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  • Bleed, Blister, and Purge: A History of Medicine on the American Frontier
  • Anton Sohn
Volney Steele . Bleed, Blister, and Purge: A History of Medicine on the American Frontier. Missoula, Mont.: Mountain Press, 2005. xxiii + 365 pp. Ill. $15.00 (paperbound, 0-87842-505-5).

This is more than a book on the history of medicine on the western frontier; it is also infused with the author's personal experience as a physician and his enthusiasm for the West. Volney Steele is a third-generation physician who experienced "horse and buggy" medicine as a boy when his driving skills were necessary to take his father, crippled with arthritis, on house calls in rural Arkansas. The book has copious references and annotations and it relies on secondary sources. Nevertheless, there is considerable new information from primary sources, mainly on frontier medicine in Montana. Steele has mined the archives of Montana State University, local hospitals in Billings and Helena, and the Museum of the Rockies, sources that detail the formation of Montana's hospitals and the ways in which local doctors in the early 1900s dealt with abortion when it was illegal: Physicians were publicly opposed to the procedure, but they referred their patients to abortionists. Helena, Montana, in fact, had two "well-trained" and well-known physicians who did abortions.

The book is divided into two parts: "Old West Healers and Healing," and "Public Health and Health Education on the Frontier." In the first part Steele delineates how the American Indian dealt with disease and injury. He then discusses Lewis and Clark, mountain men, and other early phases of western health care, including women physicians. He points out that women doctors were more accepted in the West than in the East, and also that, in contrast to the settlers, many Indian tribes gave women healers the same status as men.

Steele does allow that syphilis, although spread by white immigrants, was probably known to the American Indian before Columbus's arrival. On the other hand, he does not mention that Columbus's men and other early immigrants brought the malaria organism to America; the malaria vector, the specific species of mosquito necessary for transmission of the disease, was present in America, but the parasite came many years later. [End Page 175]

In the chapter on military doctors on the frontier Steele emphasizes that the U.S. Army had higher standards for its doctors in the nineteenth century than did the civilian population, which had no licensure or diploma requirements. He also points out that the military was concerned about public health and hygiene; consequently, the military surgeon oversaw the diet of soldiers and was responsible for providing fresh vegetables to prevent scurvy and other nutritional diseases.

Montana is similar to other western states in that mining and cattle were important to population growth and the early economy. The chapter on mining points up the dangers and diseases associated with the dust from hard-rock mining and the resulting silica deposits in the lung that cause scarring; early death and a site for tuberculosis to form were a constant threat. However, for a more detailed account of medicine as practiced in mining districts I recommend Duane A. Smith and Ronald C. Brown, No One Ailing Except a Physician: Medicine in the Mining West, 1848–1919 (2001; reviewed in Bull. Hist. Med., 2002, 76: 833).

The second part of the book deals with the development of hospitals, nursing, sanitation, and the fight against epidemic disease. All of the major diseases that ravished the frontier are described, but the discussion on Rocky Mountain spotted fever is of particular interest because of research at the Rocky Mountain Laboratory in Montana. The discovery of its cause by Dr. Howard Ricketts and the development of a vaccine constitute one of the highlights of medicine in the West. Diarrhea and tuberculosis were also prevalent during the nineteenth and early twentieth centuries, and certainly their control was important to the survival of the western pioneer. Steele provides an excellent discussion on the problems of controlling bovine tuberculosis, an important factor in the early cattle industry, but he does not adequately clinically differentiate between bovine tuberculosis and human tuberculosis...

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