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Doctors and Diseases on the Oregon Trail
June 3 Passed through St. Joseph on the Missouri River. Laid in our flour, cheese, crackers and medicine, for no one should travel this road without medicine, for they are almost sure to have the summer complaint. Each family should have a box of physicing pills, a quart of castor oil, a quart of the best rum and a large vial of peppermint essence.
The State of the Art
Today, we all have the same basic idea of what medicine is and how diseases work. We all know about germs, antibiotics, and vaccines. We watch surgeons replace internal organs on cable television. The medical professionals who keep us healthy are among the most respected men and women in the world.
Forget everything you know, because to understand medicine in the mid-1800s you will need to accept a completely different way of looking at disease. The doctors of that time had no idea that infection and disease were caused by microscopic organisms such as bacteria and viruses, and they had only recently realized, thanks to French battlefield physicians treating soldiers during the Napoleonic Wars, that wounds contaminated with dirt, bullet fragments, or other foreign matter would fester, turn gangrenous, and ultimately kill their patients.
Doctors and medical students often unknowingly infected their own patients by spreading germs from one person to another, as they did not change clothes, clean their instruments, or even wash their hands after treating one patient and before moving on to another. Hospitals were not places of healing -- they were for the poor, the dying, and the insane. Anyone in a hospital with an open wound or sore would almost certainly contract an infection and die within two weeks.
As a result, some of the best-selling books of the Nineteenth Century were home medical references such as Gunn's Domestic Medicine, or the Poor Man's Friend and the Family Hand Book. The last thing most people wanted when they were sick was to be treated by a doctor, because it was more or less an open secret by then that the medical professionals had no real idea of what they were doing when it came to curing disease. Physicians, as a profession, were held in such low regard during the early and mid-1800s that several states stopped certifying and licensing doctors -- anybody could put up a sign and call themselves a doctor, and a lot of folks did.
Predictably, the 1800s became a golden age for medical quackery. Some of the bizarre treatments prescribed by Nineteenth Century quacks included placing patients in bathtubs full of cold water or wrapping them in wet sheets for hours at a time, restricting patients to narrow vegetarian diets such as only eating apples or bread, using hypnotism to relieve pain (which did sometimes offer temporary relief but did nothing to treat the cause of the pain), and, later in the century, delivering electric shocks. The current popularity of allopathic and naturopathic medicine has its roots in the 1800s, as do some familiar soft drinks, including Coca-Cola and Dr. Pepper, that were originally sold as patent medicines. There were even "Indian Doctors" who claimed to have learned the medical properties of the native plants of North America from the Indians.
The mainstream medical treatments of the time were hardly better, and in some cases they were clearly worse. The most common way of treating a high fever, for example, was to cut open a vein and drain blood from the patient -- and not in a small way: a good doctor was expected to cut deep enough that the patient's blood would spurt into the air with every heartbeat! To make matters worse, the most commonly prescribed "drug" of the time was the toxic element mercury, usually in the form of mercuric chloride. Mercury was the active ingredient in many medicines of the period, including calomel, the "blue pill" or "blue mass" which was thought by many to be a safe alternative to calomel, and a patent medicine sold by one of America's most prominent early physicians, Dr. Benjamin Rush. These medicines were typically administered until the patient began to drool uncontrollably -- a classic sign of mercury poisoning which was mistaken for evidence that the medicine was working.
In addition to mercury in its various forms, a good pharmacy in the 1800s stocked drugs such as Dover's Powder (a mixture of opium and ipecac meant to relieve pain and induce sweating), Black Drops (a solution of opium in vinegar), laudanum (a mixture of opium in alcohol, often sweetened with sugar), and Dragon's Blood (a bright red plant resin used to treat "morbid impressions in the blood" and the like since the time of the ancient Greeks) alongside things we still see in drug stores today, such as glue, soap, castor oil, and carbonate (milk) of magnesia. The ready availability of opium in different forms -- there were even opium knockout drops marketed to women who wanted to keep their wayward husbands home at night -- reflects the fact that relieving pain was the one helpful thing that a doctor could reliably do for all of his patients. Pharmacies also sold medicinal plants like lobelia, juniper berries, and different kinds of tree bark along with crops that today we only think of as food, such as chili peppers and garlic.
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