Medical education left much to be desired. Doctor shortages and large profits from opening medical schools prompted rapid development. It took very little to open a school, as long as there were physicians willing to lecture. Entrance requirements were few and school provided very little clinical training. Medical students (men only) were undisciplined and often illiterate. Many doctors learned their trade through apprenticeships with practicing doctors. These apprenticeships provided the doctors with cheap labor, therefore, there was no desire to improve this educational system.

Common treatments for patients included “heroic medicine” – bleeding, plastering, purging, sweating, blistering, and amputation. These practices were advocated by Benjamin Rush, who was Professor of the Institute of Medicine at the University of Pennsylvania in 1791. His beliefs held fast during the first half of the century, although they were ineffectual at best.

Bleeding, also known as phlebotomy or bloodletting, was utilized to release “bad blood”. This was usually the initial treatment. It seemed like a logical solution to restore health based upon the four humours: blood, phlegm, yellow bile, and black bile. Patients were cut with a lancet or “leeched”; blood or milk was dripped over a vein to encourage the leech to bite and suck from that vein. When the patient had bled enough (a doctor often bled a patient until they fainted!), salt was sprinkled on the leech, causing it to release the skin. Bleeding was performed not just by doctors but also by barbers. (The idea of specialized professions is a fairly modern idea – barbers not only cut hair, but bled patients and pulled teeth!) This procedure did very little to help, but did a great job in regards to weakening the patient.

Plastering referred to a paste-like substance made from a variety of ingredients and then applied to the skin of the patient, such as on the back or chest to relieve colds or internal pain. Poultices were also utilized for wounds, bites, or boils. The ingredients ranged from bread and milk to herbs, and even cow manure.

Purging involved giving a patient heavy doses of laxatives or emetics to expel “poisons” from the body. Apparently it was believed that diarrhea was relaxing the interior of the body while puking was thought to relieve tension on the arteries.

Sweating a patient was believed to release poisons from the body. Anyone suffering from high fevers were warmly dressed and well-layered with blankets. When completely drenched in sweat, the patient was then doused with cold water and then massaged.

Blistering was used to treat a wide variety of maladies, although its effectiveness was nil. Victorians believed the body could only hold one illness at a time, and that blistering the skin with hot pokers, acid, or plasters could burn out an illness.

Amputation was the most commonly performed surgery; since there was no consideration for sterilization or cleanliness, surgery was often fatal. Anesthesia would either be applying a rag with chloroform to the patient’s mouth and nose or giving the patient a bit of booze to help deaden the pain. The surgeon would then use a tourniquet on the limb being amputated. A scalpel would be used to cut through the skin and outer tissue; a saw would then be used to get through the bone. During the Civil War era, the limb was then sutured with silk in the Northern U.S. or cotton in the Southern States. Infection would often claim the lives of these patients.

It is quite remarkable that Victorians held any stock in these treatments, however, they were driven by their faith in God and accepted death as part of the cycle of life. Near the mid-1800’s, many people lost faith in heroic methods and decided to take medical matters into their own hands. Various forms of “quackery” ran parallel to Rush’s treatments, including ridiculous methods based on superstition.

Homeopathy gained a cult following, as it was easy to practice at home. Kits were sold through mail order or over the counter. Founded by Samuel Hahnemann, this movement was based on the theory of the law of similars: treating disease with extremely small doses of drugs that produced symptoms similar to those of the offending disease. The apothecaries generally disliked Hahnemann’s practices because he recommended the use of only one medicine at a time and prescribing only limited doses of it. Many medical associations refused homeopathic doctors. Regardless of the prejudices against homeopathy, this systematic approach to medicine grew and is being rediscovered today as an effective approach.

Although health care in the United States leaves much to be desired (ask any middle class freelancer about their health insurance - nearly 20% of New Yorkers are uninsured), science and medicine has come a very, very long way. Curious about other medical antiquities? Do check out the additional reading below.