I want to welcome back Eleanor Sullivan with the second of her two-part series on the state of medical care in the 19th Century.
Medical Care in the 19th Century-Part Two
Previously I blogged about the illnesses that 19th century people suffered along with what they thought caused them to become sick. This blog will reveal the treatments they endured.
Because illness was believed to result in internal weakness (or sin) or that the external environment had invaded the body, aggressive treatment was designed to rid the body of its noxious incursions. Blood-letting, purging, and puking were the preferred treatments.
Blood letting, Purging, and Puking
Blood letting relieved excess blood and returned the flow to normal, it was thought. This was such an accepted belief that the reason women were believed to have fewer illnesses is because they bled regularly. To relieve pressure in the blood, the doctor lanced a blood vessel and often used glass cup to produce a vacuum to draw the blood out. Blood-sucking leeches might also be used. Often the patient would faint from the blood loss, assuring the patient and the doctor that the treatment was indeed successful.
The goal of purging was to evacuate the bowels, another way of ridding the body of unwelcome invaders. If a cathartic, using such body-damaging medicines as mercury (called calomel), wasn’t successful, enemas would be given until the body had been flushed of all contaminants.
Puking was induced by several means. Ipecacuanha root (known today as ipecac) crushed into a powder or lobelia bark, also powdered, were administered in a tincture. If nothing else was available, warm salt water could induce vomiting. Again, every bit of disease must be eliminated from the body.
Medicines and Pain
Powerful medicines were believed to be necessary to combat powerful illnesses. Mercury again was a favorite. Producing dramatic effects, such as headaches, tremors, and loosened teeth, patients were certain that they were receiving potent care. Mercury poisoning was not unusual. In fact, Louisa May Alcott is believed to have died in 1888 of mercury poisoning from the mercury she’d received for a bout of typhoid in 1863.
Pain was another sign that the medicine was potent. Patients persisted in downing medicines even realizing they suffered from its ill effects. Thank goodness for opium! Opium, and its form in a tincture, laudanum, was commonly and legally available. Opium masked symptoms so patients felt grateful relief.
Opium and alcohol were also the basis of patented medicines, promoted to cure every ailment, including venereal diseases, tuberculosis, or “female complaints.” It wasn’t until 1906 when Congress passed the Pure Food and Drug Act, forcing manufacturers of patent medicines to reveal their ingredients and discontinue false advertising claims, that the widespread use of patent medicines ceased.
Herbs and Homeopaths
Medical treatment in the unsettled parts of America (and most of the country was unsettled in the early 19th century) was especially arduous, albeit they were often spared the rigorous administrations of medical doctors (licensed as early as 1811 in Ohio). Care often fell to a local midwife who administered herbal substances. Recipes were handed down through families and communities and often helped. My character, Adelaide, is a midwife and herbalist in 1830s Ohio.
Homeopaths also treated 19th century patients. Homeopathy was promoted by a German physician, Samuel Hahnemann in the 18th century. Hahnemann observed that cinchona bark, used to treat malaria, induced symptoms of malaria. Thus, he surmised that inducing symptoms with highly diluted preparations would cause the patient’s own vital force to expel the disease. He called this the law of similars. There is no scientific evidence that the treatment was effective. Again, patients were spared energetic medical treatments and may have recovered on their own. The leader of Zoar, Joseph Bimeler, who appears in my stories, was trained in homeopathy in Germany before emigrating to America.
Surgery, Anesthetics, and Antiseptics
Surgery in the early 19th century was crudely done (usually by a barber), often unsuccessful (that is, the patient died), and excruciatingly painful. As the century progressed, however, use of anesthetics emerged to sedate the patient during the operation, carbolic acid was used as an antiseptic to prevent infection, and German surgeons used steam heat to sterilize instruments. Surgery continued to advance as the 20th century dawned.
In the end, the people who survived were sturdy stock. Many of us owe our good health to our robust ancestors.
Eleanor Sullivan is the award-winning author of books for nurses, the Monika Everhardt mystery series, and her latest, Cover Her Body, A Singular Village Mystery. www.EleanorSullivan.com
