Frontier Medicine: From the Atlantic to the Pacific, 1492-1941 by David Dary

From the Publisher

In his new book, David Dary, one of our leading social historians, gives us a fascinating, informative account of American frontier medicine from our Indian past to the beginning of World War II, as the frontier moved steadily westward from the Atlantic coast to the Pacific Ocean.

He begins with the early arrivals to our shores and explains how their combined European-taught medical skills and the Indians’ well-developed knowledge of local herbal remedies and psychic healing formed the foundation of early American medicine.

We then follow white settlement west, learning how, in the 1720s, seventy-five years before Edward Jenner’s experiments with smallpox vaccine, a Boston doctor learned from an African slave how to vaccinate against the disease; how, in 1809, a backwoods Kentucky doctor performed the first successful abdominal surgery; how, around 1820, a Missouri doctor realized quinine could prevent as well as cure malaria and made a fortune from the resulting pills he invented.

Using diaries, journals, newspapers, letters, advertisements, medical records, and pharmacological writings, Dary gives us firsthand accounts of Indian cures; the ingenious self-healings of mountain men; home remedies settlers carried across the plains; an early “HMO” formed by Wyoming ranchers and cowboys to provide themselves with medical care; the indispensable role of country doctors and midwives; the fortunes made from patent medicines and quack cures; the contributions of army medicine; Chinese herbalists; the formation of the American Medical Association; the first black doctors; the first women doctors; and finally the early-twentieth-century shift to aformal scientific approach to medicine that by the postwar period had for the most part eliminated the trial-and-error practical methods that were at the center of frontier medicine.

A wonderful—often entertaining—overview of the complexity, energy, and inventiveness of the ways in which our forebears were doctored and how our medical system came into being.

The Washington Post - Marc S. Micozzi

Frontier Medicine is fast-paced and engaging, rich with colorful events and characters

The New York Times - Dwight Garner

"MASH" meets Zane Grey and Edgar Allan Poe…[Dary] knows this material cold, and his narrative accumulates authority and dignity as it rolls along. As he piles story upon story and anecdote upon anecdote, you’ll find yourself walking around the house reading horrific bits out loud to anyone who will listen, to the great distress of the squeamish.

Publishers Weekly

Scurvy, contaminated water and challenging environments were among the medical problems faced by frontier settlers, who resorted to the rough-and-ready treatments of herbal and traditional medicines, quack concoctions and whatever worked. This is the story prolific western writer Dary (The Oregon Trail) provides in a deeply researched, anecdotal history. Fourteen chapters range from "Indian Medicine" and "In Western Towns" to "Quacks" and "Midwives and Women Doctors." A skilled storyteller, Dary fills each chapter with tales of doctors (not always well trained) and patients, colorful events, important discoveries and a seemingly endless pharmacopeia of herbal recipes and drugs, beliefs and often gruesome medical procedures. Dary agrees with today's experts that doctors in that era who practiced "heroic medicine"-bleeding, purging, administering emetics and toxic metals such as mercury and arsenic-did more harm than good. Fortunately, even quacks were too expensive for most settlers, who preferred home remedies. Dary argues that traditional Native American treatments were less harmful and probably more effective. Readers looking for a more insightful history of medicine should choose one by Roy Porter, but this collection of stories of frontier healers will satisfy many readers. 81 illus. (Nov. 10)

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Kathy Arsenault - Library Journal

Journalist Dary (Cowboy Culture; The Santa Fe Trail) arranges colorful vignettes from the days of sweat lodges, sassafras tonics, and bloodletting through the rise of modern medicine as World War II approached. He introduces a physician who wore a necklace of 24 bullets she removed from patients, a mountain man who survived a bear attack by letting maggots feast on his infections, and other intriguing characters. Readers seeking more than engaging stories, however, will be disappointed in Dary's lack of subject expertise. The devastating epidemics that depopulated Indian civilizations are given only cursory treatment, as is the 1918 influenza epidemic, first observed in Fort Riley, KS. Dary also leaves out basic statistical data like leading causes and average ages of death. Several factual errors appear, including the claim that the first cooperative hospital was established in Elk City, OK, in 1931, when in fact mutual aid societies established by immigrant cigar workers established cooperative hospitals in Ybor City, Tampa, FL, decades earlier. While Dary capably assembles rich stories about Western people and places associated with medicine, he fails to achieve a coherent historical narrative. Nevertheless, those wanting a light and engaging look at a little-explored field of Western lore will not be disappointed.

Kirkus Reviews

Western historian Dary (True Tales of Prairies and Plains, 2007, etc.) chronicles the gradual dissemination in America of enlightened sanitary, health and medical practices.

The author begins with Native American healers and the medicinal knowledge they gleaned from centuries of living off the land. After the Europeans arrived, both peoples adopted practices from each other. Shipwrecked Spanish physician Cabeza de Vaca treated sick Indians, who spread word to other tribes of his cures; early colonists learned how Native Americans made medicinal use of herbs and plants. Dary notes that when an epidemic broke out in Boston in 1721, Cotton Mather urged the use of inoculations, which he had heard described by a slave as routine practice in Africa. The "American Hippocrates," Benjamin Rush, embraced "heroic medicine" involving bloodletting, purging, vomiting, sweating and blistering, which often speeded the patient's death. There were no standards of education or certification for doctors until the establishment of the American Medical Association in 1847. Homemade remedies prevailed in a land where few doctors existed and immigrants had little understanding of the nature of disease. The author traces important work by pioneering physicians: the first writings on the relationship between environment and disease by Cincinnati's Daniel Drake in the 1850s; John Sappington's use of quinine for fever; experimental surgeries in gastric physiology performed by William Beaumont; and the efforts of Elizabeth Blackwell, the first woman to graduate from an American medical school, who was inspired by Florence Nightingale to organize nursing and sanitary relief during the Civil War. Midwives,health-seekers in the West, Chinese medicine in San Francisco, elixirs and quacks all merit their own episodes. Dary's anecdotal history ends with the folksy tale of his own grandfather, a country doctor in Kansas.

Very general, but an entertaining survey of the journey to American well-being.

Agent: Eleanor Wood/Spectrum Literary Agency

• Table of Contents
• Read an Excerpt

Table of Contents

Read an Excerpt

INDIAN MEDICINE

Wisdom begins in wonder.
—Socrates

May is a delightful time to visit the Wichita Mountains in southwestern Oklahoma. The little bluestem, the big bluestem, switch, Indian, and grama grasses are green after their winter sleep, and the wildflowers display a variety of colors. Groves of post oak, blackjack, and eastern red cedar dot the landscape. Countless birds, including rare black-?capped vireos, search for nourishment. Everywhere there is a promise of nurture and it warms the soul, as do the warm and gentle breezes from the south. The Wichita Mountains are about 300 million years old, and among the oldest mountain ranges on earth. They consist of two rugged ranges of red granite reaching nearly 2,500 feet at the highest point. They run several miles east and west and enclose a natural prairie where buffalo, elk, prairie dogs, and other wildlife still roam in what is today the Wichita Mountains Wildlife Refuge administered by the U.S. Fish and Wildlife Service. While the Wichitas may lack the majesty of the Rocky Mountains, they are impressive islands projecting upward from a sea of rolling prairie.

The Wichitas are rich in lore which includes legends of Indian battles and Spanish treasure. The Spanish penetrated the area in the 1600s, and French traders first traversed the region during the 1770s. Long before the first Europeans arrived, Indians found protection from their enemies in the Wichitas. They also found solace at what is called Medicine Bluff, located near the eastern edge of the mountains. The bluff rises three hundred feet above a creek whose waters were thought by Indians to have special qualities. Indians—Wichitas,Comanches, and Kiowas—most likely named the bluff in their native languages, designing it as a place of mystery with great spiritual powers. The first white men in the area named it Medicine Bluff after learning of this Indian belief. The word medicine probably derived from médecin, the French word for physician, which early French fur traders would have introduced into North America. The term was widely applied by whites. In time, Indians used the word to identify their own healing methods and spiritual mysteries.

Medicine Bluff is just one of countless natural places with distinctive features that Indians believed had special spiritual power because they could not rationally explain why they existed. Such natural places conveyed to them the essence of a religious experience but were not actually worshipped. Not all things with spiritual power, to be sure, were natural. Indians created smoking pipes, bundles, and other objects that became sacred and powerful once the makers performed special rituals to imbue them with qualities of sacredness or good medicine. For the American Indian, almost anything could attain such a therapeutic or mystical quality, emphasizing how great a role spiritual power plays in Indian medicine.

In “Letter Six” of his Letters and Notes on the Manners, Customs, and Conditions of North American Indians (1844), the artist George Catlin noted that “Indian country is full of doctors, and as they are all magicians, and skilled, or profess to be skilled in many mysteries, the word ‘medicine’ has become habitually applied to every thing mysterious or unaccountable and the English and Americans...have easily and familiarly adopted the same word, with a slight alteration, conveying the same meaning; and to be a little more explicit, they have denominated these personages ‘medicine-men,’ which means something more than merely a doctor or physician.”

Catlin related that every Plains Indian male has a medicine bag. When a boy is fourteen or fifteen, he leaves his father’s lodge, locates a secluded spot, cries out to the Great Spirit, and fasts. At night, he sleeps on the ground. He may stay there from two to five days, or until he dreams of an animal, bird, or reptile in his sleep. He believes the first such creature to appear to him in a dream is his protector for life, so designated by the Great Spirit. The young Indian then returns to the lodge of his father, tells of his dream, breaks his fast, and leaves again to find and kill the animal, bird, or reptile in question. After killing it, he skins it and uses the full skin to fashion his medicine bag, which he stuffs with grass, or moss, or something of the kind. He then closes it and will rarely open it again. He will carry the bag throughout his life, frequently paying homage to it and looking to it for safety and protection. Catlin saw medicine bags made from a variety of creatures, including otter, beaver, muskrat, weasel, raccoon, skunk, frog, toad, bat, mouse, mole, hawk, eagle, magpie, sparrow, and even a wolf. The size of the skin determines the size of the bag. When its owner dies, the medicine bag is placed with his remains.

Indians practiced their medicine long before Christopher Columbus arrived in 1492. Believing he had reached the Indies, Columbus called the natives Indians, a name that stuck. Since most native cultures in North America were exclusively oral, the recorded history of Indian medicine begins with the arrival of the Europeans and their written observations. One exception was the Aztecs in what is now Mexico, who did have written records. After the Spanish arrived in 1519, however, most of these records were destroyed with great zeal. The Spanish did express their amazement at the Aztecs’ vast knowledge of medicinal plants, and noted that their practice of medicine was an intrinsic part of their spiritual life.

At the time, Europeans used the word medicine to describe any substance, regimen, or physical procedure that had a beneficial effect on the human body and restored health, and they viewed medicine as separate from religion. Among Indians, however, their medicine encompassed much more. “While they used herbal remedies to treat simple physical conditions such as burns, broken bones, sore eyes, and dislocations, the majority of Indian medicine was used to cure conditions which had no obvious physical cause,” writes one authority, Clara Sue Kidwell. “Symptoms included not only overt aches and pains, but could include what modern medicine might term neuroses, any behavior that was excessive or out of the ordinary.... Illness is a matter of balance and harmony with one’s physical surroundings, spiritual environment, and social group. Thus, it goes far beyond mere physical symptoms. If one’s balance is disturbed (witchcraft is a good example of how fear of an individual as a witch can have a disruptive effect in a group of people), illness results.”

Eric Stone, a Rhode Island physician, wrote in 1932 that Indian “mythology and theology are peculiarly rich and endowed with an unexpected symbolism and beauty, bespeaking an unusual ability to express their emotional and esthetic appreciation of their all-?important physical environment. Their métier was not pictorial, but lay, on the one hand, in decorative design and, on the other, in a wealth of folklore and poetry.”

Anthropologists, ethnologists, and historians tell us that early Indian medicine was closely tied to their reverence for nature and its supernatural powers. Indians lived most of their lives out of doors, and nature charmed them, but, as Clara Sue Kidwell points out, “Nature is threatening as often as it is benevolent. Ceremonies were held to restore balance that had been disrupted, or to assure that balance continued and nature produced the results that the people desired. The natural environment of the Great Plains was a source of spiritual power for individuals through vision quests, but vision questing required the endurance of pain and physical deprivation—sleep, food, water. Going alone into special places where spirits were thought to make their presence known was a way of acquiring access to that power. Going alone into the environment could also be a source of illness if one encountered a spiritual being without proper preparation.”

In most tribes, the principal person overseeing such matters was a medicine man or sometimes a medicine woman. After the arrival of the Spanish in the Southwest, this person was often called a curandero (or curandera), but ethnologists have sometimes used the Asian term shaman, defined by Merriam-Webster as a priest or priestess who uses magic for curing the sick. Kidwell, however, points out that a shaman or medicine man’s role is not just in healing, nor is it necessarily one of high prestige. The shaman or medicine man/woman supposedly had learned to control and use the spiritual power of nature. At the same time it followed for the people who believed in his or her powers that those powers might be used to do harm as well as to help. Moreover, Kidwell added that “being a shaman is also a dangerous position for the individual who must confront the power that is causing the illness and uses his or her power to exorcise it or bring it under control. If the curer’s power weakens, the illness may affect him or her.”

Whatever their title, such individuals received what others believed was a vision or a deep spiritual insight into their patients. They never lost sight of the spiritual side of health and disease, realizing the power of the mind. Most were viewed as wise, as knowing the secrets of healing, and as visionaries who mastered death. They were thought to be able to go into a trance, leave their bodies, and visit unearthly kingdoms. Some were also poets and singers who danced and created works of art. Their medicine simply denoted a spiritual power used for many purposes including healing with natural herbs and plants.

The role of the shaman varied from tribe to tribe. The Harvard anthropologist Roland B. Dixon wrote in 1908 that in numerous instances the position of shaman descended by inheritance in either the male or the female line, depending upon the prevailing tribal system of descent. In most cases, it was mandatory that the person in line for the position accept it and the duties and responsibilities that went with it. If the person refused to do so, Dixon said, tradition had it that spirits would punish him or her in the form of sickness or death.

In some tribes, young Indians wishing to possess medicine were severely tested. In 1858, Thomas Kennard described such a test as carried out among various tribes:


At a certain period of each year, all young braves, who are ambitious to become great or medicine men, assemble and go through the horrible ordeal which is to render them immortal.... After three or four days of fasting, praying and privation, and after having witnessed all the mysterious movements of those advanced in the science, the ambitious young men present themselves for the last and most trying test of greatness. They enter the great medicine lodge, where the ceremonies have been celebrated for four days, and place themselves in a reclining position, when immediately the executioners commence their work, by pinching up an inch or two of the integument and pectoralis major muscle on each side, and thrusting a ragged knife through the flesh beneath the fingers; after which skewers are passed through the wounds thus made. A similar operation is performed in several places over the trapezius muscle, and often on the front part of the thigh, the leg or the forearm. To these skewers or sticks, passed beneath the integument and through the muscles, cords are attached, by means of which the candidates are raised clear of the ground, and left dangling until apparently dead, having fainted repeatedly. They are then lowered down and left without the slightest aid or comfort until reaction takes place, when heavy weights, such as buffalo heads, are attached to the skewers and kept dragging on the ground or suspended in the air as the poor sufferers are hurried from place to place, until they are torn loose by their own weight, or by being caught in some way as they madly rush over the plains around the encampment. The Sioux have even a more refined process of testing or torturing the ambitious than that just described as common to most North American Indians. They pass skewers through the pectoral muscles as above mentioned, and then fasten their victims to a strong sapling just stiff enough to raise them on tiptoe, in which position, with the head thrown back, they are compelled to gaze at the shining sun from its rising to its setting; and if one faints or falls whilst undergoing the trial before the sun has disappeared, he is forever disgraced as a man without medicine.



Among the Apaches, the shamans or medicine men usually acted as individuals, but among the Pawnees, Zuñis, and a few other tribes, they were organized in one or more societies and kept their secrets concealed from people at large. An herbalist was consulted for less serious health problems. If the herbalist failed to relieve symptoms, a “hand trembler,” or diviner, was called in. If the patient still did not show signs of improvement, a medicine man would finally be summoned. Healers in all tribes, however, did have one thing in common: they had complete and sincere faith in their practice and took great pride in their work as healers.

Unlike native peoples elsewhere in the world, most early American Indians did not stress ancestor worship; but many Indian peoples believed that if the dead were not properly buried, their spirits would haunt those responsible and bring illness and other misfortunes upon the living. Some believed that if a person entered an area haunted by such spirits, he would soon die, and if a dead relative called to you in a dream, you would soon die. In some tribes, it was the custom to wear small medicine bags of herbs and roots next to the body to ward off bad spirits—which might take the form of owls or wolves—and the illnesses they could cause.

Many Indians saw enemies or bad spirits as the cause of illness, but the healing methods used by medicine men varied from tribe to tribe. The medicine man would usually conduct a ceremony that supposedly created magical power to effect a cure, or that called upon spirits to aid a sufferer. From his medicine bundle, usually made of animal skin, he might produce a charm or fetish such as a deer tail, bird feather, or bone, and sometimes the stomach of a buffalo or other animal. He might use a medicine stick to serve as an offering, a warning, or an invitation.

Nearly all Indians subscribed to a particular notion of how human or spirit enemies did their work, specifically, that “disease was due to the presence in the body of some tangible, albeit mysterious, object placed there magically by a sorcerer or inimical spirit.”

It was then the medicine man’s responsibility to extract this harmful object from the body of the patient, and this was usually accomplished by sleight of hand. The object might be a bone fragment, stone, thorn, hair, or even a tiny worm or small animal. Before removing it, the medicine man might blow on the person’s body, make a small incision, or use a feather, the tip of which was placed on the body while holding the other end in his mouth. Once removed, the object might be shown to the patient and others as proof the medicine had worked. The medicine man would then destroy the object by burning it, swallowing it, tossing it into running water, or burying it in the ground.