Health Care: Old-West Style by Susan Marlow

With the national health-care debate on most everybody’s minds these days, I thought it would be enlightening to explore the options for health care in the Old West of the 1800s.

Technology exploded during the Gilded Age—the steam engine, electricity, the telegraph—marvels to behold! One would think medicine and health care would be right on track. Unfortunately, this was not the case. “Knife and pain” were two words always associated in the surgery-bound patient’s mind. Blood-letting (as much as a pint a day!) was still the “sure” technique to cure most illnesses—even into the late 1870s.

The brave folks who headed West discovered a new ailment: malaria, also know as the ague, which struck its victims with fever and chills. Very few escaped this disease. It was so common to Western life that it was considered normal: “He ain’t sick. He’s only got the ague” was an oft-heard remark.

Doctors were few and far between, if you could call them doctors at all (more about that later). Doctors could make two – three times as much money in the cities than in the country, so why would they hang around out West? The only treatment folks usually received was “He purged me, he bled me, he poked me. He never cured me.” So whiskey often served as a quick and effective pain-killer—it made the patient dead drunk.

Maybe you’ve complained about the high insurance and medical costs these days. Who hasn’t? Let’s take a look at what people paid for their health care in the late 1800s. Perhaps you’ll wish you were living back in the Old West.

Then again . . . anything you paid back then for services was too much, considering the actual, legitimate care you received in return:

Office call: 50 cents

House call (per mile): 50 cents (this could get expensive if you lived on a remote ranch 20 miles out of town). Some doctors would charge less if you fed his horse.

Labor and Delivery: $4.00

Fractures: $2.00 – $10.00

When you think that the average working-class family earned about $10.00 a week, it’s plain to see that most folks could hardly afford private medical attention. However, all things considered (the blood-letting, purging, sweating, etc.), this may not have been a disadvantage, and they probably lived longer.

Because guess what? The average patient had no clue if the new doctor (who had just hung up his shingle on the main street of Dodge City) was legitimate or not. The lack of education and proper licensing exposed the sick to all kinds of quacks posing as physicians. The medical field in those days did not attract the sons of the elite (they’d rather be lawyers), but instead attracted folks who saw a chance to get rich quickly. Most medical schools (and I use the term generously) were really diploma mills that required students to take only two, 4 – 6 month courses (the second course being a repeat of the first course). Even Harvard Medical School, which did have higher standards, rejected the idea of requiring a written examination for their graduates in 1869!

The diagnosis of the patient was based on guesswork (whether the doctor was educated or not), and the cure was totally unreliable. Sometimes the patient recovered; more often he did not. Especially if any kind of surgery was involved. During this “kitchen-table surgery,” the rural doctor was generally indifferent to any kind of cleanliness. Some of his instruments were not even rust-free (are you shuddering yet?). The doctor kept the sutures strung through his lapels or between his teeth for a handy reach. I guess the phrase, “What doesn’t kill you only makes you stronger” took on an all-too-serious meaning in the Old West.


The next time you visit a friend in the hospital, take a look around and send a prayer upwards that this place actually helps people get well rather than sends them quicker to the afterlife. Truly, the hospitals of the 19th century were the last resort for the poor. No person with any money at all would enter the doors of such a place, preferring rather to stay in their own, relatively clean and safe beds at home. I will mention that the Mayo Clinic was an exception to the general rule, but a private room in 1880 was $3.00 – $5.00 a day. Besides, the Mayo Clinic was a far cry from the Old West. Even so, most people knew that a hospital was a place to avoid, especially if one valued his or her health!

When you look at the news and wonder what our American health-care system is coming to, take a little trip down memory lane and try to imagine your health-care options of the late 1800s. Hollywood has glamorized most aspects of the Old West, but the truth is: The Good Old Days . . . They Were Terrible!


In honor of the release of my new Circle C Adventure Book 6, Andrea Carter and the Price of Truth, I’m offering an autographed copy. You can read the first chapter at

To enter the contest, just leave a comment about some aspect of health care—modern or old-time. Perhaps you have a health-care story from grandparents or great-grandparents.       Share and win!

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28 thoughts on “Health Care: Old-West Style by Susan Marlow”

  1. My paternal grandfather was a GP in the late 1800’s-early 1900’s. He died in 1927 from gangrene a complication of diabetes. He was 60 yo. They didn’t have insulin. His first wife died in childbirth. He went on to marry my grandmother and they had 3 sons. The middle son died at the age of 27 from spinal cancer. When my dad was 17, he was driving with his elbow resting on the car door/window edge, he was sideswiped. He was taken to the hospital where they reattached just over 3/4 of his arm. They thought he would eventually lose his arm because they didn’t have antibiotics. He was lucky. He did not develop an infection.

    My mom had a c-section in 1947. They kept her on 3 days of bed rest. She developed a blood clot and almost died. Now they get you out a bed the next day. They also used to keep you in the hospital after giving birth at least 3 days. Now you can go home the next day. Today, day surgeries are very common for hernias etc.

    My MIL said they tied her to the bed rails when she gave birth to my husband in 1952.

  2. My dad was born at home in 1938. Never received a birth certificate. It was the hardest thing for my mom some 40+ years later to get a live birth certificate for home. Lots of red tape.

  3. i agree that healthcare was very scary back then….though it’s not completely wonderful now…if you look at our overall health it’s much worse….the rates of disease and obesity have skyrocketed because we think we can use drugs to cover up all of our symptoms instead of actually eating real food and moving our bodies (other than from the fridge to the couch)
    the US has one of the highest rates of infant mortality despite all of our “expertise”

    working in the medical field in a hospital i can tell you…just cause a dr made it though medical school does not make him a good dr
    you can have 5 different dr’s give you 5 different diagnoses/treatments for the same patient
    and i think sometimes the treatment is worse than what ails you

    as far as skyrocketing medical costs…well…look at how unhealthy we are…if we all just took better care of ourselves we’d be happier and richer 🙂

    thanks for sharing the excerpt from the book
    i LOVE that you write books for the whole family! what a great series!! i’m going to have to start collecting so when my girls can read i have the whole set 🙂
    looks like all the reviewers on amazon agree you are pretty darned talented!

  4. My grandmother was a nurse who went through the mountains on a wagon with the doctor in the hollers of Southwestern Virginia.

    It’s a miracle anyone survived over the years, isnt’ it?

    Peace, Julie

  5. It is incredible that we are even here today. Thank goodness for all of the medicine women who knew and understood how to use natural medicine and the neighbor wives who assisted in birthing.

    I have always wondered how to pronounce “ague?”

  6. I don’t think our bodies were meant to take drugs. I was diagnosed with diabetes almost two years ago. I took my pills and my sugar was always in the 70s. I walked like I was drunk!! I ran into doors, walls and was always dizzy. I could hardly wait for night so I could go to bed. Two months ago the doctor gave me pills that were not so strong. My sugar now stays around 110 and I have not hit a door or wall since. I will always have to take this but I don’t believe drugs are good for us.

  7. Hats off to the doctors and nurses of today and yesteryear. Great post. I know one thing for certain, I’m glad I live under today’s medical conditions. Even today, 40 years later, I vividly remember being in labor with both of my daughters with the “grin and bear it” philosophy of labor and delivery. Never knew where the “grin” part came into the picture, except of course when I saw my newborn babies! My daughters were much more lucky with today’s technology. I recall a nurse remarking that the mommy to be didn’t get kudos added to the birth certificate for not having an epidural and you don’t get a discount for going without one. LOL Susan, thanks for stopping by the Junction. Enjoyed your post.

  8. Good morning, Susan.

    Great post—fun and very informative. My mother worked in a hospital up in Northern California in the 1940s. As little girls, she used to tell us all kinds of strange stories. We were spellbound. One I can remember was when a surgeon frightened her with a gang green arm they had amputated. Can you imagine?
    No question, going into the hospital then or now, is scary, and a place to avoid by straying as healthy as we can on our own.

    Thanks for the great post. Your book s looks amazing!!

  9. Hey Susan, interesting post.

    As a Canadian citizen, free health care is a privilege I’ve enjoyed my whole life. It doesn’t matter if I need to see a doctor because I can’t shake a virus or if I’m high-risk when pregnant, it’s always the same… you go see a doctor, he either prescribes meds, sends you out for more tests, recommends you see a specialist, or tells you you’re imagining it. Then, you take the next step. Money isn’t mentioned because money has no place in proper medical treatment. Or at least, it shouldn’t.

    When my hubby was diagnosed with cancer, the oncologist offered 3 or 4 methods of treatment from radiation, chemotherapy, beads or balls (or something), or surgery. Together, hubby and his doctor chose surgery as the first course because it was the best chance to eradicate the disease. Period. The treatment worked and hubby has been cancer-free for over 2 years. We didn’t receive a single bill for either the doctor’s appointments, his surgery skills, the hospital use, anesthesia, etc.

    Same for my pregancies and all 4 of my preemie babies who needed neo-natal care in NICU’s. My babies were taken care of under superior skilled medical staff with modern equipment for as long as it took for them to grow until they weighed enough to come home. No bills. No fuss. The only worries were their health and growth.

    IMHO, that’s the way it should work regardless of your financial status. I really don’t understand how the rest of the world manages to survive otherwise.

  10. I enjoyed your post today. Doctors and nurses who devote their lives to the public should be honored. They should be revered and not be looked upon as state employees and criticized. they work long and hard hours and deserve recognition.

  11. Susan, welcome back to P&P. We sure love having you come. I think it’s neat that you write children’s books, not only that but they’re historicals. Wow! Don’t see that a lot.

    I would’ve hated to depend on health care back in the old West. I’m sure there were a few good doctors but they were few and far between. So many settlers learned how to treat the sick. They had to or they’d have been up a creek without a paddle.

    Your new book looks very interesting. Good luck with it.

  12. Reading all these posts is giving me the shudders! All stories are scary yet fascinating. I know back in the 50s new moms were kept in the hospital for up to two weeks. (I think my daughter, who just delivered #7–yes, that’s not a typo–probably wishes that rule still applies.)

    What I noticed with this last baby is that now that our little community hospital has been “bought out” by the big guys, a whole bunch of new rules have gone into effect. For the other 6 kids, the hospital was more like a relaxed “home birth” place–natural and supportive. But this time, she had to get dr. permission not to have the new IV, etc. that they’re starting to make the delivering moms have. Plus fetal monitoring for “X” minutes every hour, plus scanning her wrist band if she wants a Tylenol . . . and so forth.
    Kristel’s words: “I’m glad this is the last baby.”

    I’ve SO enjoyed reading the posts!

  13. Medicine can save lives, it can cause death. We must be our own advocates and insist on the care needed or wanted.

  14. Lots of stories but most of them not good. My granfather died at 45 because he had appendicitis – they kept him in bed until he developed pneumonia. My grandmother had some experimental radiation treatments that eventually led to leukemia but she lived to be 83 which was amazing. I almost died from gall stones because it took them 3 months to diagnose me. I can go on but the good news is medicine is constantly improving and has saved many lives. Who knows what the future will bring. Looking back they will think it’s as bad as we do when we look back lol.

  15. I never realized malaria was a problem in the US West. I can see it arising in the southern part of the Gulf states, but wouldn’t expect it further north. Wonder why there isn’t a problem today? It is never mentioned when they talk of mosquito problems.

    Even today, you can’t be sure of you doctor. Too many of them are pill pushers. If you start talking about your symptoms, they are likely to medicate without doing tests or working on other options. My husband had outpatient surgery and they sent him home with 60 heavy duty pain pills. He took a couple of tylenol and was fine. They wouldn’t listen when he said he didn’t like that type of medicine and probably wouldn’t need it. This state has the highest per capita level of prescription drug use. I think the average for the state is something like 14 per person. That is a frightening number when you consider those who aren’t on any meds or only take one or two. It doesn’t help that so many people feel they must have a pill to fix their problem. Shame on the doctors for giving in.

    Our son who was born about 150 years too late, has little faith in doctors. He is someone who gets hurt more than he should and we have spent too many hours in emergency rooms. Hw cut his finger off working on a car and sat in the ER for over 5 hours before the doctor popped in to say we could wait for the next doctor after shift change. They did nothing for him the whole time. There have been other times when he has needed stitches when the doctor has said “With this type of injury, you should use this type of stitch, but I am going to use this other easier one.” (there was a med student with him. Excuse me?! He has gotten so he stitches himself up and frankly he does a better job than they usually do.

    I agree with Anita. Health not money should be the primary concern when you are ill. It really is criminal that a country with our resources does not have universal health care like Canada. It has become a major money making endeavor for too many segments of the industry. The drug companies sell the same drugs in Canada and other countries for much less than they charge patients here. Much of my family lives on the border and it is amazing how many people drive across to have their prescriptions filled or do it by mail. They can save quite a bit. Hospitals charge people with insurance one fee for a procedure while those without insurance who must pay on their own are charged sometimes 4 or 5 times more. In our own family our insurance company was charged about $300 while our relative with no insurance was charged about $1200 for the same procedure.

    No one in this country should be unable to get medical care or go bankrupt to pay for it. Why should so many people have to rely on free clinics that are understaffed, over burdened, and don’t have the resources they need. For those who say they don’t want government run health care, what do they think the VA hospitals, Medicare and Medicaid are? Their overhead is much lower than most insurance companies. No system is perfect, but ours just isn’t working.

    Sorry for the rant. It is sore point. We are lucky enough to have excellent insurance, but we live in an area that runs clinics once or twice a year. Volunteer medical professionals run them and see several thousand people over the weekend. It is almost like a third world country when you look at what they treat and the lack of access to health care these people have.

    Thanks for a great post. I ordered your Circle C books for our children’s section when I worked at the library. A good series for the kids.

  16. My mother was born at home, luckily the doctor reported it so she could get a birth certificate. She was one of 10 kids and they were all born at home. Three died when they were babies. I didn’t realize what a hassle it was over a birth certificate until we had to get one on my stepfather. I think he was born at home too and the state has no record of his birth. When I took him to Social Security to sign up we had to go to his old school district to get records to prove his age. Boy was that a hassle.

  17. I don’t think some things have changed all that much as far as Doctors way back when “guessed” a lot on their diagonoses…sometimes I think modern Doctors guess too.

  18. Thank you for sharing such interesting facts… I had a doctor that never even took the time to find out exactly what I had, just listened to me explain my problem and then handed me two prescriptions… said if it helped he could give me a prescription for the rest of the year… 🙁

  19. Being a trained surgical tech the medical field intriques me. I went to a Civil War museum once and spent the majority of my time looking at the Doctor’s Medical kit. It was amazing. A museum that most people went through in a half hour I spent over two hours in. I stood looking at the medical kit and imagined how everything was used. My family always makes me steer clear of the medical items in museums now.

    Cindy W.

  20. My Dad was born at home in 1904. He never had a birth certificate
    His mother died in childbirth in 1916. Her appendix ruptured.

  21. I love all these medical stories! Looks like we really opened up today about health care. I knew we’d see a lot of interesting comments when anything medical is brought out.
    Very much enjoying the conversation!

    And Patricia, I too was surprised to learn about the mosquito/malaria problem in the West back then also. I know it was a problem in CA. Did you know that once upon a time, the Valley held the largest freshwater lake west of the Mississippi River? Sounds hard to believe, since CA suffers water woes. But I can imagine a gazillion mosquitoes hanging around that big, old Tulare Lake.
    Here’s the site to learn about that real lake, if anybody is interested (OK, chasing a rabbit here, since it has nothing to do with health care aside from the fact that somebody brought up the malaria issue). LOL

  22. Both my parents were both born at home, my Dad
    was a preemie, who was kept warm enough by being wrapped in blankets & placed on an open oven door.(Was 1910) To get a fairly good idea of his weight, the next time the produce wagon came by, they used the dealer’s scale to weigh him. I, too, was born at home. My aunt, who was a practical nurse, delivered me just before the doctor arrived at the house. The only home visit that I can remember was when my youngest sister was bitten on the neck by a dog. I got to watch Dr. Pratt suture the bite closed.

    Pat Cochran

  23. Great article, Susan. It gives me the creeps to think what those poor people had to endure in the “Not-so-Good-Old-Days.” By the way, I didn’t realize that ague was actually malaria.

    Even with the new restrictions, annoying as they are, we can be thankful medicine has come a long way. . .

    Colleen L. Reece

  24. thank goodness for pain pills if needed I say; taken properly and proper amounts they are very helpful but taken improperly they can become an enemy to someone.

    I agree with Anita as I live in Canada also. I had breast cancer last year and went out of province for 2 surgeries at 2 different times and went to the Cancer clinic in the same province I live in for 5 weeks of treatment; the only cost being where I stayed for meals/lodging and the gas costs. No price on medical treatment.

  25. Great blog Susan. Your research is amazing.

    Abound 1900 my grandmother had “milk leg” after childbirth.(That’s thromboflebitis–quite dangerous) She stayed in bed, but scrubbed the laundry in a tub beside the bed.

    Deliver us from the Good Old Days.

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