Thursday, April 29, 2010

19th Century Medicine

Last month I did research on 19th century medicine. I was reading a diary of a minor historical figure working on the Underground Railroad. Edmund Howe died at the age of 19, probably from malaria, in 1849. Malaria was rampant in America in the 19th century. Although this disease wasn’t indigenous to the continent, it was another little gift brought by European invaders, probably the Spanish. Once it gets into a population, it is spread by mosquitoes. In the first part of the 19th century, medicine was practiced very much as it was for a thousand years in Europe. Diagnosis was based on “humors” or “tensions.” The cure for any ailment was opium and, more often, blood-letting. It’s a wonder that anyone lived. It didn’t help to drain the blood of people who were already weak.

In the 1840’s, medicine was not a well-respected profession. There was little that doctors could do. Surgeons removed broken or septic limbs and some external sores, but they never washed their hands, and there was no anesthesia. Surgeons were prized only for their strength and their speed. The American Medical Association came into being in the late 1840’s. Orthodox physicians wanted to distinguish themselves from non-traditional practitioners. Some doctors even noticed the obvious, namely that blood-letting didn’t help. The A.M.A. conducted modern trials of blood-letting in the 1850’s, and eventually, later in the 19th century, the practice was discontinued.

There was a lot of what we would today call alternative medicine in the 19th century. It’s not clear why some doctors wanted to distinguish themselves from others. Some alternative medicine may have actually been more effective than traditional medicine. In the late 18th century, an American doctor named Thomson developed a system that was eventually named after him: Thomsonian medicine. Thomson told people not to go to doctors, but to cure themselves with the help of plants and herbs. Some Thomsonian medicine helped. Thomson had a system of natural herbs that he told people to take for illness. He said his cures came from watching native people’s use of medicinal plants.

Homeopathy began to be practiced in the 19th century as well. It is still practiced today. The theory is that by giving people a small amount of something, they will build a resistance.

Two other courses of alternative medicine were used by Edmund Howe and others in the 19th century. Howe went to a spa where he took hydrotherapy, or water cure. Patients were given steam baths and cold plunges alternately. Howe was awakened every morning at 4:00 by an attendant who helped him up, and then poured cold water on him. After that, he was wrapped in hot towels, and left to sweat for an hour.

One of the more unusual medical theories was Grahamism. Like homeopathy, some aspects of it are still practiced today. Rev. Sylvester Graham was a Presbyterian minister who taught that the way to health was vegetarianism, whole wheat flour, and frequent bathing. It sounds reasonable, but Graham wanted people to be vegetarians because he thought meat inflamed passion. Graham feared that even dairy products would cause people to masturbate, and he taught that masturbation led to insanity. He invented the Graham cracker. Few people who eat them today consider the cracker an anti-masturbatory victual. Americans bathe more frequently than anyone else in the world, another legacy of Reverend Graham. Grahamism fell out of favor in the 1850’s, since Graham himself died relatively young. Vegetarianism, sexual abstinence and frequent baths didn’t guarantee him a long life, as he taught.

In the 1880’s, germs were discovered, almost independently in America, England, and France, with the invention of the microscope. It was much later when viruses were discovered. Antibiotics weren’t discovered till the late 1930’s, although the sulfa drugs became available after 1920. The early sulfa drugs had the side effect of turning people red.

With the discovery of germs, hygiene and sanitation became important to people. By 1900, doctors began wearing gloves before surgery. Ether was discovered, and this put people to sleep--- sometimes permanently. Eventually better anesthetics were developed. Sewers were becoming the norm even in small towns. London was the first Western city to get them, in the 1860’s. Before that, waste flowed down a trench in the middle of the street. Concepts like public health were developed, and this gradually became the task of the state.

Healthcare reform in America is not very progressive, and it’s hard to know what the fuss is over. The new system, when and if it takes effect, offers little cost containment, and isn’t as good as the worst European model. But it’s a start. Considering where we’ve come from in the last century and a half, it’s pretty good.

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