Healthcare

Medicine Kit, on display at the Hearse House Museum

PHYSICIANS

The History of Salisbury by John Dearborn, published in 1890, includes a list of 24 physicians who practiced medicine in the town, detailed on pages 397-406.

One particularly notable physician was Dr. Joseph Bartlett, who arrived in Salisbury at the age of 21 in 1772. He became the town’s first permanent doctor, serving its residents for 30 years while building an extensive practice and volunteering his time for town affairs.

Dr. Bartlett was also the nephew of Josiah Bartlett of Kingston, New Hampshire, a signer of the Declaration of Independence. Josiah often visited both his nephew and his daughter, who lived in Salisbury Heights.

THE DOCTOR’S KIT

In the 1800s, physicians had access to around 100 medicines, many of which were herbal remedies like Digitalis leaf, Basil, Camphor, Myrrh, Anise, Valerian, and Opium. Glauber’s Salt, also known as miraculous salt, was a popular all-purpose laxative. Some treatments included inorganic compounds like Mercury.

The medicinal kit on display features small vials containing substances such as Strychnine, Digitalis leaf, Mercury, and various herbal agents, some of which are highly toxic powders.

Physicians would dispense these medicines in small paper envelopes, instructing patients to dissolve them in water before consumption.

Among New England doctors, inorganic Mercury was a widely used treatment for numerous illnesses. However, its high toxicity often led to fatal outcomes for patients.

THE FOUR HUMORS

A Common Medical Theory in Early History

This concept remained largely unaltered from the compilation of ancient medical knowledge presented by the Roman physician Marcus Aurelius around 200 AD. Medicine in New England during this era adhered to the Theory of the Four Humors:

Blood– Sanguine

Phlegm– Dull

Yellow Bile– Quick to Anger

Black Bile– Depressed

INFECTION

At the time, New England physicians lacked an understanding of infection and transmission. Childbed Fever (Puerperal Fever) was nearly epidemic, as doctors often failed to wash their hands, spreading infections between patients. In 1849, at Bellevue Hospital in New York, half of the women giving birth contracted Childbed Fever, with a devastating 80% mortality rate. Interestingly, midwives had much lower infection rates due to their superior hygiene practices and consistent hand washing before deliveries.

QUARANTINE

The concept of the Four Humors remained influential during Colonial times, but some forward-thinking individuals began exploring new approaches to healthcare. Prevention was one such approach, even though the causes of disease were not yet understood. Among these pioneers were Thomas Jefferson and John Adams.

Jeanne Abrams, in her book Revolutionary Medicine, The Founding Mothers and Fathers in Sickness and In Health, highlights Jefferson’s unique perspective. Unlike many of his contemporaries, Jefferson recognized that certain diseases were communicable before symptoms appeared. This understanding led him to advocate for preventative measures like quarantining against Yellow Fever. In 1825, Jefferson achieved a remarkable milestone by founding and designing the University of Virginia. As Abrams notes, the university’s design prioritized both the physical and mental health of its students while also preventing the spread of infectious diseases.

Also see:

Episode 005: Jeanne Abrams, Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health – Ben Franklin’s World

Jeanne Adams discusses the major illnesses of the time, including Smallpox, Malaria, and Measles epidemics, as well as the procedure known as inoculation.

VARIOLATION/INNOCULATION

It’s fascinating to learn that John Adams and his family were inoculated against smallpox through an incision. Speaking of the devastating smallpox outbreaks in New England, here’s some information from the link below:

The Great Smallpox Epidemic | History Today

“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 method, used even after Edward Jenner introduced vaccination in 1796, was inoculation. Unlike vaccination, which relied on the cowpox virus, inoculation involved intentionally infecting a person with the Variola virus, typically through a cut on the hand. For reasons still unclear to scientists, inoculated smallpox was generally much less severe than the natural form of the disease. Those who survived gained lifelong immunity, just as they would from natural smallpox, but with a significantly lower mortality rate.

There was a catch, though: people who were inoculated could still get smallpox and could easily spread the disease to others. Without strict quarantine measures, the procedure was just as likely to spark an epidemic as it was to prevent one. This made inoculation highly controversial in the English colonies, where smallpox outbreaks were relatively rare. In England, however, the disease had been endemic for a long time, so the practice gained more acceptance. As a result, during the early stages of the American Revolution, British forces were much more likely than American troops to have immunity to the Variola virus.

“What is the History of The Smallpox Vaccine?

The story of smallpox prevention and its ultimate eradication through immunization is fascinating. For centuries, people knew that surviving smallpox granted immunity, so many cultures developed ways to induce immunity in healthy individuals. The Chinese used tubes to blow powdered smallpox scabs into noses, while in Turkey, pus from sores was scratched into the skin.

These methods, known as variolation, eventually made their way to Europe and the Americas. While variolation sometimes worked, it also had risks — some people contracted the disease, died, or spread new outbreaks. Despite the dangers, by the early 1700s, smallpox inoculation had become a common practice.

EDUCATION FOR THE PHYSICIAN IN THE 1800s

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.
The 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

Bloodletting, the practice of removing blood from a vein, dates back to at least 400 BC. By the 1800s in New England, it was commonly used to treat various illnesses. During childbirth, women were often bled to the point of unconsciousness in an attempt to manage pain. George Washington, suffering from fever, sore throat, and cough, was attended by three physicians. The two older ones insisted on bloodletting, despite objections from the younger physician. Over a span of less than twenty-four hours, Washington lost two-thirds of his blood volume and died shortly after.

Additional details about George Washington’s death: A Physician Looks At The Death of Washington

THE USE OF LEECHES

For centuries, leeches have been used as a method of healing. In the past, people believed that diseases were caused by evil spirits and thought that bleeding themselves could remove the “bad blood” containing these spirits. Later, it was believed that an imbalance of body fluids caused illness, and blood removal was seen as a way to restore balance. Today, it is known that leeches can aid in healing for certain patients with compromised recovery. When applied to infected wounds, leeches feed on necrotic (dead) tissue instead of live tissue, helping the healing process.

OLD NAMES OF DISEASES

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

Asphyxia/Asphyxia – Cyanosis 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 a high mortality rate

Black Pox – Black Smallpox

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 the 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 the mouth or lips, or herpes simplex

Catalepsy – Seizures/trances

Catarrhal – Nose and throat discharge from a cold or allergy

Cerebritis – Inflammation of the cerebrum or lead poisoning

Chilblain – Swelling of the extremities caused by exposure to cold

Childbed fever – Infection following the 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
Cholecystitis – Inflammation of the gall bladder

Cholelithiasis – Gallstones

Chorea – A 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 the blood

Cynanche – Diseases of the 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 – A Tumor of the eyelids that causes hair loss

Diary fever – A fever that lasts one day

Diphtheria – A Contagious disease of the throat

Distemper – Usually an animal disease with malaise, discharge from the nose and throat, and anorexia

Dock fever – Yellow fever

Dropsy – Edema (swelling), often caused by kidney or heart disease

Dropsy of the Brain – Encephalitis

Dry Bellyache – Lead poisoning

Dyscrasia – An abnormal body condition

Dysentery – Inflammation of the colon with frequent passage of mucus and blood

Dysorexia – Reduced appetite

Dyspepsia – Indigestion and heartburn. Heart attack symptoms

Dysuria – Difficulty in urination

Eclampsia – 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 the brain; aka sleeping sickness

Enteric fever – Typhoid fever

Enterocolitis – Inflammation of the intestines

Enteritis – Inflammations of the bowels

Epistaxis – Nosebleed

Erysipelas – Contagious skin disease, due to Streptococci, with vesicular and bulbous lesions

Extravasated blood – Rupture of a blood vessel

Falling sickness – Epilepsy

Fatty Liver – Cirrhosis of the 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 – A Condition caused by the loss of salt from the body

Heat Stroke – Body temperature elevates because of the surrounding environment temperature, and the body does not perspire to reduce temperature. A coma and death result if not reversed

Hectical Complaint – Recurrent fever

Hematemesis – Vomiting blood

Hematuria – Bloody urine

Hemiplegy – Paralysis of one side of the body

Hip Gout – Osteomyelitis

Horrors – Delirium tremens

Hydrocephalus – Enlarged head, water on the brain

Hydropericardium – Heart dropsy

Hydrophobia – Rabies

Hydrothorax – Dropsy in the chest

Hypertrophic – Enlargement of an organ, like the heart

Impetigo – A Contagious skin disease characterized by pustules

Inanition – Physical condition resulting from a lack of food

Infantile Paralysis – Polio, Intestinal colic, Abdominal pain due to improper diet

Jail Fever – Typhus

Jaundice – A Condition caused by blockage of the intestines

King’s Evil – Tuberculosis of the neck and lymph glands

Krüchhusten – Whooping cough

Lagrippe – Influenza

Lockjaw – Tetanus, or an 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 the infant

Malignant Sore Throat – Diphtheria

Mania – Insanity

Marasmus – Progressive wasting away of the body, like malnutrition

Membranous – Croup Diphtheria

Meningitis – Inflammation of the brain or spinal cord

Metritis – Inflammation of the uterus or purulent vaginal discharge

Miasma – Poisonous vapors thought to infect the air

Milk Fever – A Disease from drinking contaminated milk, like undulant fever or brucellosis

Milk Leg – Postpartum Thrombophlebitis

Milk Sickness – A Disease from the milk of cattle that 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 the heart muscles

Necrosis – Mortification of bones or tissue

Nephrosis – Kidney degeneration

Nepritis – Inflammation of the kidneys

Nervous Prostration – Extreme exhaustion from inability to control physical and mental activities

Neuralgia – Described as discomfort, such as a “Headache,” was neuralgia in the head.

Nostalgia – Homesickness.

Palsy – Paralysis or uncontrolled movement of controlled muscles. It was listed as “Cause of death”

Paroxysm – Convulsion

Pemphigus – A Skin disease of watery blisters

Pericarditis – Inflammation of the heart

Peripneumonia – Inflammation of the lungs

Peritonitis – Inflammation of the abdominal area

Petechial Fever – Fever characterized by skin spotting. Puerperal exhaustion, Death due to childbirth

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 Phthisis

Pott’s Disease – Tuberculosis of the 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 the skeletal system

Rose Cold – Hay fever or nasal symptoms of an allergy

Rotany Fever – (Child’s disease) ???

Rubeola – German measles

Sanguineous Crust – Scab

Scarlatina – Scarlet fever

Scarlet Fever – A disease characterized by a red rash

Scarlet Rash – Roseola

Sciatica Rheumatism in the hips

Scirrhus – Cancerous tumors

Scotoma – Dizziness, nausea, and dimness of sight

Scrivener’s palsy – Writer’s cramp

Screws – Rheumatism

Scrofula – Tuberculosis of the neck lymph glands. Progresses slowly with abscesses and fistulas developing. Young person’s disease

Scrumpox – Skin disease, impetigo

Scurvy – Lack of vitamin C. Symptoms of weakness, spongy gums, and hemorrhages under the skin

Septicemia – Blood poisoning

Shakes – Delirium tremens

Shaking – Chills, ague

Shingles – A 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 the brain Result of stroke or hemorrhage in the brain, with a result of the tissue softening in that area

Sore Throat Distemper – Diphtheria or quinsy

Spanish Influenza – Epidemic influenza

Spasms – Sudden involuntary contraction of a muscle or group of muscles, like a convulsion

Spina Bifida – Deformity of the 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 involuntarily.

Stomatitis – Inflammation of the mouth

Stranger’s Fever – Yellow fever

Strangery – Rupture

Sudor Anglicus – Sweating sickness