In lieu of an abstract, here is a brief excerpt of the content:

215 10 Calomel, Cholera, and Science 1825–1865 Thomas Jefferson charged that medical science had not advanced since ancient Greece and Rome—he contended that “time had stood still” and that it was dangerous to come under the treatment of a physician. He wrote to physician Caspar Wistar on June 21, 1807, that a revolution was needed because a physician would propose “some fanciful theory” and declare that it was a new key to understanding that gave him unique insight into all nature’s secrets. He wrote that he had seen systems come and go “like the shifting figures of a magic lantern” and that the patient “sometimes gets well in spite of the medicine.” On the other hand, Jefferson realized that the best physicians had dissected human bodies and had knowledge of anatomy. Having lost his wife in childbirth, when his daughter Maria was preparing to deliver, he advised her to alert a physician and be ready to call him “on the first alarm.” Ephraim McDowell taught his apprentices that the all-purpose laxative calomel and other drugs were quackery and did more harm than good. Surgery, he said, was the only branch of the healing art that was reliable.1 The revolution Jefferson demanded would not come until the discovery of bacteria generations later, and one wishes for a time machine to travel back to the early nineteenth century to dispel the darkness with the discoveries of modern science. Jefferson and early Kentuckians lived in a time, beginning about 1750, when medical science was divided into two extremes. Extreme empiricists emphasized sense impressions and mistrusted all intuition and theories, while extreme rationalists developed elaborate theories of disease and treatment based on theories. Influenced by scientific breakthroughs in mathematics, physics, and other fields, doctors following both 216 KENTUCKY RISING empiricism and rationalism searched for the revolution, for the “one key to open all doors” that would make the theorist the Sir Isaac Newton of medicine. All their “breakthrough” systems began with what medical historian Charles E. Rosenberg called the central body metaphor, a theory dating back to the second-century Greek physician Galen. It was the idea that, when the human body is in balance, the person is healthy but that, when it gets out of balance from a change in the weather or some other cause, sickness results. Galen concluded that the body had four humors—black bile, yellow bile, blood, and phlegm—and that, when one is in excess, equilibrium and health could be restored by removing the excess humor by bleeding , purging, and perspiring. New theories arose in the later half of the eighteenth century, but they all began with the central body metaphor.2 English physician Thomas Sydenham claimed that his modification of the Greek humoral theory was the key. He taught that illness was caused by tiny particles of peccant or foreign matter that invaded the body and produced fermentation that made the person sick. The cure was to remove excess foreign matter with the same purgative methods as Galen. However, more influential in Kentucky history was the theory of William Cullen, a highly respected professor at the University of Edinburgh. Cullen taught Benjamin Rush, who in turn taught at the University of Pennsylvania and was the most influential medical theorist in the United States in 1800. Cullen said that the cause of illness was the loss of nervous force in the capillary walls and that the cure was the restoration of nervous energy in the body through the same purging treatments.3 In Philadelphia, when the great yellow fever epidemic of 1793 occurred, Rush reasoned that there was only one disease in the world and that it was caused by tension or “excessive action” in the capillaries. He avowed that disease was harsher in America because both cold weather and hot were more extreme; therefore, the cure must also be more rigorous. He blighted Americans of the early nineteenth century with heroic medicine, the most extreme bleeding and purging in the history of medicine, far more extreme than treatment in Europe. Heroic therapy was an American phenomenon that treated seriously ill patients by removing three-quarters of their blood and giving them extreme diarrhea from huge doses of the calomel. Rush taught that the great fear was that the doctor would timidly stand by and not save the patient by taking enough blood or purging enough. He said that anyone could observe that his system succeeded because, when...

Share