11/16/24, 8:31 PMHistory – Article – medicine in the antebellum period
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medicine in the antebellum
period
As the 19th century began, Americans had witnessed many revolutionary changes in their lives, but
medicine had not kept pace. Medical practices di!ered little from those of the 18th century. Citizens of
antebellum America were faced with a life filled with diseases and epidemics, poorly trained doctors,
unsafe cures, poor diet, and generally unsanitary living conditions.
Scientific medicine at the beginning of the century was heroic medicine. All diseases resulted from an
excess of fluids, and the cure was to relieve the body of the excesses through bloodletting and purging.
The basic scientific knowledge necessary to disprove such beliefs was slow to develop in America. The
generation of men like Franklin and Je!erson, who dominated the intellectual life of the country from
1750 to 1800 and promoted scientific research, was largely gone by 1800. Besides, the country had
little time and little use for such aristocrats as it was swept up in the Age of Common Man. As Alexis de
Tocqueville commented, the combination of democracy and economic opportunity in the Jacksonian
era placed an emphasis on profitable technology over basic science. As a consequence, medical
science based on empirical research su!ered too.
Contributing to the stagnation of scientific advances in the 19th century was the philosophical
movement that dominated American society: Romanticism. Romanticism came to America from
Europe between 1812 and 1861 as a revolt against the Age of Reason. Rather than rational empirical
thought, Romanticism emphasized feeling, sensitivity, and the supernatural. As this philosophy mixed
with Jacksonian democracy in the 1820s and 1830s, it developed many uniquely American traits, one
of them being religious evangelism.
By the mid-1800s, scientific medicine had taken a back seat to quackery. Scientific medicine was
11/16/24, 8:31 PMHistory – Article – medicine in the antebellum period
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hampered by poor training, the continued practice of heroic medicine despite patient protests, and
quarreling among the brightest physicians. Proprietary medical schools and their common practice of
grave-robbing to obtain dissection specimens did little to improve the public’s image of the medical
profession.
These factors combined in the 1820s and 1830s with a wave of Jacksonian democracy, producing an
egalitarian America with no use for aristocratic physicians. The public came to believe that anyone
could cure the ill if they applied the common-sense principles promoted by quack doctors. Physician
licensing, once commonplace, was abolished in most states in the 1840s, so anyone was free to
practice. Scientific medicine was rapidly replaced by quackery such as hydropathy, patent medicines,
phrenology, and mesmerism. When quackery became inextricably linked to the religious revivalism
and social reform movements sweeping the country at mid-century, it was unstoppable.
Since the scientific community was doing little to improve medicine, and the public was rebelling
against the painful and debilitating treatments of heroics, a void developed in medical treatment. With
no organizing body or set of standards for physicians to follow, few could agree to what constituted
appropriate practice. Lay health reformers and practitioners, filled with the millennial, democratic
spirit, rushed in with theories of their own. Their treatments included water, electricity, manipulation
of animal magnetism, and vegetable compounds. Many of the quack theories took on qualities of
social reform and religious revivalism to become movements of their own. Each practitioner claimed
to be from a specific “school” of medicine. The result was a wide selection of treatments for patients
from which to chose. Almost all doctors were “general” practitioners, with very few specializing in one
area, such as surgery.
Meanwhile, a new European movement began in Paris. French doctors who caught the spirit of their
country’s revolution did not feel confined by the writings of the “masters” and instead observed for
themselves how patients reacted to disease. Dubbed the French Clinical School, it emphasized both
clinical and pathological observations to determine treatments. Doctors collected statistical evidence
such as temperatures and pulse rates. Diagnostics were stressed over heroics. Some 700 of the best
American doctors traveled to France to study between 1820 and 1860. Yet despite the opposition of
those who returned from abroad, heroic medicine continued to be practiced, and eventually the
public developed a deep skepticism of doctors and an increased interest in quackery.
The United States produced some of the best surgeons, many of whom studied in France. The rigors of
life on the frontier also stimulated the advancement of surgical techniques, as doctors living there
o”en had no alternative to surgery, because they lacked drugs and access to the latest medical
11/16/24, 8:31 PMHistory – Article – medicine in the antebellum period
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advances. Surgery was the last resort because it was o”en fatal and always painful. Performed with no
regard for cleanliness, doctors wore filthy coats—o”en directly from the autopsy room to the
operating room—with pride. This practice spread deadly infections like septicemia or gangrene. The
only anesthetics were opium and alcohol. In the 1840s, chloroform, nitrous oxide, and ether began to
be used as social drugs by the upper classes, and were eventually applied to surgery. Anesthetics
removed the pain of surgery, allowing for longer, more complex and delicate operations.
Three doctors who emphasized diagnostics over heroics were especially influential. Dr. Daniel Drake
lived most his life on the frontier rather than on the East Coast, where medical training was centered.
Realizing that the frontier lacked adequate facilities to train doctors, he started the Medical College of
Ohio in Cincinnati in 1819. He is best known for his exhaustive study Systematic Treatise on the
Principal Diseases of the Interior Valley of North America. The work not only examined disease but
detailed geography, climate, and frontier society. Dr. William Beaumont used an unusual method to
study how the digestive system worked. An army doctor at Fort Mackinac, he encountered a patient
with a severe stomach wound that would not heal. Beaumont used the opening in the unfortunate
victim as a window into the gastrointestinal tract, and his 1833 work Experiments and Observations on
the Gastric Juice and Physiology of Digestion explained the chemical process of digestion. The work of
Dr. Samuel Gross to improve surgical techniques resulted in A System of Surgery; Pathological,
Diagnostic, Therapeutic, and Operative, used by Gross in his lectures at the Je!erson Medical College
in Philadelphia, and by many other medical schools.
This was also the era when women would start to gain a foothold in the medical profession. The
prevailing stereotype at the time defined women as sympathetic and nurturing, making them ideally
suited to care for children. Women had a long tradition as midwives and lay practioners, but they were
not considered suitable for professional medicine, given their irrational and delicate sensibilities.
During the 1840s, supporters of the training of female physicians received a boost from a controversy
surrounding midwives and childbirth. Male doctors were starting to claim that only they had the
medical training and the instruments (namely forceps) that could safely deliver a child. However,
many doctors were accused of interfering too much in the process of delivery, sometimes injuring the
mother or child (or both). Supporters of female medical training used the resultant backlash to argue
that it was immoral for men to be involved in gynecological and obstetric practice. As a result, several
schools started to allow women into their programs. In 1849, Elizabeth Blackwell graduated from
Geneva Medical College in New York to become the first woman anywhere to receive a medical degree.
Blackwell’s achievement spurred further advances for women in the medical field, such as the
establishment of women’s medical colleges. The first such institution was the Women’s Medical
College of Pennsylvania, which opened in Philadelphia in 1850.
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In 1847 the American Medical Association (AMA) was established by Nathan Davis Smith, and for the
first time a code of medical ethics and educational standards for physicians was published in an e!ort
to improve and standardize medical practice. The AMA also launched an investigation into quack
remedies in an e!ort to enlighten the public in regard to the nature and dangerous tendencies of such
remedies. Soon many medical schools were also involved in standardizing medical education, and
physicians were now engaged in clinical teaching and research in hospitals. New medical institutions
were emerging to provide a more scientific approach to medicine, and new instruments were being
developed to assist doctors in treating patients. The 19th century started out with a bleak outlook for
American medicine, yet by mid-century it had entered an age of improvement and reform.
Further Information
John Du!y, From Humors to Medical Science: A History of American Medicine, 2nd ed. (Urbana:
University of Illinois, 1994)
Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1983).
RECORD URL
https://chamberlainuniversity.idm.oclc.org/login?url=https%3a%2f%2fonline.infobase.com%2fAuth%2fIndex%3faid%3d239824%26itemid%3dWE52%26articleId%3d191606
Record Information
From: Expansion and Reform, Third Edition
Series: Encyclopedia of American History
By: Malcolm J. Rohrbough
Published: 2017 [Last updated: 2018]
Record Type: Encyclopedia Entry
Tags
Alternative medicine Gender studies Medical ethics Medical school Midwifery Pejoratives physician
Pseudoscience Quackery Women in medicine
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