CColonial Period  1607 - 1783


Medical Practice in Colonial Times

    Medical practice in the early colonial American period was characterized by kitchen remedies and preacher - physicians.  As the colonial period progresses we will see a shift from the utilization of kitchen remedies and preacher physicians to the private practices of professional doctors and the building of general hospitals.  There are three different factors we can look at during the colonial period to see these shifts in medical practice.  These factors are the role of the preacher physician and it's transition into the modern medical practitioner, the smallpox epidemic, and the art of obstetrics (childbirth) and it's advances during the colonial period. .  
.  The first physicians in America were mostly preachers.  Preachers were called preacher physicians because of their double practice in medicine and religion.  Sickness was often related to sin or a test from God in early colonial times (Le Beau 3).   Preacher physicians being the most learned professionals in the field of religion resulted in the the belief that  the preachers knew the most about the sicknesses and their origin during the early colonial period.  Over nine percent of  preachers in early colonial America were physicians (Watson 96). This shows the great number of preachers who participated in medical practice. As a physician the preacher could be used as a tool for the conversion of many people into Christianity because illness were explained by religous reasons (Watson 96).  Preacher physicians were motivated to help out the sick for not only financial stability but the health of his congregation and townspeople.  Medical practices were supposedly advanced in England because they had medical graduates but Le Beau argues that colonial America was just as advanced because they were learning all of the same criteria(Le Beau 1). This shows that medicine wasn't advanced well in the 1600's and the early 1700's because a preacher in America without being trained in school had the same amount of knowledge as a medical graduate in England.  The reason that professional physicians didn't come to America because of the hardships of starting colonies and the limited opportunity for a professional practice in the crudely defined colonies of America (Deutsch 563).  The preacher physician and the lay physicians didn't have much conflict until the smallpox epidemic in 1721 hit Boston and the use of inoculation was questioned.  
    The smallpox epidemic had a great impact on Boston which proved to be the battleground for the argument of inoculation.  Inoculation is the use of a mild form of a virus or disease that is given to the patient to prevent the affects of the full blown virus.  There were two influential sides of this argument.  The one side was that of the preacher physicians, which was lead by Cotton Mather and Zabdiel Boylston.  Cotton Mather first argued that preachers should be the only physicians of the colony because they were the most learned professionals of the colony (Le Beau 3). This first argument doesn't involve inoculation, but the argument of the abilities of a preacher physician compared to the lay physician of the colonial period.  He also supported inoculation on the basis of "angelical conjunction" (Le Beau 3).  The bond between the roles of preacher and physician and their ability to perform inoculation was praised by Cotton Mather and his colleagues on the basis of their great knowledge and relationship with God.  Cotton Mather was a Harvard graduate who received his M.A. degree by the time he was 18, he lived a life dedicated to study and prayer (Britannica).    Three opposing views belonged to William Douglas, John Williams, and the Applebee Journal.  William Douglas opposed inoculation mostly because of his opposition to the preacher physician and his inability to practice medicine on the basis of religion (Le Beau 3).  John Williams opposed it because it didn't coincide with the law of physic (Le Beau 7).  Applebee's Journal stated in August 5, 1721 that they only have had bad luck with inoculation in Boston (Miller 479).  They also continued to criticize inoculation throughout it's experiments and trials.  Despite harsh opposition to inoculation it prevailed over it's opponents as stories of it's success spread throughout the country.  Zabdiel Boylston inoculated 247 people and only 6 of them died (Le Beau 4).  Dr. Charles Maitland and Dr. Thomas Nettleton were very successful in their experiments with inoculation, Dr. Nettleton performed 40 successful inoculations with no fatalities (Miller 479).  The battle of inoculation was won by the preacher physicians, and the "Society for Inoculating the Poor Grates" was formed with eight physicians to provide inoculations for the needy (Deutsch 574). This was formed because poor children were often the victims of smallpox because they couldn't afford inoculations.  Douglas even commented privately that inoculation was better to go through than to contract smallpox through nature (Le Beau 4).  Douglas's approval of inoculation only helped to confirm it's success.  The lower death rate in the inoculated also provides more evidence for proving the success of inoculation.  This is confirmed by Albert Deutsch who notes that, "the chief victims of this visitation [smallpox] were children of the poor, who could not afford the expense of inoculation (574).  However the battle between the preacher physician and the lay physicians was won by the lay physicians because they proved that preachers weren't the most learned physician (Le Beau 8).  The battle of inoculation and of the preacher physician allowed for a cure for smallpox and a new method for the prevention of epidemics, and allowed for the transition of the preacher physicians into the medical physicians of America today.  
    Medical advances can be shown in obstetrics (medical practice in childbirth).  Childbirth was left up to the midwifes in the colonies until the 1760's (Scholten 427).  The midwife had to rely on the help of their mother or another female women in the neighborhood for the assistance of childbirth.  Many women became talented in this field and enjoyed some medical recognition (Scholten 429).  There wasn't much success in childbirth though.  Many instances of babies and their mothers dying is reported throughout history.  For example, when there were complications during the pregnancy, the midwife would sometimes try to turn the child and deliver the baby, but if that didn't work the birth usually failed (Scholten 429).  Scholten describes a case in which Thomas Clap, president of Yale College, lost his wife in time of childbirth (Scholten 428) The complications of childbirth were somewhat solved in the introduction of forceps.  In "On the Importance of Obstretick Art:  Changing customs of Childbirth in America," we find in the beginning the first doctor in America with London training in midwifery, his name is William Shippen Jr.:  He used forceps to retrieve the child in the account of a delivery in the first part of this article (Scholten 429).  If a child was born feet first, it could be retrieved with forceps to complete the process.  Obstetricks moved from the responsibility of the midwife to the responsibility of the professional practitioners and physicians of the late 1700's.  We can see the first transition from midwife to physician when midwifes were required to take an oath in Massachusetts and New York in 1716 in order to deliver children legally (Scholten 428).  This was enforced to recognize the responsibilities of the midwives.  More doctors came to America in the late 1700's participated in midwifery as medicine advanced and the medical needs of our society grew.
    There was many advances in medicine during the colonial period of America.  The early part of the colonial period consisted of midwifes and preachers who provided comfort in time of sicknesses.  Explanations for sicknesses were provided by religion instead of science, and death rates were high from epidemics and childbirth.  As we grew into the late 1700's, we find many advances in medical practices.  The medical practices advanced as the need of our people increased, such as in the smallpox epidemic of 1721.  America's people moved from the practice of kitchen remedies and the comforting of the soul to the education of doctors and advances in vaccines and tools to increase the success rates of our medical practitioners. The truth of success in numbers helped to promote inoculation, the numbers in successful childbirths increased as well.  Medical practices advanced greatly during colonial America.    


Bibliography


Deutsch, Albert.  The Sick Poor in Colonial Times.   The American Historical Review  46 (Apr., 1941):  560-579.  

Le Beau, Bryan F.  The 'angelical conjunction' revisited:  Another Look at the Preacher-Physician in Colonial America.      Journal of American Culture 18 (Fall 95):  10.  

"Mather, Cotton."  Enyclopedia Britannica.  2001ed.

Miller, Genevieve.  Smallpox Inoculation in England and America:  A Reappraisal.  William and Mary Quarterly  13             (1956):  476-492.  

Scholten, Catherine M.  "On the Importance of Obstetrick Art."   William and Mary Quarterly 34 (Jul., 1997):  426-445.

Watson, Patricia Ann.  Book Reviews:  "The Angelical Conjunction:  The Preacher-Physicians of Colonial New England."                   Journal for the Scientific Study of Religion 32 (Mar 93):  96.

   
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