In 1854, Dr. Edwin Snow pioneered efforts to document and analyze a wave of cholera which attacked the citizens of Providence. Tracking the disease among his own patients, he devoted himself to tracing its source and preventing its recurrence. Snow became the first Superintendent in 1856 when Providence established a permanent city health department. Twenty-two years later, a State Board of Health was formed with three mandates: preventing the spread of disease, collecting vital statistics, and implementing a sanitation program.
In 1883, Dr. Charles Value Chapin became Providence's Superintendent of Health. Dr. Chapin continued Dr. Snow's efforts, improving sanitation, advocating city sewer construction, establishing quarantine regulations, and identifying the source of a cholera outbreak in 1888. Dr. Chapin instituted mandatory reporting of contagious disease cases such as scarlet fever and diphtheria. He was a leader in discouraging fumigation of houses as a disease prevention measure and established the nation's first contagious disease hospital, the Providence City Hospital, in 1910.