It was in an era of "hog, hominy and home spun." The North had just emerged from the age of white slavery; Negro slavery was in full flower in the South. In the West the process of murdering Indians and stealing their lands was still going on, a process that was to continue until it reached the blue waters of the Pacific, beyond which there were no more Indians to kill and no more lands to steal. Having thrown off the Old World tyrannies, the New World was busily engaged in forging new tyrannies.

Grains, bread, pork and lard pies predominated in the people's diet--vegetables and fruits were neglected, were contraband in fact. Nobody took baths, a strong body odor being regarded as a badge of merit. Fresh air was feared. Especially feared were cold air, damp air, night air, and draughts. Houses were unventilated and foul; no sunlight was permitted to enter them lest it fade the rugs, carpets and upholstering. Sanitation was neglected; tobacco was chewed, smoked and snuffed almost universally; alcohol was the favorite beverage and disease was common.

The people suffered with typhus and typhoid fevers, malaria, cholera, yellow fever, summer complaint (diarrhea) dysentery, cholera infantum, diphtheria, scrofula, meningitis, tuberculosis and pneumonia. The general death rate was high; the death rate among infants and children was appalling; mothers died in childbirth of child-bed fever. It was a day of frequent and heroic dosage and equally frequent and heroic bleeding. In the South during the summer season there was a cry of fever, fever, fever and calomel and quinine were administered lavishly, thus adding to the horror.

It is said that a new impulse pervaded the "healing art." Previously, it had taken form in every country in keeping with ancient customs. But Europe had followed in the path of Asia and her schools had taken their first instructions from the Jewish and Muslim universities. The "medical art" had speedily become overshadowed by scholastic subtleties embroidered with vague and visionary doctrines. Then followed a series of other schools and methods that were often rivals of each other. These schools invaded America so that Thomas Jefferson could declare in his famous letter to Dr. Wistar that he had witnessed the various sects and theories of medicine, "disciples of Hoffman, Boerhaave, Stahl, Cullen and Brown succeed each other like the shifting figures of the magic lantern; and their fancies, like the dresses of the annual doll babies from Paris, becoming, from their novelty, the vogue of the day and yielding to the next novelty their ephemeral favors."

The "medical art" in America during the colonial period had been simple and unpretentious. There were no medical schools and few physicians. The facilities afforded the student for learning medicine consisted chiefly in the familiar association with rural practitioners, the observing of their procedures and a diligent prosecution of such opportunities as colonial society afforded. Inquiring individuals, men skilled in woodcraft, and expert housewives learned the use of so-called medicinal plants (and other simple means) which they gathered from the fields and forests. There has been fostered the myth that they also learned many healing secrets from the Indians who are said to have known the medicinal virtues of many plants. Actually, the so-called "medicineman" among the Indians was a sorcerer or shaman and practiced no "healing art."

By the time the period arrived of which we now write, all of this had been changed. The schools of healing had arrived; folk medicine was almost obsolete. A considerable medical literature with Latin and Greek terminology had accumulated; medical colleges (schools of physic) had been established; medical laws were enacted and the process of setting up a National Medical Church which would dominate the lives of the people was well under way. Homeopathy and chrono-thermalism had come from Europe to compete with the dominant school, which became known as the allopathic school; indigenously, the Thompsonian (physio-medical) and eclectic schools of drugging had sprung up and these four schools (the chrono-thermal school soon faded out of the picture) competed with each other for supremacy.

The medical historian, Shryock, says that "unfortunately, the standards in medical education tended to fall during the first half of the nineteenth century. This was true in an absolute sense in the United states and at least relatively in Great Britain. In the former the rapid expansion of population over a large area brought with it a mushroom growth of private 'medical colleges.' Their owner's interest in fees, or perhaps the limitations of their staffs, led these schools to shorten courses and otherwise to cheapen their degrees and by 1850 it was easy for a man of no particular training to attend lectures for one winter and emerge a full-fledged doctor." I need only add that not much was done to better medical education until after 1912.

Shryock says that "a somewhat analogous trend in Great Britain was marked by a continued dependence upon partially trained apothecaries . . . surgeons, barbers, apothecaries, and even chemists . . . all pressed their claims upon a bewildered people. According to one good authority, anyone could assume the title of 'doctor' or 'surgeon' in England and practice with impunity." In Germany conditions were little, if any, better. In France, where medicine was better organized and medical education more advanced, there was an increasing "therapeutic skepticism" among the medical leaders and, in many instances, as in England and in the United States, an actual drug nihilism. The profession had actually lost faith in its poisons.

Almost the whole of the nineteenth century was taken up with a fierce struggle between these four schools for survival and supremacy. Each school claimed to have the truth and the true medical art; each claimed to possess the true "law of cure;" each asserted its superiority over all others and each accused the other of killing its patients, an accusation which could be well substantiated against each school. In addition to this struggle, there was a wide-spread drug nihilism among medical men, the leading medical authorities of both Europe and America agreeing with the statement made by Dr. Oliver Wendell Holmes that if all the drugs of the pharmacopeia were cast into the sea it would be better for mankind, although a bit hard on the fishes. Is it to be wondered that the people became distrustful of their physicians and began to believe that they were being killed in the process of being cured?

The apothecary shops of the period were filled with measures of ornamental glass and weights of burnished brass or shining silver with which to divide and redivide the doses from ounces down to any fraction of a grain. There were powders, tinctures, dilutions, solutions, infusions, decoctions, lotions, gargles, lubricants, salts, acids, alkalies, gums, resins, gum resins, roots, barks, leaves, flowers, seeds, stems, piths, cerates, soaps, syrups, balsams, oils, essences, bitters, oxymels, patented nostrums and elixirs innumerable, beautifully labeled with gilded capitals, in polished boxes and drawers and in decorated phials, bottles, gallipots and demijohns, constituting a veritable museum of therapeutical curiosities which charmed the eyes while they occasioned nausea of the stomach. The drugging ranged from simples to minerals, from almost non-toxic herbs, like mint, to those of the highest virulence.