Rupert Blue
Encyclopedia
Rupert Blue was an American physician and soldier. He was appointed the fourth Surgeon General of the United States
from 1912 to 1920.
, and raised in Marion, South Carolina
. He attended the University of Virginia
(1889–1890) and earned his M.D. from the University of Maryland
(1892). His first association with the Public Health Service (PHS), then known as the Marine Hospital Service
(MHS), came through a nine month internship (1 June 1892 to 2 March 1893), after which Blue applied for entrance into the MHS Regular Corps and was commissioned as an Assistant Surgeon on 3 March 1893.
, participating in the medical inspection of immigrants to the United States
and battling outbreaks of epidemic disease. Then-Surgeon General Walter Wyman
dispatched Blue twice to oversee rat eradication and urban sanitation programs after bubonic plague
struck San Francisco, once in April 1902 and again in August 1907, following the 1906 earthquake and fires
. Blue’s skilled diplomacy with California
state and city officials and with civil and business leaders fostered successful public education campaigns, stemming plague and enabling Wyman to avoid imposing a Federal quarantine on the Bay area
. His longtime friend and assistant Dr. W. Colby Rucker was a vital part of the San Francisco campaign and worked alongside Blue in New Orleans.
When he wasn’t trapping rats and squirrels in California, Blue directed mosquito
eradication efforts to control yellow fever
in New Orleans (1905), at the Jamestown Exposition
(1907), and in Honolulu (1911), to help Hawaii prepare for traffic to follow the opening of the new Panama Canal
. In addition, he represented the United States on a number of sanitation projects in South America
and attended the London School of Tropic Medicine (1910). Blue’s successes in the field made his reputation. He was promoted to the position of Surgeon (17 May 1909), and after Wyman died unexpectedly, President William Howard Taft
nominated Blue to serve as Surgeon General (13 January 1912 through 3 March 1920). Blue would go on to serve a second four year term under President Woodrow Wilson
(1916–1920).
Surgeon General Blue the plague fighter became an institution builder as well. He inherited the Act of 1912, which reoriented PHS toward research and public campaigns against disease. Passage of the Act of 1912 capped 6 years of lively debate about how to strengthen Federal public health efforts more generally. It designated the U.S. Treasury Department’s Marine Hospital and Public Health Service, rather than the Department of the Interior, as the lead Federal agency (and shortened the name to PHS), responsible not only for interstate quarantine and health services delivery to Federal wards but also for the health of the general public. The Act stepped up Federal public health activities, most notably in response to repeated outbreaks of typhoid fever that tore through cities and towns that drew drinking water from increasingly contaminated supplies. The Act of 1912 authorized Hygienic Laboratory investigations into water pollution’s contribution to the disease burden, including a new field research station at Cincinnati, Ohio
. Interstate guidelines were developed and put into effect to ensure potable water and pasteurized milk. PHS received authority to initiate field research independently of county and state health departments and to extend campaigns against infectious disease toward the control of occupational and environmental threats. During 1914 PHS opened an Office of Industrial Hygiene and Sanitation at the Marine Hospital in Pittsburgh
, near the Department of the Interior’s new Bureau of Mines.
Under Blue’s leadership, physician researchers at PHS turned the new science of bacteriology and the age-old practices of sanitation and public education to effective use against diseases linked to poverty in both rural and urban areas.
on 3 April 1917, Blue oversaw a dramatic short-term expansion of PHS duties without the benefit of increased appropriations. The military draft underway by July 1917 meant the movement of hundreds of thousands of draftees to temporary encampments around the country, with few provisions for public health by the War Department
or state health departments. In response, PHS established venereal disease control programs with funding from the Red Cross, provided industrial hygiene and health services for the thousands of workers laboring in war plants and the communities surrounding them, emptied swamps and sprayed for mosquitoes to prevent malaria, and built sanitary privies. Back in Washington, D.C.
, the Hygienic Laboratory produced vaccines against tetanus
, diphtheria
, typhoid, and smallpox
. Blue’s public health infrastructure was up and running by the time that Congressional support came, in the form of earmarked dollars and a statute covering the control and prevention of venereal disease (the Chamberlain Act of 1918).
During World War I, under SG Rupert Blue, cigarettes were issued as part of each fighting man’s basic field rations kit.
Recruiting and retaining physicians during wartime was a challenge to PHS, a situation made worse by the global Spanish influenza pandemic
that reached the United States in September 1918. Blue had applauded President Wilson’s Executive Order making PHS an arm of the military (issued in April 1917 and repealed in 1921), and subsequent moves to set officers’ pay and benefits on a par with those of the armed forces, but did not see passage of legislation creating a PHS Reserve Corps until October 1918, well into the flu pandemic. Pressure to add staff also came from Congress’s mandate (1917) that PHS provide health services for disabled and, as of March 1919, all World War One veterans, through a new Bureau of War Risk Insurance in the Treasury Department. Over the following year, PHS assembled a network of fourteen district offices and transformed war surplus facilities into hospitals and clinics, scrambling for staff and resources to stretch the $10.5 million given by Congress to fund the new program. Given his tenure during this period, it may not come as a surprise that Blue advocated enacting national health insurance, then known as universal sickness insurance, as part of an overall Federal public health strategy. Blue spoke not only as Surgeon General and on behalf of the Association of State and Territorial Health Officers but also as President of the American Medical Association (1916–17).
A change in leadership at the Department of the Treasury, PHS’s home, may have led to Blue’s decision to step down from his posting as Surgeon General, on 9 March 1920. He resumed the rank of Assistant Surgeon General and was assigned to Paris, France, to oversee PHS operations in Europe and to serve as U.S. delegate to the Office International d’Hygiene Public (1920–1923) and subsequently to the League of Nations. After a full career at PHS, Blue retired from PHS on 1 December 1932. He died on 12 April 1948, in Charleston, South Carolina
.
Surgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
from 1912 to 1920.
Early years
Rupert Blue was born in Richmond County, North CarolinaRichmond County, North Carolina
-Demographics:As of the census of 2000, there were 46,564 people, 17,873 households, and 12,582 families residing in the county. The population density was 98 people per square mile . There were 19,886 housing units at an average density of 42 per square mile...
, and raised in Marion, South Carolina
Marion, South Carolina
Marion is a city in Marion County, South Carolina, United States. The population was 7,042 at the 2000 census. It is the county seat of Marion County...
. He attended the University of Virginia
University of Virginia
The University of Virginia is a public research university located in Charlottesville, Virginia, United States, founded by Thomas Jefferson...
(1889–1890) and earned his M.D. from the University of Maryland
University of Maryland, Baltimore
University of Maryland, Baltimore, was founded in 1807. It comprises some of the oldest professional schools in the nation and world. It is the original campus of the University System of Maryland. Located on 60 acres in downtown Baltimore, Maryland, it is part of the University System of Maryland...
(1892). His first association with the Public Health Service (PHS), then known as the Marine Hospital Service
Marine Hospital Service
The Marine-Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the U.S. Merchant Marine, U.S. Coast Guard and other federal beneficiaries....
(MHS), came through a nine month internship (1 June 1892 to 2 March 1893), after which Blue applied for entrance into the MHS Regular Corps and was commissioned as an Assistant Surgeon on 3 March 1893.
Career
Blue spent his early years at MHS at the front lines of turn-of-the-century public healthPublic health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
, participating in the medical inspection of immigrants to the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and battling outbreaks of epidemic disease. Then-Surgeon General Walter Wyman
Walter Wyman
Walter Wyman was an American physician and soldier. He was appointed the third Surgeon General of the United States from 1891 until his death in 1911.-Early years:...
dispatched Blue twice to oversee rat eradication and urban sanitation programs after bubonic plague
Bubonic plague
Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...
struck San Francisco, once in April 1902 and again in August 1907, following the 1906 earthquake and fires
1906 San Francisco earthquake
The San Francisco earthquake of 1906 was a major earthquake that struck San Francisco, California, and the coast of Northern California at 5:12 a.m. on Wednesday, April 18, 1906. The most widely accepted estimate for the magnitude of the earthquake is a moment magnitude of 7.9; however, other...
. Blue’s skilled diplomacy with California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...
state and city officials and with civil and business leaders fostered successful public education campaigns, stemming plague and enabling Wyman to avoid imposing a Federal quarantine on the Bay area
San Francisco Bay Area
The San Francisco Bay Area, commonly known as the Bay Area, is a populated region that surrounds the San Francisco and San Pablo estuaries in Northern California. The region encompasses metropolitan areas of San Francisco, Oakland, and San Jose, along with smaller urban and rural areas...
. His longtime friend and assistant Dr. W. Colby Rucker was a vital part of the San Francisco campaign and worked alongside Blue in New Orleans.
When he wasn’t trapping rats and squirrels in California, Blue directed mosquito
Mosquito
Mosquitoes are members of a family of nematocerid flies: the Culicidae . The word Mosquito is from the Spanish and Portuguese for little fly...
eradication efforts to control yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....
in New Orleans (1905), at the Jamestown Exposition
Jamestown Exposition
The Jamestown Exposition was one of the many world's fairs and expositions that were popular in the United States in the early part of the 20th century...
(1907), and in Honolulu (1911), to help Hawaii prepare for traffic to follow the opening of the new Panama Canal
Panama Canal
The Panama Canal is a ship canal in Panama that joins the Atlantic Ocean and the Pacific Ocean and is a key conduit for international maritime trade. Built from 1904 to 1914, the canal has seen annual traffic rise from about 1,000 ships early on to 14,702 vessels measuring a total of 309.6...
. In addition, he represented the United States on a number of sanitation projects in South America
South America
South America is a continent situated in the Western Hemisphere, mostly in the Southern Hemisphere, with a relatively small portion in the Northern Hemisphere. The continent is also considered a subcontinent of the Americas. It is bordered on the west by the Pacific Ocean and on the north and east...
and attended the London School of Tropic Medicine (1910). Blue’s successes in the field made his reputation. He was promoted to the position of Surgeon (17 May 1909), and after Wyman died unexpectedly, President William Howard Taft
William Howard Taft
William Howard Taft was the 27th President of the United States and later the tenth Chief Justice of the United States...
nominated Blue to serve as Surgeon General (13 January 1912 through 3 March 1920). Blue would go on to serve a second four year term under President Woodrow Wilson
Woodrow Wilson
Thomas Woodrow Wilson was the 28th President of the United States, from 1913 to 1921. A leader of the Progressive Movement, he served as President of Princeton University from 1902 to 1910, and then as the Governor of New Jersey from 1911 to 1913...
(1916–1920).
Surgeon General Blue the plague fighter became an institution builder as well. He inherited the Act of 1912, which reoriented PHS toward research and public campaigns against disease. Passage of the Act of 1912 capped 6 years of lively debate about how to strengthen Federal public health efforts more generally. It designated the U.S. Treasury Department’s Marine Hospital and Public Health Service, rather than the Department of the Interior, as the lead Federal agency (and shortened the name to PHS), responsible not only for interstate quarantine and health services delivery to Federal wards but also for the health of the general public. The Act stepped up Federal public health activities, most notably in response to repeated outbreaks of typhoid fever that tore through cities and towns that drew drinking water from increasingly contaminated supplies. The Act of 1912 authorized Hygienic Laboratory investigations into water pollution’s contribution to the disease burden, including a new field research station at Cincinnati, Ohio
Cincinnati, Ohio
Cincinnati is a city in the U.S. state of Ohio. Cincinnati is the county seat of Hamilton County. Settled in 1788, the city is located to north of the Ohio River at the Ohio-Kentucky border, near Indiana. The population within city limits is 296,943 according to the 2010 census, making it Ohio's...
. Interstate guidelines were developed and put into effect to ensure potable water and pasteurized milk. PHS received authority to initiate field research independently of county and state health departments and to extend campaigns against infectious disease toward the control of occupational and environmental threats. During 1914 PHS opened an Office of Industrial Hygiene and Sanitation at the Marine Hospital in Pittsburgh
Pittsburgh, Pennsylvania
Pittsburgh is the second-largest city in the US Commonwealth of Pennsylvania and the county seat of Allegheny County. Regionally, it anchors the largest urban area of Appalachia and the Ohio River Valley, and nationally, it is the 22nd-largest urban area in the United States...
, near the Department of the Interior’s new Bureau of Mines.
Under Blue’s leadership, physician researchers at PHS turned the new science of bacteriology and the age-old practices of sanitation and public education to effective use against diseases linked to poverty in both rural and urban areas.
- Dr. George McCoy documented tularemiaTularemiaTularemia is a serious infectious disease caused by the bacterium Francisella tularensis. A Gram-negative, nonmotile coccobacillus, the bacterium has several subspecies with varying degrees of virulence. The most important of those is F...
’s bacterial origins. - Dr. Charles Stiles charted the extent of hookworm diseaseHookworm diseaseHookworm disease is a cutaneous condition characterized by skin lesions that are erythematous macules and papules. Specific types include:* Ancylostomiasis* Necatoriasis...
, and its positive correlation with insanitary soil conditions, throughout the Southeast. - Dr. Joseph GoldbergerJoseph GoldbergerJoseph Goldberger, M.D. was a Hungarian Jewish physician and epidemiologist employed in the United States Public Health Service . He was an advocate for scientific and social recognition of the links between poverty and disease...
used field studies at Spartanburg, South CarolinaSpartanburg, South CarolinathgSpartanburg is the largest city in and the county seat of Spartanburg County, South Carolina, United States. It is the second-largest city of the three primary cities in the Upstate region of South Carolina, and is located northwest of Columbia, west of Charlotte, and about northeast of...
and at the Greenfield, Mississippi prison farm to uncover the nutritional deficiencies at the root of pellagra (1914–1915). - Dr. Leslie Lumsden reduced the prevalence of typhoid feverTyphoid feverTyphoid fever, also known as Typhoid, is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica, serovar Typhi...
through rural privy-building campaigns and spurred the establishment of the first full-time county health department, at Yakima, WashingtonYakima, WashingtonYakima is an American city southeast of Mount Rainier National Park and the county seat of Yakima County, Washington, United States, and the eighth largest city by population in the state itself. As of the 2010 census, the city had a total population of 91,196 and a metropolitan population of...
(1911). - Dr. John McMullan brought his knowledge of trachoma treatment and prevention from work with immigrants to public health campaigns among American Indians and rural populations in the Ozarks and Southern Appalachian mountains, setting up the first of his temporary hospitals at Hindman, KentuckyHindman, KentuckyAs of the census of 2000, there were 787 people, 356 households, and 220 families residing in the city. The population density was 232.5 people per square mile . There were 415 housing units at an average density of 122.6 per square mile . The racial makeup of the city was 97.59% White, 0.38%...
(1913).
World War I
After the United States officially entered World War IWorld War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...
on 3 April 1917, Blue oversaw a dramatic short-term expansion of PHS duties without the benefit of increased appropriations. The military draft underway by July 1917 meant the movement of hundreds of thousands of draftees to temporary encampments around the country, with few provisions for public health by the War Department
United States Department of War
The United States Department of War, also called the War Department , was the United States Cabinet department originally responsible for the operation and maintenance of the United States Army...
or state health departments. In response, PHS established venereal disease control programs with funding from the Red Cross, provided industrial hygiene and health services for the thousands of workers laboring in war plants and the communities surrounding them, emptied swamps and sprayed for mosquitoes to prevent malaria, and built sanitary privies. Back in Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....
, the Hygienic Laboratory produced vaccines against tetanus
Tetanus
Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, rod-shaped, obligate anaerobic bacterium Clostridium tetani...
, diphtheria
Diphtheria
Diphtheria is an upper respiratory tract illness caused by Corynebacterium diphtheriae, a facultative anaerobic, Gram-positive bacterium. It is characterized by sore throat, low fever, and an adherent membrane on the tonsils, pharynx, and/or nasal cavity...
, typhoid, and smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...
. Blue’s public health infrastructure was up and running by the time that Congressional support came, in the form of earmarked dollars and a statute covering the control and prevention of venereal disease (the Chamberlain Act of 1918).
During World War I, under SG Rupert Blue, cigarettes were issued as part of each fighting man’s basic field rations kit.
Recruiting and retaining physicians during wartime was a challenge to PHS, a situation made worse by the global Spanish influenza pandemic
Spanish flu
The 1918 flu pandemic was an influenza pandemic, and the first of the two pandemics involving H1N1 influenza virus . It was an unusually severe and deadly pandemic that spread across the world. Historical and epidemiological data are inadequate to identify the geographic origin...
that reached the United States in September 1918. Blue had applauded President Wilson’s Executive Order making PHS an arm of the military (issued in April 1917 and repealed in 1921), and subsequent moves to set officers’ pay and benefits on a par with those of the armed forces, but did not see passage of legislation creating a PHS Reserve Corps until October 1918, well into the flu pandemic. Pressure to add staff also came from Congress’s mandate (1917) that PHS provide health services for disabled and, as of March 1919, all World War One veterans, through a new Bureau of War Risk Insurance in the Treasury Department. Over the following year, PHS assembled a network of fourteen district offices and transformed war surplus facilities into hospitals and clinics, scrambling for staff and resources to stretch the $10.5 million given by Congress to fund the new program. Given his tenure during this period, it may not come as a surprise that Blue advocated enacting national health insurance, then known as universal sickness insurance, as part of an overall Federal public health strategy. Blue spoke not only as Surgeon General and on behalf of the Association of State and Territorial Health Officers but also as President of the American Medical Association (1916–17).
A change in leadership at the Department of the Treasury, PHS’s home, may have led to Blue’s decision to step down from his posting as Surgeon General, on 9 March 1920. He resumed the rank of Assistant Surgeon General and was assigned to Paris, France, to oversee PHS operations in Europe and to serve as U.S. delegate to the Office International d’Hygiene Public (1920–1923) and subsequently to the League of Nations. After a full career at PHS, Blue retired from PHS on 1 December 1932. He died on 12 April 1948, in Charleston, South Carolina
Charleston, South Carolina
Charleston is the second largest city in the U.S. state of South Carolina. It was made the county seat of Charleston County in 1901 when Charleston County was founded. The city's original name was Charles Towne in 1670, and it moved to its present location from a location on the west bank of the...
.