During the summer of 1907 a large passenger steamer from Chicago arrived at Buffalo with a number of patients with typhoid fever aboard, among whom deaths occurred. A physician1 of the Buffalo Board of Health had charge of the investigation. It was revealed that the tank of the steamer had been filled with infected water, taken at some indefinite point on the long lake trip of over one thousand miles.
As a measure of future safety, it would have been of great value to know at what point the infected water was obtained, and who, if any one, was to blame. Under existing conditions of conflicting authority, it would be difficult to determine on whom the responsibility should be placed. The surgeon of the steamer, often a new and inexperienced graduate, appointed for the trip, could not be expected to know the sanitary character of the channels traversed. State
FELL GE. ADVISABILITY OF GOVERNMENT MEDICAL CONTROL OF THE HYGIENIC FACTORS OF THE WATERS OF THE GREAT LAKES. JAMA. 1911;LVII(26):2055-2057. doi:10.1001/jama.1911.04260120245009