Archive for the ‘medical history’ Category

New Ideas

Thursday, November 20th, 2014
Chest Treatment With Electrostatic Generator

Chest Treatment With Electrostatic Generator, circa 1908

Food was not the only way to treat physical illnesses (see last few posts), though healthy eating may have been the least harmful way to ward off sickness.

The turn of the 20th century saw many innovations and experimental treatments by physicians who were working on new ways to help patients. The August, 1907 issue of The New Albany Medical Herald monthly journal ($1/year for a subscription) reported that:

A Tuberculosis Sanitarium

A Tuberculosis Sanitarium

“[Dr.?} Stuver has used galvanic electricity with splendid results in chronic rheumatism.

 

He uses a current of from 6 (?) to 20 mp. for a person, 20 minutes to a half-hour and says that the results are better if a thin layer of cotton, wet with a solution of cocaine, is placed under the positive pole.”

Tuberculosis Patients at J.N. Adam Memorial Hospital in Buffalo, NY, courtesy Edward G. Miller Library, University of Rochester Medical Center

Tuberculosis Patients at J.N. Adam Memorial Hospital in Buffalo, NY, courtesy Edward G. Miller Library, University of Rochester Medical Center

Another article in the same issue concerned the treatment of tuberculosis. The writer, a Dr. Thos. P. Cheesborough, from Asheville, NC, noted  that he usually received patients who were far along in the condition, due to their home physicians either missing the diagnosis entirely or being reluctant to tell their patients the bad news about their health.

 

Dr. Cheesborough then says, “One of the greatest disadvantages that I have found in treating this disease is that the poor unfortunate, when at last his disease has been diagnosed, and he has been sent from home and its comforts, has been advised by the home physician not to consult anyone here, but to exercise and drink whisky and to come home in a few months cured.”

Obviously, medical care could sometimes be hit or miss.

 

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Food Woes

Sunday, November 9th, 2014
Smoking Fish for Preservation

Smoking Fish for Preservation

Choices concerning Bran Flakes and Shredded Krumbles (see last post) weren’t the only food problems patients at the Canton Asylum for Insane Indians suffered. They, like most Native Americans, had already lost a basic underpinning of life–their traditional foods. This loss led to nutritional deficiencies and diseases that had never affected them before encountering the white man’s culture.

Native American diets had been varied, nutritious, and plentiful until they lost control over their food. Depending upon the part of the country they inhabited, tribes ate liberally of the “Three Sisters” (beans, corn, and squash), wild rice, nuts, berries, fish, and game of all sorts. Besides hunting and gathering food from the surrounding area, many tribes cultivated crops, as well.

Native American Woman Preparing Food on a Stone Slab, circa 1923, Edward S. Curtis

Native American Woman Preparing Food on a Stone Slab, circa 1923, Edward S. Curtis

When Native Americans were forced to live on reservations, they lost their homes, their cultures, and their independence. Along with that, the quality of their food immediately deteriorated. Reservation land which they were forced to farm was usually so poor that tribes became dependent on government rations.

Rations typically included flour, tea, sugar, coffee, salt, beans, and other staples. These foodstuffs were a far cry from the unrefined, whole foods that Native

Americans had previously eaten. Beef replaced buffalo as a meat source, and Native Americans had to learn to cook new foods which were drastically different and of inferior nutritive value from their traditional foods. Their health began to suffer almost immediately.

 

Receiving Rations at San Carlos Agency, AZ, circa 1892, courtesy National Park Service

Receiving Rations at San Carlos Agency, AZ, circa 1892, courtesy National Park Service

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Unfired Foods

Sunday, October 26th, 2014
George Julius Drews

George Julius Drews

As generations move away from them, old ideas become new again. Just as foraging has become popular in the past few years (see last post), so has the idea of eating raw foods. George J. Drews wrote about “unfired food” in 1912 in Unfired Food and Trophotherapy. (Troph simply means “preparing and combining provisions for the unfired diet.”) His ideal dinner consisted of soup, salad, a “brawnfood” (such as two ounces of unfired wafers with nut butter or three ounces of unbaked bread or cake) nibblers, and fruit.

Drews' Book About His Food Beliefs

Drews’ Book About His Food Beliefs

Drews also anticipated today’s juicing craze with his “health drinks.” Besides typical “ades” like lemon and limeade, he suggested a tonic drink of beet juice, rhubarb juice, honey and water.

A bit more unappetizing was his suggestion for oatmeal fruit soup: 6 1/2 ounces of grape juice, 1 ounce oatmeal, and 1/2 ounce of olive oil, beaten together and left to soak for five minutes before serving.

Drews was convinced that natural foods could prevent disease and help heal the body; he also had a high distrust of medical drugs and their effects on the body. He scoffed at people who ate unnatural cooked foods and who were then willing to swallow “nauseating drugs irrespective of the dangerous after effects the expected cure may lead to.”

Grocery Stores of the Period Were Full of Unnatural Foods

Grocery Stores of the Period Were Full of Unnatural Foods

 

Drews may have been an unwitting feminist, since he characterized housewives as “imprisoned vassals” who were tied to the kitchen because of the unnatural American diet. “She must stand over a miniature furnace for an hour in the morning and breathe the poisenous [sic] odor of broiling flesh, and spend another hour among the grease and slime of pots . . . . “

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Water Closets

Sunday, October 12th, 2014
An Old Outhouse, courtesy Library of Congress

An Old Outhouse, courtesy Library of Congress

Ordinary homes during the late 1800s and well into the 1900s had few conveniences (see last post); unlike homes today, a dedicated bathroom was a luxury. A largely rural population typically used an outhouse, which could be indifferently built at worst and an uncomfortable distance from the home at best. Cold in winter and hot in summer, outhouses could smell unpleasantly, attract flies and other insects, and offer little comfort in the way of washroom amenities and hygiene.

A Package of Toilet Paper, circa 1887 - 1900

A Package of Toilet Paper, circa 1887 – 1900

 

In contrast, insane asylums often provided indoor toilets that included the benefit of indoor plumbing for both flushing and washing. The Canton Asylum for Insane Indians was no exception, even though it opened the last day of 1902 in a remote area of the country.

Canton Asylum’s system used range toilets, which shared a common pipe and flushed all at once. If they weren’t flushed regularly, unpleasant odors (and presumably bacteria) could build up and make the room distasteful to use and unhealthy as well. Unfortunately, attendants were sometimes lax in their flushing intervals, and the toilet area did become distasteful to use.

A Tenement Toilet in Douglass Flats in Washington, circa 1908

A Tenement Toilet in Douglass Flats in Washington

 

Some patients may not have known how to use the toilet properly, and sometimes violent patients destroyed part of the equipment. The toilets and lavatory areas were a perpetual headache for asylum superintendent Dr. Harry Hummer, and surely for many of the attendants as well. In time, the washroom system degraded into the fallback use of chamber pots, which were even more unpleasant and unhealthy because they were allowed to fill to overflowing.

 

 

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In the Long Run

Sunday, October 5th, 2014
Pliny Earle, courtesy National Library of Medicine

Pliny Earle, courtesy National Library of Medicine

 
Insane asylums were initially embraced because they held out the hope of curing the insane, rather than merely incarcerating them. Recovery rates were high at first, in the typically small asylums where doctors could devote themselves to patient care and set up individualized plans.

That initial hope gave way to pessimism, however, as institutions became larger and alienists (psychiatrists) found themselves as involved in administration as in practicing medicine. When noted 19th-century alienist and asylum superintendent, Pliny Earle, showed that earlier “cure rates” had been inflated, alienists everywhere accepted the fact that most of their patients were not going to recover, after all.

 

A Common Restraint for Patients Who Remained in Asylums

A Common Restraint for Patients Who Remained in Asylums

However, the new pessimism was almost as unwarranted as the earlier enthusiasm. One of the field’s few longitudinal studies showed that there could indeed be hope for patients. Between 1858 and 1870, Arthur Mitchell studied 1,297 patients in a Scottish asylum. He found that 53% either stayed resident at the asylum or died there during the time involved, but that nearly half of the discharged remainder (44.9%) had remained sane. This “half of the remaining half” only represents a cure rate of about 25%, but that rate might really have been higher; Mitchell could not get information concerning 32% of the discharged patients. Similarly, Dr. John G. Park  of the Worcester State Lunatic Hospital, followed discharged patients for nearly 15 years in the late 1800s and found that more than half (58%) of those who had been discharged as recovered were never again institutionalized. This may not have meant that the discharged patients never had further psychological problems, but it did show that they had been able to function suitably enough to let them remain with family or friends.

Worcester Hospital for the Insane

Worcester Hospital for the Insane

 

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Practicing Medicine on a Frontier

Sunday, September 28th, 2014
Frontier Doctor Andrew Taylor Still

Frontier Doctor Andrew Taylor Still

Any reasonably ambitious man could become a doctor during the nation’s early years. Few licensing requirements existed, and men could choose to attend one of many substandard medical schools that were unbelievably slack in their requirements for both entry and graduation. Some men never went to school at all, but either “read” to be a doctor or served as apprentices under a practicing physician until they felt able to go out on their own.

Though some aspiring doctors took these routes to avoid overtaxing themselves mentally or financially, many others simply were not able to “go East” to an established medical school. They studied earnestly–probably harder than many of their college-educated peers. In Appalachia, many doctors took an interest in herbs and local healing folklore, and incorporated this knowledge into their practices.

Patent Medicines Thrived Despite the Availability of Doctors

Patent Medicines Thrived Despite the Availability of Doctors

 

Because it was so easy to become a doctor, physicians in the early 1800s often saturated their markets to the extent that nearly none of them could earn a real living. (This is one reason that a well-paid superintendency at an insane asylum was initially such a coveted position.)

Physicians moving into Appalachian territory often advertised their services, and sometimes offered testimonials from (supposedly) impartial and healed patients they had helped. Others made money on the side through the sale of medicines, or pulled teeth, preached, or farmed. Many physicians were paid in produce or livestock and found it difficult to actually earn cash.

Despite some undisputed charlatans and incompetents, frontier doctors in Appalachia and elsewhere were incredibly dedicated. Many doctors risked their lives to travel tremendous distances over dangerous terrain to attend patients who might pay them with fresh eggs and produce, or not at all.

Dr. Carl Hoffman, circa 1910, courtesy Orgeon Health and Science University Archives

Dr. Carl Hoffman, circa 1910, courtesy Oregon Health and Science University Archives

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The Push West

Thursday, September 25th, 2014
Appalachian Homesteads Had Few Comforts, 1933, courtesy TVA archives

Appalachian Homesteads Had Few Comforts, 1933, courtesy TVA archives

In April, 1750, “Colby Chew and his horse fell down the bank,” wrote Dr. Thomas Walker, an Appalachian explorer, in his journal. “I bled and gave him valatile [sic] drops and he soon recovered.”*

Pioneers going to the West encountered harsh conditions as they moved away from settlement and civilization  (see last few posts), but the western frontier itself was an ever changing border. It began in what we would now say was the East, and simply slid westward as the growing population overwhelmed their available land and resources.

Huge Trees Led to Extensive Lumbering in Appalachia, photo circa 1895, courtesy of Shelley Mastran Smith and foresthistory.org

Huge Trees Led to Extensive Lumbering in Appalachia, photo circa 1895, courtesy of Shelley Mastran Smith and foresthistory.org

As might be expected, medicine and medical care on these borders were crude and unenlightened, though not much more so than what was seen  in cities. Bleeding a patient after a physical injury, as Walker did, sounds counterproductive today but was a common response to almost any illness during Walker’s time.

As each new frontier settled a bit and doctors moved into regions like Appalachia, they brought a variety of experiences, philosophies, and training with them. Doctors were not required to have licenses or even to attend medical school, and they thrived or failed upon the public’s perception of their success. When patients lived through bleeding, dosing with calomel (a toxic compound of mercury chloride), narcotics, and other dangerous concoctions, doctors–rather than the patient’s robust constitution–received credit for the recovery.

* Quoted from Frontier Medicine by Ron McCallister.

Medicine Wagon Allowed Traveling Medical Care

Medicine Wagon Allowed Traveling Medical Care

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Territories Not Immune to Mental Illness

Sunday, September 21st, 2014
Arizona Bad Lands, circa 1905 to 1910, courtesy Library of Congress

Arizona Bad Lands, circa 1905 to 1910, courtesy Library of Congress

The vast expanses of the West usually meant adventure, opportunity, and fresh beginnings for the people who traveled there. However, the road West was rigorous, dangerous, and oftentimes dismal. Frontier travelers could not escape mental illness any more than their brethren in the East could, and authorities quickly understood that they needed to build Territorial insane asylums (The Push West). The Insane Asylum of Arizona was established in 1886 at a cost of $100,000–a tidy sum for such a sparsely populated region.

 

G. L. Rule Residence With Family, Arizona Territory, 1898

G. L. Rule Residence With Family, Arizona Territory, 1898

The asylum’s original capacity was 200 patients. When it opened in 1887, administrators immediately admitted the 61 patients from Arizona Territory (49 males and 12 females) who had been cared for in a Stockton, California institution because of Arizona’s lack of facilities. By 1900, the institution–now named Territorial Asylum for the Insane–held 175 patients. The asylum eventually became overcrowded, since it took in all the Territory’s (and later, state’s) feeble-minded and alcoholics as well as its insane. Because the Territory had so few public institutions for social care, the asylum at first also accepted the merely old or tubercular.

Like most asylums, Arizona’s tried to be as self-sufficient as possible. Set on 160 acres of land about three miles east of Phoenix, the grounds contained a vegetable garden and an area to grow grains. Patients who were able worked in the gardens and helped tend the orchard’s 2,000 trees.

Photo, Arizona Insane Asylum, courtesy Phoenix, Arizona Historical Images

Photo, Arizona Insane Asylum, courtesy Phoenix, Arizona Historical Images

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An Asylum in South Dakota

Thursday, September 18th, 2014
Scene From Yankton, SD, circa 1903

Scene From Yankton, SD, circa 1903

The Canton Asylum for Insane Indians was not the state’s first asylum; the Yankton Insane Asylum was established in 1879 during South Dakota’s territorial days. Interestingly, Canton had been considered as a site for that asylum, as well. The Territory had been served by the St. Peter State Hospital in Minnesota before that time, and by 1878, the facility housed 22 patients from Dakota.

Yankton Insane Asylum

Yankton Insane Asylum

The hospital became overcrowded, and Governor William A. Howard was advised that Dakota patients would have to be removed by October of that year. By scrambling for other resources and extending Minnesota’s contract for a few more months, the governor managed to keep the status quo until early 1879.

Frugality and speed were drivers in the effort to relocate Dakota Territory’s mentally ill. Governor Howard wanted to house patients in preexisting buildings within the Territory, but had no luck finding suitable accommodations in Canton, Vermillion, or Elk Point.

Mead Building Lobby, courtesy Christopher Payne via NPR

Mead Building Lobby, courtesy Christopher Payne via NPR

Yankton had two large wooden buildings which the governor secured and had rebuilt north of the city for under $2,500. He used his personal funds for the enterprise, for which he was reimbursed in 1880. The territorial legislature was similarly frugal and only appropriated enough money for the patients’ basic needs; real treatment of any kind was not available. In 1899, a fire killed seventeen female patients, and funds were finally appropriated for a more suitable building. By 1909, the institution’s Mead Building followed the norm in insane asylum architecture, and stood out as a beautiful structure.

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Going Insane in the West

Sunday, September 14th, 2014
Covered Wagons Pulled by Oxen, circa 1870 - 1880, courtesy Library of Congress

Covered Wagons Pulled by Oxen, circa 1870 – 1880, courtesy Library of Congress

People went West for many reasons, but most carried a dream of creating a better life for themselves in this new, undeveloped territory. Homesteading was advertised as attractively as possible, and though emigrants may have prepared for it physically by bringing as many supplies as they could carry, few were prepared psychologically for the intensity of the pioneer experience.

When they reached the vast stretches of the Great Plains after losing equipment, livestock, and perhaps even family members, it became harder to keep believing the propaganda about new railways, bustling towns, and bountiful harvests–because they were nowhere to be seen.

Pioneer life in 1882, courtesy Library of Congress

Pioneer life in 1882, courtesy Library of Congress

Loneliness and isolation soon took their toll. Women, especially, seemed to find the West filled with nothing but chores amid all the discomforts of a prairie (sod) home filled with insects, snakes, and ugliness. Men who did not realize their dreams of wealth or farming success could easily become depressed; unremitting stress could impact both genders. Hysteria, melancholia, or “nervous exhaustion,” as well as alcohol abuse and violence could destroy isolated prairie families, who seldom had anywhere to turn for help.

A Pioneer Home, 1880, courtesy Library of Congress

A Pioneer Home, 1880, courtesy Library of Congress

Women seemed to succumb to mental illness more than men, but that may only appear so because women wrote more about what they felt and experienced. Diaries from the trail tell a dismal story of death and privation. From Cecilia McMillen Adams’ 1852 diary:

June 25: Passed seven graves . . .

June 26: Passed eight graves . . .

June 29: Passed ten graves . . .

July 1: Passed eight graves . . .

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