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Mountain Medicine: Health Care in the 1800’s:

In the early 1800’s it was generally believed that illness and disease were caused by an accumulation of “poisons” in the body, and that if these poisons could be eliminated, the patient would recover their health.  There were three main therapeutic principles for treatment of disease: bleeding by opening a vein or use of leaches, purging the gastrointestinal system with laxatives, emetics (agents which cause vomiting) and enemas; and sweating or blistering.  Gastric and intestinal disorders were an everyday occurrence in these times because of poor sanitation, and poor food handling practices.

People who lived in the 18th and early 19th Centuries were largely helpless in the matter of health.  They lived in constant dread of sudden death from disease, plague, epidemic, pneumonia, or accident.  Their letters always began and usually ended with assurances of the good health of the letter writer, a query about the health of the recipient and a wish for continuing good health.  Most doctors during this period learned their trade through the apprentice system in which young men of about 15 years of age lived and trained with established physicians. The arrangement would last for anywhere from two to six years.  A few students might continue on to a formal education in a medical school for another two to four years. However, most physicians at the beginning of 1800’s opened their practices without the benefits of any degree or advanced training.

State licensing of physicians was required only sporadically during the 1800’s, and medical practices were never inspected.  Quacks and charlatans practiced virtually unchecked.  Additionally it was difficult to determine what was a quack treatment from what was useful, because even legitimate treatments of the time were often based on ignorant notions and hunches to begin with, and frequently did more harm than good.  An example of this is the “inoculations” that were practiced at Fort Union during the Small Pox epidemic of 1837, based on the best practices of the time and detailed in The Modern Practice of Physic, the standard guide for treatment of disease at the time.  Distrust of physicians ran high during these times, and often those afflicted with illness would attempt their own treatments through folk medicine or Indian Medicine before resorting to “professional care.” Thomas Jefferson wrote “I believe we may safely affirm that the inexperienced and presumptuous band of medical tyros [tyrants] let loose upon the world, destroys more of human life in one year, than all the Robinhoods, Cartouches, and Macbeaths do in a century.”  The Mountain Men may have had more successful recoveries from some illnesses, precisely because they lacked access to "professional" medical care.

A glossary of medical terms, medicines, practices and diseases can be found here.  

The faintest glimmers of modern medical practice and science were beginning in the early 1800’s.  By 1800 it was generally known that exposure to the puss from cow-pox would prevent small pox and Thomas Jefferson, his family and Meriwether Lewis were inoculated.  However, the men of the Lewis & Clark expedition were not protected by vaccination against this disease.  In 1832, the U.S. Government would send two doctors to vaccinate all of the Indians along the Missouri River.  Perhaps as many as half of the Indians the two doctors met accepted vaccinations, and maybe several thousand total were vaccinated during the course of the season. Many Indians, however, refused the vaccinations, being distrustful of medicines administered without any evidence of a disease.  

The Mountain Men would likely have experienced all manner of wounds and lacerations, from mishaps with tomahawks and knives, to gunshot and arrow wounds. Gastric and intestinal disorders would have been a common occurrence due to poor food handling, and the propensity to eat whatever was available during lean times, no matter how "ripe".  Venereal diseases were passed between the mountain men and the Indian tribes with which they associated.  These included syphilis, gonorrhea and possibly chlamydia.  Outbreaks of Malaria and Yellow Fever would have impacted the Mountain Men.  They would also have been susceptible to Small Pox (Follow this link for more information on the 1837 Small Pox epidemic), though without the quite the devastation wreaked by this disease on populations of native peoples.  (William S Williams was said to have been heavily scarred by Small Pox)  Cholera, which periodically swept up the Missouri River was a disease deadly to all and could be fatal within two hours of the onset of symptoms (Follow this link for a description of the 1832-33 Cholera epidemic).  

Hypothermia may have been a common affliction because of the requirement to wade waist deep in freezing streams to set traps.  Winter travel always came with the risk of frostbite.  Temperatures as low as -44 degrees Fahrenheit were recorded on the plains by Lewis & Clark in the winter of 1803-1804.  Professional medical attention for injuries or illness was only available in the wilderness at extremely rare intervals.  When illness or injury struck, most trappers were reliant on folk medicine known to themselves or their companions, or Indian remedies.

An extensive inventory of medicines and medical supplies taken along on the Lewis and Clark expedition is available.  This being a military expedition, the officers were responsible for the health of their men and so considerable thought and effort was given to health care and medicines.  A doctor did not accompany the expedition, although Lewis did receive brief training from Dr Benjamin Rush in Philadelphia prior to departing.  In practice, Clark more often acted as the physician, especially in treating ailments of the Indians, perhaps because he had a more soothing manner. Treating Indian ailments aided in the success of the return trip to St. Louis.  At this time most of the Corps. trade goods were depleted, however, Clark was able to trade medical services for food, and horses at critical times on the return trip. Many of the medicines listed below are described in the medical glossary.  

Medical Supplies and Medicines Taken By Lewis and Clark

15 lbs Peruvian Bark

2 oz Gum Camphor

2 lbs Saltpeter

½ lbs Jalap

1 lbs Assafoetida

2 lbs Ferrous Sulfate

½ lbs Rhubarb

½ lbs Opium

6 oz Lead Acetate

4 oz Ipecac

¼ lbs Tragacanth

1 oz Tartar Emetic

2 lbs Cream of Tartar

6 lbs Glauber Salts

4 oz White Vitriol

Calamine (Calomel)

Pocket Instruments

½ lbs Root Columbo

Epispastric

Dental Instruments

¼ lbs Sulfuric Acid

Mercury Ointment

1 Clyster Syringe

¼ lbs Wintergreen

Emplast

4 Penis Syringes

¼ lbs Copaiboe

2 oz Magnesia

1 Tourniquet

¼ lbs Benzoin

2 oz Gum Elastic

3 Lancets

2 oz Nutmeg

2 oz Cloves

2 oz Patent Lint

5 oz Cinnamon

2 lbs Basilicum Oinment

50 dzn Rush’s Pills (aka Thunderbolts)

4 oz Laudanum

Medical theory and practice in the early 1800’s was no more effective than Indian medicine, and with the use of medicines that are today consisdered poisonous substances, was perhaps far more destructive of human life and health.

To learn more about health care and medicine in the 1800’s see the following references:

The Writer’s Guide to Everyday Life in the 1800’s, by Marc McCutcheon, published by Writer’s Digest Books, 1993.  The health, medicine and hygiene chapter gives a brief description of common maladies, and diseases of the 1800’s as well as typical treatments, and the philosophy behind the treatments of the day.

Lewis & Clark: Doctors in the Wilderness, by Bruce C. Patton, published by Fulcrum Publishing, Golden Colorado, 2001.  An excellent description of disease theory, medical practice, and an analysis of the various illnesses and maladies, and remedies, as described in the journals of Lewis & Clark.

American Indian Medicine, by Virgil J Vogel, published by University of Oklahoma Press, 1970.  A complete description of Indian disease theory, remedies, and the effect of Indian medicinal practices on white civilization.

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