How Makeup Has Changed From 1800s Until Now
Nineteenth-century British depiction of a cholera outbreak. Credit: University of St. Andrews.
Before modern medicine, the agreement of disease and other bodily afflictions was based on ideas that were at least 2,000 years old but lacked any scientific basis. All people in the Western globe, and not merely medical personnel, assumed that affliction was acquired by an imbalance or disturbance within the body. A miasma (a foul odor in the air), or an evil spirit, or a contagious disease, or whatever number of exterior influences could bring on that imbalance. The cure lay in eliminating those elements called humors by removing the offending substance through some actual orifice -- the mouth, nose, rectum, or the skin -- using various drugs or by removing blood. Such were the major therapies that had prevailed in both orthodox medicine and folk practices for centuries. In that location was no agreement of germs invading the body or of mosquito vectors, or of fleas causing affliction.
During the colonial era, most American doctors were trained in Europe or had been apprenticed to those who had. They followed procedures that were universally acceptable and adequately moderate. Letting nature heal and the amelioration of symptoms had become hallmarks of the best trained. Most were educated men with elite condition who could convey a sense of authority and competence because of their social form. Yet, well-nigh people did not consult doctors, who charged high fees, relying mostly on habitation remedies, midwives, local folk healers, or in the instance of African Americans, the obeah or conjurer. Such healers charged less and offered remedies that mimicked the orthodox. But all admired and respected the physician in the years before the Revolution.
After independence the character of the physician changed. They lost their special social condition. Few went to Europe to report and thus they were cutting off from advances on the other side of the Atlantic. Fewer still came from the educated population. Standards of medical didactics in this country declined dramatically. Minimally-trained doctors opened their own medical schools every bit moneymaking ventures encouraged by a growing commercial and avaricious social climate. To entice students they eliminated most of the academic requirements that had been traditional. They seldom offered whatever laboratory experience or taught anatomy or even required literacy for admission. To compete, even the colleges with medical schools reduced their requirements.
The diploma mills were encouraged past a public that abhorred government regulation or any interference with the rights of the common man to practise as he wished. There were no licensing requirements for medical personnel or professional oversight. In the face of declining respectability, physicians, anxious to reestablish their credentials, began to use more than extreme depletion methods. Their model was Benjamin Rush, who as a leading medico at the turn of the century proposed using more extreme haemorrhage and purging. The poorly trained could point to the dramatic effects of their therapies as a form of success.
But not all people accustomed this "heroic" medicine. The result was a proliferation of competing health initiatives, a growth of medical sectarians such as homeopaths, hydropaths, new botanical theorists such equally Thomsonianism besides as fitness gurus such as Sylvester Graham and John Harvey Kellogg. The carbohydrate-coated pill advertised past a diverseness of entrepreneurs also competed freely. They had only to patent the shape of the bottles. There was no control over their ingredients. The medical scene in the nineteenth century was a chaotic gratis-for-all.
Every bit American doctors moved to bear witness themselves through their heroic therapies, European doctors were moving in the opposite direction by drawing on scientific methods. Laboratory studies had begun to extract the central ingredients of herbal remedies such every bit quinine from the cinchona bark that was one of the very few curative remedies available for malaria. In France doctors were using autopsies to evaluate detail therapies while investigating mortality rates for those same procedures. They concluded that the time-honored therapies did not work and could cause harm. The European studies were putting science to use to evaluate their traditions and institute them wanting. Thus Europeans drastically moderated their actions in the face up of disease.
Americans rejected both the science and the idea of moderation. Even the most forwards-looking physician in America, Oliver Wendell Holmes, Sr. (the begetter of the future Supreme Court justice), a proponent of make clean hands, ridiculed the thought that scientific discipline could have any applied value for the medical profession. In the absence of verifiable cures doctors who wanted to follow the European trends to allow nature heal were accused of "therapeutic nihilism" that could destroy them as a profession. Americans, the orthodox argued, were superior and did not take to follow the practices of their weaker European forebears.
When the idea of germs causing disease was first introduced in Europe in the 2nd half of the nineteenth century, peculiarly with the work of Pasteur and Koch, American doctors vigorously denied such a notion. Science did not apply to American medicine. Americans, they insisted, were an exceptional people.
The parochial, anti-scientific, and highly commercial atmosphere that prevailed in the nineteenth century was a major factor in retarding American medicine and contributing to the decline of the profession. As the social condition of doctors deteriorated, and so too did their political clout. They were not wanted on the local Boards of Health, or as city inspectors. Nor did the few aware of public health concerns accept whatever ability to change American attitudes to poverty and disease. The public envisioned poverty as the cause of disease and not disease the result of poverty and poor living weather. Political leaders believed that low morals predisposed people to bad health; thus the poor were responsible for their own sicknesses. In such a climate, picayune could be done to help the citizenry of the urban slums that lacked clean water or ways of disposing of waste products. The rich refused to spend money that might alleviate the awful living conditions and halt the spread of contagious diseases.
The few attempts to control educational standards or license medical personnel failed in the face up of general public opposition to laws that might restrict private liberty. The forces limiting government ability in the area of wellness, the proponents of American exceptionalism, and the rejection of the needs of the poor had won their day in nineteenth-century American medicine. Volition they practise so again?
Source: https://historynewsnetwork.org/article/149661
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