When I was working on my new release, The Bargain, I had a rare chance to do research with my husband. (Not the way you’re thinking. LOL.) Like the hero in my story, my husband is a doctor, although in a different specialty. The history of medicine is a hobby of my husband’s, so he enjoyed sharing with me what it was like to be a doctor back in the 1800’s. I’d like to share with you what I discovered.
The first Medical College in America was founded at the University of Pennsylvania in 1765. American medicine in the mid-19th century was a far cry from today’s curriculum of 4 years of college, 4 years of medical school, and 3-6 years of residency training.
Most aspiring doctors would spend a few months in a medical school for 2 terms, often without having a college degree, then spend a year or two apprenticed to a practicing doctor where they would learn the practical aspects of patient care. Medical students were renowned for their raucous and drunken behavior. Most medical schools in America were privately owned and run by individual doctors.
Medical techniques were still rudimentary. No anesthesia, save for perhaps intoxicating the patient with liquor, was available at that time for surgery – even ether was not yet available. A surgeon was prized for his ability to perform operations quickly due to the pain, and a good surgeon could, for example, amputate a leg in about 2 minutes.
Antibiotics were still decades in the future, so post-op infections were the rule, with mortality rates for even simple operations running about 50%. Wounds were usually cauterized with boiling oil or hot pokers after surgery. The operating theaters in hospitals were often located in towers or in a separate building so that other patients could not hear the screams of the surgery patients. Surgeries of the abdomen or chest were uniformly fatal.
Medicine theory was still grounded in the passive, nature-based principles of Hippocrates, a Greek physician from 4th century BC, and Galen, the 2nd century AD Roman physician. Some herbs were available in 19th century America and some plants were used, such as the foxglove plant which provided digitalis for dropsy, or congestive heart failure, but the mechanism of action was unknown and doses were not precise.
Hospital wards were unsanitary to say the least – often 3-4 patients shared a bed, and one could often awaken to find oneself sleeping with the corpse of a bedfellow who had passed on during the night. Doctors had little knowledge of the germ theory, which was doubted and ridiculed by some doctors, so handwashing between patient visits, or even between the doctor doing an autopsy and examining his next patient, was rare. No wonder people would do most anything to avoid going into a hospital when they could.
With standard medicine in such a state, many people sought out herbalists or homeopaths who, even if their nostrums were ineffective, at least did little harm and let the patient heal by themselves if possible. This was preferable to the frequent bloodletting or provision of emetics and strong purgatives to make the patient vomit or have diarrhea which were among the “heroic medicine” treatments most doctors used at the time.
Of necessity, medical practice advanced during the Civil War, possibly due to the sheer number of patients. Attention began to be paid to basic hygiene as cause and effect perhaps became more readily apparent, and army physicians began to compare notes on epidemics and infection. Slowly, new methods of dealing with traumatic injuries were developed and patient care overall began to improve, although it was still primitive. Some believe that medicine advanced more during the Civil War than during any other four-year period in history.
My latest release, The Bargain, takes place in a Union field hospital in the closing days of the Civil War. It is the jumping off point for my Western series, Finding Home. Researching the medical practices of the time gave me a greater sense of admiration for the doctors of the Old West and what they went through to try to help others.
The Bargain is available in print & e book from www.whiskeycreekpress.com
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