While Mass General’s first patient, admitted on September 1, 1821, was treated for syphilis, 18 years later the hospital’s trustees voted to refuse admission to syphilis patients unless their condition was “urgent” and they paid twice the normal rate of board. (Health insurance was still a century off, so patients either paid their own hospital fees, used a philanthropically supported “free bed” if they were eligible, or used a “free bed” sponsored by their employer.) Syphilis was stigmatized for being sexually transmitted, but there was not a clear clinical reason for this policy. The efforts of a number of doctors convinced the hospital to drop this rule in 1900.