Prevention of Communicable Diseases.
The opinion of the doctor who wrote the 1890 letter shown below reveals the widely held belief that malodorous air caused disease.


Toronto’s first medical officer of health Dr. William Canniff’s drive to clean up cluttered yards and cesspools was influenced in part by this misconception. His successor Dr. Charles Sheard wrote in 1897 that this view was now considered wrong, but still maintained that gases from sewer pipes “are capable of lowering vital power, and diminishing resistance to disease.”
Letter regarding air pollution from a vent pipe making people sick.
Letter from acting Medical Officer of Health A.R. Pyne to City Solicitor
Medical Officer of Health’s letter book
November 14, 1890
Series 518, File 1


“No sooner had diphtheria been conquered and almost cast into oblivion than this new horror appears on the horizon,” wrote Medical Officer of Health Dr. G.P. Jackson in 1934. He was referring to polio, but he could have been talking about any new disease in history—smallpox, typhoid, scarlet fever, tuberculosis, diphtheria, polio, or AIDS. Every generation has its plague.


Quote, "Deaths from preventable diseases lack that tragic interest that deaths from accidents are surrounded with." MOH Dr. Charles Hastings, 1914.
Health officials now routinely use vaccination as a method of combating disease, but it can be contentious. Toronto provided free smallpox vaccinations in the 19th century, but many people didn’t believe it worked, or thought they might catch the disease from the vaccination itself.


In the early 20th century, there was resistance to compulsory vaccination, even amongst some doctors.


Some people believed that vaccination was unproven scientifically, that it polluted the body, and that catching smallpox was unlikely in any case. Others feared that vaccination might cause them physical harm, and sometimes this did occur.

Vaccination then was more dangerous and painful than it is today. For example, smallpox vaccinations required scratching a patch of skin raw, and occasionally this led to sores that did not heal for weeks.

People on a platform speak to the crowd, who hold signs that say Stop the slaughter of the innocents, protest against compulsory vaccination and Compulsory vaccination is German born, down with compulsion.
Rally of the Anti-Vaccination League of Canada, Old City Hall
November 13, 1919
Photographer: William James
Fonds 1244, Item 2517


With better vaccination techniques and education, public opinion slowly changed, and in time vaccination of school children against a wide variety of diseases, including diphtheria, polio, and measles, became standard.

In 1937, Dr. Jackson observed that vaccination is a case in which “individual hazard is improved in direct ratio to the intelligent action of one’s neighbours.”


A woman of Asian heritage holds her toddler on her lap while a nurse or doctor prepares to give the child a needle.
Vaccination clinic
September 19, 1945
Photographer: John H. Boyd
Fonds 1266, Item 99074


The Department of Public Health has always encouraged people to take charge of their own health. In 1912 Medical Officer of Health Dr. Charles Hastings introduced a “swat the fly” campaign to reduce the spread of typhoid from garbage to food via flies.


“Flies spell death”, with the letters in the word death made from drawings of flies.
“Flies spell death”
August 6, 1913
The Toronto Telegram
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 233a
The Toronto Star newspaper offered cash prizes to the children who killed the most flies. Hastings agreed to be the judge. Beatrice White was the winner, having swatted an amazing 543,360 flies. Collectively, the children of Toronto killed an estimated 3.5 million flies.


The three photographs below illustrate how the Department of Public Health used epidemiology (the study of what causes and spreads disease) to decrease risks in such common activities as drinking water.

The first photograph shows a drinking fountain with a tin cup chained to it that was used by every person who needed a drink. Horses used the large basin on the opposite side, and dogs drank from the basin near the ground. Dr. Canniff supported the installation of these fountains in the 1880s, saying that they prevented disease and, as a bonus, might deter people from going into saloons to quench their thirsts.


A boy fills a cup in front of a cast iron fountain that has a spout for humans, a large basin for horses, and a smaller basin for dogs.
Drinking fountain with common cup, Spadina Avenue at College Street
April 26, 1899
Photographer: F.W. Micklethwaite
Series 376, File 2, Item 49


Canniff’s successor, Dr. Hastings, believed that this kind of fountain could spread disease and documented scientifically how the common drinking cup could pass bacteria and sickness from one user to the next.

Hastings’ solution was the “bubble fountain”—the kind of drinking fountain we use today, where the drinker’s mouth touches only clean water. The fountains below are waiting for installation by the Department of Public Works.

Light-coloured bacterial growths make patterns resembling feathers and flowers against the dark background.
Bacteria on common drinking cup
April 22, 1912
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 133


A row of freestanding cast-iron fountains, about three feet high, with white basins at the top.
Bubble drinking fountains to replace common drinking cups
April 13, 1917
Photographer: Arthur S. Goss
Series 372, Subseries 72, Item 834


The department knew it was important to trace the spread of diseases. Doctors were legally required to report to the medical officer of health when they learned of cases of infectious diseases such as typhoid and scarlet fever. However, many doctors didn’t know of the requirement, or didn’t bother.


Kids sitting on a step underneath a "quarantine" sign.
Children at Stanley Barracks housing under quarantine for polio
August 6, 1947
Photographer: John H. Boyd
Fonds 1266, Item 117576

Tracing people who may have been infected with disease required discretion and an understanding of the need to balance public health with the right to personal privacy.

Once a contagious illness was revealed, the department had the right to quarantine a household until the danger of infecting others was past. Stanley Barracks at Exhibition Place was used as civilian housing before and after World War II. Five families were quarantined there because one child had polio. The children shown here were pictured in The Globe and Mail newspaper for ignoring the quarantine and playing with other children.



Before antibiotics, the only way to recover from tuberculosis was to try to strengthen the immune system with plenty of rest, nutritious food, and fresh air. The department encouraged tuberculosis patients to live outside, away from coal fires and stuffy indoor air. The woman in the photograph to the right may be a public health nurse checking on patient George de Ber’s condition, or a bedside nurse hired by the family.
Nurse stands beside a man in a bed in a tent.
Tuberculosis patient George de Ber in tent September 6, 1912
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 153


Teenaged girls extend their arms so nurses can stick bandaid-sized patches on them.
Patch test to detect tuberculosis in high school students
ca. 1950
Photographer: Unknown
Series 474, Subseries 3, File 2, Item 50
Paper bag, cloths, case full of bottles, and inspectors' badges made of metal in the shape of shields.
Health inspector’s badge and kit, and bag and supplies used by tuberculosis nurses
September 6, 1912
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 155



Graph shows TB deaths falling from 130 per 100,000 population in 1910 to 40 in 1934.
Tuberculosis deaths, Toronto, 1910-1934
December 5, 1935
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 860


As communicable diseases became less common, the need for quarantines declined. However, quarantine was used in 2003 to combat SARS and it is possible that new diseases in the future may bring it back into use.


Graph shows diphtheria rates falling from 170 per 100,000 population in 1929 to 5 cases in 1947.
Diphtheria rates, Toronto, 1929-1947
ca. 1947
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 927
Graph shows typhoid fever deaths falling from 44 per 100,000 population in 1910 to 2 in 1925. Chlorination of drinking water was started in 1910, and complete pasteurization of milk in 1914.
Typhoid fever mortality, Toronto, 1910-1925
January 11, 1927
Photographer: Arthur S. Goss
Series 372, Subseries 32, Item 773