Purges, Plasters and Phlebotomy

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Medical care in the small towns of Connecticut during the late 17th to early 19th centuries was chancy. Few physicians attended a medical school, and those who did were severely limited by the appalling lack of accurate medical knowledge.

Doctors relied heavily on pain killers (opium, morphine, laudanum, alcohol), phlebotomy (bloodletting), purges and blistering with hot plasters. The drugs prescribed were a curious mixture of folk remedies, such as comfrey and bloodroot, and lethal-sounding potions of mercury, cyanide and ox gall inspissated.

There were no standards or colony regulations for physicians. A medical license from the General Court was optional. Some doctors were self-taught, such as Robert Howard of Windsor. He emigrated from England in 1635, a miller by trade. He also practiced medicine from 1660 until his death in 1684, when his son, Ephraim, inherited both the mill and the medical practice. 

Other prospective doctors of that era read the few available medical texts under the guidance of established physicians. The medical student then went on rounds for a year or two with his mentor.

In 1717, Samuel Higley, of Simsbury, completed his apprenticeship with the highly respected Hartford physicians Thomas Hooker and Samuel Mather. They praised Higley in a document to the Connecticut General Assembly, recommending that he be licensed to practice “physick and chirurgery, considering ye great want of learned and faithful physicians amongst us.”

Medicine was not yet a lucrative profession. Doctors received rather meager fees, being paid by the mile – one shilling (13 ½ cents) for under two miles and one shilling for each additional mile. To augment their incomes, most doctors also had other jobs. The Howards were millers and Higley, who had multiple occupations, was best known for minting the famed Higley Copper.

Early doctor-patient relationships were based entirely on house calls. People did not call in a doctor until all home remedies had failed and the patient was seriously ill. Therefore, it is not surprising that he went to the patient’s house, often staying all night.

Medicines were prepared and sold by the doctors and the glass vials were returnable for credit. Diagnosis was rudimentary and treatment seemed to be guesswork. Often the medicine was changed at each visit. Patients were dosed with peculiar concoctions of arsenic, mercury, camphor and turpentine.

Illnesses were often lengthy in this time before antibiotics. A patient might suffer for several months and require 40 or more visits from the doctor. Vigorous medical treatment frequently resulted in the death of the patient. Most country doctors were conservative and depended on rum, opium and time for a cure.

A doctor also became a trader, because most of his business was done on the barter system. Very little cash actually changed hands. He was paid in food and labor—the cooper gave a barrel, the cobbler made shoes, the blacksmith repaired his sleigh and the tailor sewed a vest. If he was paid with something he didn’t need, such as half a dozen brooms, then he had to sell or trade them for more useful items. 

In 1812, Yale established a two-year medical school. The lectures of Dr. Nathan Smith of London, Professor of the Theory and Practice of Physic Surgery and Obstetrics, reveal how little was really known about the human body. Smith advised more bleeding to cure a hemorrhage, electricity to treat palsy, flagellation (whipping) for hysteria, leeches for eye problems and he suggested that typhoid fever victims be doused with cold water.

Smith’s prescribed treatment for pneumonia resembles medieval torture. Frequent bloodletting (every six to eight hours) was the principal remedy, “until the patient’s face is pale.” Then an emetic was given, a large hot plaster was placed on the chest over the lungs, antimony was administered to cause sweating and, mercifully, opium for the cough.

These notes from Smith’s lectures were taken in 1822 by Yale student Jairus Case of Barkhamsted. He graduated the following year and opened a medical practice in Torringford and then came to Granby.

Some aspiring physicians only stayed in Yale for one year. Justus D. Wilcox of Simsbury was a student in 1823. He was a noted physician in West Granby for over 50 years and received an honorary degree from Yale in 1855.

The dark ages of medicine were not that long ago. Even the most respected physicians were poorly trained and ignorant. Charlatans and quacks preyed on the helpless, promising cures for cancer and epilepsy. Treatments were often worse than the illness. Surgery was brutal. The best medical knowledge was a combination of superstition, hearsay, guesswork and experimentation.

The records of the village doctors show cautious rather than aggressive medical treatment, probably resulting in less harm done. They were treating friends, neighbors and relatives. They seldom resorted to surgery. They fought sickness and death with morphine and brandy.

Perhaps the cherished image of the country doctor was forged in the realization and frustration of medical ignorance—leaving only caring and compassion.