Lake County Ohio GenWeb

Medical Pioneers and Pioneer Medicine
by J.C. Hubbard, M.D.

From History of Geauga and Lake Counties, Ohio, Williams Brothers, 1878 pages 32-34

Transcribed and submitted by Becky Falin, 1996.

Before proceeding to consider the subject in a general way, we will note the early acts of legislation to regulate the practice of physic and surgery. The first law dates from January 11, 1811, the preamble reading as follows: "Whereas, the practice of medicine and surgery is a science so immediately interesting to society that every encouragement for its promotion should be given, and every abuse of it, so far as possible, suppressed." The State was then divided into five districts. Geauga County was included in the fifth district, with Jefferson, Belmont, Columbiana, Stark, Trumbull, Cuyahoga, Portage, Huron, and Ashtabula. The names of the censors appointed for this district were George Wilson, John McDowell, and Thomas Campbell. The functions of these officials were to examine and license candidates to practice. This law was repealed February 8, 1812, by an act to incorporate a medical society. Among the names of medical men from the Reserve who were embraced in this corporation are those of Drs. Allen, Manning, and Casset of Trumbull; Orestes K. Hawley, of Ashtabula; and J.H. Matthews and Palmer, of Geauga. These counties were in the sixth district, along with Portage, Cuyahoga and Huron. All physicians and surgeons who had diplomas or proper credentials were at liberty to join on application.

In both of these acts irregular practitioners were not allowed the benefit of law in the collection of fees, and by the latter act were subject to fines but not imprisonment for practicing. In 1817 the foregoing act was repealed, and another passed and amended in 1818, and also in 1820. The districts were changed to accomodate the growing population, and the fine for illegal practice increased from five to seventy dollars as the maximum sum. The following year this act was succeeded by one which remained in force and without alteration until February 21, 1824. By this law, there were nine districts, corresponding in territory to the judicial ones. The only penalties for violating it were the deprivation of the aid of the law in the collection of fees and ineligibility to the office of censor. In 1824 a new and more comprehensive legal organization was effected. The State was divided into twenty districts, and the last aforementioned act repealed. Geauga and Ashtabula constituted the twentieth district, and the corporators' names are O.K. Hawley, Ashbel Dart, Nathan B. Johnson, John W. Scott, John Emory, Jr., Charles ___, Storm Ross (ie, probably Storm Rosa) and Andrew Merriman. The corporators, and such other qualified practitioners as chose to join, constituted a district society and body corporate. Each district elected from three to five censors, whose duties were similar to those prescribed in the foregoing acts. All resident physicians of the State were required to be members; otherwise they were subject to fines, and were deprived of the benefit of law in the collection of their medical accounts. One feature of this act is noticeable. There were no fines imposed on the irregular. He could not have the aid of law in securing his remuneration, and he was ineligible to the position of censor. These were the sole punishments to which he was liable, while the non-affiliating regular was fined, and labored under all the other disabilities imposed on the quack besides. This section will indicate, on the part of the profession, a policy to close up their ranks for a final struggle to retain their legal privileges and immunites against the leveling tendencies under democratic institutions which, with us, so far as governmental forces are concerned, have decreed that scientific and intellectual height shall come down and repose quietly on the plain of ignorance. Before dropping the consideration of these acts to sustain scientific medicine, we wish to commend the twelfth section of the act of 1824, which declares the fine and ethical spirit of the pioneer doctors to those of their successors who are prone to introduce the question of fee rates into the sessions of our medical societies. The section reads as follows: "That the medical society aforesaid shall not either directly or indirectly make any order, resolution, or arrangement defining or fixing the amount of compensation to be charged or received for any services which may be rendered or medicine furnished by any surgeon or physician within this State, nor make any other order or arrangement relating to such charges or compensation."

Disease or pain is not the result of design on the part of nature. Some unseen interference with the development of a parent cell by which it acquires an amorphous character may give the mobid cast to countless numbers of cells, which are to follow and take part with it in giving form and function to the various organs of our bodies. In vegetable life even we daily behold the perverting influence of morbid growth in the shape of the trunk of a tree, - the unseemly curve, the protruding gnarl, the fungoid excrescence or decay, beginning at the root or the heart of the lofty and graceful monarch of the forest. In the animal organization the perversion of cell growth manifests itself in many ways. Unseen in its small, mysterious outstart, it makes itself known by changes in forms and functions of the creature. It causes our parts to shrink, swell, ulcerate and pain us. It may destroy permanently normal functions and powers, without the enjoyment of which life is hardly desirable. So beset are we with the dangers of perverted growth and minor morbid influences that disease and pain are the daily inheritance of our race. Were ignorance and temerity banished from human society, there would still remain a moiety of ills ever seeking relief. We cannot, therefore, imagine human society but in which, next after establishing the family relations, there would follow efforts to secure the benefit of some medical system. Were it possible for a people to spring out of the earth like Achilles' myrmidons in a day, ere nightfall some casualty or disease would be certain to intrude, and compel the sufferer to seek for remedies in the domain of medicine. It would appear needless to remind the world of its dependence on an enlightened organizatin of therapeutics. But in health we forget that sickness and death are a part of the drama of life, - the unwelcome part of the play on which we fain would drop the curtain ere the final act is finshed. The pioneer settlers of the Reserve were sober, earnest, thoughtful men, descended from a race possessed of the highest type of European civilization, and though necessity often compelled them to penetrate far into the unbroken wilderness to enforce their civilizing mission, leaving behind them the ministers of medicine, law, theology and education, they no sooner had formed a successful settlement than these co-workers were invited into their midst.

As this article is intended to spread before the readers of this history a representation of pioneer medicine, we must briefly and perhaps imperfectly present a picture as best we can, which shall at least have the merit of brevity and truth. The first practitioners of medicine on the Reserve were almost invariably from the New England States, - the same sort of men as the enterprising, hardy settlers themsevles. While here and there was to be found a doctor who had a classical education, the great majority of them had, at the outset of their professional career, no literary acquirements beyond that obtained at the common schools and village academies of their native States. Nearly all of them, however, were thoughtful readers, and in a few years became remarkable in their respective communities for their general intelligence, and as a body they exerted a decided influence in favor of honor, integrity and good morals. They were energetic, fearless men, who, after surveying the trials and the almost incredible hardships to be endured in their new sphere of usefulness, deliberately chose it. Here they cast their lot with the stout-hearted settler. They lived in humble cabins as he did, and as he fared so did they.

On their errands of mercy they rode by day from one settlement to another, and in the saddle by night they wended their way by blazed trees along the bridlepaths in the solitude of the interminable forests, without guide, arms, or companion, wading through swamps or fording streams whose depths they scarcely knew, despite the appalling cry of the panther and the baying of the stealthy wolf.

These dismal journeyings were often made without hopes of pecuniary reward. They were endured through two or three decades in behalf of humanity, in the broadest and purest sense of the term. They were done in the interest of society, of civilization, and to sustain professional propriety and honor, and to lay a successful claim to manly personal respect. The ambitious soldier in quest for glory, and imbued with the spirit of patriotism, willingly perils his life in a few campaigns, and then prefers to leave the "tented field" for the easier pursuits of peace. War-worn and scarred, he sheaths his sword and rests contented with honors won. But these sturdy ministers of mercy voluntarily pursued their calling, undaunted by toils not less than herculean and heroic, to the end of their lives. They enlisted in the advance-guard of civilization, in the spirit of a forlorn hope; they sought no golden fleece, no public honor, no glittering renown; and we appeal to the memory of those who knew them for a verification of our views, or else to point us to a body of our countrymen who were more self-sacrificing, more abounding in mercy, kindness, charity, and all good works. As a profession, they no doubt had faults, but they were such faults as the world readily forgives. We do not fear contradiction from the descendants of the pioneers when we say that take them all in all they were noble men, - stalwart in form, broad-shouldered and erect, with manly faces, genial, agreeable, and all that society had a right to require. Most of them were educated for their profession in country towns and villages by a preceptor. A few of them were graduates of New England country medical schools, notably that of Castleton, Vt. A few had enjoyed the rare privilege of attending lectures and practical instruction in the medical department at Yale or Harvard. Some came with licenses from the medical societies of the eastern States, while others were licensed by the medical societies of the Reserve. Up to the year 1824 the title of M.D. was an honor somewhat difficult to obtain, and therefore highly prized by the possessor and appreciated by the public.

They detested quackery with an honest and conscientious disgust, for the empiricism of the forefathers made no pretensions to science or learning. It based its claim to skill upon intuition, in which its votaries more than half believed. Age had not then taught it to wrap itself around about in the flimsy garb of erudition. It had no dogma even to stand upon till Thompson, in 1834, announced that "Heat was life, and cold was death." The pioneer doctors were tenacious of the few legal rights and privileges they possessed. They were the medical profession, and quackery was unfashionable. Here and there a self-styled doctor, remarkable for ingenuity and audacity, flourished. But he lived from day to day at his peril. The eccentric, the ignorant, and the hopeless cases of disease made up his list of patients. He was ridiculed to his face and at his back by the regular profession, abused by the people, and hunted about till he disappeared out of sight and out of memory, like the wild beasts of the forests. His means of subsistence was frightened away from him. The force which crushed acknowledged empiricism as often as it raised its head from the earth was the relentless order of things. For there were plenty of people then, as now, who really preferred its legitimate medicine. But the honor, dignity, and merit of scientific medicine, as it has grown from age to age, had never been successfully disputed. It was, as we trust it is now, a solid part of organized society. Like church, law, and kindred forces, it was armed like an iconoclast that crushed all opposition. Settled opinions and customs are in their day invulnerable. We must allow that the pioneer doctors were as a body much influenced in their practice by authorities. Inductive philosophy, while it had shed a flood of light on medical science, though it was interrupted now and then, since the study of anatomy and experimental physiology was first introduced into the medical schools at Alexandria, had not really unfettered the medical mind from the domination of leaders who were men of genius and acquirements sufficient to saddle the profession from generation to generation with successful dogmas. They were mostly closet philosophers, who instituted hypotheses for investigation and unfounded theories for verification.

In the days of pioneer doctors, the bondage of hereditary medical opinions was not wholly broken. New opinions were slow in forcing their way into positions no longer tenable for mere metaphysical systems which science had blasted and were crumbling down. Conservatism in science, religion, and politics, and all social questions, is slow to yield. It is the very nature of things, and it is well; for underneath and over all the surface-works of man are the unalterable laws of nature, which govern and shape everything, from the most inorganic molecule up the the most subtle and delicate affairs of society. In the latter part of the eighteenth century the theories and practices of Boerhave, Sydenham, and others, as modified and improved to keep pace with the growing knowledge of the times by Cullen, Brown and Broussais, were the opinions of the men whose professional lives we are considering.

The leading idea of the humoral theory, as taught by Galen, was that the fluids of the body were the source of the materies morbi, or proximate cause of all disease; it held undisputed sway for more than a thousand years, and yet lingers in the popular mind. No doubt this theory has its grain of truth; but as an exclusive dogma it has long ceased - as have all other dogmas - to exercise a controlling influence over the medical world. One of the most mischievous features of dogmatic systems, of all kinds whatsoever, is their necessity for asserting their own finality. Science, on the contrary, is always aspiring for more and better light. The celebrated Dr. Wm. Cullen, who flourished in the latter part of the eighteenth century, was remarkable for his learning, industry and sagacity. He rejected hypotheses as bases for practice, and while he indulged in theories as a necessary sequence of induction, he founded therapeutics and pharmacy as far as possible upon actual experiment and clinical observations. His work on "Practice" was the text-book and guide of our earliest physicians. His teachings and great example, together with the physiological discoveries of Haller, paved the way for a new departure, which began with the date of the discoveries of these true philosophers, but which did not fully declare itself in the western States of our country till about the years between 1830 and 1840. Nowhere among the most civilized nations was there more need of medical reform than on this Western Reserve. The imperfect acquirements of a considerable number of these practitioners - then isolated from the great medical centres of the country - all predisposed them to desert the patient and cautious ways of Cullen, and to embrace and found their therapia on extravagant and meddlesome theories. Not all of them, by any means, but many of them, justly fall under this criticism. They eagerly indorsed the practice of copious bleedings in nearly all diseases as taught by the versatile and brilliant Dr. Rush. They used the lancet even in the pleurisy of consumption, and to check hemorrhage from the lungs in that disease. They bled in all sthenic disease for "spasms of the extreme arteries, for congestion," etc. They employed venesection to break up fevers, which were then well known to be endowed with a certain number of days in which to exist, as are insects or flowers. That the free use of the lancet was and is now sometimes demanded, we do not hesitate to believe, but it was fearfully abused; because its use was based upon dogmas and speculative assumptions, which could not be satisfied till the potent little blade should be asserted as a general means of cure rather than as an occasional necessity. Prof. Hamilton, of Edinburgh, Scotland, early in the present century, was an ardent and able advocate of drastic purgation in nearly all febrile and inflammatory affections. His extravagant notions were taught in New England by Professor Gallup with abounding zeal, and an ability worthy of a better practice.

The graduates of these schools who settled here from about 1818 to 1830 were especially remarkable for their penchant for the use of active cathartics and the lancet. Having been brought up among a robust population, who fared well, in a simple, quiet way, in a pure and bracing atmosphere, and being themselves men of iron constitutions, they no doubt often overrated the limits of endurance among common humanity, and between excessive purgation and unindicated bleeding, furnished disagreeable proofs of the old adage, "the remedy may be worse than the disease." The most sanguine of this school of doctors gave now and then most extraordinary doses of cathartics and emetics. They did not hesitate, as we know from actual observation, to give a teaspoonful of calomel at once in severe cases of disease, if the patient was young and robust. Often tartarized antimony or ipecac was added to the cathartics, to produce a double action, - ie, emeto-catharsis. The amount of evacuation resulting from these doses would now be considered marvelous. Quantites of bile, viscid matter of various hues, and water would be thrown up, while the bowels were relieved of additional bile, tenacious mucus, half-digested food, and feces of course. If it was a case of fever in its initial stages, the skin often became moist, the headache and backache ceased, and general relief for a considerable period obtained. Occasionally excessive salivation followed the heroic use of mercury, and a nice set of teeth were nearly destroyed. Doubtless these strong purgative drugs sometimes produced intestinal inflammation and other evils. The fevers of that day were mostly remittent and intermittent. Sometimes during their course they changed their type from one to the other. For instance, a case would begin as a remittent or bilious fever and change into ague, and vice versa. Typus and typhoid were then unknown in the west. Typhus, we think, has never prevailed on the Reserve with the exception of a few cases termed ship-fever in the commerical towns. Typhoid was first noticed here between the years 1832 and 1840, according to the best dates we can obtain. (Our venerable friend, Dr. H.H. Webster, of Kingsville, Ohio, informs us that thypus prevailed in the years 1823-1825. After these years fevers were sthenic until 1832, when the cholera invaded the country. This disease for years afterwards seemed to stamp the diathesis of other diseases with the typhoid type.) Oweing to ulceration of the bowels and diarrhea, which are features of this disease, the necessity of milder plans of treating fevers became apparent, and were adopted. According to the opinions of the pioneer doctors about this period, the diatheses of all diseases which were severe and somewhat protracted became typhoidal, and they saw very plainly the necessity of pursuing more conservative ways of treatment. The constitutions of the early settlers, their simple habits, their diet of pork, corn-bread, and other heavy carbonaceous foods, their freedom from the cares, expense, and vexations of modern society, enabled them to bear, as a body, very well the active treatment of the day. Had the type of their fevers corresponded to these of later days, the treatment in fashion then would have been very pernicious; its evil effects would have been so palpable that all the authorities and preconceived notions in the profession and among the laity could not have sustained it for a day.

To pursue a little further the account of the treatment of fevers by our medical grandfathers; after thorough evacuation, if the febric symptoms partially or wholly abated, Peruvian bark in powder was given in tablespoonful doses, to arrest the further manifestations of pyrexia, precisely as we now give quinine to interrupt intermittent and remittents, and to lower the temperature in fevers of various kinds when it becomes dangerously high. This cooling power of quinine is a discovery of the last decade, and is as novel and surprising as any discovery in therapeutics. At the beginning of this century quinine was unknown. It lay like a hidden treasure in the coarse fibers of cinchona bark, which the pioneers gave so freely in substance. They knew that the rare virtues were in the nauseous bark, but it remained for science to solve the mystery by separating and salifying the alkaloid or alkaloids into salts, one of them quinine, the chief of all remedies. The pioneer patients swallowed as best they could the heaping large spoonfuls of bark, and were cured.

Let us imagine if we can the condition of the poor patient's stomach after swallowing a half dozen doses of the nauseous stuff, and be thankful for quinine. It comes as near dining on saw-dust as anything we can think of. The early settlers directed all their energies to felling the forest and clearing the land for the plow. Drains and ditches were practically unknown. The water of the wells, streams, and superficial springs, running over and percolating through the new soil, was laden with organic matter, and was as a rule far more unwholesome than at present. The air, and rude dwellings of the people, were more damp than at present, and we might infer from these conditions that pneumonia and other inflammatory diseases of the respiratory organs were more prevalent than now. An epidemic pleuro-pneumonia of a thypoidal type appeared in the eastern States in 1812 and 1813, and swept over the western territories. We have often listened to a very good description of this epidemic from the late Dr. Elijah Coleman, of Ashtabula, who was a surgeon in Harrison's army, and participated largely in its treatment. He says that it struck down many of the strongest men, and that often the premonitory symptom was a sudden darting pain in the fingers or toes, the sufferer otherwise feeling well as usual. At the end of an hour or two a chill, excrutiating pleuritic pains, high temperature and delirium came on, death often resulting in twenty-four hours. The surgeon- in-chief of Dr. C.'s division, a Rushite, officially advised free bleeding, and other depressing remedies. The disastrous results of this treatment soon led to the adoption of more successful methods. Authorities and theores were ignored for the safer and surer guidance of clinical observations. The better treatment consisted in the early administration of ipecac as a nauseant, soon followed by homely sweating, doses of hemlock tea, and steaming, hot blocks of wood, stimulating expectorants, such as serpentaria, carbonate of ammonia, senega, etc. Among the early cases of this fearful disease related to us by Dr. Coleman was that of a stalwart Kentuckian, who was spending the evening with the doctor's mess, card-playing. Suddenly he dropped his cards and cried out with pain in the thumb, and said to the doctor, "What does this mean?" "Poor Fellow!" replied the doctor, "I am afraid you will know too well in an hour what it means." Soon came the chill and the other symptoms of the epidemic, and he died the following morning.

Before draining the soil became customary, inflammatory croup was common in damp localities. The treatment was by blood-letting and mercury, and was very successful when used sufficiently early. From the earliest settlement dysentery prevailed over a large extent of country about once every decade. The most urgent symptoms in the bad cases were the great loss of blood and general prostration. The treatment pursued in the earliest times was first a mild cathartic of castor oil or calomel and rhubarb; ipecac in frequent and increased doses; opium by mouth; and enemata to control pain. This treatment, which we saw employed from 1842 to the present time, was, as we think, as successful as any plan whatsoever. Owing to coarse food, and the use of surface and other contaminated water, intestinal parasites abounded in early days. The lumbricoid, or common round worm, was very troublesome. A pioneer doctor informed us many years ago that on one occasion, while treating two children under twelve years of age for pneumonia with repeated doses of calomel, one of the little patients voided one hundred and fifteen and the other one hundred and thirty-five round worms in one day, and he added that the strangest part of the matter was that the children were not much better for several days after their surprising riddance. Ague never prevailed extensively along the lake-shore east of the mouth of Cuyahoga river till after the year 1836. During the previous spring the water of the lake rose about three feet higher than it had done within the remembrance of any white man. The swamp-oaks, which had grown on comparatively dry land, near the mouths of Grand river, Ashtabula and Conneaut creeks, many of which were a foot in diameter, were killed by the overflow. The water level fluctuated annually for nearly twenty years next following, exposing the fresh deposits to the sun, and ague was at different periods very prevalent at all the harbors along the shore of the lake.

Mankind, restive under present evil, have always indulged in the ideal of a past golden age and of a future millennium of unalloyed bliss. The medical profession had its good time past, when empiricism did not even claim the basis of knowledge, but practiced by charms and nostrums upon the yet fetish elements in civilized society. Had the errors of practice in the old profession yielded more readily and in quicker response to the spirit of scientific progress, quackery would not have gained its present foothold. Exploded evils, and long since abandoned, are the sustenance on which it feeds. While the other great professions trace a long line of descent, and possess a hereditary succession of knowledge through accumulating ages, medicine alone can, it would appear from the isolated dogmas and plausible theories of empiricism, spring into full being like an armed Minerva, from the head of some Thompsonian Jupiter. Thus to ignore the slow and experimental course of science is to fasten upon the innovations of the inductive system of physic the stamp of superficialism. But no great revolution of any polity, social or scientific, takes place without extreme and radical views sloughing to the surface; remedies and systems of remedies, under a quickened mental inquiry, obtain a mushroom growth; consequently, though it seems paradoxical, the surest evidence we can have of the change in the practice of medicine, and its conformity to the wisest and best system of therapeutics, is the comparative prevalence and popularity of empiricism, which exists and fattens on the fruits of errors long since corrected or abandoned.

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