American Medicine Progress

Expanding colonization came with an abundance of challenges in the many facets of a growing society: economics, culture, commerce, and a new democracy. Not one of these aspects could survive without the nation’s good health. The advancement of medical practice was vital to a young nation that was afflicted by new diseases, sanitation issues, poor medical facilities, and untrained/under-trained medical professionals. The 1830s marked a changing point for medicine and for health-care professionals. To begin with, citizens were unaware of the health danger of streets filled with garbage and human waste. Once the effects of sanitation issues to the public’s health were addressed, changes were implemented. Likewise, advancements in medicine, through dedicated research and education, made it possible for physicians to treat the sick more with medicines like antibiotics and less with concocted theory. A third, and possibly the most humane, step forward was in the delivery of a human life. Present-day obstetrics welcomes dramatic advances in tools, in procedures, and in antiseptic technique.

There have been great advances in the treatment of sanitation. It is unthinkable to have human waste piling up in the streets, but that is how it was disposed of. There was no consideration to the spore that was generated from bacteria, fungi, and algae. In 1824 governments began to pass health regulations that are upheld in today’s society. Our modern world perceives sewer systems (in infrastructure) as a necessity and not a luxury, greatly reducing the adverse effects to public health. Another striking point on public health was the insect-ridden environment. The bothersome mosquitoes that caused restless nights irritated settlers. The nuisance factor would be of the least concern, after learning that this insect was carrying the deadly disease, malaria. Today we are safeguarded from that threat with vaccines and inoculations. Our local governments also take proactive measures to insecticide areas prone to the attraction of mosquitoes.

As in Jacksonian times, today’s medical professionals are vast. The greatest difference is that, in those days, doctors had very little medical training. Anyone that offered a remedy for an ailment called himself (or herself) a doctor. Surprisingly, this list included herbists, florists, and quacks. Today, the large field of physicians and specialists are required to be trained, educated, and licensed. Unscientific theories were developed and used to treat patients. For example, there was the theory that bodily fluids controlled our biological wellness. If there was an imbalance of one of these fluids, the body became ill. One method of treating the “imbalance” was through bloodletting. Bloodletting is a process of drawing ten to twelve ounces of blood each day for fourteen days. This was supposed to expel toxins. The rebuilding of white blood cells was expected to re-balance the system. Although blood transfusions are used in modern treatments, we are afforded the use of evaluations, therapies, and pharmaceuticals before draining the plasma that transports oxygen and nutrients through our body.

Bringing a new life in to the world was not taken for granted in Jacksonian times. It is shocking: the processes that were used to deliver babies and those that were used to save a mother’s life. Caesarian deliveries were a death warrant for a mother because of the dangers of infection. The common practice of embryology is appalling. Nothing other than saving the mother’s life could have excused this practice. As science advanced, the forceps came in to use, reducing embryotomies. The use of forceps still could not retrieve a fetus that was turned in the mother’s womb. Dr. Patricia Jimenez, Ob/Gyn at Washington University notes, “Caesarean delivery is now widespread, and often thought to be safer than normal delivery in some cases. This is due to understanding how germs and infection are passed to the patient and how to control infections. Antiseptic technique allows surgery to be possible.” She goes on to explain  that the fetus is monitored now. In regards to forceps, Dr Jimenez says, “In Jacksonian times, it seems that forceps were a necessary tool that helped improve survival of both mother and baby. Today, most practitioners do not use forceps. This is an art that is not taught in many residency programs. It takes proper training and skill to use them properly and select the appropriate patients in which this would be beneficial.”

As with the human body, a young nation’s survival relies on healthy growth. It is fascinating to study the history of medicine in Jacksonian America and to learn how indifference and neglect eventually changed. The minds of the time began to reject the atrocities that were once acceptable. The new world settlers could not have been pleased with the mutilation of a fetus or the needless loss of life to infectious disease. Fortunately, it is our nature to learn and to advance. Today, sanitation is a multi-faceted industry, medical practice is regulated and licensed, and progress in obstetrics has made a surgical delivery safer than a natural one in many cases. It’s encouraging to know that “We the People” don’t tolerate the acceptable, but instead find the fortitude to evolve.

Dr Patricia Jimenez, Ob/Gyn; Washington University; St Louis, MO; email response to prompt (Dr Roy Vu, NLC_History_1301) comparing medicine in Jacksonian America to today's standards.