photograph could be used in conjunction with the “Rules for the preserving the health of the soldier” (the primary source listed above) to showcase some of the measures taken for the health of soldiers.

This four-page August 19, 1864 letter is from African American surgeon Dr. John H. Rapier, Jr.  In the letter, Dr. Rapier recounts being paid by the US government for his medical services. This primary source shows the important role of African American medical practitioners in the Civil War, and makes reference to Frederick Douglass being summoned by the President and meeting with Dr. Rapier thereafter.

These photographs are from the Marine Hospital at Staten Island, New York, where the Hygienic Laboratory was established in 1887. The tents are for people with tuberculosis; Joseph James Kinyoun was the Assistant Surgeon at this location and urged isolation as a way to combat tuberculosis. According to the NIH, this Marine Hospital “marked the beginning of the National Institutes of Health and laid the groundwork for government-supported scientific research in the United States”. A major purpose of this location was to look for diseases among immigrants arriving from Europe, at a time when anti-immigrant beliefs were already a problem in the US.

This 1907 photograph shows immigrants being examined at Ellis Island. The US government required medical examinations upon arrival in the US. It could be important to point out public perceptions of immigrants at this time in American history, and how anti-immigrant beliefs were influencing government decisions about medicine and health.

In terms of government public health initiatives over time, local governments are an important part of that history. This primary source is from Birmingham, Alabama’s School Board minutes from December 1918, in which the possibility of closing schools due to the flu epidemic. The document explains that doctors of the Committee of Health have been consulted on the issue as well. This could be a useful primary source for studying local government decisions in public health issues.

This 1919 newspaper article has the headline “Swat the Flu is Slogan for 1919 Campaign Against Dread Destroyer that Looms Again: Measure Approved in Both Houses of Congress Would Appropriate $5,000,000 for Investigation of Epidemic Which Swept Over America in 1918, Costing Thousands of Lives”. The article details government actions regarding public health during the 1918-1919 flu epidemic.

This 1955 primary source is about the US government’s Polio Vaccine Assistance Act and the US government’s public health efforts to fight polio. This two-page document explains how states will receive money for vaccination programs and distribute the vaccine, among other details. Notice the first page calls this a “new advance in preventive medicine”.

This 1955 White House press release details President Eisenhower’s honoring Jonas Salk with a “citation for his extraordinary achievement” in developing a polio vaccine. Eisenhower, in this press release, details the massive efforts the National Foundation for Infantile Paralysis has taken to work towards a polio vaccine. President Franklin D. Roosevelt’s own struggle with polio, and the gratitude of America as a whole, are also discussed.

This Library of Congress 14 minute and 35 second video is from 1955 and details the efforts made to fight polio. From the NBC Television Collection, this primary source allows students to watch a primary source video that details items such as how vaccines are made, including the safety of vaccines. The description reads: “HEW Secretary Oveta Culp Hobby and Surgeon General Leonard Scheele talk about the Salk polio vaccine and assuage concerns about its safety”. (HEW is “Health, Education, and Welfare”.)