Doctors Of The Frontier

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At every step in the trek westward, America’s pioneers found an enemy more ubiquitous, more stealthy, and more deadly than the Indians, yet in our histories we tend to forget this dread opponent. It was, quite simply, disease. Epidemics of malaria ravaged frontier settlements through most of Ohio, Indiana, Illinois, and Michigan. In the gold camps of California, cholera, malaria, typhoid, and scurvy struck down even the hardiest fortune seekers. Scarlet fever, yellow fever, diphtheria, smallpox, tuberculosis, and influenza attacked settlers along the westbound way. In addition to these scourges, fatalistically received as acts of God, there was violence, and the festering ills it trailed behind.

Against such hazards there were few defenses. Pioneers closed themselves with folk remedies and patent medicines, believing as a general rule that strongsmelling, vile-tasting, thoroughly disagreeable treatments were the most effective. Drinking sulphur, for instance, was thought to be good for almost anything. When the illness was really grave, they summoned what was rather loosely called a doctor—if there was one within fifty miles.

Like the patients they treated, the pioneer physicians were long on courage and endurance, and short on almost everything else. The typical practitioner could stuff all his supplies and equipment into his saddlebags. Usually he carried homemade bandages, a few drugs, a mortar and pestle for mixing prescriptions, some syringes, perhaps some hot water bottles of pewter or crockery, and a small assortment of knives and saws. By 1840 the progressive, well-equipped frontier doctor had added tooth forceps, stethoscope, and obstetrical instruments to the meager list.

Some of them also used a device called a pulsometer. This was a dumbbell-shaped glass container partially filled with colored liquid. A stream of air bubbles rose through the liquid when the patient held the gadget while his pulse was taken. It was a fraud, of course-the bubbling liquid revealed nothing at all about the pulse—but it gave the patient the satisfying feeling that the latest marvels of science were being applied on his behalf.

Through the 1830’s most of the drugs at the doctor’s command were narcotics or purgatives, administered usually in staggering doses. Ipecac, which induced vomiting, was a particular favorite. Another was a chloride of mercury compound called calomel which supposedly cleansed the system by causing saliva to jxjur from the mouth. Unfortunately, it also softened the gums and caused the teeth to fall out. Not until the 1840’s, when the curative properties of quinine became widely appreciated, did the pioneer physician have a really sale and effective drug; but it was prohibitively expensive. As late as 1846 an Indiana doctor sold a heicl of fat cattle at $7.50 a head in order to buy the precious medicine at $6 to $8 an ounce.

The greatest shortage of all was in medical knowledge and training. Until the 1860’s—and in some sections long afterward—a frontier doctor was almost any man who called himself one. It is a safe guess that not more than a fourth of them held degrees from medical schools. Most learned by the apprentice system, and some were self-taught, self-appointed healers who hung out their shingles when they “got the call.”

In this institutional void, more than a dozen systems and theories of medicine sprang up. Steam baths, free/ing baths, weird diets, secret Indian herbs, and the draining away of bad blood—each theory of healing had its partisans. The contending camps engaged in fierce disputes while borrowing so freely of each other’s methods that it was often hard to tell where one system ended and another began. The confusion gave rise to a group called eclectics, or people’s doctors, who practiced medicine on the democratic frontier principle that one man’s opinion was as good as another’s. Some people’s doctors claimed to be equally proficient in all methods, and allowed the patients to choose the treatments they preferred.

The one belief held in common by most systems was that serious ills called for drastic remedies. One doctor’s treatment for malaria advised: Carry then your patient into the passage between the two cabins—strip oil all his clothes that he may lie naked in the cold air and upon a bare sacking—and then and there pour over and upon him successive buckets of cold spring water, and continue until he has a decided and pretty powerful smart chance of a shake.

If the resultant tremors seemed a bit excessive, that could be countered by immersing the victim in warm water and administering stiff doses of a patent medicine containing opium.

Doctors who professed the precepts of orthodox medicine were called allopaths, or “regulars,” and were in their way quite as rough-hewn as their irregular colleagues. In the early part of the pioneer period the credo of the regulars was “bleed, blister, and purge.” How far they went with it is indicated by the teachings of Dr. Daniel Drake, who helped to found the first medical college in Ohio, which survives today as the Medical College of the University of Cincinnati. He was a brilliant man, far ahead of his time in many ways, but a traditionalist on the question of bleeding. In an 1832 medical periodical he advised: To bleed a patient who cannot be raised from his pillow without fainting, whose pulse is nearly imperceptible, whose skin is cold, and extremities shrunk up to half their ordinary size, would at first view, seem rash and unwarrantable. But experience … has sanctioned the use of the lancet even when all these and other symptoms of extreme prostration are present.