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Doctors Of The Frontier
Underschooled and ill-equipped, the men who attended the pioneers practiced a rugged brand of medicine—but they made some major advances all the same
April 1963 | Volume 14, Issue 3
If the patient was so wasted away that blood would not flow from the veins, Dr. Drake urged “recourse to the jugulars.”
Another theory involved relief of illness through counterirritation-peeling away a section of epidermis and rubbing a strong irritant on the exposed flesh. Or a specially treated coil of cotton could be burned slowly on the skin. When infections were cauterized, an iron at gray heat was found to be most painful, and, therefore, was thought to be the most effective.
Not surprisingly, many people feared physicians at least as much as they dreaded disease. Popular distrust of medicine was expressed in derisive journalistic comments such as, “When we hear of a man’s getting well, after being given over by the doctors, we can’t help thinking how lucky he was to be given over by the doctors.” When a system appeared called homeopathy, whose treatments in those rugged clays often amounted to little more than letting nature take its course, skeptics saw it as a Hobson’s choice. The alternatives were spelled out in an irreverent jest. “The patients of the homeopaths died of the disease, and the patients of the allopaths died of the cure.”
Despite their mistakes, however, not all pioneer doctors can be dismissed as bumbling quacks. Many were dedicated men, struggling earnestly to solve terrible problems at a time when medicine everywhere was burdened with much ignorance. If they were more freewheeling than doctors elsewhere, more prone to extreme measures and violent experiments, that was part of the frontier spirit.
The calling was hard and dangerous, even by frontier standards. When epidemics raged, the pioneer doctor often labored heroically, riding from one lonely dwelling to another, snatching his sleep in the saddle, never really resting until the threat abated. He risked his life every time he set foot in a cabin where someone lay stricken with a deadly, highly contagious disease. And he did it for very little money. A typical fee in some areas during the early 1800’s was twenty-five to fifty cents a visit, perhaps a dollar if the doctor stayed all night; payment was made in goods, services, or promises more often than in cash.
Here and there the frontier produced a physician of extraordinary vision and skill. Dr. Benjamin Dudley was one of these. He taught anatomy and surgery at Transylvania University, Lexington, Kentucky, the West’s first medical school. A hot-tempered man, Dr. Dudley was constantly embroiled in quarrels with his colleagues. Fortunately for medicine he also quarrelled with some of the established ideas of his day. Long before germs were discovered, Dr. Dudley was advocating the quite novel notion that infection could be reduced by cleansing surgical instruments in boiling water.
Dr. Dudley was inclined to take personal offense at those who dared to dispute his views. He fought at least one duel, with a colleague, a Dr. Richardson, felling his opponent with a pistol ball in the thigh. Whether stricken by regret or merely moved by professional instincts, the cantankerous Dudley then rushed forward to treat the wound he had just inflicted. The duellists thereupon became fast friends.
A quite different type was Dr. Ephraim McDowell. Modest, soft-spoken, and gentle, McDowell began practicing at Danville, Kentucky, in 1795, and soon became known as one of the great surgeons of what was then the frontier territory. As his fame spread, he travelled throughout the Ohio and Mississippi valleys, sometimes riding hundreds of miles to take charge of particularly difficult cases. Once he operated on a youth suffering from a painful bladder stone and fourteen years afterward received a grateful letter telling how much the patient’s fortunes had improved since the day when he was brought to Dr. McDowell as a “meagre boy, with pallid cheeks, oppressed and worn down with disease.” The testimonial was from James K. Polk, later President of the United States. Dr. McDowell also performed a delicate and dangerous operation for a friend and neighbor of President Jackson. These, however, were only incidents in Dr. McDowell’s career. His enduring place in medical annals rests on the operation he performed on a forty-five-year-old Kentucky housewife named Jane Crawford.
In 1809 McDowell was summoned to the Crawford farmhouse at Caney Fork to assist in what was thought to be a long-overdue childbirth. He found at once that Mrs. Crawford was not pregnant. She was suffering from an enormous ovarian tumor and could expect to live only a year, perhaps two at most. There might be a chance for recovery if the tumor were removed, but that was an expedient so desperate that it had never been attempted, most medical authorities being certain that it could only hasten the end. Dr. McDowell recommended the operation as the only hope, but added that he would not risk it under the primitive conditions at the farmhouse. If Mrs. Crawford could come to his home at Danville, he would operate there.