Healthcare

Doctor's Kit

Doctor’s Kit

 THE MEDICINE KIT FROM THE 1800’s

The Physician had about 100 medicines available to him in the 1800’s.

What was in the Doctor’s Kit?

Many were herbal in nature such as Digitalis leaf. Others were inorganic compounds such as Mercury. The medicinal kit in this 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 Prevalant 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

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   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.

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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”.

 From the following website:

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.


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.