Is There a Doctor in the House?

Regina's thankfulness for modern medical care is heartily shared by me. I spent all my Thanksgiving holiday in bed with a feverish cold, and am very grateful for ibuprofin and cough medicine and disposable tissues...none of which existed in 1815. What would a 19th century miss have done in a similar situation?

Not much, as it turns out.

In the first half of the 19th century, medicine was still barely one step up from mysticism and magic. The germ theory of disease was still decades away, as were antibiotics. Human health was still thought in some quarters to be based on the balance of “humors” in the body, and illnesses were thought to be caused by too much or too little of these humors. It was a pretty grim time to get sick, when something as simple as an infected paper-cut could possibly prove fatal.

Medicine, such as it was, was actually practiced by different classes of people, divided in a way that seems to modern eyes quite bizarre. At the top of the pyramid were the physicians, doctors who prescribed drugs (or “physic”, hence their name.) They didn’t deal with external injuries, or even do much in the way of examining patients apart from taking their pulse and examining the state of their urine: rather, they’d let the patient describe symptoms and then prescribe drugs. Physicians were gentlemen, usually with university degrees, and gentlemen did not do labor—in fact, use of the stethoscope, an 1816 invention, was slow to catch on among physicians because use of a tool implied physical labor. Setting broken bones, treating skin or eye diseases, or giving serious physical exams was the job of surgeons. Surgeons usually got their training through apprenticeship, like any other trade, which meant that a surgeon was not a gentleman. And below surgeons were apothecaries, the people who mixed up the medicines that the physicians prescribed but who often did their own doctoring as well, especially for the poor who could not afford the services of a physician.

So back to our young lady with a bad cold--what would she do?

First of all, she was sent to bed—certainly a wise idea, since central heating didn't exist. If she were very ill, a physician might be sent for. If she had a bad cough, he might prescribe her an opium derivative to soothe it (and knock her on her butt so she could rest!)--an ingredient still used today in codeine-based cough medicines. He might suggest that she eat only broths or milk products and avoid heavier foods, especially pastry. If her nursing were left to a faithful old nanny, she might be given herbal remedies. Willow bark tea was an old remedy for fever--and studies of it led to the synthesis of aspirin in 1853 by a French chemist. And she would probably be scolded for having caught the cold in the first place, and exhorted in future to not ride in an open carriage against the wind, nor remain too long in her bath, nor neglect to keep the area between her shoulder-blades sufficiently protected...all thought to be prime causes of catching a cold.