Our Medical History

Season 4 Episode 6 | 24m 42sVideo has Closed Captions

Settlement era medicine was a vital service that provided care in rural America.

Discuss settlement era medicine and how this vital service has evolved and faced the challenges of providing care in rural America.

Aired 04/21/2024

Cottonwood Connection is a local public television program presented by Smoky Hills PBS

Cottonwood Connection

Our Medical History

Season 4 Episode 6 | 24m 42sVideo has Closed Captions

Discuss settlement era medicine and how this vital service has evolved and faced the challenges of providing care in rural America.

Aired 04/21/2024

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Culture

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From accidents to disease, from gunshot wounds to an infected splinter, settlers on the plains had to find ways to overcome the many hazards to their health. For this episode we're at historic Ford Hays and I'm going to visit with Sherrie Smith today. She has been a volunteer out here for many years but she is a registered nurse.

She is also, what is your position with the DAR, the Daughters of the American Revolution?

Currently I'm state historian The State historian.

For the Kansas DAR. So we have someone with the DAR being very strick on their history and stuff. I started out with my interest in historical things as a volunteer here at historic Fort Hays 36 years ago. And during that time I was already a nurse, but then I began working on my master's degree through KU and nursing. We had to do a project, and so I did my project on the history of medical care at historic Fort Hays. And that is basically how I began collecting photographs, making a slideshow, which now is a PowerPoint show about the evolution of medical care in the United States from the time the first Europeans landed on our shores in the 1600s. But then it just evolved into civil war, Revolutionary War, Spanish-American War, and all the advancements that were made in medicine throughout the years until where we are today. Warfare you said early on that that kind of advanced the medicine quite a bit, especially in surgery, because they had so many people they worked on that they were finally getting an idea of what worked and what didn't. Exactly. But in the Civil War, one estimate is 620,000 Americans died on both sides. And estimates as high as 750,000. And two-thirds of those were from disease, but so many of those were of the surgeries of those who survived were amputations. And that was the one thing they actually could treat. You get shot anywhere else, you know. There's some amazing stories of people who did survive. We think about medicine today, and it's incredibly different from what they had. You think of during the Civil War, and probably, too, after Fort Hays was established, there was basically no anesthesia or any antiseptic. As far as anesthesia, the 1840s was a real bonus year time frame decade for the establishment of anesthesia. We actually had nitrous oxide, which is still used today commonly in dentists' office, but it required a really cumbersome three bell jar apparatus to administer. But they also had chloroform. Chloroform during the Civil War, for instance, was the anesthesia, because ether, even though when it became more widely used, was used well into the 1950s, is all we had with ether. The problem with ether is, it's highly flammable, and you're working in a time period of what, candles and lanterns, all open flames. So chloroform was really the anesthesia of choice. Yeah, after the war was over, and when they started putting forts in Kansas, all the posts had surgeons. And the surgeon had a very big responsibility in reporting the weather, reporting diets. The post surgeon brought here some medical care, but as every town settled, usually they would get some medical people in, be it only perhaps a midwife at first, but then they would also get surgeons and doctors in. And we had a lot of doctors coming out of the Army who had had a lot of experience in the Civil War. So they came out, they may have come out of medical school with very little training or knowledge, but they certainly got a lot of the job training. And of course, the quality of physician that was out here varied a lot. Hello, my name is Jamie Rees. I am the manager of historical collections here at the Clendening History of Medicine Library and Museum here at KU Medical Center in Kansas City. So this saddlebag dates back to 1885. It belonged to Dr. Marion Duncan, who was originally from Indiana, but practiced in Wilson County, Kansas and Chanute, Kansas. But it's a really great example of an early saddlebag. The physicians might be based out of a town, but he is going to have a range that he has to ride out and then see his patients. What you'd have in here would be your medications, but you might have sort of a role of surgical instruments if you're expecting maybe to deliver a baby with forceps or take someone's tonsils out, you could roll that up and tie it to the back of your saddle and get going. So on this side of the bag, most of the medications that would have been in here are actually gone now. But if you open this side, you have space for larger bottles. So you can see some residue in that bottle. There is no pharmacy to go get a pre-mixed pill often. So what you're going to do is take the raw ingredients or you're going to take whatever medications, pharmaceuticals that you think you might need with you to go see your patients out in the field. Then on this side, you can see a great example of the little tiny vials. This case can carry as many as 30 vials of medication if that's what is needed. So this lovely piece of paper mache folk art actually was made by someone in New Hampshire and made its way to us. But what it's depicting is very much a Kansas sort of idea, this idea of the horse and buggy doctor, which I think does, you know, it's very much an American idea, but it comes from a Kansas physician named Arthur Hertzler. So Hertzler was originally from, I believe, Ohio, but moved to Kansas to start his medical practice. And he set up shop in Halstead, Kansas in the 1890s and was very much working as a horse and buggy doctor. He wrote quite a few technical medical textbooks, but he also became a best-selling author with his reminiscences of being a frontier physician back in the late 19th century. And he kind of represents this transition from, you know, the doctor going out to take care of his patients at home into sort of ideas of clinical centers. So he started in Halstead, what was known as the Halstead Clinic, colloquially known as the Hertzler Clinic by many. But he basically started a hospital that was extremely well-respected across the country. To get a medical degree and become a doctor, was it like a lawyer where you just read and then tried to pass the boards? It depended on where you went. One of our surgeons that was here in Hays, not at Fort Hays, was Dr. Middlekoph. He graduated in the late 1870s from the University of Maryland, and they were one of the first or second medical school in the United States to require that they work on a cadaver and do an autopsy and to understand the human body. So the degree of training differed a little bit by where you went to medical school. And then of course in the Civil War, I have to put a plug in for the nurses of America. In the Civil War, over 3,200 women volunteered for the Union Army to help with it because the Army was totally ill-prepared for what was going to happen. They thought it would be over within three months and it lasted four years. Didn't Red Cross begin during the Civil War too? The organization knows Red Cross. Clara Barton eventually would establish the Red Cross and she was one of the volunteer nurses for the Union Army, along with many other women like Dorothea Dix, Mother Bickerdike. And Phoebe Pemberton from the Confederate Army, I want to give her some credit too because there were women on both sides that really stepped up to the plate. As civilization moved, towns grew like Hays. Hays' first hospital was in 19, was it 1904 or 1909, St. Anthony's opened. In 1879, the residents of Lakin, Kansas were 75 miles away from the nearest physician. How far does a horse go in one day? And when I used to give programs, I'd talk about if somebody had a broken bone, you can now go to the doctor and get an x-ray and get a cast on it, you're okay. You used to have a broken bone and the transportation to the doctor, even to set it, would, the bouncing of the wagon or going horseback would probably kill you. And also they called it blood poisoning, but you could die from a splinter. Sure. You could die from septicemia pretty easily. And then you think about some of the wild game they were eating. I know when I was younger, we ate quite a few rabbits because young jackrabbits in the spring were really tasty, but they had tularemia. And the thing with the cowboys and stuff eating a rare steak, no, they cooked stuff to death because they wanted it cooked to kill anything in it. And home canning. If you don't do it right, you certainly can die from food poisoning. And if your well became contaminated, which is probably why until the day my grandmother died she boiled water in a tea kettle and that's when she did her final rinse with the dishes. He always scolded the dishes on the farm. I think the diseases at the time, for instance, diphtheria could go through. Diphtheria was a tragic thing because it typically only affects children between the ages of one and ten are the most likely to die. I remember reading a diary, a family lost five children in the course of three weeks. Yeah, in smallpox. Smallpox. The Chinese historical literature shows them doing inoculations, live virus inoculations in a painting. It is currently the only disease ever considered eradicated by the World Health Organization and that was declared in 1980. But before then, smallpox epidemics were frequent. They were feared. Next, I think, on the list that might happen will be polio. Polio was terribly feared. We had huge outbreaks. I think you and I are the same age that can remember. I bet you right there you had a scar at one time. I did. Yeah, so did I. We're coming up on the anniversary, April 12th of 1955, that Church Bells of America rang out because Dr. Salk's, at last, had released his polio vaccine. Cholera, definitely because of contamination in the well. That's what they think here. The 1867 cholera epidemic was one of the wells here was contaminated. Dr.

Snow in London... London had a cholera outbreak and he suspected this one certain well. He was the one that came up with, If you boil the water, you will kill it, which is why, one of the reasons why, in the transcontinental railroad building era, there was a smaller death rate from disease amongst the Chinese versus everyone else because what did Chinese drink? Hot tea. What do you have to do to water to make hot tea? You have to boil it. That has actually proven fact, that their disease rate was much lower. That was about the only break the Chinese got in that project. That's right. Typhoid. Yeah. Malaria. The whole Mississippi Valley was prone to malaria cases and you could just pick them out of the crowd because of the specific coloring they had, this sallow yellow color that the malaria patients had. Tuberculosis consumption, highly contagious and nothing to be done about it at the time. There were a million ways to die. Mumps, measles, chicken pox. You had to depend upon your neighbors, perhaps the local midwife, the neighbor lady who knew how to deliver a baby. Your family members are the ones who usually took care of you in your home or the kindly neighbor, which is, I'm dressed as a kindly neighbor that would come in and give you help with you and your illness. It was usually a rugged constitution and a great deal of luck that got you through it. Then there were a lot of self-help books. Dr.

Gunn had a well-known book out that's a really big volume. In it he has a quote that I always remember. It says, "Any man, unless he's an absolute idiot or a complete fool, can perform this operation.

" That was how to perform an amputation. What I've pulled are two examples of medical advisor books. This is by John Harvey Kellogg, who you might know as the inventor of cornflakes. He was also a physician as well as being an inventor. This is about a 1,600 page book starting with human anatomy, but literally going on to show, you know, talk about hygiene, about what to do if you have various diseases, or the physiology behind what's causing diseases. This one is actually called The Common Sense Medical Advisor, written by Ray V. Pierce. What's particularly interesting about this book is, you know, this idea of a remedy. Pierce turns out he was a medical doctor, but he was more famous as a politician and a snake oil salesman. If you look closely, these are two empty patent medicine bottles. One says Dr. Pierce's favorite prescription and Dr. Pierce's golden medical discovery. These tonics consisted basically of water, a mixture of roots and botanical ingredients, and glycerin. Basically, they could treat whatever ails you. So if you're having stomach issues, if you have a headache, if you're having women's troubles, you can take either and it will cure all your aches and pains. Probably didn't actually work. And I will say the ingredients in these two particular formulas were a lot less dangerous than some patent medications that were widely available in the 19th and early 20th century. But again, to have this connection back to the medical advisor, you have to wonder, is it a bit of advertising as well as medical care? Oh, patent medicines. Patent medicine was good. Patent medicines, and I mean, and you could cure anything with patent medicines. Dr.

Paul's pills for pink, for pale pink people, that was actually the name of something. And so many of them, number one, they had to taste bad or they weren't worth anything. So they tinted it with quinine, which is extremely bitter. And of course, they had a lot of opiates in them because at least it made you feel better. Traveling salesman, especially, would travel around and go not only door to door, farm to farm, but also to various confectionaries, pharmacies, whatever, in a town. And they would try to sell their Mrs. Wurf's worm medicine. And cocaine tooth drops for children with two little kids on the front. It was cocaine. You rubbed it on their gums. And patent medicines typically could actually be dangerous because a lot of them had heavy metals like mercury in them and things. And they really didn't cure anything. The only thing that it helped with was if they had quinine in it to make it bitter, that if you had malaria, then that was a little bit beneficial. This is a substance called calomel. Calomel is a mercury compound. It's mercury chloride. It's not really something you want to ingest. But going back as far as the ninth century AD, calomel is a popular medication. And it's kind of prescribed for everything. It's seen as a panacea to treat anything from a baby's toothache to headaches, stomach problems, syphilis. You know, all sorts of diseases, all sorts of severities. You're going to get some calomel. It doesn't taste very good, so it was usually compounded with something sweet. So in this case, it's spearmint and saccharin, but probably not going to help whatever was going on with the patient. I know that when they did the archaeology work here, they were finding opium tins. Oh, yeah. But it wasn't-- Popular product. Yeah. It wasn't all used for medicine. That's true. And so-- and laudanum, too, probably. And it's an opiate also. And laudanum, in defense of the number of opium addicts and laudanum addicts that we had at the time, aspirin was not commercially available to the general public until 1899. So if you had a chronic headache, you had migraines, you had a bad back, what were you supposed to do? And laudanum was cheap, cheaper than alcohol, and it was sold everywhere. They sold it at the pharmacy. They sold it at the barbershop. They sold it in clothing stores, in the general store, and anybody could buy it.

Until Kansas established a state board of health in the late 1880s. It was totally unregulated. Anybody could buy it. It didn't matter your age or how much you bought. As medical education is kind of developing, advancing, technology moves on, medical science, all these things, a lot of the practicing physicians are resistant to it because, OK, great, a bacterium is causing this disease in my patient. Penicillin isn't discovered until 1928. It's great you can put a name to this problem, but you still can't treat it any better. And I've been treating it and giving comfort to my patients for decades, so why should I do it your way? So calomel ties into this because it's something that these doctors could give. They kind of probably knew it wasn't helping, but the patient kind of expected it. So again, there's this idea maybe there's a bit of a placebo effect. So there's this idea of the Kansas physician up to that point is more artisan than scientist. So what we have here is a "Don't spit on the sidewalk" brick pulled out of a sidewalk from a town in Kansas. They appeared in towns all over the state. Dr.

Samuel Crumbine, one of my favorite people, what a forward thinker he was. Very much so. Probably best known for haranguing the brick companies to print bricks that said don't spit on the sidewalk. That was Dr. Crumbine's slogan. But there was a bit of controversy when they first came out because they used the word spit instead of expectorate. But I think the brick producer was the one who pointed out how are we going to fit expectorate on a five by 10 brick. But one of the things that he saw, Dr. Crumbine saw was as, Hays had one too, there was a common city well for anyone who needed to draw water. And they also had a common cup there hanging for everybody in town. He saw a man come up who was known to have consumption, tuberculosis, cough and spit out a bunch of stuff and drink from the cup and hang it up. And then a four year old boy came up and drank out of the cup. And he thought this isn't good. And he kind of was the forerunner of the Dixie cup. He came up with this paper cup, the cone paper cup. Same with the common towel being used in the depot by everyone. He also came up with an early version of the fly swatter and we had a public campaign of swat the fly. And that was pretty successful. The one that didn't go so well was bat the rat. The average housewife would be happy to whack a fly but beating a rat to death with a board just never caught on very well. So he went on to become one of the early officers in the newly established Kansas Board of Health. In the late 19th century as the standards for Kansas doctors are getting stricter and the state is really trying to improve the standard of care and the standard of quality of physicians available to the citizens, the legislature recognized the need for a school of medicine and there was lots of discussion about if we were going to have a medical school where could we put it, how are we going to pay for it. Someone who was aware of these discussions was Simeon Bishop Bell. In addition to being a farmer he had also trained as a physician at what would become the University of Ohio School of Medicine. So he moves to Kansas and starts his practice. He also operates a general store and a farm right on the state line. Unfortunately this was during the bleeding Kansas era that led up to the Civil War. During the Civil War his farm and store were raided nine times. One of those raiders was Quantrell's Raiders who went on to sack Lawrence and so he sort of left his farm, let it, you know, didn't try to rebuild and then resettled back in Wyandotte County a couple of years later and that's really where he made his fortune. He convinced the city planners of Kansas City to build Southwest Traffic Way, a major north-south boulevard through his land and from then he became extremely wealthy through land speculation. So he lived a very long life but by the 1890s he was wanting to do some good with that wealth. So he had a nice tract of land right on Southwest Traffic Way that he wanted to donate to the state along with a certain amount of funding to build a school of medicine. The other bit of context that's important to the story is his wife had sadly passed away right at the end of the Civil War, Eleanor Taylor Bell. He wanted to build this school of medicine and a hospital in memory of her. So with the ability to, you know, train doctors in-house so to speak, you know, it created a pipeline for people to, you know, get their education and then go back to their hometowns to raise the standard of care throughout the state. So I hope that advancements in medical science never cease because there will always be a need. And we look at the fact with modern medicine how many, you know, premature babies can be saved now at such low birth weights compared to what was once the case. I always hoped in my lifetime that someone would figure out how to make a computer chip to put into someone's spine so the paralyzed could walk. And I really think we might be coming to that sometime. But with a lot of knowledge you need to have some wisdom. And sometimes I think those two things are hard to achieve the right mix. So in 1912, as there's this effort to increase the quality of the training of the physicians at the KU School of Medicine to, you know, improve the facilities to make them bigger, Simeon Bell writes a letter to the Chancellor of the University of Kansas, Chancellor Strong. His hope was that this hospital will never be limited to any class or conditions, that the sick of every kind will be admitted, white and colored, adults and children, those suffering from contagious diseases as well as those who are not, the well-to-do as well as private patients, and the poor free or with charges suitable to their financial conditions. I believe that this institution may be of great good and it is my wish that through the university it may develop to his highest possible use for the teaching and care of the sick. Yours very truly, Simeon Bishop Bell. [MUSIC] [BLANK-_AUDIO]

Cottonwood Connection is a local public television program presented by Smoky Hills PBS