Socrates Litsios

Selskar Gunn’s father decided that the Massachusetts Institute of Technology (MIT) was the school that his son should attend upon hearing General Francis Amasa Walker speak in 1891 when Selskar was only 8 years old! Walker, who had risen from an enlisted man in the Union Army to the rank of brigadier general at the age of twenty-five, was President of MIT, a position that he held from 1881 until his death in 1897.

MIT’s requirements for admission in 1900 were few: applicants had to be at least 16 years old and demonstrate a good training in arithmetic, algebra, geometry, English grammar, geography, and the rudiments of French. Also required was that the applicant write in “a rapid and legible hand.” Gunn’s education was more than sufficient to meet these requirements. The private tutors in Ireland and Kensington Park College, London, (1897 – 1900) had done their job. Out of this education he had cultivated a fine memory and excellent Latin which facilitated his learning of French and other foreign languages later in his life.

Gunn enrolled as an Electrical Engineering student in 1900. It was Walker who told Gunn’s father about the advantages of an electrical engineering degree. However, Gunn found that he was not really interested in engineering. By chance he heard of a professor “who was so popular that his classes were always crowded even with men who were not taking his course.” He looked in and liked what he heard and saw. The professor was William Thompson Sedgwick, head of the department of biology. After a long talk with Sedgwick, Gunn changed his program and enrolled in the course of biology.

In 1903 Gunn was obliged to return home. The nephew that Gunn’s father had selected to take over his business interests had squandered the family fortunes. Fortunately, Bessie Gunn had managed to save some of her legacy which was untouched. This was used to send Gunn back to MIT where he continued his studies, obtaining his B.S. degree in biology in 1905. His thesis was entitled Lactic acid and some investigations of its production; Professor Samuel C. Prescott was his supervisor.

Public health was ill defined when Selskar Gunn first arrived in America in 1900. It is doubtful that he appreciated that fact or that by enrolling in Sedgwick’s course he would find himself in the forefront of this field in the decades that followed. MIT was considered by many at the time to be the best school for preparing students for a career in public health. This was due Sedgwick, an inspiring teacher, as Gunn learned first hand. Sedgwick knew how to present subjects in a way that challenged his students and attracted their interest. As one of his most well-known students, Charles-E. A. Winslow (MIT class of 1898) described it:

The whole world, past and present, was in the background of his thoughts. He would take a simple fact and turn it this way and that, and play with it, and toss it in the air, so that it caught the light from a hundred different sources.

Intent on a career in medicine, Sedgwick entered the Yale School of Medicine in 1877 where he quickly realized that there was nothing to be learned there! As he put it:

I shall never forget my regret that I had been born too late, for I gathered from the tone of the textbook and the teacher that everything in physiology was already known, so there was therefore nothing under debate, nothing to be settled, nothing to be discovered.

He sidestepped medicine and entered the field of biology, obtaining his PHD from Johns Hopkins in 1881. In 1883 he couldn’t refuse the offer from an old teacher and friend to take the chair of biology at MIT. With medicine still a major preoccupation, Sedgwick designed a four-year course in biology for prospective medical students. This came to naught for the simple reason that no medical school at the time required any specialized training before accepting students. Fortunately it was around this time that the fruits of Pasteur’s and Koch’s research were beginning to be appreciated. Sedgwick turned his interests to bacteriology where he quickly gained prominence, especially with studies that traced where and how typhoid germs entered into drinking water and what steps were needed to keep water safe, studies that led Winslow to say: “Sedgwick was indeed the first scientific American epidemiologist.”

Exactly what courses Gunn took is not recorded. Biology, sanitary science, public health, anthropology, the history of natural sciences, courses that Sedgwick himself taught, were certain to have been part of his curriculum. Some of the most eminent public health figures of the time taught on a part time basis. Of particular importance was Charles V. Chapin, Superintendent of Health for the City of Providence Rhode Island, a position that he held for 48 years beginning in 1884. Chapin and Sedgwick were close friends. Together they helped shape the practice of epidemiology and the use of statistical methods, courses that in time Gunn would teach as well. Other names that Gunn later cited included  Earle Phelps (class of 1899) and Percy Stiles (class of 1897).

Gunn’s nickname was “Gunny” at MIT. Later he would be known as “Mike.” His classmate Earle L. Ovington, who went by the name “Volts,” became an engineering assistant to Thomas A. Edison in New Jersey before training as a pilot. He was one of the earliest pilots to carry air mail. Later he opened a flying service in Atlantic City which took passengers up in seaplanes for a fee. At some point, probably before he left for France in 1917, Gunn introduced the famous American doctor William Welch to Ovington which resulted in Welch taking one flight piloted by Ovington on August 25, 1919. Welch, however, embroidered on this story a bit. He claimed to his friends and relatives that he had taken lessons, flown solo and received his pilots license, citing Gunn’s name to his biographers as being responsible for arranging the lessons with Ovington. Gunn was certain that Welch did not take any lessons but it was only after Welch’s death that the certificate of the flight, with Welch as a passenger, was uncovered.

The breadth of the MIT curriculum can be judged from that of Sedgwick, as reflected in his remarks at a meeting of the Biological Society:

The behavior of bacteria, the behavior of the larger microscopical organisms, the behavior of mankind as individuals and as nations, our reactions to climate, reactions to poverty and wealth, reactions to industry and idleness; reactions to polluted water, to smoke, to sunlight, to darkness; these are some of the problems which are today beginning to  absorb the attention of mankind as never before.

Also important in Sedgwick’s approach to education was his passion for tracing the historic development of knowledge. This led him to organize a series of lectures on the history of science for students in the departments of biology and physics, the first of its kind in America.

Gunn’s first job was as a bacteriologist at the Boston Bacteriological Lab which was run by his thesis advisor, Professor Prescott (class of 1894). There he was mainly responsible for carrying out farm inspections. He held this job for a year before moving to Des Moines where he was a lecturer on Hygiene at the University of Iowa as well as 1^st Assistant Bacteriologist for the State Board of Health. He left Iowa in March 1908 to accept the position of Health Officer in Orange City, New Jersey, a position “to which was attached a considerable increase in salary,” as noted at the time in Iowa. Sedgwick is credited with having gained Gunn this appointment. When he left Orange in 1910 he was honored with a public dinner of city officials for appreciation of the work that he had carried out.

While working in Orange he met his first wife, Clara Josephine Coffin. They were married on November 15, 1911. Perhaps worthy of note is the fact that she featured in a long article in the New York Times, published in 1903, in which it was reported how she claimed to have been kidnapped (hypnotized by a woman and abducted) only to find herself, upon wakening, in Omaha, at which point she contacted the local police. The article cast some doubts on the whole episode especially when evidence was found that she had planned her escapade out West.

Gunn returned to Massachusetts in July 1910 but he did not immediately take up his new posts of Instructor at MIT in sanitary biology and Assistant at the Lawrence Sewage Experiment Station. As reported in a New York Times article entitled “Europe’s Sanitation Best” and dated September 18, 1910, he had “resigned to devote the interim to traveling and studying conditions abroad.” Having done so, he reported:

I don’t mean to disparage the great work that America is now doing… but merely to emphasize that in spite of the rapid strides that this country has made in recent years it still has far to go if it is to get up in the van of progress with the countries of the Old World. The popular appreciation of municipal sanitation in Germany and France is far ahead of this country.

Perhaps it is revealing that Iowa and the Nation, a popular book written in 1915, listed ‘protection of public health’ after first listing ‘public highways and property’, ‘importance of good roads’, and ‘relief of the poor’. Here the responsibilities of Iowan township trustees as far as public health was concerned, read as follows:

Health is protected by proper attention to sanitation and to the prevention and spread of contagious diseases. The trustees act as the board of health for the township, and as such they may pass regulations concerning nuisances which are injurious to the health, and may compel the removal of filth, rubbish or other insanitary accumulations which breed disease germs or otherwise impair the health. They may check the spread of contagious diseases by requiring persons to be vaccinated and by enforcing quarantine regulations. A great deal has been accomplished by boards of health, but public health can be best promoted by the intelligent help of private citizens. Sanitation in rural districts is largely a household matter. Much can be done in the homes in the disposal of garbage, the ventilation of rooms, and in cleaning and disinfecting all germ-breeding places. Thousands of human lives have been saved by careful attention to sanitation. Every citizen ought to cooperate loyally with the board of health and with every agency in the fight against disease.

Gunn may have been attracted back to Massachusetts by the dramatically superior state of public health there as compared with both Iowa and New Jersey. In a survey of State Boards of Health conducted by Chapin in 1914 and 1915 Iowa, despite the laudable view on public health expressed above, received only a score of 225 (out of a thousand) as compared to Massachusetts which received the highest nationwide score of 745. New Jersey scored 555.

In his written commentary Chapin noted that Iowa was “far from taking its proper position in sanitary affairs.” One reason was the poor record of the State Board of Health. New Jersey was commended for steps taken to strengthen its Board of Health but local health administration left much to be desired. Chapin judged the five cents per capita expenditure, permitted by law for health purposes “entirely inadequate.”

Gunn’s professional life over the next 7 years was frenetic, possibly driven by the fact that MIT did not have the funds to pay its staff an adequate salary. Thus, while occupying a post at MIT at all times during these years, Gunn sought opportunities elsewhere, often following the advice of Sedgwick.

In 1911 the MIT course changed its name from Biology to Biology and Public Health as the public health aspects of the work of the department gained in importance. This is reflected in the assignments that Gunn undertook over the next two years: an investigation of housing conditions in Salem, Massachusetts followed by a series of studies for the Milwaukee Bureau of Economy and Efficiency on the needs of the health department in the areas of milk supply, education and publications, and communicable diseases. In November 1911, on the same day that he was married in South Orange, NJ, he presented a paper on Economy and Efficiency in Municipal Health-Administration Work at the 17^th Annual Meeting of the National Municipal League in Richmond, Virginia. He made his presentation late morning while the marriage was an evening ceremony with Franz Schneider Jr. (MIT class of 1909) as Best Man.

At the annual meeting of the American Public Health Association in December 1911, held in Havana, it was decided to unite the offices of the Association with the editorship of the AJPH (p96 AJPH 1912) with the intent of expanding the membership of the Association by making the Journal more attractive and authoritative. Dr Livingston Farrand, Executive Secretary of the National Association for the Study and Prevention of Tuberculosis, accepted the post of Treasurer of the Association and that of responsible Editor for the Journal while Gunn, who in the meantime had succeeded Winslow as Assistant Professor of Public Health at MIT, accepted the position of Managing Editor of the Journal and secretary of the Association. Gunn took over from Farrand the job of Editor in 1914, a position he held until his departure for Paris in July 1917.

Gunn, in his capacity as Editor of the AJPH, used his skills to fill the journal with useful information drawn from American sources as well as from abroad. While he no doubt had the help of others the responsibility for the consistent manner in which specials sections were developed must rest on his shoulders. Each monthly issue of some 80 to 90 pages in length contained, in addition to a series of technical articles, an editorial page, health department reports and notes, and public health notes. In 1916 he helped create a Health Information Bureau which would answer questions from journal subscribers concerning almost any aspect of public health. Periodically the journal would include pages listing articles of interest from American and foreign journals. On occasion there was a biting cartoon and snappy bits of promotional text, as witness a column entitled “What is your Motto?” that listed:

• Public health is purchasable. Within natural limitations a community can determine its own death-rate.
• Sanitary instruction is even more important than sanitary legislation.
• No sanitary improvement worth the name will be effective, whatever acts you pass or whatever powers you confer on public officers unless you create an intelligent interest in the public mind.
• Nothing great was ever achieved without enthusiasm.
• Public health is the foundation upon which rests the happiness of the people and welfare of the state.
• Reform directed towards the advancement of public health must ever take precedence over all others.
• Money spent for the public health is an investment, not an expenditure. It costs less to keep the people well than to get them well. (JPHA, p372)

While Gunn was not personally responsible for any of these, his career demonstrates that he was fully in tune with each and every one of them.

Gunn used his editorials to promote various public health positions and did not hesitate to enter the political arena when the cause of public health was at stake. One such occasion was the enactment by the Republican dominated New York State Assembly of bills that interfered with the establishment of the State’s Sanitary Code and reduced the number of inspectors. The public raised sufficient protest to keep any of the damaging bills from ever being voted on, leading Gunn to conclude:

The lesson of all this is that Public Health is coming into its own; that it may and should be made a political issue in the good sense of the term; and that, if a health department in this present day achieves results and lets the people know about it, it need not fear the attacks of the politician. (1915 AJPH, p422)

From 1912 to 1914 Gunn served as Assistant Professor of biology at Simmons College. In 1914 he was promoted to Associate Professor at MIT by which time he had become Sedgwick’s principal aid on the public health side of the department (Jordan, p45). He was also on the faculty of the joint Harvard-MIT School of Public Health which opened its doors in May 1914 at which time Gunn participated in the examination of the School’s first candidate, Mark Frederick Boyd, who passed and would go on to become one of the leading malariologists of his generation.

Gunn helped develop a course for the joint school that dealt with the methods for cultural diagnosis of diphtheria and tuberculosis and use of the Widal test for typhoid. He also taught immunology and sanitary biometrics, as well as providing a once-a-week semester course covering the detrimental effects of factory life upon health, including occupational accidents and industrial poisoning”

Later in 1914 Gunn was released from part of his duties at MIT to help organize the new Division of Hygiene which had been created in 1914 as part of Massachusetts reform of the State Department of Health. (Jordan, p68). He assumed title of Director of the Division for the period 1915-1916.

Gunn’s ability to write intelligently and quickly and to be able to make sense out of diverse and sometimes copious bits of information, skills that he harbored until he died, suited his next assignment admirably, namely that of compiling a report on a voluntary survey of organizations interested in public health. The report, which was issued in 1915, was guided by a committee that consisted of some of America’s leading social and public health figures at the time. In addition to Farrand there was Surgeon-General Rupert Blue, Chapin, Wickliffe Rose, John M. Glenn and Prof. Henry R. Seager. Wickliffe Rose was Secretary of the Rockefeller Sanitary Commission, while Glenn was General Director of the Russell Sage Foundation and Seager represented the American Association for Labor Legislation.[1] Given its importance we will return to this stage of Gunn’s career in a later chapter. During the same period Gunn prepared a nearly 100 page chapter on Public Health that appeared in a book on Women and the Larger Citizenship.

In February 1916 Gunn’s application was accepted by the newly established Harvard/MIT School of Public Health to be a member and a candidate for the Certificate in Public Health. Unlike other candidates who were obliged to take numerous courses to fulfill the school’s requirements, Gunn took only two – that of Vital Statistics, which he took at MIT, and Preventive Medicine and Hygiene, which was offered by Harvard. He received passing grades; his 99% grade for the latter course being the highest grade noted for that year. Gunn passed his oral exam on June 9, 1917, shortly before his departure to France.

Gunn’s writings during this period were totally consistent with what was emerging at the time as the New Public Health, for which Charles Chapin was recognized as its leading proponent. Contrary to the importance of nuisances given in the book on Iowa quoted above, Chapin had demonstrated that filth, rubbish and other so-called “insanitary accumulations” were not dangerous to health. As he put it in his Sources and Modes of Infection published in 1912:

Except for a few diseases, or except for very indirect effects, the cleansing of streets, alleys, and back yards, of dwelling and stables, the regulation of offensive trades, and the prevention of nuisances generally, have, so far as we can see, no effect on the general health, nor any value in the prevention of specific diseases.

Cleaning and elimination of nuisances should be handed over to whatever branch of government was responsible for cleanliness and public welfare. Even the value of ventilation and disinfection were heavily questioned as more and more evidence demonstrated their ineffectiveness.

Gunn was in full agreement with a position that Chapin had been advocating for several decades, namely that public health practice must rest on solidly established facts and not on opinions of individuals no matter what their expertise might be. Gunn put it most succinctly: “the duty of science is twofold, first to seek the truth; second, having obtained truth to apply it towards the welfare of humanity.” Evidence-based thinking, much in vogue today, was at the center of the epidemiological approach to public health advocated by Gunn and his colleagues.

Gunn followed another great American public health leader of that time, Herman Biggs, in arguing that “public health is purchasable.” But to get the benefits of science, health departments must rest outside the influence of politics, a condition that sadly was rarely to be found in most American cities and states at the time. Talking to a meeting of mayors under the heading “A Model Health Department,” Gunn argued that the head of health departments “shall not be removed unless for a failure to discharge his duties.” Such an individual should be trained in the sanitary arts and should not be “tied down and fettered with interferences in the execution of his duty,” as often was the case when the health officer was forced to deal with committees and boards “composed of persons who oftentimes have little or no qualifications for such a position.” Gunn used this occasion to suggest that every health officer “should belong to the American Public Health Association.” Every city should pay for its health officers to attend the annual meeting of the APHA. Police and Fire departments sent their representatives to their meetings; why not the health department, for in the final analysis “is there any city official more important than the health officer?”

Gunn believed that the  most important work of a health department “is the control and prevention of communicable diseases.” The measures needed for this to be accomplished were fourfold: quarantine, education of the public and attaining their cooperation, collection and recording of suitable histories of all cases of communicable disease, and the scientific study and interpretation of these records by a competent epidemiologist.

The importance of quarantine was still undergoing considerable change in the face of the growing evidence of the presence of so-called health carriers, i.e. individuals carrying the infection and still capable of spreading it to others but suffering no or hardly any sickness. The importance of public education was partly driven by the need for people to recognize “that violation of quarantine is among the most serious offense against society.”

Gunn, in his study of communicable diseases in Milwaukee, delved deeply into the problem of how to improve the methods used for keeping records of quarantinable disease. He was particularly concerned with the reporting of scarlet fever and diphtheria, the two leading causes of death due to communicable disease following tuberculosis. At issue was the gathering and study of information from all cases, recognizing that “unless each history is subjected to careful, scientific and analytic study by some competent person, it would be a waste of time to find out all the particulars of a case.”

When Farrand agreed to lead the Anti-Tuberculosis program in France, he asked Gunn to join him as Associate Director. Gunn’s departure for France was announced in the AJPH in an editorial written by the APHA President, W.A. Evans, who noted that the APHA had been called upon “to make a sacrifice in behalf of the sufferers in France.” “Professor Gunn’s brothers have been at the front since the war began, and he has felt all along that the time would come, when he must do his bit. When he asked for a leave of absence we felt that however much his going might cripple us, if he felt it to be his duty to go, it was our duty to agree to his going.” (p672, 1917) Later in the year, the General Assembly of the APHA resolved:

That the cordial and hearty thanks of the American Public Health Association are tendered to Prof. Selskar Gunn, on account of his faithful and efficient services as Secretary of this Association, and as Editor of the Journal, an its is the wish and hope of the Association that Professor Gunn will be successful in the work he is now doing for his country and human liberty, and that he will finally return safely in health, to again serve in the public health cause. (p1049)

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[1] At this point Gunn’s Best Man, Franz Schneider was working as a Sanitarian for the Russell Sage Foundation.