A Chronology of The History of Public Health in South Carolina
Charles Towne is established as an English Colony.
Anton van Leeuwenhoek invents the microscope and discovers "little animalcules."
Provincial Legislature forbids swine from running free in the city of Charleston and instructs all property owners to refrain from littering their land and to cut "stinking weed in and about the lots and streets."
Provincial Legislature requires incoming vessels to produce evidence that no persons on board are suffering from a contagious disease before the ship could dock in Charleston Harbor.
Yellow fever epidemic in Charleston kills about 160 of estimated 3,000 residents. "A most infectious pestilential and mortal distemper...which from Barbados or Providence was brought in among us in Charles Town about the 28th or 29th of Aug. last past....This Distemper from the time of its beginning aforesaid to the first day of November killed in Charles Town at least 160 persons." Among the victims were the "chief justice, receiver-general, provost marshal, and almost half of the assembly."  From Duffy, Epidemics in Colonial America,1953, p. 143.
Yellow fever epidemic in Charleston.
A brick pest house is constructed on Sullivan's Island for isolation of individuals suffering from contagious diseases.
Yellow fever and smallpox epidemics in Charleston. Gideon Johnson wrote on November 11, 1711: "Never was there a more sickly or fatall season than this for the small Pox, Pestilential ffeavers, Pleurisies and fflux's have destroyed numbers here of all sorts, both Whites Blacks and Indians." From Duffy, Epidemics in Colonial America,1953, p. 75.
Provincial Legislature passes an act that created the first provincial health officer in America. Commissioner Gilbert Guttery was the first, and last, person to hold the position, which was abolished in 1721.
Yellow fever and smallpox epidemics in Charleston, with further yellow fever outbreaks in 1718 and 1719.
Outbreak of diphtheria in Charleston: "a Distemper that within a short time prov'd mortal to a great No. of people here." From Duffy, Epidemics in Colonial America,1953, p. 117. 
Yellow fever and smallpox epidemics in Charleston each year, continuing through 1739. 
Smallpox epidemic in Charleston: Dr. James Kilpatrick introduces variolation (smallpox innoculation), with success: only 4% of the people inoculated died. Of 1,675 infected naturally, 295 died. Of 437 inoculated, 16 died. The population of Charleston was approximately 5,000 in 1738: almost half were infected. From Duffy, Epidemics in Colonial America,1953, pp. 82-83. 
The sum of 1,000 pounds was appropriated for construction of a new pest house "for the reception of all infected or distempered persons which shall be brought to this province..."
Yellow fever epidemic in Charleston.
Yellow fever epidemic in Charleston.
A public hospital is established in Charleston for sick sailors and transient persons.
A Charleston City Ordinance provides that scavengers be hired to keep the city clean. Diphtheria spreads widely: "a 'Quinsie' which resulted in an inflammation of the throat and lungs so severe...that 'They mortify in less than Four & Twenty Hours.'" From Duffy, Epidemics in Colonial America,1953, p. 125. 
The South Carolina Gazette reported, "It is pretty certain that the Smallpox has lately raged with great Violence among the Catawba Indians, and that it has carried off near one-half of that nation, by throwing themselves in the river, as soon as they found themselves ill - This Distemper has since appeared amongst the Inhabitants of the Charraws and Waterees, where many Families are down." From Duffy, Epidemics in Colonial America,1953, p. 92. 
Smallpox epidemic in Charleston, one of the worst in the colonial period. Variolation is widely used, over 2,000 persons were inoculated and "only ninety-two died under inoculation." (According to David Ramsay, History of South Carolina, II, 79.) In a population estimated at 8,000, there were an estimated 6,000 cases and over 730 deaths, or 9% of the population. From Duffy, Epidemics in Colonial America,1953, pp. 94-95. 
Yellow fever epidemics occur each year in Charleston. The worst outbreak kills 362 in 1799. The 1790 population was approximately 16,920. 
Edwin Jenner finds that cowpox vaccination will protect people against smallpox more safely than live smallpox vaccination.
Yellow fever epidemics were recorded in Charleston in 1800, 1802, 1804, 1817, 1820, 1821, 1824, 1827, 1828, 1838, 1839, 1849, 1852, 1854, 1856, 1858, 1864, 1871, and 1876.
Charleston City Council asks the Medical Society to constitute themselves as a Board of Health.
The City of Charleston establishes a Board of Health with 13 commissioners.
The Ladies Benevolent Society of Charleston begins volunteer care of the sick and needy in Charleston - this is the starting point for public health nursing in South Carolina.
First major cholera pandemic of the 19th century began in India in 1817and spread throughout Asia by 1823. 
Medical College of South Carolina is established by the state Legislature, but not funded. The faculty establish it, anyway.
Second major cholera pandemic begins in India and spreads throughout Asia, Middle East, Europe, Britain, North and South America by 1837. 
Edwin Chadwick begins sanitary reform campaign in London.
Robert Mills Building opens as the sixth state supported mental asylum in the United States. (The Mills Building is home to DHEC Health Services central offices in 1997.)
Chadwick presents "report on the Sanitary Conditions of the Labouring Population" to British Parliament. International Health of Towns Association has its beginnings as a coalition of national and local voluntary orgainzations concerned with sanitation and health.
Third major cholera pandemic spreads worldwide by 1863. The fourth cholera pandemic followed almost immediately, when major resurgences of cholera began in 1865 and continued until 1875 with tremendous loss of life.
Ignaz Philip Semmelweis, Viennese physician, advocates for handwashing to prevent transmission of puerperal fever (streptococcal) infections at childbirth.
John Snow puts a lock on the pump at Broad Street to end an outbreak of cholera in London. Epidemiology takes a giant step forward.
Louisiana establishes the first permanent state board of health in the United States. 
Florence Nightingale begins the Nightingale School and Home in London, for training nurses.
Joseph Devaine identifies anthrax bacillus.
Louis Pasteur discovers "pasteurization:" heating wine briefly to high temperature destroys the bacteria that makes wine go sour.
Charleston City Council creates the first full-time city health department.
Joseph Lister begins use of carbolic acid (phenol) for prevention of septic infections during wound care and surgery.
Massachusetts establishes state board of health.
Dr. Manning Simons chairs a committee of the South Carolina Medical Association that produces a report on "State Medicine and Public Hygiene." This report on the sanitary conditions of the state formed the basis for the creation of the State Board of Health.
Major yellow fever epidemic strikes New Orleans, Memphis and the Mississippi River Valley - more than 200 communities in eight states were affected. There were an estimated 120,000 cases and 20,000 deaths between August and October.
Legislature creates State Board of Health, on December 3, 1878.
Louis Pasteur publishes "The Germ Theory and Its Applications to Medicine and Surgery."
Robert Koch publishes "Investigations into the Etiology of Traumatic Infectious Diseases."
Alphonse Laveran identifies parasites that cause malaria.
Louis Pasteur develops vaccines for chicken cholera and anthrax, with attenuated bacilli.
Carl Eberth identifies the typhoid bacillus.
Pneumococcus bacilli is identified as a cause of pneumonia by Pasteur.
Robert Koch announces discovery of the tuberculosis bacteria.
Diphtheria bacillus is discovered by Edwin Klebs and Fredrich Loeffler.
Pasteur develops rabies vaccine, and it is first used on a nine year old boy, Joseph Meister, bit by a rabid dog.
Pasteurization of milk is first recommended by Franz Soxhet.
Shibasaburo Kitsato and Emil Behring develop tetanus and diphtheria toxin vaccines and antitoxins for treatment.
William Roentgen discovers x-rays.
Almroth Wright develops vaccine for typhoid using heat-killed bacilli.
Malaria transmission through Anopheles mosquitoes is proven.
State Board of Health is given responsibility for the purity of drugs.
Board of Health is given power to license and regulate embalmers and undertakers.
Dr. Walter Reed and colleagues demonstrate that yellow fever is carried by Ades Aegypti mosquito.
First full-time nurse is hired by the Ladies Benevolent Society for public health nursing.
Board of Health is authorized to mandate smallpox vaccination and take other measures to control smallpox epidemics.
Charleston undertakes the first government sponsored malaria control drainage project. Municipalities are authorized by state law to construct drains and sewers.
Testing of public water supplies for bacterial and chemical contaminants is required by state law.
A safer diphtheria toxin-antitoxin vaccine is developed.
Dr. Charles Fredrick Williams is hired as the state's first full-time, paid State Health Officer. In 1915, Dr. Williams became head of the Department of Mental Health, and served there for thirty years.
South Carolina hosts a national conference on pellagra.
The state public health laboratory is established.
Paul Ehrlich develops Salvarsan, an arsphenamine used to treat and cure syphilis.
The Rockefeller Sanitary Commission finances a campaign against hookworm in SC, which led to establishment of the Division of Rural Sanitation.
Laboratory begins free distribution of diphtheria antitoxin.
South Carolina is the first state to distribute typhoid vaccine free, manufactured by State laboratory.
Dr. James Adams Hayne is appointed as the second State Health Officer. He serves as State Health Officer until 1944.
The American Red Cross begins offering public health nursing services in Spartanburg. Over the next 24 years, local Red Cross chapters will provide public health services in 25 counties.
Law passed for the registration of births and deaths in South Carolina.
Board of Health is given authority to permit discharge of sewerage into streams.
Joseph Goldberger determines that pellagra results from a dietary deficiency. He identified brewer's yeast, turnip greens and other cheap available foods that could treat or prevent the disease.
Bureau of Vital Records established.
State tuberculosis hospital is established.
South Carolina's first county health departments are established in Greenwood and Orangeburg, with sponsorship from the Rockefeller Foundation.
Division of Rural Sanitation and County Health Work is established.
Greenville county health department is established.
Orangeburg and Greenville counties appropriated $2000 each for public health work in their respective counties.
The Division of Rural Sanitation staff included 3 physicians, a stenographer and 24 sanitary inspectors employed for rural community work.
Seven county health nurses hired by the Board of Health.
Darlington and Lexington counties appropriated funds for public health departments. 
Venereal Disease Control program started.
World-wide Spanish influenza epidemic kills 20 million people. In South Carolina, there are an estimated 170,000 influenza cases and 6,100 deaths.
Bureau of Child Hygiene is established to provide prenatal care, infant and child health services and health education. Mrs. Ruth Dodd was appointed Director of the Bureau of Child Hygiene and State Supervisor of Public Health Nurses.
State Sanitary Engineer employed.
Medical epidemiologist employed.
Eight counties have health departments. Twenty-six counties had nursing services.
Hotel and Restaurant Inspector employed.
One thousand midwives were registered after completing a course of instruction.
The Board of Health had 42 nurses serving nearly every county.
Malaria control program underway.
Division of Venereal Disease is discontinued, due to lack of funding.
The State Board of Health received $20,000 from the Federal government for maternal and child health through the Sheppard-Towner Act.
State dental clinics established.
First public health nutritionist is hired to teach nurses about diets for mothers and infants.
Dillon and Marboro counties establish a joint bi-county health department.
Rehabilitation program for crippled children begins, with an orthopedic clinic in Columbia.
Shellfish sanitation program begins with inspection of oyster beds and oyster processing plants.
Midwife Institute is opened to train midwives.
A Child Health Center is established in Florence to provide immunizations and child health care in a full-time child health clinic.
Alexander Fleming discovers penicillin.
Federal funds from the Sheppard-Towner Act were withdrawn.  Bureau of Child Hygiene staff was reduced from 16 to 3 due to loss of Federal funds.
40,000 cases of pellagra in South Carolina.
Bureau of Child Hygiene ceases operations. Sanitary engineering division discontinued. Epidemiologist abolished by state legislature, due to state funding shortage.
Influenza virus first isolated from swine.
The State Board of Health was in danger of being eliminated entirely due to economic stress.
The Bureau of Child Hygiene ceased to function when federal funds were withdrawn and no state appropriation was made.
State Board of Health is given responsibility for control of narcotics.
The state appropriation for rural sanitation and county health work enables the establishment of health units in all counties, with a health officer, nurse, clerk and one or more sanitary inspectors.
Federal funds appropriated under Title V of the Social Security Act enable creation of the Division of Maternal and Child Health. Other programs created or re-established with Federal funding include Industrial Hygiene, Crippled Children, Venereal Disease Control, Medical Epidemiology.
Tuberculosis Sanitorium is constructed at State Park, with Works Project Administration funding. Construction is completed in 1938 of a 264 bed facility, which was expanded to 550 beds in 1940.
All counties have established a county health department. The state is divided into three administrative public health districts.
Yellow fever vaccine is developed.
Division of Venereal Disease Control is re-established.
Nicotinic acid is identified as the specific B vitamin deficiency that causes pellagra.
Cancer Control Division established.
Sanitary inspections of restaurants are implemented statewide.
Penicillin is first used to treat humans.
All 46 counties are served by 34 health departments: 23 one county, 10 bi-county and 1 tri-county.
Penicillin is introduced for the treatment of bacterial infections.
The South Carolina Public Health Hospital is established for rapid therapy of venereal disease.
Streptomycin developed by Selman Wakeman and Albert Schatz, and introduced for treatment of tuberculosis. Other anti-TB drugs were introduced soon after: p-aminosalicylic acid (1949), isoniazid (1952), pyrazinamide (1954), cycloserine (1955), etahmbutol (1962) and rifampin (1963).
Dr. Ben Wyman becomes the third State Health Officer.
Ms. Lucia Murchison is hired as the first public health social worker.
Drug Control program begins.
Federal Hill Burton Act funding and state laws support building, licensing and inspection of hospitals and nursing homes. Board of Health is given responsibility for setting standards, inspection and licensure, planning, and allocating Federal assistance for health facilities. Division of Hospital Construction is formed.
Division of Heart Disease Control is created, with a diagnostic and surgical heart clinic at the Medical University of South Carolina. Diabetes Control is included in the chronic disease program.
Legislature creates the Water Pollution Control Authority. Legislature passes the Rabies Control Act. 127,000 animals are vaccinated during the first year of its enforcement.
Marriage registration law is enacted.
State Tuberculosis Sanatorium becomes an independent agency.
Dr. George Peeples becomes the fourth State Health Officer.
Salk polio vaccine is distributed through nationwide immunization campaign.
World Health Organization launches global malaria eradication program, relying on DDT spraying.
Asian influenza (H2N2) pandemic, new sub-type emerges.
Shellfish program begins inpection of shellfish harvesting areas and processing facilities.
Divorce registration law is passed.
Measles vaccine is developed.
Air pollution Control program begun. Water Pollution Control Authority name is changed to Pollution Control Authority.
Home Health program begins to provide services under Medicaid and Medicare.
Sims Building completed.
Dr. Kenneth Aycock becomes the fifth State Health Officer.
Meat inspection is assigned to Clemson University by the Legislature.
Tuberculosis Sanatorium is returned to the State Board of Health.
Mumps vaccine is developed.
A supplemental food commodities program for pregnant women and children begins.
Health districts are established.
Hong Kong (H3N2) influenza pandemic, new sub-type emerges.
The WHO's Global Eradication of Malaria program is ended. Malaria was eradicated from most of North America, Europe and some areas of Asia and South America. Malaria remains endemic to large areas of South and Central America, Asia and Africa.
Pollution Control Authority is made a separate agency.
State Board of Health is given authority to regulate and promote emergency medical services.
Responsibility of occupational health and safety is assigned to the State Department of Labor.
Responsibility for illicit trafficking in controlled substances is transferred to the State Law Enforcement Division.
The "No Shots, No School" law is passed, which made it mandatory that all school children be immunized by the time of school entry.
State Board of Health and Pollution Control Authority are merged into the Department of Health and Environmental Control. The State Board of Health is dissolved, and a new Board structure is implemented. Dr. Ken Aycock is the first Commissioner of the Department of Health and Evnironmental Control.
Supplemental Food Program for Women, Infants and Children (WIC) begins.
The R.J. Aycock Building, home to DHEC central offices, is completed.
State Safe Drinking Water Act is passed.
First Legionnaire's Disease outbreak occurs.
First case of human infection with cryptosporidium diagnosed.
"Swine flu" outbreak at Fort Dix prompts massive, controversial Federal response.
World Health Organization's smallpox eradication campaign succeds: last known case of smallpox in the world occurs.
Hazardous waste management assigned to DHEC by the Legislature.
Hayne Building is completed at State Park. 1980
Hepatitis B vaccine is developed.
County health department staff are transferred to the State payroll.
E.coli 157:H7 is first recognized as a pathogen.
Tuberculosis Sanitorium is closed, with transition to community treatment and general hospitals.
HIV-I retrovirus is identified as the causal agent of AIDS.
Note: This chronology incorporates and updates a chronology prepared by Dr. Malcolm U. Dantzler in 1986.
1. Rosa Heyward Clarke. 1937. "History and Development of Public Health Nursing in South Carolina." Unpublished Master's thesis, University of South Carolina, pp. 62-73.
2. John Duffy. 1953. Epidemics in Colonial America. Baton Rouge, LA: Louisiana State University Press.
3. Geoffrey Marks and William K. Beatty. 1976. Epidemics. New York, NY: Charles Scribner & Sons.
4. John Duffy. 1966. Sword of Pestilence. Baton Rouge, LA: Louisiana State University Press.
5. John H. Ellis. 1992. Yellow fever and Public Health in the New South. Lexington, KY: The University Press of Kentucky.