Medicine in Clarke County, Georgia vs. Medicine in America

Matthew R. Fricker

The Antebellum period of history in the United States was of tremendous importance in helping the country develop into what it is today. This time period, spanning from approximately the end of the American Revolution until the start of the American Civil War, bore witness to many outstanding developments in most all aspects of society. It is especially interesting to examine the development of the medical profession and the many new medicinal products that emerged during this era of history. I personally find it to be absolutely amazing the ways in which this country has progressed over a period of shortly over 200 years to become one of the most advanced in the world as far as medicine and doctors are concerned. Thus for the purpose of this assignment I have chosen to look at some of the aspects of medical development during the antebellum period. To be a bit more specific, this paper will examine the role that doctors and medicine played in preventing diseases, improving surgical procedures, developing new forms of medicine, and working to improve the overall general quality of life for the people of the United States of America. This paper will also serve as a case study for one particular small southern town. In doing so I shall attempt to show how the town of Athens, Georgia kept up with the rest of the nation as far as medicine and doctors are concerned. Thus, this paper will not only examine the role and progress of medicine throughout the country but it will also discuss this issue as it relates to the city of Athens, Georgia. I shall attempt to show similarities and differences between ways that the country as a whole practiced medicine and the ways that people here in Athens did so. In order to begin to undertake such an involved study, it will first be necessary to examine the history of medicine in general throughout the United States of America during the Antebellum period.

What can be said of the medical profession in the United States throughout the Antebellum period? Well, one might first start by making a few broad generalizations. In general, medicine was not all that great during this period of American history. It seems to be the case that the earlier in the Antebellum period that it was the less likely you were to survive. Of course this idea is consistent with the notion that things improve with time. People who caught diseases such as small pox, yellow fever, typhoid, typhus, or dysentery were lucky to survive.1 Such diseases brought with them an extremely high death toll. Typhoid, typhus, and dysentery would not hit the American people until later in the 19th century but yellow fever and small pox had been significantly noticeable in the country for quite some time.2 Regardless of when they arrived the above mentioned diseases certainly took their toll on the American people. In Geoffrey Marks and William K. Beatty's book The Story of Medicine in America the authors inform us that when the United States Civil War was over the "deaths from disease were more than double the deaths in action and from wounds received in action."3 Right around this same time period diseases such as diphtheria and scarlet fever were ravaging the children of this nation. Neither of these two diseases ranked with any of the previously mentioned ones in terms of the numbers of deaths to which they were attributed.4 Since we have taken the time to describe some of the various diseases that left their mark on Antebellum America it seems necessary to mention that pneumonia and influenza both are known to have taken the lives of many people.5

We have thus far attempted to look briefly at the various types of diseases that were present throughout the given time period. The next part of this paper will examine the doctors that treated such diseases and several of the manners in which they went about trying to do so. The American Revolution left its mark on the quality of medical care throughout America. The end of the war brought a shortage of supplies to the new country. There were now fewer doctors because many of the people who had previously been in medical school were forced to go to the lines and fight. The diseases that were mentioned in the previous paragraph spread across the country, due in part to the filthy and polluted conditions that were resultant of years of war.6 Thus, because of the increase in disease that was present throughout the country there was an increase in the need for doctors. But exactly where would these doctors come from? How and by whom would they be trained? And, most importantly, would they be able to provide an adequate and effective system of treatment for the sick? We will now look at questions such as these to try to get a better feel for medicine during the antebellum years of America.

It can be said that the medical practices that were common to America during the 17th and 18th centuries were far different from the various kinds that would come to face the American people during the 19th century. During these earlier two centuries there were far fewer doctors and medical practitioners present within the country. When people became sick during these time periods they were most likely to simply take a dose of some sort of medicine, likely prescribed or recommended, and then simply wait to get better.7 Much of the reasoning behind this idea was that they thought that God would eventually make them better. I believe that some of the likely reasons for doing this include the fact that there were far less doctors throughout the country as well as the fact that medical technology was not yet very highly evolved. The next century would begin to see changes in this system of healing as people would begin to experiment with many new forms of treatments for sickness.

The years of Antebellum America were rampant with disease and sickness. With many more people becoming sick and many more dying as a result the country witnessed a tremendous growth in the medical profession from what it had seen in the previous years. This growth did not necessarily only constitute an increase in highly trained physicians, as we might expect in modern day America. In fact, this time period gave rise to many new forms of medicine. Much of the knowledge that trained doctors possessed had often proved ineffective early in the Antebellum period. Thus, because of the ineptitude of the current medical practices people began to look elsewhere for hopes of curing their sicknesses and ailments. We should not think that trained medical doctors disappeared at this time. The point to understand is that during the Antebellum years of American history there arose many new forms of medicine. While there were advances in the traditional fields of medicine there was also a general trend for people to lean towards other non-orthodox ways of seeking relief and comfort.8

It is important not to forget that trained medical doctors did play a large role in the practice of medicine during the Antebellum years. Those certain families that were particularly wealthy and successful often called on the services of such professionals.9 These people had received some formal educational training at any one of the country's medical colleges. Just because they had been to school to learn medicine did not necessitate that their methods were perfect and without their downsides. They definitely did not look at medicine in the same way that modern physicians tend to. In The Reshaping of Everyday Life John Larkin tells us that trained Antebellum physicians believed that when a person became sick it was because of a "morbidly over stimulated state of bodily excitement".10 Basically this means that these trained physicians felt that people became ill because they their bodies were too full of something. Thus they felt that the way by which a person could become better was by ridding their bodies of the excess solutions, whichever type in particular that they might be. There were four basic ways in which a physician might attempt to rid the body of some certain type of excess fluid. These ways included bleeding, blistering, puking, and purging. Bleeding involved pricking the skin thus causing some of the blood to drain from the body. Blistering was the art of applying a substance of high pH to the skin in an effort to produce a blister that would expel some of the bad fluids. Purging and puking were both very similar to each other. Purging required the ingestion of laxatives in order to evacuate harmful substances while puking simply demanded that a person take in materials that would induce them to vomit. Doctors who practiced this type of medicine were satisfied that the procedure had worked when they saw liquids such as blood, feces, or urine coming out of the body. Like most types of medicine that were practiced during the Antebellum period this system produced only very limited successful results. In fact, patients often became sicker because they were loosing many of the fluids that helped to keep the body's immune system up and running. While it may seem ironic, this system of healing is now what historians refer to as "orthodox medicine".11 These orthodox physicians were an important force in the fight for state licensing laws as well as the development of the American Medical Association.12 Orthodox doctors also were instrumental in the creation of medical schools across the country which in turn produced more trained doctors. In fact, in the later part of the Antebellum period medical schools were producing near to 18,000 doctors.13

Although orthodox doctors had been formally trained they were not necessarily the most effective medical practitioners in the land. There was another group of doctors who strongly opposed such heavy reliance on their methods. John Larkin has labeled those who challenge the orthodox views on medicine as "sectarian" doctors.14 Non-traditional forms of practicing medicine had always been around during the Antebellum years. Often times people could not afford the services of a professionally trained doctor and so thus they were forced to rely on alternative measures to improve their health. These methods could range from individuals going and picking roots themselves to make medicines to relying on the services of an alternative healer. This type of medical practice was more prevalent outside of the big city areas. Larkin's findings tell us that rural America was full of people who treated themselves and others with simple herbs that could grown in one's own garden. Slaves were yet another example of a group of people who preferred not to use professional doctors. This is most likely because the doctors who would have treated them would be white and thus slaves might find it difficult to trust them. Because of the accessibility and cost effectiveness of such alternative medical treatments the amount of people who claimed to be affiliated with the medical profession grew drastically during the Antebellum period of United States history. The amount of training that these people received varied from formal training at a medical university or academy to learning by apprenticeship to those who simply taught themselves. There were many different ways of practicing non-traditional medicine. While these methods were not necessarily better than any others they were effective at minimizing the possible harm that could come to the patients, a key factor that was often lacking in the orthodox practice of medicine.15

Sectarian medicine was practiced in many different forms and fashions. While it is not necessary to list and describe all of these practices I shall rather briefly attempt to explain several of the more popular ones. Thomsonianism was a botanical practice founded by Samuel Thompson that called for the use of cayenne pepper and lobelia. Along with taking in these herbs a person would subject themselves to intense steam in order to cause the body to sweat. Another form of alternative medicine was called hydrotherapy. This was a system by which people would take in lots of water internally as well as subject their bodies to lots of water externally. This particular form put forth the idea that strong personal hygiene was a key factor in helping to cure sickness.16 Homeopathy, which according to Richard Harrison Shryock's Medicine and Society in America: 1660-1860 was the major sect of sectarianism, said that the cause of most illnesses was an "internal psora".17 Homeopathy preached that diseases could be cured by dispensing a highly diluted solution of a drug to the sick person that would cause the same effects to come about in a healthy person. Shryock phrases this much more simply for us by saying that "like cures like".18 The solution of a drug that would make an otherwise healthy person display the symptoms of the sickness will in fact cure a person who already has that sickness. While this may seem like a crazy idea it was the most popular of the non-traditional forms of medicine.19 In fact, it is still practiced by some physicians to this day.

We have now examined the non-traditional and orthodox forms of medicine that were practiced in Antebellum America. While they may seem quite different they both had several similarities, most important of which was the fact that neither of them were extremely effective in curing or preventing sickness and disease.20 Everything that has been stated up to this point has been general information that is applicable to most of the United States during the Antebellum period. It is now time to change directions for a little bit and address one of the original intentions of this paper. The time has now come to examine the role of medicine as it pertains to the city of Athens, Georgia during the given time frame. I shall attempt to show how Athens and Clarke County, Georgia compare with the rest of the country with relation to the given topic. Basically it is now time to go from the general to the specific.

We have already learned that doctors were generally not that plentiful in rural areas throughout the country.21 The same should not be said for Athens. Ernest Hynds' Antebellum Athens and Clarke County, Georgia gives the names of the doctors that served the Clarke County area from the years of 1802 through 1860. These lists show the names of the various doctors who serviced the area during various time frames, most of which consist of approximately 10 years. By examining such lists we come to realize that Athens never appeared to be hurting for medical professionals during the given years.22 The first few decades of the 19th century saw fewer doctors servicing the city than did the next few decades of the Antebellum era. After 1831 the number of doctors present in the Clarke County area grew tremendously.23 In fact, on February 8, 1849 a notice was placed in the Southern Banner Herald that requested all doctors interested in establishing a Medical Society for Clarke and neighboring Oglethorpe and Greene counties to meet at the home of Dr. William Walker Durham, the son of a very famous Athens doctor who we will look at further down the road.24 The fact that there might be enough doctors to establish such a group gives strong indication of the heavy presence of medical professionals in the immediate area. Several years later, in 1854, the Athens Board of Health was organized, thus another indicator that there were a sufficient number of doctors in the city. Thus, from the information found in Hynds' book we have what I believe to be ample evidence to say that John Larkin's claim that doctors were rather sparse in rural areas does not fit in with the city of Athens, Georgia. Athens was not hurting for doctors during the Antebellum years.

Given the fact that the Athens-Clarke County did not appear to be understaffed during the American Antebellum time period it might be worthwhile to briefly examine the training that such professionals appear to have underwent. We have already learned from famed historian John Larkin that many of the individuals who practiced the so called Sectarian forms of medicine were often lacking in sufficient training. They usually had not studied at any sort of formal academy of medicine. In fact, many were self-taught.25 Any records of the doctors who served the Athens area during the Antebellum era fail to indicate any exact figures that would point to the number of non-orthodox practitioners present during this time period. We do however know that they were present. An article published in the Southern Banner in the year of 1845 stated that there would be "two lectures defensive of the Botanic or Thomsonian practice of medicine" delivered at the Town Hall by Dr. I. M. Comings, a professor at the Botanic Medical College of Georgia.26 Thus there must have been some degree of interest in the subject in Athens during this time. There is also evidence that many of the doctors in the area did receive formal medical training. By examining the records present in Hugh G. Rowe's History of Athens and Clarke County we can indeed see that many of the people practicing in Athens attended medical school. Some of the schools attended by physicians practicing in Athens during the Antebellum era include the Medical College of Augusta and Jefferson Medical College at Philadelphia, one of the nation's leading institutions in the matter.27 Therefore, it is safe to say that while the rest of the country was lacking in the amount of professionally trained medical professionals available Athens, Georgia indeed was not.

I have thus far attempted to explain the background of medicine in Antebellum America as well as a little about its practice in Clarke County. I have attempted to take the position that Athens was ahead of the rest of the country with regard to its medical professionals. This paper will now examine two specific examples of people who indeed prove this theory of mine to be true. The two individuals are Dr. Crawford Long and Dr. Lindsey Durham. Both of these individuals were exceptional doctors and both serve as good examples to the idea that Athens' medical professionals were indeed above average in their abilities when compared with the rest of the nation.

Perhaps the most famous doctor to ever practice in Athens, Georgia was a man by the name of Dr. Crawford W. Long. Dr. Long was born in nearby Danielsville, Georgia in 1815. He received his undergraduate degree from the University of Georgia in Athens when he was only nineteen years old. From there he went on to attend medical school at Transylvania University and the University of Pennsylvania.28 Afterwards he studied in New York for a year and a half, concentrating his studies in the field of surgery. In 1842 he moved to nearby Jackson County, Georgia. It was while he was practicing here that Dr. Long gained his fame. Jackson County was not very populated and shortly after arriving his practice grew by leaps and bounds. In 1842 he made a discovery that would permanently change the way that surgery was performed.29 It was during this year that Dr. Long made the important discovery that ether could be used as an effective means of anesthesia. He held a rag soaked in ether to a man's nose, causing the man to become unconscious. He was then able to remove two cysts without the man feeling any sense of pain.30 This permanently altered the way that surgery was to be performed. In 1851 Dr. Long moved to Athens where he would live out the remainder of his years.31 Prior to this discovery a good surgical doctor was one who could operate with great speed.32 This was because of the tremendous pain that an operation yielded to a patient. After Dr. Long proved that ether could be used to anaesthetize people surgeons could afford to take more time and thus perform better. Even though his discovery was made outside of Clarke County Dr. Long was important to the medical field of Athens. He moved to Athens shortly afterwards where he continued to practice medicine and operate a drugstore until his death in 1878.33 Dr. Crawford Long serves as yet another fine example of how doctors in Athens, Georgia were undoubtedly a cut above the rest.

Not only did Athens bare witness to incredible orthodox doctors but it also saw non-traditional medical practitioners achieve great success as well. Dr. Lindsey Durham was one such practitioner. Born in nearby Greene County in November of 1789 Dr. Durham attended the University of Pennsylvania Medical School. In addition to his traditional schooling he studied herbs and plants as forms of medicine at a botanical garden outside of Philadelphia.34 By the year 1820 Dr. Lindsey Durham had begun to acquire land in the Scull Shoals district of Clarke County.35 Having set up his home here he would soon be faced with the problem of obtaining supplies to cure the sick who surrounded him. He had previously worked with some of the Indians and had learned from their mistakes. Now it was time for Dr. Durham to apply his advanced medical knowledge in hope of coming up with better medicines. It was a combination of his traditional and botanical fields of medicine that enabled him to establish a practice that was able to handle upwards of six hundred people.36 He enjoyed great success while at Scull Shoals as he was able to help many sick people return to better health. Dr. Durham was closely involved when Dr. Crawford Long first performed an operation with ether as anesthesia.37 He was a devout Christian who always lent his help to those in need. Thus while many botanical doctors were practicing throughout the country with only limited success Dr. Lindsey Durham helped to improve the lives of hundreds and hundreds of people throughout the Clarke County area.

The Antebellum period of history in America saw a new nation rise up and begin to fend for itself. The medical profession began to take hold more actively during this era. While there were many different forms of medicine practiced throughout the country by many different people, from professionally trained doctors to local townspeople, there was, according to John Larkin, one thing that tied them all together and that was "a common inability to cure decisively."38 Across most of the country doctors were often ill- equipped to handle all of the sickness that was present. Different practices and medicines yielded different results.39 The city of Athens, Georgia makes for an interesting study as it pertains to antebellum medical practices. Athens was not like the rest of the country. It was full of many well-educated professionals, unlike other parts of the nation where uneducated self-proclaimed healers ran rampant. While the rest of the country was lagging behind in developing new and effective forms of medicine Athens was leading the way by pioneering new and efficient methods of handling disease and sickness. Dr. Lindsey Durham helped the community by establishing a place at Scull Shoals that was able to treat hundreds of patients, thus saving hundreds of lives throughout Clarke County.40 Dr. Crawford Long pioneered the use of ether as an anesthetic and thus revolutionized the way that surgery would be performed forever.41 Yes, after much research it is the personal opinion of this historian that while the rest of the country's medical abilities suffered during the Antebellum period Athens, Georgia served as an exception because it was a host to many brilliant doctors and their respective practices.

1. Jack Larkin, The Reshaping of Everyday Life (New York: Harper & Rowe, 1988), 85-91.

2. Geoffrey Marks and William K. Beatty, The Story of Medicine in America (New York: Charles Scribner's Sons, 1973), 246-248.

3. Marks and Beatty 246.

4. Marks and Beatty 249.

5. Marks and Beatty 251-253.

6. Barry Mehler, "Study Guide for Medicine in America"; available from www.ferris.edu/htmls/academics/syllabi/mehlerbarry/geninfo/study/ammedch2/ammed.htm; Internet; accessed 04 Nov. 2002.

7. Larkin 85-91.

8. Larkin 85-91.

9. Larkin 86-87.

10. Larkin 87.

11. Larkin 88-89.

12. Mehler

13. Mehler

14. Larkin 89.

15. Larkin 85-91.

16. Mehler.

17. Richard Harrison Shryock, Medicine and Society in America: 1660-1860 (New York: Cornell University Press, 1975), 144.

18. Shryock 144.