January 31, 1941: Charles V. Chapin dies. “Charles Value Chapin (January 17, 1856 – January 31, 1941 in Providence) was a pioneer in public-health practice, serving as one of the Health Officers for Providence, Rhode Island between 1884 and 1932. He also served as President of the American Public Health Association in 1927. His observations on the nature of the spread of infectious disease were dismissed at first, but eventually gained widespread support. His book, The Sources and Modes of Infection, was frequently read in the United States and Europe. The Providence City Hospital was renamed the Charles V. Chapin Hospital in 1931 to recognize his substantial contributions to improving the sanitary condition of the city of Providence.”
From a draft of The Chlorine Revolution: (McGuire 2013)
In the U.S., Charles V. Chapin was responsible more than any one person for instituting the progressive aspects of the public health movement, but he started his career when miasmas dominated beliefs in disease transmission. In a paper published in the American Journal of Public Health in 1909, he recalled his early career and the incredible ideas that were believed at that time.
“The foul emanations from decomposing organic matter were sucked up from cellars by the warm air of the house and carried sickness and death…Air was the chief vehicle of infection, nay, it was infection itself. The emanations from cellars and untidy cupboards which dealt death and destruction through the house have been referred to, as well as the more specific effluvia which gave rise to yellow fever, consumption, and diphtheria.” (Chapin 1915)
In 1884, the appointment of Charles V. Chapin as Superintendent of Health for the City of Providence, Rhode Island was one of the milestones that can be noted in making boards of health more professional. Much has been written about his career, but it was his assumption of the duties of Superintendent of Health that defined his contribution to public health. He was trained as a physician but Chapin became instrumental in improving not only medical education but also the education of public health specialists. Chapin is one of the best examples of the new professionals who bridged the period from miasma to germ theory. He had been trained in the arts of fumigation and cleaning the streets to remove filth. He was obtaining his medical education just as the age of bacteriology was dawning. He had taken courses in the new bacteriology and had followed the publications of Robert Koch in Germany who had identified the tubercle bacillus and the bacillus comma that caused cholera. In addition, Chapin adopted and used Koch’s new laboratory technique called the plate method to quantify the number of bacteria present in a water supply.
Unlike many health officers who were confused by the seeming conflicts between the worlds of miasmas and germs, Chapin integrated the two and devised a new approach to public health protection. “He was one of a few in America before 1885 who followed the English sanitarian John Simon in pointing out that the danger from filth was not in the stench but in specific disease germs….For many good reasons, the cleansing of the city had to go on.” (Cassedy 1962)
Indeed, the story of the advances in public health during the 1890s and early 1900s could be nothing more than a recitation of Chapin’s biography. That task has already been brilliantly done by James H. Cassedy in his book about Charles V. Chapin. (Cassedy 1962)
“Chapin’s efforts to improve the sanitary environment of his city were valuable to sanitarians across the country. But he was impatient with much of this work. He had early realized that cleansing of the physical environment was, by itself, insufficient for improving the public health. Minimizing the broad dogmas of the filth theory from the first, and concentrating on the truly dangerous forms of filth, Chapin progressively deemphasized nuisances that had no direct or demonstrable connection with disease and avoided much of the tedious routine of nuisance abatement….Attuning himself to the age of bacteriology, he turned from general measures against disease to specific measures against particular diseases.”(Cassedy 1962)
Disinfection of households which held victims of infectious diseases was one of the lingering effects of the miasma theory. In 1902, Leal discussed the useful and ridiculous aspects of disinfection of a diseased household after the removal of the infected person.
“Disinfection, then, is the process of destroying such infection by the destruction of the disease germs there existing…Too often, however, it is intrusted (sic) to one whose training possibly has made capable of distinguishing a pile of filth or an unpleasant odor, but who as no true conception of the cause of the disease, how it is possible to destroy it, and the means to be employed. In such hands it is more a ceremony of incantation than a scientific process.” (emphasis added) (Leal 1902)
Ceremonies of incantation persisted for decades. Chapin lamented in a paper published in 1923 that cities were loath to give up what he called “terminal disinfection” which referred to the disinfection of surfaces or the atmosphere in a dwelling where a person has died from a contagious disease or had recovered from such a disease. He emphasized that by the time of his writing, everyone was pretty sure that contagious diseases were spread by people (and their emanations) and not things. Swabbing a house down with formaldehyde, burning sulfur or heating pans of chloride of lime provided impressive special effects, but were of little use to prevent transmission of epidemic diseases. (Chapin 1923)
Yet, cities felt compelled to continue the tradition because it was ingrained in the public psyche and the public expected it. Providence, Rhode Island stopped terminal disinfection for diphtheria cases in 1905 but it was not until 1908 that Chapin was able to stop terminal disinfection for scarlet fever cases. In 1913, New York City eliminated virtually all terminal disinfection and many other cities followed suit. (Chapin 1923) Part of the resistance to eliminating terminal disinfection was public relations, but a huge part of the problem was that there was a deeply ingrained belief that if someone was sick, they probably infected the air and the bad air had to be cleansed.
The work on mechanical filtration done in Providence, Rhode Island, over the period 1892 to 1894, seldom gets the credit it deserves for marking advances in the science of drinking water filtration. (Swarts 1895) After an epidemic of typhoid in Providence in 1888, Charles V. Chapin began to seriously investigate filtration for use on the City’s water supply. “This Providence experimentation provided the first careful tests anywhere of the mechanical type of water filtration.” (Cassedy 1962) In a paper published by Chapin, bacteria removals were typically 98.7 percent. Chapin recommended that mechanical filtration be installed on the source of supply for Providence. (Chapin 1895) However, the City Council was not ready for such a new technology. A slow sand filter was installed instead. (Cassedy 1962)
Commentary: I knew nothing about Charles V. Chapin when I started writing The Chlorine Revolution. After seeing his name pop up in many contexts dealing with the new public health movement, I read his autobiography. He was an extraordinary individual who did more than most to modernize public health efforts in the U.S.
Cassedy, James H., Charles V. Chapin and the Public Health Movement. Cambridge: Harvard University Press, 1962.
Chapin, Charles V. 1895. “The Filtration of Water.” The Medical News. 66 (January 5, 1895): 11-4.
Chapin, Charles V. 1915. “Truth in Publicity.” American Journal of Public Health. 5 (June 1915): 493-502, In Papers of Charles V. Chapin, M.D. Clarence L. Scamman ed., New York:Oxford, 1934, 13-9.
Chapin, Charles V. 1923. “Disinfection in American Cities.” The Medical Officer (London). 30 (November 17, 1923): 232-3, In Papers of Charles V. Chapin, M.D. Clarence L. Scamman ed., New York:Oxford, 1934, 92-5.
Leal, John L. 1902. “Facts vs. Fallacies of Sanitary Science,” Eleventh Biennial Report of the Board of Health of the State of Iowa for the Period Ending June 30, 1901. Des Moines:Iowa, 129-40, from The Christian Advocate. New York, August 21, 1902.
McGuire, Michael J. 2013. The Chlorine Revolution: Water Disinfection and the Fight to Save Lives. Denver, CO:American Water Works Association.
Swarts, Gardner T. 1895, “Discussion on the Foregoing Group of Papers From ‘The Cart Before the Horse’ to ‘The Report of the Committee on the Pollution of Water Supplies,’ Inclusive.” In American Public Health Association, Public Health Papers and Reports. Vol. 20, Columbus, OH:APHA, 83-4.