200 years ago, health care a priority

Doctors’ petition helped give birth to Mass. General

Dr. Shaw Warren, a great-great-great-grandson of an MGH founder, signed a copy of the original petition that called for the establishment of the state’s first public general hospital. Dr. Shaw Warren, a great-great-great-grandson of an MGH founder, signed a copy of the original petition that called for the establishment of the state’s first public general hospital. (Wendy Maeda/Globe Staff)
By Jack Nicas
Globe Correspondent / August 21, 2010

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In the early 19th century, Bostonians largely had two options if they got sick: house calls from expensive private physicians or an overcrowded poorhouse.

So two centuries ago yesterday, in a 2,677-word petition, two of the city’s top doctors called on the city’s gentry to help establish the state’s first public general hospital.

“When in distress every man becomes our neighbour, not only if he be of the household of faith, but even though his misfortunes have been induced by transgressing the rules both of reason and religion,’’ Drs. James Jackson and John Collins Warren wrote.

In other words, whether a good Christian, insane, or immoral, everyone deserves health care.

Eleven years after Warren and Jackson spurred the city to action, Massachusetts General Hospital opened in 1821 in the Bulfinch Building. Yesterday, five of Warren and Jackson’s descendents, four of whom have worked at the hospital, stood on the building’s steps and with hundreds of others gathered on the lawn signed copies of the original petition.

“This hospital has had an amazing place in the developing history of Boston that we tend to forget,’’ Marion Rideout, an MGH nurse and researcher, said after the ceremony yesterday. “[T]he allied health profession really traces its roots to the social and political development of this country.’’

Warren and Jackson — the former stern, the latter affable — were professors at the young Harvard Medical School. Each enjoyed a successful private practice, but in 1810, a local minister turned their attention to the hardships at the public poorhouse, called “a place for the dead to die’’ by historian Webster Bull.

Bull, 59, and his 24-year-old daughter, Martha, coauthored a book on the history of MGH, set to be released next year. He recounted the hospital’s history for this article. The ailing poor and the insane filled the Boston Almshouse, Bull said, “but they were just going there, wasting away, and dying.’’

So Warren and Jackson drafted their petition, which they called The Circular Letter, making its aim clear in the first line: “It has appeared very desirable to a number of respectable gentlemen, that a hospital for the reception of lunatics and other sick persons should be established in this town.’’

The letter details the lack of medicine available for the poor and the moral obligation to help them.

“It was basically a fund-raising letter,’’ Bull said. “It doesn’t have any specifics of a campaign, doesn’t say we need to raise X dollars by this date. It was purely an appeal to the Christian charity of Bostonians.’’

The appeal worked.

Six months later, the Legislature formed a fund-raising organization of 56 residents, including former president John Adams and future president John Quincy Adams, and donated a state-owned mansion for the hospital, which the group later sold.

But donations slowed with the War of 1812, and it was not until 1817 that the group was able to open a mental hospital in an old Charlestown mansion, which later became McLean Hospital in Belmont.

On Sept. 3, 1821, a 30-year-old saddler was treated for syphilis at the Bulfinch Building, a Greek revival structure still in operation today. MGH had become the country’s third public general hospital.

Its second patient did not come until three weeks later, and the hospital treated only 18 patients in its first four months. But admissions soon increased, and now the hospital is one of the country’s leading research and medical facilities.

“They’d be proud of the way the hospital has evolved, and they’d hope that would continue,’’ said Warren’s great-great-great-grandson, Dr. Shaw Warren, 59, a pediatrician at MGH for the past 24 years, whose son, Caleb, interns at the hospital.

Jackson’s seventh-generation granddaughter, also at the commemoration yesterday, said the founders’ vision must continue.

Jackson “was a hard-striving man and would see the work is not all done,’’ said Dr. Hannah Jackson Parker, 42, who completed her residency in obstetrics at MGH. “There are still inequalities in health care, still populations that do not have the same access to achieve the health outcomes that others do across the world.’’

To Warren and Jackson, solving that problem begins with one step: “Above all,’’ they wrote of those less fortunate, “he suffers from the want of that first requisite in sickness, a kind and skilful nurse.’’

Jack Nicas can be reached at