roLUMBIA LIBRARIES OFFSITE H^LTHSQENCES STANDARD Z HX00053333 Medicine in the Colonies By William Scott Wadsworth, M. D. A Paper read before the Pennsylvania Society of the Order of the Founders and Patriots of America January 14th, 1910 M e d i ci ft e in the Colonies By William Scott Wadsworth, M. D. A Paper Read before the Pennsylvania Society of the Order of the Founders and Patriots of America JANUARY THE FOURTEENTH NINETEEN HUNDRED AND TEN Officers and Councillors of the Pennsylvania Society Officers, 1910 Governor Prof. Herman V. Ames, No. 210 South Thirty-Seventh St., Phila. Deputy-Governor. Harris Elric Sproat, Westtown, Pa. Chaplain Rev. Dr. Charles Wadsworth, Jr., No. 2038 Spring Garden St., Phila. Secretary Theodore Anthony Van Dyke, Jr., Union League Club, Phila. Treasurer Elbert Augustus Corbin, Jr., No. 542 Land Title Building, Phila. State Attorney John Chambers Hinckley, Witherspoon Building, Phila. Registrar George Edward Scranton, Witherspoon Building, Phila. Genealogist George Linden Cutler, No. 519 East Broad St., Chester, Pa. Historian Charles Lester Leonard, M. D., No. 112 S. Twentieth St., Phila. Councillors 1910 Louis Samuel Fiske, No. 2042 Locust St., Phila. Lewis Converse Lillie, No. 328 Chestnut St., Phila. Edward Lang Perkins, No. 131 S. Fourth St., Phila. 191O-I91I O. LaForrest Perry, No. 3717 Baring St., Phila. CoL. Charles Allen Converse, No. 500 N. Broad St., Phila. Eugene Larue Vansant, M. D., No. 1929 Chestnut St., Phila. I9IO-I9II-I912 Charles WurTS Sparhawk, No. 400 Chestnut St., Phila. Charles Field Haseltine, No. 1822 Chestnut St., Phila. William Scott Wadsworth, M. D., The Normandie, Phila. CO Medicine in the Colonies HAVE a large topic. I hope I shall not so dis- tress you this evening as to give you a full real- ization of just how large it is. Surely it is large enough without extending it, but how can we come to a just understanding of what we find happening during those 170 years unless we extend it even more so as to grasp the conditions elsewhere which affect- ed most vitally the history of the Colonies. At the beginning of the 17th Century, civilization had not gotten a very firm hold, outside of the Latin countries, in Europe. The Arts and Sciences were beginning to take root in Holland. Freedom of mind was just beginning to exist following the struggles of the Reformation. The mental stagnation of the late Middle Ages was being swept away, good things and bad things all were being changed. The monopoly of learning by the priests and monks had been broken, the honorable "trust busters" had been at work and there was chaos. The whole of northern Europe was in turmoil. Henry VUI had granted charters to the universities of Britain to teach medicine, but who was ready to teach it? England was even more provincial then than now. It was years before medicine was even a farce at the English Universities. Edinburgh gave its first medical degree in course in the 18th century. Almost any second grade High School in America to-day is better fitted to grant degrees in medicine than were the schools of Great Britain in 1600. Henry VHI separated the apothecaries from the grocers and the guilds in London were rapidly taking new form and character, but the state of the arts and sciences in the country districts was worse than barbarous. The mass of English despised the learning of the Latin races and feared it because it was so firmly associated with the ItaHan church. Holland alone had any glimmerings of what was to come in medicine, and as yet only the faintest glimmerings. It is not to be lA^ondered at then, that no very important place was made for medicine in the first plans for the Colonies. That the condition in the Colonies got worse while the rest of the world progressed needs careful thought, and is no simple problem. The settlement in Virginia, of w^hich Captain John Smith writes, had surgeons and a moderate store of remedies, and Smith speaks gratefully of his doctor's skill, but there appears to be little backing for medicine in such an aggregate of silly, greedy nondescripts as Smith describes, and we are not surprised that medicine came to the sorry state in which we find it later on. The adventurers in the various Companies that were formed to promote settlements had a mild realization of the need of surgeons to care for the settlers, who were to make profits for them. The Hollandish settlers were supplied with hired surgeons of the barber surgeon type, at least for a while, but they were not long encouraged and were not of a type to enlarge their field of usefullness, and the supply from Holland was not very well maintained. The Pilgrims, while in Holland, must have gained something of an appreciation of medicine from their neighbors, and we find Dr. Fuller going to Plymouth, and evidently he was a man of character and wisdom though probably of only modest medical attainments. We find him loaned to the Massachusetts Bay Colony to help them during an epidemic and staying at the house of the Governor during the winter, and have reason to believe his advice was sought in forming plans for the establishment of the church there. Later on we hear of a contract surgeon coming over from England, and in his sadness, he wrote the truth home to England about the Colony ; as a result he had a terrible time. In fact that little affair shows that the unmeasured assurance, which is so characteristic of the Massachusetts Bay Colony, developed very early, and went to ludicrous extremes even then. The impulse of religious fervor and freedom had taken hold on these pilgrim planters, and the God of battle hardened their hearts that they go forward, through a very terrible wild- erness, by a very long wandering, eschevving the arts of civili- zation with much fear and firmness. What they did accomplish is a very glorious thing. I would be sad indeed, if what I have to say about what they did not do, caused any misconcep- tion about my high appreciation of what they did accomplish. They founded and maintained Harvard College, which has so often led all who were capable of being led in educational matters, but they waited 150 3-ears before they reluctantly consented to follow the rest of the world in the matter of medi- cal education. I found it hard to believe, as others no doubt will, that men who were nominally Christians, followers of the Great Physician, who said to those who came asking proof of his mission, "the blind receive their sight, the lame walk, and the deaf hear, and the poor have the Gospel preached to them," that these men could have forsaken the mercy of God and turned toward the hardness of Sinai. Clearly they sought freedom, but the methods of priestcraft were not easy to shake off and they were long finding it. They gained a mighty power in the finding, but they left civilization behind, even as the Benai Israel had forsaken the arts and wisdom of Egypt. The story of medicine in the Colonies, outside of Penn- sylvania, is not attractive. Virginia in 1631 passed laws regulating the clergy rather severely, and in 1639 passed laws restraining physicians and surgeons. These laws indicate that greed was not confined to the planters and adventurers but pervaded the professions. At later dates they elaborated these restraints in a way that shows clearly that there was a real condition quite unpleasant to contemplate. Virginia early sought to have an educational system and a college largely for the benefit of the clergy, in fact their efforts antedate those in Massachusetts, but owing to various setbacks, it was not till 1693 that the Attorney General for William and Mary became famous for remarking to the Rev. Agent, "Souls! damn their souls, let them make tobacco." This school became rich in goods and being located in the capitol of the Colony was not forgotten by the legislature, and it also became a social feature as well, but never a medical school. The Church of England had not even then become free from the thraldom of priestcraft. Little hope for the healing art was to be found in the less wealthy Colonies, where mistaken methods of administration prevented that material progress that could furnish enough money to send young men to Europe to study, or entice European young men to venture on a country practice, when laws and conditibns were against them. Virginia in 1736 passed a law allowing double fees to grad- uates of Universities, but she was then a wealthy and populous colony, and could have supported a medical school. The Duke of York issued laws to his grants based on old English laws, in which "physicians and chyrurgeons and mid- wives" should do no violence without due consent of the patient but Massachusetts had, apparently with joy, already in 1649 adopted the following pleasing law:- "For as much as the law of God allows no man to impair the life or limb of any person, hut in a judicial way. It is there- fore ordered, that no person or persons whatsoever, emplo^^ed at any time about the bodyes of men, women or children, for the preser^^ation of life or health as chyrurgeons, midwives, phy- sicians or others, shall presume to exercise or put forth any act, contrary to the known approved rules of art in each mystery or occupation, nor exercise any force, violence, or cruelty upon or toward the bodyes of any, whether young or old, nor in the most difficult and desperate cases, without the advice or consent of such as are skillful in the same art (if such ma}' be had) or at least of some of the wisest and gravest then present, and consent of the patient if they be mentis compotes, much less contrary to such advice and consent, upon such severe punishment as the nature of the fact may deserve. "Which law, nevertheless, is not intended to discourage any from all lawful use of their skill, but rather to encourage and direct them in the right use of and to inhibit and restrain the presumtuous arrogancy of such as through p residence of their own skill or any other sinister respects, dare boldly attempt to exercise any violence upon or toward the bodyes of young or old, one or other, to the prejudice or hazard of life or limb of man, woman or child." Imagine any skillful surgeon being bound to listen to the pompous dictum of utterly uneducated farmer select men or still more dangerous clerical quacks, like Cotton Mather as to what operation to perform. The horror of the thing is not to be smothed over by soph- istries. Does it not grow clearer why medicine in Massachusetts Colony lagged back so far behind? Why even with Harvard in their midst, there was no medical education until after the Revolutionary War, even then it was hardly a decent pretence, and carried on by men wholly unfitted by medical training to conduct a medical school, with the results to be expected : 44 graduates in twenty years, only one of note. A professorship was founded by a doctor and his family ; later three fifths of the income was appropriated by the college. Such were the enlightened methods used toward medicine in Massachusetts. As I read the laws and statutes of IMassachu- setts I see how medicine was stultified, as it always must be when the arrogance of classes that have assumed dominance are allowed to make their little knowledge a very dangerous thing in preventing the progress of medical work for the community. Connecticut gave promise of progress in spite of the clerical domination and there can be little doubt that if she had been more advantageously situated for commerce and the accumulation of wealth, she would have reached a better place in medicine. In all communities where the population was separated, the support of learning, the church and medic 'ne was a burden, and not infrequently it was decidedly a good thing to have all these functions united in one person, provided of course, that the learning consisted of something more than a reveling in the lacivious doings of the deified beings of high Olympus and the religion of more than cursings and male- dictions with side lights on the life and methods of the devil and medicine was something more than the monkish vulgari- ties of the Middle Ages. Connecticut medical men early sought to restrict the practice of medicine, at least to a small degree, to prevent the reckless quacker}^ that was rampant all around her, but no very great success crowned their early efforts. It is to her credit that the right spirit was working before the days of the Revolution. I suppose we must give Governor Winthrop credit for some share in the views of medicine held in the colony for he was a man of no small ability and he practiced medicine successfully and the fact that the Governor and leader of the colony was in active practice lent dignity to the art, which among the English of that day was sadly neglected, as in fact were most of the other fine arts. New Hampshire had a curiously medicated history from its inception. Doctors in the old country appear to have been interested in her settlement and of all medical characters in Colonial history Dr. Barefoot is one of the most striking, a constant thorn in the sides of the 'Xords Brethren of Boston." He practiced medicine and sharp poHtics along the north shore, and was probably very helpful in freeing New Hampshire from the bondage of Massachusetts and doubtless did many other wicked things. He had a sense of humor and cursed dreadful oaths. Portsmouth had her doctors, who were men of affairs as well, during her whole Colonial period, and the state has had medical men as Governors, Judges and legislators. When she did develop a medical school, the fourth one in the country', she backed it so well that it became the second in importance for a considerable time. Rhode Island sought to make some medical progress and had her honorable doctors, some of whom were high in the councils, but she could not command sufficient resources to become a medical centre, though her attitude toward medicine has in the main been good. Vermont was too far from the coast to be in any way a metropolitan centre during the Colonial period, and as a result her medical history is little more than a record of the local doctors. Maine stayed too long under the dominance of Massachu- setts. New York had been for many years under the States General of Holland, but had rather less than nothing when they gave up the territory to the English. Accustomed to look for Clergy, Teachers and Doctors to Holland, though the supply of these was never satisfactory, she found it very hard to readjust herself at first to the change, and but for im- portations from Europe and the other Colonies would have fared very badly indeed. 8 I would not want to be misunderstood about the system in the Dutch Colonies; for the times in which it was planned, it was remarkable, it was by far the best one in America. It depended too much on Holland, and was not calculated for what was to take place, and when discontinued, left the colonies helpless. In 1656 the Burgomaster of New Amsterdam, under the express promise that "the wounded be properly taken care of by means of good surgeons, and if any person in the employment of the City and in the execution of their commands, office or service, happened to be maimed, lamed or otherwise be deprived of health, they shall be reimbursed." Then follows a scale of accident insurance, and further, "the barbers whether on board a ship or ships or on land shall be bound to give their services cheerfully, and to use all diligence to restore the patients to health, without receiving any compensation except their monthly pay." I assure you this is pleasanter reading than the records of the Acts and Resolves of Massachusetts, nevertheless it pauperized the community in matters medical, and in the end lowered the tone of medicine in the Colony. The stage following this is too unpleasant to go into; quackery and commercialism ran riot, and her medicine has staggered under these ever since. Most of her notable medical men during the Colonial period were importations. After the middle of the 18th century the Colony began to show a more rational attitude toward medicine, possibly the French and Indian wars had an influence here as elsewhere, and as an indication we find a law passed in 1760 against quacks, restricting the practice of Physick and Surgery to those who pass an examination and are approved. At this time Dr. Colden was high in the council and evidently a power in the Colony, being of mature years, though still virile; in favor with the English government and a man of education and experience, having graduated from Edinburgh and practiced in Philadelphia; a scientist and a founder of the American Philosophical Society ; a friend of Franklin and a correspondent of Linnaeus ; active in affairs and publicly advocat- ing sanitary reforms, which were adopted ; said to have advocated a medical school while in Philadelphia before 1718, also said ' to have helped in the founding of the hospital in New York and aiding in charities and encouraging education ; well hated by his enemies (an excellent sign,) altogether one of the great men of the Colonial period. New York had the second medical school in the country, but it had a hard time during its first years, and exerted little influence in Colonial medicine. Medicine doing more for King's College than it did for, medicine from the start. Dr. James Jay represented the College in England, and solicited funds before the Medical School was begun. New Jersey belongs medically in three groups. East New Jersey with its Connecticut settlement at New- ark and its English, or New York settlement at Elizabeth (town) resembled those Colonies. West New Jersey shares with Pennsylvania many things, including the influence of the Medical Metropolis. Under Governor Franklin some very good laws v/ere passed, and some very good doctors practiced in various parts of the State, and early founded a Medical Society. The Scotch influence at Princeton aided very surely, if not directly, in helping medicine take its proper place, and fur- nished many men of note to the University of Pennsylvania. Delaware was practically a part of Pennsylyania. The conditions in the South were most unfortunate; here and there a doctor arose above the country practice, some took part in the affairs of their colonies, but none did anything for medical education. The Southern states however, availed themselves of the Philadelphia medical schools from the start, and showed a readiness to appreciate and follov/ Philadelphia medicine that was far more creditable than the spirit shown in some other Colonies. The immediate results were appar- ent before the Revolution, but the full effect, of course, came later, when, to the great betterment of medicine in those states, the Philadelphia medical graduates became very numerous. It is with a distinct sense of relief that we turn to the Colony that for more than two centuries led the country, if in- deed it does not still lead in medicine. From the first, medi- cine was appreciated, and the practice of the art encouraged in Pennsylvania. lO The Swedes had surgeons, and they were apparently quite as notable as their fellovv-countr}^men whom they served. The Hollanders had their surgeons ; as in New Amsterdam these had little or no influence on Colonial medicine. The Germans could not be expected to be in advance of the country from which they came, which at that time was medically worse than barbarous. The descendants of these settlers became eminent under the influence and teaching of the Cosmopolitan school of medicine that arose later. The influence of Sweden later on, became quite marked by reason of the work of Gustavus Adolphus for the University of Upsala and by the influence of Linnaeus. The Philadelphia botanist were among his correspondents and this undoubtedly aided materially in making this city the botanical center of the country for years, from which arose its absolute pre-eminence in Medical Botany and therapeutics which has scarcely yet been challenged. Holland shared in this in a double \vay, by having given Linnaeus his medical degree and great assistance in his studies and labors. The doctors of Sweden and Holland made his career possible, and he paid his debts fully. Holland, by her medical botanists and by her rapid prog- ress in the arts and sciences of medicine, so recently brought from Italy, became of the greatest importance in the formation of medicine in Scotland and America. An extended study of the early history of medicine in America shows clearly that Philadelphia medicine depended on a great man}^ things working together. William Penn brought with him two capable medical men, both Welsh, both given to public affairs and the practice of medicine. In this as in other things he showed great breadth of mind and true human- ity, and the tremendous import of this act should not be lightly overlooked. From that day to this the influence of the Welsh in medi- cine has deen strong — this does not appear to be generally appreciated. From that day to this Philadelphia has never lacked great doctors. The influence of the French is often difficult to trace with assurance, but it certainly is considerable. The immigrants furnished something to the mental atmosphere and now and II then a distinct contribution to medicine directly. It is probable that the French surgeons had an influence during the Revolution. Very important are the persistent and powerful Scotch- men who occasionally appeared, though they almost always had a bit too much of egotism, which frequently marred their work. This same egotism has caused a greatly exaggerated valuation of the Scotch influence in Philadelphia medicine to become commonly accepted. The greatest factor is undoubtedly the sound, sane English character of the folks among whom these doctors practiced, mellowed by a religion of human friendliness. As a result, the Philadelphia profession has had a greater measure of har- mony than any other in the country, and has therefore, been able to keep ahead of the other centers. The history of medicine in Philadelphia is the history of the best in America, every- thing that was great was very earty adopted and the story is far too large for this little review. The chauvenistic orators of other places joyfully cry aloud over a first operation, or a small fad earliest taken up, but those who were to be the giants of the profession came to Philadel- phia to study and many stayed here to help and to be helped by the medical life of the city. The first hospitals and medical school, the first hospital clinics, the first medical museum, the first medical library, the first progress in care of prisoners and insane. These are enough firsts, but they are all of Colonial times and often half a century passed before other colonies followed. The great body of the profession was immeasurably ahead as a whole of anything to be found in America and in some things ahead of Europe. What I say is not orator>'^ but fact for which I can cite hundreds of references that are con- clusive. A series of pictures of the medicine of the colonies would be too markedly incomplete it we did not touch at least a few of the many details. The medicines used in those days were food for thought if not for the body. Every man had his favorites and in turn their pupils were apt to follow the pecu- liar therapeutics of the teacher who had originally learned of several masters abroad. The tendency was naturally to become narrower with each generation. Drugs were not specially easy to get nor was it a joy to gather the herbs from places where 12 they were hard to find and were grown with difficulty. Drug- gists were few and mostly very bad, even in the larger towns. Apprentices had a charming time pounding herbs, grinding ointments and mixing potions, not to mention preparing plasters, clysters and pills. Possibly the results were not pleasant. I suspect the hairs of the doctor's nag very often took part in the cures, for bottles and boxes were scarce in those days and saddlebags and pockets are not always very clean. Mixtures with honey and molasses often took the place of clean syrups. Nauseous vinegars had great vogue; brimstone, salts, calomel and antimony were in great demand. Dried herbs for teas and infusions were kept in the lofts of houses and country stores. Barks from the oak, wild cherry and sassafras worked overtime then. Rum and spirits took up the general un- pleasant qualities of the stronger and rarer drugs. Opium and bark from Peru were given in no light doses when they could be had. IMadeira wine was a great luxury in the pharmacy, and gold foil was really aristocratic, no matter what filth it covered. Mineral springs were eagerly sought after and the stories about them are too good to keep and too bad to tell. A truly grand lot of purges, emetics, plasters, poultices and mixtures of all sorts was to be had from one end of the land to the other. The lancet bled them all. Occasionally the lust of poly -pharmacy was not curbed and as many as seventy-five stuffs were tumbled together into horrible boluses. Sometimes a fine pharmaceutical phrensy; sometimes a Scotch philosophy, oftener a pure unmitigated quackery controlled these wonderful compounds; with no instruction in anatomy or physiolgy, with no medical journals, with few books, very apt to be in Latin, with almanacs full of cure- alls and specifics and enough old wives remedies to put an end to the whole human race. Now and then a clerical follower of the writers of the Middle Ages who put in classic Latin what was too foul for even modem French, would find something sufficiently filthy to drive out the evil diseases which they believed were like, if not very devils. Much real wisdom was found among the sturdy fellows who rode miles through rough country to help a rugged folk who died young or lived to be quite old. It is 13 surprising to see how many of the noted doctors lived beyond the three score and ten years. How they did cover ground in those days, a hundred miles to see one patient, and on a cart horse at that. Ten miles on foot in Philadelphia was no unusual thing, even to the great Rush, and in any weather; carriages were not common even in the towns and very rare in the country. Instruments were usually simple, perhaps bad and surely hard to get. The story of the supplies for the Continental Army is almost increditable. Dressings were scarce and valuable in the days when all the cloth was spun at home, and a lot of linen was a dower and to last a long time. The diseases were apt to be severe and many epidemics are recorded, fevers were common and serious; small pox was most deadly, and with ship and yellow fevers, and the flux led to the establishment of quarantines in nearly all the col- onies. Some of the laws being quite wise, and some being pompous and painful ; liquor vv-as freely used in any form obtainable for medical and other purposes. Snuff had probably more in- fluence on the health of the people than is generally realized at present. Tobacco was not so generally used as now, in fact one would be heavily fined if found smoking on the streets of certain towns. Tea was said to cause the falling out of the teeth, it did cause a very serious falling out later on. Warming pans and feather beds, night caps and wood smoke played very impor- tant roles in life then. Baths were religiously avoided in winter. The English idea that to wash the feet in January was a par- ticularly vicious way of tempting Providence, was largely prevalent. Exercise was to be had in great plenty. Fresh air could be found away from the house. Water suggested transmigration, with strong indications of the last incarnation having been a cow. Food, anything that could be obtained. Clothing, as happened, usually fair, but now and then breaking out in follies, such as sore throat coaxers called mufflers. Probably the most cruel thing to contemplate of the whole lot was the midwife business. Doctors may have slain their thousands, but the mid wives slew their tens of thousands. Avery genuine but often fatal modesty forbade a male attendant 14 at child birth and often in other sickness. Many a poor woman died in child birth, or as the result of it simply because no help lay in a lot of miserable old women who were utterly ignorant and wholly incompetent. No wonder the grave yards are a joke to moderns with their names of rows of wives. It was no joke to the poor women. The conditions in India and China to-day are almost as bad as they were in the Colonies before the Philadelphia doctors introduced the teaching of midwifery. The poor had a miserable time, for the workhouses outside of Philadelphia were anything but decent. Dispensaries, there were none. Hospitals in Philadelphia and New York. Boston took 200 years, nearly, to get one. The Penns3dvania Hospital stands out in the history of America as a bright spot in drear}'- darkness. I wish I had time to go into the history of that institution, but you can find it written by our late secretary and beloved associate, Dr. Morton. I heartily commend his book to your attention. I cannot close without one more word about the doctor. "The brave old doctor, the good faulty old doctor, the faithful country doctor" "His bones are dust, his lancet rust, his soul is with the Saints we trust" If you don't know him, go get your Bonnie Briar Bush down and read about Dr. Mac Laren till your eyes get damp ; you will be better men for it. The world was better because such men lived in our Col- onies and I am glad the picture of such has been done by a master hand. I would like to tell you of the lives of those men, but those things are written. I have striven to give you a medical man's insight into the past in a way that is not written. Lest you think me biased about the theological influence in the past, let me quote from the autocrat, our dear spicy doctor poet "Medical Science is destined to react to much greater advantage on theology of the future, than theology has acted on medicine in the past." 15 Note The authorities from whom information was obtained would take up as much space as the paper itself. Some of the more interesting reading in this field will be found in the histories, catalogues and other official publications of the Universities of Europe and America and in the publications of the U. S. Gov., the works of Paulson, lyodge. Wood, Carson, Rush, Frank- lin, Colden, J. Smith, Packard, Wickes, Grim, Thatcher, O. W. Holmes, Toner, Fiske, N. Webster, Watson, Morton, A. Ames, Bowditch, O'Calahan, Sanborn, De Chastelleux, Kohn, Harshberger, Rosengarten, Morris, Schouler, Bond, Segur, Ramsey, Morgan, Davis, Norris, Westcott, Levick, Gross, Dulles, Mumford, Hammersley. The various general and local histories not especially named. The original laws, reprints and codes of the Colonies. Accounts of societies, patriotic and social. Also files of publications of historical and medical societies for addresses and papers. I am under special obligation to Mr. Luther E. Hewitt, librarian of the Law Association in the matter of the laws of the ^Colonies. i6 COLUMBIA UNIVERSITY LIBRARIES This book is due on the date indicated below, or at the expiration of a definite period after the date of borrowing-, as provided by the library rules or by special arrangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE 'm (') ^y( , / r A'^' jC>-