The 1890 Charter established a Board of Health. Among the Board's duties was appointment of a Health Officer who would act as "city physician" and serve as the executive of the Board.

The Health Officer had the responsibility of enforcing city health ordinances and the Board of Health's regulations; other duties included visiting public buildings and reporting on their level of sanitation, making monthly and annual reports on birth, death, and disease statistics, and recording births, deaths, and burials. The physicians and midwives of the city were obligated to report births, occurrences of infectious disease, and deaths to the Health Officer, who was also responsible for issuing permits for disinterment and exhumation.

The Health Officer was also involved with quarantining citizens suffering from "smallpox, yellow fever, Asiatic cholera, or other infectious disease" as necessary; flags and placards indicating the nature of the disease were posted at the houses of the ill, and the names of infected persons were reported to the Police Department, superintendent of schools, and the public librarian.

In 1908, the mayor-appointed position of Commissioner of Health took over the powers and responsibilities of both the Health Officer and the Board of Health.