Massachusetts also contributed the first medical article written and published in the New World-"A Brief Rule to Guide the Common People of New England how to order themselves and theirs in the Small-Pocks, or MeaSels." It was written by Thomas Thacher, the first minister of the Old South Church. (Not all the energies of the colonists were directed toward intellectual pursuits, however, for Massachusetts also contributed the first epidemic of syphilis in the New World, in Boston, 1646.)

Nevertheless, Boston had no general hospital for two hundred years after the landing of the Pilgrims. During this time the city had been growing rapidly-from a population of 4,500 in 1680, to 11,000 in 1720, and finally to 32,896 in 1810. By now it was clear that an almshouse was inadequate for the population, a conclusion reached some years earlier in the larger cities of Philadelphia and New York.

Thus the Reverend John Bartlett, chaplain of the overcrowded almshouse, wrote a letter in 1811 to "fifteen or twenty-five of the wealthiest and most respected citizens of Boston," urging support of a general hospital. Shortly before, two professors of the newly formed Harvard Medical School had written a similar letter. Their emphasis was slightly different, for the medical school needed a hospital for clinical teaching, and every attempt to use the existing almshouse or to build a new hospital had been blocked by the local medical society, whose members feared the encroachment of the school on the conduct of medical practice.

Through these letters run a number of recurrent themes: that a hospital is indispensable for training young doctors; that existing facilities are inadequate; that the obligations of Christian charity demand support of a hospital; and that Boston has fallen behind Philadelphia and New York.

The appeal, on many levels, was certainly successful. When fund-raising began in 1816 (it was delayed by the War of 1812), $78,802 was collected in the first three days, and donations eventually exceeded $140,000.