PHYSICIANS
In the History of Salisbury by John Dearborn pages 397-406 published in 1890 there is a listing of 24 physicians who practiced medicine in town.
One very notable Doctor was Joseph Bartlett who came to Salisbury at the age of 21 in 1772 and was the first permanent physician serving the town’s residents for 30 years. He grew an extensive practice and volunteered time to town office.
He was also the nephew of Josiah Bartlett of Kingston New Hampshire, a signer of the Declaration of Independence. Josiah Bartlett frequently visited his nephew and daughter as well who resided in town at Salisbury Heights.
THE DOCTOR’S KIT
On display in the Salisbury Historical Society Museum is the Doctor’s Kit.
The Physician had about 100 medicines available to him in the 1800’s. Many were herbal in nature such as Digitalis leaf, Basil, Camphor, Myrrh, Anise, Valerian, and Opium etc. Glaubus Salt or sal mirabillis (miraculous salt), a general all purpose laxative was common. Others were inorganic compounds such as Mercury.
The medicinal kit in our display case has small vials containing Strychnine, Digitalis leaf, Mercury and Herbal agents. Some are deadly powders!
The Physician would dispense these in small paper envelopes and the patients were instructed to take the medicine mixed in water.
Inorganic Mercury was a very popular treatment for many illnesses among New England Doctors at that time. Unfortunately, inorganic Mercury is highly toxic and many patients died from its use.
THE FOUR HUMORS
A Prevalent Theory of Medicine in early times
This theory was essentially unchanged from the synthesis of historical medical information provided by the Roman physician Marcus Aurelius in 200 AD!
Medicine in New England during this period was based on the Theory of the Four Humors:
Blood- Sanguine
Phlegm- Dull
Yellow Bile- Quick to Anger
Black Bile- Depressed
INFECTION
Basic concepts of infection and transmission were not understood by New England Physicians at that time.
Childbed (Puerperal Fever) Fever was near epidemic because Physicians did not wash their hands and thus transferred infection from one patient to another.
In 1849, at Bellevue Hospital in New York, half of the women giving birth contracted Childbed Fever and eighty percent of those died.
It is interesting to note that the infection rate was much lower when midwives attended the delivery since they practiced superior personal hygiene and careful hand washing before each delivery.
QUARANTINE
The concept of the Four Humors persisted through Colonial times but there were several forward thinkers exploring other approaches healthcare. One was prevention though at the time the causes of disease were not understood. One was Thomas Jefferson and another John Adams.
According to Jeanne Abrams in her book, regarding Thomas Jefferson:
Revolutionary Medicine, the Founding Mothers and Fathers in Sickness and In Health
“Contrary to many of his contemporaries, he was aware of the fact that certain diseases were communicable before symptoms occur and this awareness led him to promote preventative measures such as the quarantine for Yellow Fever. In 1825 he performed an achievement of paramount importance, the opening of the University of Virginia, of which he was not only the founder but also the principal designer”. As Abrams notes, the design of the buildings was such that it promoted both the physical and mental health of the students and prevented the spread of infectious diseases.
Also see:
Broadcast (Podcast)#5 Jeanne Abrams:
http://www.benfranklinsworld.com/
Jeanne Adams also discusses the prevailing major illnesses such as Smallpox, Malaria and Measles epidemics.
The procedure called Innoculation is also covered.
VARIOLATION/INNOCULATION
It is interesting to note that John Adams and his family were inoculated against smallpox via an incision.
Regarding the devastating outbreaks of Small Pox in New England, from the link below:
http://www.historytoday.com/elizabeth-fenn/great-smallpox-epidemic#sthash.01iqMSo2.dpuf
“Fearsome though it was, eighteenth-century Americans did not face smallpox unarmed. Even without an understanding of virology, they employed two weapons against the disease: isolation and inoculation. Isolation or quarantine simply meant avoiding contact between individuals sick with the disease and individuals susceptible to it. Bed linens and clothing might receive special handling. Done properly, quarantine could often halt further contagion. In the colonial period, isolation was used by colonists and Native Americans alike.
The second weapon – employed even after Edward Jenner’s discovery of vaccination in 1796 – was inoculation. Unlike vaccination, which utilised the cowpox virus, inoculation involved the deliberate infection of a susceptible individual with Variola virus, usually through an incision on the hand. For reasons that elude scientists to this day, inoculated smallpox was in most cases much less virulent than the ‘natural’ form of the disease. Survivors won lifelong immunity, just as they would from ‘natural’ smallpox, but mortality was notably lower.
There was, however, a catch: individuals under inoculation did come down with smallpox, and they were therefore fully capable of infecting others with the disease. Unless practised under strict quarantine, the operation was as likely to start an epidemic as to stop one. For this reason, inoculation was highly controversial in the English colonies, where smallpox outbreaks were comparatively rare. In England, however, the disease had long been endemic, and the procedure achieved wider acceptance. These combined factors meant that in the early stages of the American Revolution the British forces were far more likely than the Americans to have acquired immunity to the Variola virus”.
https://www.iaff.org/ET/Smallpox/What_is_the_history_of_smallpox_vaccination.htm
“What is the History of The Small Pox Vaccine?
The story of smallpox prevention — and its eventual eradication through immunization — is a long and compelling one.
For centuries, it was known that people who survived smallpox became immune to it. For that reason, nearly every culture tried to induce immunity in healthy individuals. The Chinese used tubes to insert powdered smallpox scabs into their nostrils. In Turkey, pus from lesions was scratched into the skin.
Eventually these methods — collectively known as variolation — reached Europe and the New World. There, as elsewhere, variolation had varying degrees of success. Some people became immune, but others contracted the disease and died or became the source of a new epidemic. Still, by the early 1700s, “do-it-yourself” smallpox inoculation had become widespread”.
EDUCATION FOR THE PHYSICIAN IN THE 1800’s
To Become a Physician…
”All a young man has to do is gain admittance to the office of a physician, have access to some medical books, see a patient once a month and attend lectures for three months” -New England Journal of Medicine 1846.
Many Physicians had less training than this.
A minority of Physicians had formal education, such as the University of Michigan Medical School in 1850.
- The tuition, $5.00 per year, covered 2 years of education.
- No college graduation was required.
- Requirement was the knowledge of some Greek and enough Latin to read and write prescriptions.
- The curriculum consisted of lectures only and the second year was a repeat of the first year.
BLOODLETTING
Removing various amount of blood from a vein had been used at least as early as 400 BC.
In the 1800’s in New England it was used to treat a variety of illnesses.
During childbirth, women were often bled into un-consciousness in an attempt to control the pain of childbirth.
George Washington had a severe illness characterized by fever, sore throat and cough. He was attended to by three Physicians, two older Physicians and one younger. The two older Physicians wanted to treat Washington with bloodletting. The younger Physician disagreed but was overruled. Washington was bled two thirds of his total blood volume in less than twenty four hours. He died shortly thereafter.
More on the death of George Washington:
http://www.earlyamerica.com/review/2005_winter_spring/washingtons_death.htm
THE USE OF LEECHES
For centuries leeches have been used for healing.
From the very interesting website below: During these times, people believed that evil spirits were the cause for disease and thought that by bleeding themselves, they could get rid of the “bad blood” containing the spirits. It was also later believed that an imbalance of body fluids influenced disease and one way to fix the imbalance was to remove blood. They could remove blood in one of two ways.
http://bioweb.uwlax.edu/bio203/2011/harris_mic2/
In present day it has been discovered that for certain patients with compromised healing issues when leeches are applied to infected wounds the leeches will feed on necrotic cells (dead tissue) and not on live tissue thereby aiding in wound healing.
OLD NAMES OF DISEASES
From the following webpage:
http://www.usgennet.org/usa/ar/county/greene/olddiseases1.htm
Old Disease Names Frequently found on Death Certificates:
Ablepsy – Blindness
Ague – Malarial Fever
American plague – Yellow fever
Anasarca – Generalized massive edema
Aphonia – Laryngitis
Aphtha – The infant disease “thrush”
Apoplexy – Paralysis due to stroke
Asphycsia/Asphicsia – Cyanotic and lack of oxygen
Atrophy – Wasting away or diminishing in size.
Bad Blood – Syphilis
Bilious fever – Typhoid, malaria, hepatitis or elevated temperature and bile emesis
Biliousness – Jaundice associated with liver disease
Black plague or death – Bubonic plague
Black fever – Acute infection with high temperature and dark red skin lesions and high mortality rate
Black pox – Black Small pox
Black vomit – Vomiting old black blood due to ulcers or yellow fever
Blackwater fever – Dark urine associated with high temperature
Bladder in throat – Diphtheria (Seen on death certificates)
Blood poisoning – Bacterial infection; septicemia
Bloody flux – Bloody stools
Bloody sweat – Sweating sickness
Bone shave – Sciatica
Brain fever – Meningitis
Breakbone – Dengue fever
Bright’s disease – Chronic inflammatory disease of kidneys
Bronze John – Yellow fever
Bule – Boil, tumor or swelling
Cachexy – Malnutrition
Cacogastric – Upset stomach
Cacospysy – Irregular pulse
Caduceus – Subject to falling sickness or epilepsy
Camp fever – Typhus; aka Camp diarrhea
Canine madness – Rabies, hydrophobia
Canker – Ulceration of mouth or lips or herpes simplex
Catalepsy – Seizures / trances
Catarrhal – Nose and throat discharge from cold or allergy
Cerebritis – Inflammation of cerebrum or lead poisoning
Chilblain – Swelling of extremities caused by exposure to cold
Child bed fever – Infection following birth of a child
Chin cough – Whooping cough
Chlorosis – Iron deficiency anemia
Cholera – Acute severe contagious diarrhea with intestinal lining sloughing
Cholera morbus – Characterized by nausea, vomiting, abdominal cramps, elevated temperature, etc. Could be appendicitis
Cholecystitus – Inflammation of the gall bladder
Cholelithiasis – Gall stones
Chorea – Disease characterized by convulsions, contortions and dancing
Cold plague – Ague which is characterized by chills
Colic – An abdominal pain and cramping
Congestive chills – Malaria
Consumption – Tuberculosis
Congestion – Any collection of fluid in an organ, like the lungs
Congestive chills – Malaria with diarrhea
Congestive fever – Malaria
Corruption – Infection
Coryza – A cold
Costiveness – Constipation
Cramp colic – Appendicitis
Crop sickness – Overextended stomach
Croup – Laryngitis, diphtheria, or strep throat
Cyanosis – Dark skin color from lack of oxygen in blood
Cynanche – Diseases of throat
Cystitis – Inflammation of the bladder
Day fever – Fever lasting one day; sweating sickness
Debility – Lack of movement or staying in bed
Decrepitude – Feebleness due to old age
Delirium tremens – Hallucinations due to alcoholism
Dengue – Infectious fever endemic to East Africa
Dentition – Cutting of teeth
Deplumation – Tumor of the eyelids which causes hair loss
Diary fever – A fever that lasts one day
Diptheria – Contagious disease of the throat
Distemper – Usually animal disease with malaise, discharge from nose and throat, anorexia
Dock fever – Yellow fever
Dropsy – Edema (swelling), often caused by kidney or heart disease
Dropsy of the Brain – Encephalitis
Dry Bellyache – Lead poisoning
Dyscrasy – An abnormal body condition
Dysentery – Inflammation of colon with frequent passage of mucous and blood
Dysorexy – Reduced appetite
Dyspepsia – Indigestion and heartburn. Heart attack symptoms
Dysury – Difficulty in urination
Eclampsy – Symptoms of epilepsy, convulsions during labor
Ecstasy – A form of catalepsy characterized by loss of reason
Edema – Nephrosis; swelling of tissues
Edema of lungs – Congestive heart failure, a form of dropsy
Eel thing – Erysipelas
Elephantiasis – A form of leprosy
Encephalitis – Swelling of brain; aka sleeping sickness
Enteric fever – Typhoid fever
Enterocolitis – Inflammation of the intestines
Enteritis – Inflations of the bowels
Epitaxis – Nose bleed
Erysipelas – Contagious skin disease, due to Streptococci with vesicular and bulbous lesions
Extravasted blood – Rupture of a blood vessel
Falling sickness – Epilepsy
Fatty Liver – Cirrhosis of liver
Fits – Sudden attack or seizure of muscle activity
Flux – An excessive flow or discharge of fluid like hemorrhage or diarrhea
Flux of humour – Circulation
French pox – Syphilis
Gathering – A collection of pus
Glandular fever – Mononucleosis
Great pox – Syphilis
Green fever / sickness – Anemia
Grippe/grip – Influenza like symptoms
Grocer’s itch – Skin disease caused by mites in sugar or flour
Heart Sickness – Condition caused by loss of salt from body
Heat Stroke – Body temperature elevates because of surrounding environment temperature and body does not perspire to reduce temperature. Coma and death result if not reversed
Hectical Complaint – Recurrent fever
Hematemesis – Vomiting blood
Hematuria – Bloody urine
Hemiplegy – Paralysis of one side of body
Hip Gout – Osteomylitis
Horrors – Delirium tremens
Hydrocephalus – Enlarged head, water on the brain
Hydropericardium – Heart dropsy
Hydrophobia – Rabies
Hydrothroax – Dropsy in chest
Hypertrophic – Enlargement of organ, like the heart
Impetigo – Contagious skin disease characterized by pustules
Inanition – Physical condition resulting from lack of food
Infantile Paralysis – Polio Intestinal colic Abdominal pain due to improper diet
Jail Fever – Typhus
Jaundice – Condition caused by blockage of intestines
King’s Evil – Tuberculosis of neck and lymph glands
Kruchhusten – Whooping cough
Lagrippe – Influenza.
Lockjaw – Tetanus or infectious disease affecting the muscles of the neck and jaw. Untreated, it is fatal in 8 days.
Long Sickness – Tuberculosis.
Lues Disease – Syphilis.
Lues Venera – Venereal disease.
Lumbago – Back pain.
Lung Fever – Pneumonia
Lung Sickness – Tuberculosis
Lying in – Time of delivery of infant.
Malignant Sore Throat – Diphtheria.
Mania – Insanity.
Marasmus – Progressive wasting away of body, like malnutrition.
Membranous – Croup Diphtheria
Meningitis – Inflations of brain or spinal cord
Metritis – Inflammation of uterus or purulent vaginal discharge
Miasma – Poisonous vapors thought to infect the air
Milk Fever – Disease from drinking contaminated milk, like undulant fever or brucellosis
Milk Leg – Post partum thrombophlebitis
Milk Sickness – Disease from milk of cattle which had eaten poisonous weeds
Mormal – Gangrene
Morphew – Scurvy blisters on the body
Mortification – Gangrene of necrotic tissue
Myelitis – Inflammation of the spine
Myocarditis – Inflammation of heart muscles
Necrosis – Mortification of bones or tissue
Nephrosis – Kidney degeneration
Nepritis – Inflammation of kidneys
Nervous Prostration – Extreme exhaustion from inability to control physical and mental activities
Neuralgia – Described as discomfort, such as “Headache” was neuralgia in head
Nostalgia – Homesickness.
Palsy – Paralysis or uncontrolled movement of controlled muscles. It was listed as “Cause of death”
Paroxysm – Convulsion
Pemphigus – Skin disease of watery blisters
Pericarditis – Inflammation of heart
Peripneumonia – Inflammation of lungs
Peritonotis – Inflammation of abdominal area
Petechial Fever – Fever characterized by skin spotting Puerperal exhaustion Death due to child birth
Phthiriasis – Lice infestation Phthisis Chronic wasting away or a name for tuberculosis
Plague – An acute febrile highly infectious disease with a high fatality rate
Pleurisy – Any pain in the chest area with each breath
Podagra – Gout
Poliomyelitis – Polio
Potter’s Asthma – Fibroid pthisis
Pott’s Disease – Tuberculosis of spine
Puerperal Exhaustion – Death due to childbirth
Puerperal Fever – Elevated temperature after giving birth to an infant
Puking Fever – Milk sickness
Putrid Fever – Diphtheria.
Quinsy – Tonsillitis.
Remitting Fever – Malaria
Rheumatism – Any disorder associated with pain in joints Rickets Disease of skeletal system
Rose Cold – Hay fever or nasal symptoms of an allergy.
Rotanny Fever – (Child’s disease) ???
Rubeola – German measles
Sanguineous Crust – Scab
Scarlatina – Scarlet fever
Scarlet Fever – A disease characterized by red rash
Scarlet Rash – Roseola
Sciatica Rheumatism in the hips
Scirrhus – Cancerous tumors
Scotomy – Dizziness, nausea and dimness of sight
Scrivener’s palsy – Writer’s cramp
Screws – Rheumatism
Scrofula – Tuberculosis of neck lymph glands. Progresses slowly with abscesses and fistulas develop. Young person’s disease
Scrumpox – Skin disease, impetigo
Scurvy – Lack of vitamin C. Symptoms of weakness, spongy gums and hemorrhages under skin
Septicemia – Blood poisoning
Shakes – Delirium tremens
Shaking – Chills, ague
Shingles – Viral disease with skin blisters
Ship Fever – Typhus
Siriasis – Inflammation of the brain due to sun exposure
Sloes – Milk sickness Small pox Contagious disease with fever and blisters Softening of brain Result of stroke or hemorrhage in the brain, with an end result of the tissue softening in that area
Sore Throat Distemper – Diphtheria or quinsy
Spanish Influenza – Epidemic influenza
Spasms – Sudden involuntary contraction of muscle or group of muscles, like a convulsion
Spina Bifida – Deformity of spine
Spotted Fever – Either typhus or meningitis
Sprue – Tropical disease characterized by intestinal disorders and sore throat
St. Anthony’s Fire – Also erysipelas, but named so because of affected skin areas are bright red in appearance
St. Vitas Dance – Ceaseless occurrence of rapid complex jerking movements performed involuntary
Stomatitis – Inflammation of the mouth
Stranger’s Fever – Yellow fever
Strangery – Rupture
Sudor Anglicus – Sweating sickness
Summer Complaint – Diarrhea, usually in infants caused by spoiled milk.
Sunstroke – Uncontrolled elevation of body temperature due to environment heat. Lack of sodium in the body is a predisposing cause.
Swamp Sickness – Could be malaria, typhoid or encephalitis
Sweating Sickness – Infectious and fatal disease common to UK in 15th century
Tetanus – Infectious fever characterized by high fever, headache and dizziness
Thrombosis – Blood clot inside blood vessel
Thrush – Childhood disease characterized by spots on mouth, lips and throat
Tick Fever – Rocky mountain spotted fever
Toxemia of Pregnancy – Eclampsia
Trench Mouth – Painful ulcers found along gum line, Caused by poor nutrition and poor hygiene
Tussis Convulsiva – Whooping cough
Typhus – Infectious fever characterized high fever, headache, and dizziness
Variola – Smallpox
Venesection – Bleeding
Viper’s Dance – St. Vitus Dance
Water on Brain – Enlarged head
White Swelling – Tuberculosis of the bone
Winter Fever – Pneumonia
Womb Fever – Infection of the uterus.
Worm Fit – Convulsions associated with teething, worms, elevated temperature or diarrhea.
Yellowjacket – Yellow fever.