1899–1918 Early Academic Programs and Teaching Hospitals
Public Health Concerns and the Affiliated CollegesProgressive reform flourished in the West, as San Francisco rebuilt after the earthquake and prepared to advertise itself as a gateway city in the Panama Pacific exposition. In 1906 the Civic League of Improvement Clubs was organized to rebuild San Francisco as “a beautiful and modern sanitary city.” One of the most appealing features of Progressive social reform was the reliance upon scientific expertise and efficiency through the public health movement, and San Francisco was no exception.
As the science of bacteriology became more sophisticated, the role of human carriers in diseases like diphtheria, tuberculosis, typhoid and venereal disease became a major focus of prevention. San Francisco had one of the highest rates of tuberculosis in the nation, and citizens organized along with health officers, creating voluntary associations to help fight the disease by enforcing anti-spitting ordinances and opening a tuberculosis clinic. In the early twentieth century, the UC Medical School took the lead in diagnosis and treatment of syphilis, utilizing the Wasserman Test, and Dr. L. S. Schmitt pioneered the use of Salvarsan in a special clinic at Parnassus. City physicians like Dr. Adelaide Brown became active in campaigns to provide clean milk, sanitary garbage disposal, and to enhance maternal and child welfare through visiting nurses services.
The extreme disruptions of the 1906 earthquake and fire refocused professional and public attention to the needs of the public’s health. Bubonic plague appeared in the city in 1907, and officers from the U.S. Public Health Service worked alongside local health officials, isolating patients, cleaning up filth and rubble, and trapping rats in an effort to control the spread of the disease by rat fleas. The outbreak produced 77 deaths out of 159 cases, a 50 percent fatality rate, but a major epidemic was halted, and in 1908 the decrepit rat-infested buildings of the city county hospital were burned to the ground. County patients were re-housed in horse stalls at the Ingleside race track and the city drafted plans to build a new City and County Hospital.
Preventive Hygiene and DentistryThe popularity of public health concerns also had an impact on the College of Dentistry, which had long been concerned with providing dental care for the city’s indigent population. The disruptions of the earthquake reinforced this tradition of assessing and treating the dental needs of all the city’s inhabitants. One of the school’s more famous graduates was M. Evangeline Jordon, who graduated from UC Dental Department in 1898 and developed the specialty of pedodontia, at a time when the care of children’s teeth was not a professional priority. In the early twentieth century, she actively taught and did research, developing programs in dental care for pregnant women and children. She characterized dental caries as a disease of childhood, connected it with bottle-feeding, and wrote, “Rid the country of the deadly candy shop and grocery store, get most of your living from the vegetable garden and the family cow, and apply the teaching of oral hygiene.” In 1915 she presented a paper on oral hygiene at the Panama Pacific Exposition and remained active in organized dentistry throughout her career.
As the role of bacteria and nutrition in dental caries was debated, the field of dental hygiene emerged. In 1918 Guy S. Millberry created a one-year course for dental assistants and dental hygienists, one of the first in the nation. The program was increased to two years of instruction by 1924.
Public Safety and the Reform of Pharmacy Education
“…there is from east to West a more urgent demand than ever before for well-educated and well-trained pharmacists. Employers are looking for men who have a college education, and the supply is not equal to the demand. Furthermore, the national and state pure food and drug laws call for such constant care in the making of pharmaceuticals, such vigilance in the examination and testing of drugs and chemicals, that no drug store can be considered properly equipped that has not in it at least one person who is capable of applying the tests of the Pharmacopaeia. ….Pharmacists must adjust themselves to public sentiment, and the public expect reasonably pure drugs and medicines and reasonably competent persons to manufacture and dispense them.”
- (Bulletin 1907-1908)
- (Bulletin 1907-1908)
One of the most emblematic legislative initiatives of Progressive reform at the federal level was the passage of the Pure Food and Drugs Act of 1906, which sought to protect consumers from dangerous, adulterated, and mislabeled or contaminated food and drugs. This brought a unique focus to the pharmacy profession and a direct mandate for more sophisticated chemical analysis in the early twentieth century. At the inaugural meeting of the California Pharmaceutical Society in 1869, a major agenda item concerned the need to “prescribe the manner of dispensing poisons.” In 1891 the State Board of Pharmacy was established to regulate pharmacies and the sale of poisons and narcotics, requiring warning labels and a sales registry.
The pharmacy curriculum had included courses in toxicology in its earliest curriculum, and pharmaceutical chemistry was considered a basic preparation for its graduates. After 1906, a special course was added on “Histology of Food and Drugs” to include microscopical examination of “food products and drugs and their more common adulterants.” This course was designed “to better prepare the student to meet the demands of the Pure Food and Drug Law. Similarly, bacteriology was expanded to include study of “microbic contaminations of pharmaceutical preparations of water, of foods, etc.” A full course in Pharmacal Jurisprudence was also added by 1910. The course was intended to present, “the trend of recent legislation affecting the pharmacist,” including liability issues and “pure food and drug decisions.” By 1914, the school provided “special advanced instruction” for students “seeking to qualify themselves to serve as examiners under the Pure Food and Drugs Laws.”
Nursing and Public HealthThe ethos of the new public health was an explicit subject in the nursing curriculum of the early twentieth century. The rhetoric of the early UC nursing bulletins reveal a ubiquitous concern with the social environment of patient care, even in routine bedside training. During four months of outpatient work, students “not only learn[ed] to handle large numbers of ambulatory patients, but… gain [ed] an insight into the social problems of the poor.” Maternity instruction included “deliveries in homes and complete social studies of these cases.” Work in public health nursing included field assignments in Juvenile court, work with the city’s active Society For The Study And Prevention Of Tuberculosis, and opportunities in industrial and workplace medicine. Coursework included “The Control of Poverty” and work within the Medical School’s social service department included training in vital statistics, milk inspection, foster home work, and contagious disease nursing.
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