In the early 19th century, Bostonians largely had two options if they got sick: house calls from expensive private physicians or an overcrowded poorhouse.

So two centuries ago yesterday, in a 2,677-word petition, two of the city’s top doctors called on the city’s gentry to help establish the state’s first public general hospital.

Eleven years after Warren and Jackson spurred the city to action, Massachusetts General Hospital opened in 1821 in the Bulfinch Building. Yesterday, five of Warren and Jackson’s descendents, four of whom have worked at the hospital, stood on the building’s steps and with hundreds of others gathered on the lawn signed copies of the original petition.

So Warren and Jackson drafted their petition, which they called The Circular Letter, making its aim clear in the first line: “It has appeared very desirable to a number of respectable gentlemen, that a hospital for the reception of lunatics and other sick persons should be established in this town.’’

The letter details the lack of medicine available for the poor and the moral obligation to help them....