Page 37 - 2015_Cabin Days curriculum booklet

(Indiana Journal 5 November 1836)

Although early nineteenth century doctors tried desperately to combat illness without the benefit
of antibiotics, anesthesia, or proper equipment, they inadvertently contributed to the settler's ill
health. Not only were early doctors unaware of germs and contagion, but they failed to associate
unsanitary conditions with disease. Practitioners classified disease on the basis of similarity of
symptoms and employed the same treatment for illnesses showing like manifestations. Harsh or
"heroic" treatments, such as powerful drugs and bloodletting that altered their symptoms of the
patient, were hailed as effective cures by the scientific or medical school trained doctors (known
as the "orthodox" or allopathic physicians). Working without the benefit of the germ theory
(formulated in 1865) and forced to perform operations on conscious patients, the Indiana
practitioner of the Jacksonian era was limited in the treatment of various illnesses, surgery, and
obstetrics.

The general practice of medicine or "physick" in 1836 was based upon humoral pathology,
formulated in Greece in the 4th century B.C. by Hippocrates; he maintained that the human body
contained four humors: blood, phlegm, yellow bile, and black bile. Diseases occurred when one
of these fluids was in excess, or "out of balance." As the body temperature increased, the ill
humor separated from the others so the body could eliminate it. Physicians helped the patient
either by raising the body temperature with drugs to help "cook the ill humor" or by assisting to
expel it through bloodletting, purges or laxatives, emetics or pukes, and sudorifics or perspirants.
The body was then rebuilt through the use of tonics.

Bloodletting was probably the most common therapy of the early nineteenth century, two types
of which were employed: general, known as venesection or phlebotomy; and localized. Some
people believed that the patient should be bled until unconscious or "syncope." By using a lancet,
ten to twelve ounces of blood were drawn at one time, and the process was often repeated for an
average of fourteen ounces of blood for ten consecutive days. The practice of venesection
(cutting open a vein) was popular with

Indiana doctors, such as Dr. Lawrence Johnson of Rossville who performed 43 venesections
between June 1837 and February 1838, as well as with eminent physicians like Drake and John
Eberle. For local affectations, such as stomachache or headache, other modes of bloodletting
were employed: the application of leeches to the affected part; or scarification, which entailed
the use of a scarificator (a small brass box approximately two inches square which held small
knives and which when released by a trigger, produced a series of lacerations on the skin) and
small cupping glasses.

Once the patient was bled, the doctor proceeded to expel the system's remaining ill humors by
the use of cathartics, emetics, diuretics, and sudorifics. Cathartics or purgatives, powerful
laxatives used to cleanse the bowels, were given with great frequency. Probably the most used,
and most abused, was chloride of mercury or calomel. Other cathartics used were jalap,
gamboge, senna, manna, salts, rhubarb, castor oil, cream of tartar, and aloes. Emetics were used
to cleanse the stomach or cause vomiting. The most commonly used medicines were
ipecacuanha, tartar emetic, antimonial wine, and lobelia. Diuretics such as balsam copaiva were
used to promote the discharge of urine, and sudorifics or diaphoretics such as tartar emetic,
nitrous powders, antimonial wine, and spirits of nitre were used to promote a free and copious
perspiration (John Gunn, Domestic Medicine, 1835, pp. 610-629).

Medicine of Jacksonian America Page 3 of 8