Scholarship Essay Example
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OF LEECHES, BARBERS,
AND HUMORS
(essay by 2003 Donnell B. Young Scholarship
winner)
By
Emily Alden
Preface
to the research paper
By August 2003, I will have begun undergraduate studies in
biomedical engineering at the University of Iowa. Fulfilling my career goals will require many years of diligent
study, making this scholarship opportunity all the more important to my
future. Ultimately, I hope to
become a pediatric cardiothoracic surgeon. Therefore, a personal interest in surgery, along with a keen
fascination for medieval history, was the catalyst for this research
paper. The most common
medical practice and basic cure-all of the colonial period was the act of
bleeding. Doctors believed
that bleeding a patient would reestablish a balance between the body’s
humors and return the person back to good health. Until scientists discovered bacteria and their all-important
connection to disease, health care providers were handicapped in their
thinking about how to heal the sick or wounded. It is my hope that the discoveries yet to be made will place
twenty-first century medical theory and practice into the realm of the
barbarous past. So, forget
your ideas about a sterile, hospital environment and enter the era of the
first settlers to North America. Are you feeling poorly today? Well, let’s get your humors back in balance! Roll up your sleeve…..
*************************************************
Of
Leeches, Barbers and Humors
Fifty-two of the
original one hundred and three Pilgrims died before the first spring. Among the survivors was Samuel Fuller, who was a deacon in
the church and physician to the colony. During the twelve years following the Pilgrim’s landing at
Plymouth, Dr. Fuller served both settlers and native people. “He bled
the sick and tried to keep people alive with a mixture of prayer and doses
of medicine.” 1
From one physician in 1620 to nearly 3,500 in 1750, the medical
profession in the American colonies grew in numbers, but unfortunately not
in knowledge. Most medical
practitioners of the colonial period had more in common with medieval
barbers than modern M.D.’s. Before
the 17th century, physicians in Europe had little formal education and
were considered tradesmen not professionals. Even though medical schools slowly emerged on the European
continent, none were founded in the American colonies during this early
period. A physician’s
training was accomplished through an apprenticeship, like any other
craftsman. “A medical
apprentice lived in a physician’s house, did odd jobs, and often acted
as his servant. In addition,
the apprentice learned how to make up medicines, he read the few available
medical books, and observed the physician as he treated his patients.” 2
Colonial wives kept a supply of medicinal herbs in a physic chest
to treat family illnesses at home. Outside
medical treatment would be considered only after all other treatments had
failed. Because trained
physicians usually charged high fees for their services, colonists were
forced to look for healing from gardeners, blacksmiths, midwives, tailors
and wig making barbers. Barbers
were licensed surgeons, allowed to bleed patients, perform amputations,
and pull abscessed teeth in addition to their primary duties of shaving,
cutting hair, and curling wigs. Surgery
was considered a dirty job, better suited to a skilled craftsman, to a
knife peddler or to a barber than to a doctor. “The 17th century surgeon was considered inferior because he used
his hands, while a physician used his head.” 3
Prevailing 17th century medicinal theories supported the idea that
an imbalance in bodily humors or fluids caused disease. The majority of
doctors practiced heroic medicine; the balance of bodily fluids
reestablished by bleeding, purging, blistering and vomiting. To treat an illness, fluids were added or drained away. Contained in a healer’s little black bag were implements designed
to purge, sweat, and bleed infected fluids from the body: laxatives, diuretics, scalpels, and leeches. According to colonial notions of proper medical care, no surgical
procedure was performed so frequently or with such perceived necessity as bleeding. Fevers, believed caused by too much pressure in a patient’s
veins, were relieved by blood letting. For patients suffering from inflammations, such as those of the
stomach, throat, and eyes, bleeding was recommended. Doctors believed bleeding useful in treating asthma, sciatic pains,
coughs, epilepsy and rheumatism. After
falls, blows, bruises or any violent hurt received either externally or
internally, bleeding was performed. The
procedure was deemed necessary for the strangled, drowned, or suffocated. “Whenever the vital motions have been suddenly stopped for any
cause whatever, it is proper to open a vein.” 4
Leeches, found in rivers or streams, were used to bleed patients in
areas that were difficult to access, like the eyes or mouth. Children were generally bled with leeches, however it was
impossible to know exactly how much blood was drawn. Bleeding with leeches was difficult to stop, and the wounds created
didn’t heal easily. After a
patient’s skin was washed and shaved, a drop of milk or blood encouraged
the leech to begin sucking. Each
leech was capable of removing about one ounce of blood in one hour’s
time. Once enough blood was
drawn, the leech was removed by sprinkling it with salt or vinegar. Leeches were stored in jars at doctor’s offices, barbershops, or
at the local smithy.
Colonial doctors believed that, where the intent was just to lessen
the amount of blood in the body, the arm was the best place to be bled. A bandage was used to tighten the area and raise a vein. The
bandage was released as soon as the blood began to flow. Bleeding was typically accomplished with a lancet. At other times, a metal box holding a group of small spring-loaded
blades, also known as a scarificator, was used to create several cuts in
the skin. Drawing blood by
heating a cup and placing it next to the cut vein or skin was another
successfully mastered technique practiced by colonial physicians and
barbers. As the cup cooled, a
vacuum formed causing the blood to flow more freely.
Blood was normally drawn until the patient became faint or even
unconscious. The few positive
results of bleeding were reducing fevers and lowering high blood pressure. Serious danger to patients occurred from excessive blood loss and
dramatic drops in blood pressure, or from infections caused by non-sterile
surgical instruments. “The quantity of blood to be let must always be
regulated by the strength, age, constitution and other circumstances
relating to the patient. It
would be ridiculous to suppose that a child could bear to lose as much
blood as a grown person, or that a delicate lady should be bled to the
same extent as a robust man.” 5 Doctors believed that blood
was replenished in hours, not weeks.
Miscalculations and misconceptions resulted in high mortality rates
for physicians. It’s no
wonder early colonists waited until nearly treading upon death’s
doorstep to consult a doctor or barber for their care. Letting nature take its course often yielded better results. Advances in medicine came by trial and error, with colonists
regularly serving as guinea pigs for physicians attempting to improve
their patients’ odds of survival. The
mythical “balance of humors” proved difficult to dispel.
So, are you feeling poorly today? Visiting the barber for a shave and a bleeding? Pay him first. He might wipe off the blade. Roll up your sleeve...
May your humors always be in balance!
Footnotes
1 The
Doctors, p. 22
2 The Doctors, p. 24
3 The Doctors, p. 28
4 “Domestic Medicine”, p. 2
5 “Domestic Medicine”, p. 3
Bibliography
http://www.pbs.org/ktca/liberty/chronicle/medicine.html - “Medicine”
http://www.stratfordhall.org/ed-med.htm - “Medicine and Health”
http://www.americanrevolution.org/med50.html - “Domestic Medicine”, Chapter 50, Of Surgery , p. 1-18.
Fisher,
Leonard Everett. The
Doctors. New York,
Marshall Cavendish Co., 1997.
Speare, Elizabeth George, Life
in Colonial America. New
York, Ramdom House, 1963.
Terkel, Susan Neiburg. Colonial
American Medicine. New York, Franklin Watts, 1993.
Van Steenwyk, Elizabeth. Frontier
Fever. New York, Walker
and Company, 1995.
Williams, Guy. The Age of
Agony. Chicago, Academy
Chicago Press, 1986.