Chapter 10 "Clinton's Ditch"

› required tons of manpower used to use local farmers, but malaria hit

work force in summer of 1819 they were replaced by Irish laborers who were more

reliable if they survived

Chapter 11 Mortality rates for slave children under

5 were twice those of white children of the same age group› Reasons:

black women not given adequate nutrition during pregnancy

they were worked too hard were too frequently pregnant (commonly

have 6-8 kids at 18 month intervals)

Malaria and infectious disease like yellow fever and cholera were endemic in the South

the life expectancy in 1850: for whites- 40-43 years; for African Americans: 30-33 years

20% or more of the slave labor force on most plantations were sick at any given time› slave owners believed slaves were "malingering"› They didn’t realize that adequate diet, warm housing, and

basic sanitation might have prevented diseases People knew so little about nutrition, a slave

master accused mothers of killing their own infants because the mortality rate was so high

Medicine from 1800-1850 first American pharmacopeia published in

1820› consisted of mainly herbal medicines› had a few inorganic compounds with calomel

(mercury) being a favorite among doctors midwifery thrived during times of war

because doctors were heavily needed for the war, leaving midwives to fill the hole doctors left behind

nursing was, for the most part, a man's job, but when dealing with the Yellow Fever epidemics, sometimes slaves were hired to be nurses because they were immune from the disease

Doctors didn't like midwives very much and tried to put them out of business

› in Philadelphia 1815 there were 21 women who said they were midwives; by 1824, the number dwindled to 6

› doctors would claim hospitals were more sterile than midwives, but midwives would always wash their hands between patients- a practice that was rarely, if ever, seen by doctors

› doctors could spread disease patient to patient in a hospital because of lack of hygiene Hydropathy:

› believed in the curative powers of water (personal hygiene habits somewhat realized and required) Thomsonian:

› put the medicine into the hands of the common people› founded by Samuel Thomson after 6 different doctors gave 6 different remedies to his sick wife

he said the cure and medicine should be left with the person because they know what medicine will work best on them

Medical Licensing The Medical Practices Act was enacted in the very early 19th century

› fined people practicing medicine without a license $25 people thought this was stifling their rights and in 1807 the act was modified so it

wasn't repealed› the fine was lowered and the definition of an irregular physician hardly met anyone› a similar bill was filled in 1832 by Connecticut

Homeopathy developed in 1796 by Samuel Hahnemann but didn’t find its way to America until

1825 sort of holistic medicine: nutrition, exercise, minimal medicine, and human

relationships one of the basic beliefs is with just a hint of help, the human body can heal itself

› malingering-to pretend illness, esp. in order to shirk one's duty, avoid work, etc

› pharmacopeia- a book published usually under the jurisdiction of the government and containing a list of drugs, their formulas, methods for making medicinal preparations, requirements and tests for their strength and purity, and other related information

› hydropathy- the curing of disease by the internal and external use of water

› Thomsonian- believed medicine should be at the hands of the people

› Medical Licensing Act- the fight to control who could treat patients. A form of the Medical Licensing Act was passed in all the states except 2, but they all got repealed because of protesters like the Thomsonians

founded Thomsonian- the belief that the medicine should be in the hands of the common people. Was a force to be reckoned with when trying to pass the Medical Licensing Laws in the states

founded the belief of Homeopathy in 1796 even though it wouldn’t show up in America until 1825. Had sort of a holistic approach to healing and believed with a pinch of help. the body could heal itself

Which of the following was untrue about Clinton's Ditch?

a. It was better to hire the local farmers because they were more resistant to disease

b. Irish workers were usually used to workc. it required a lot of manpowerd. none of the above

What was the average life expectancy for a white person in 1850?

a. 30-33 yearsb. 50-55 yearsc. 40-43 yearsd. 25-30 years

Which contributed to the fact that African American children under 5’s mortality rate were double the white races'?

a. mothers would kill their babies so they didn’t have to live in slavery

b. the slave life didn’t leave enough nutrition for a pregnant woman

c. the slave owners would take away the childrend. most African America women had their babies in

winter, so they got hyperthermia

Why was there such a sharp decrease in the average number of children from 1800-1900?

a. the economic strengths of having many kids no longer outweighed the cost of having them

b. people were too busy to have kidsc. the food of the time didn’t allow for child

bearingd. the government restricted how many children a

family could have

Approximately one in _____ pregnancies were aborted from 1840-1860.

a. 6b. 10c. 3d. 4

Abortions were mainly used by _______ class women.

a. Upperb. Middlec. Lowerd. Yeomen

The first American pharmacopeia is NOT...

a. a list of medicinesb. mainly herbal remediesc. a medical dictionaryd. they are all correct

Calomel is also known as __________.

a. Tree barkb. Waterc. Beerd. Mercury

Medical Licensing was a (n) _________issue in America.

a. Easily settledb. Controversialc. Not talked aboutd. None of the above

Hydropathy...

a. increased attention to clean waterb. was not widespreadc. both of the aboved. none of the above

Faragher, J, Buhle, M, & Czitrom, D. (2003).

Out of Many: A History of the American

People. Upper Saddle River, NJ: Prentice

Hall

The history of medicine 1800-1850. (2003).

Retrieved from http://www.mnwelldir.org

Chapter 13 early 1800's: city living conditions- no municipal water supply, sewers, or

garbage collection› people threw garbage into streets that was then eaten by hoards of roaming pigs

every American city suffered epidemics of sanitation disease like yellow fever, cholera, and typhus

Philadelphia's yellow fever epidemic of 1793 killed 4,000 people and stopped all foreign trade for than a month› Philadelphia completed a city water system in 1801 in response to the epidemic, but

residents had to pay a fee only the rich could afford Neither New York or Boston had a public water system until the 1840's Garbage collection was a private service Cities charged for costs of sewers, water mains, and street paving

› poorer parts of the city couldn't afford it excessive drinking became a national issue

› religious reform would attempt to encourage men to take a bow not to drink drinking more of a man's problem because it was considered rude for women to drink in public

they would drink alcohol based medicines like Lydia Pinkham's Vegetable Compound, which was 19% alcohol and marketed for "female complaints"

› more than 7 gallons per capita of hard liquor per year in 1830, (double the amount of today)

› with drinking becoming more socially unacceptable, the per capita was less than 2 gallons in the mid 1840's

Chapter 14 Farmers would cross the Overland Trails to Oregon's

Willamette Valley because of promising economic opportunity and to get away from the malaria prone mid-west after being devastated by the Panic of 1837

Cholera killed 1,000 people per year in 1849 and early 1850's› spread by contaminated water› causes vomiting and diarrhea› led to extreme dehydration to death often in a single

night Hawaiian men known for their sailing skills would join

British and American fur ships, but died from European diseases

200 Years of American Medicine 1848: the Committee on Medical Literature of the AMA

(chaired by Oliver Wendell Holmes) identified 20 American medical journals› The committee thought the journals needed to be more

focused and not put such unworthy articles in them 1850: Lemuel Shattuck urged Massachusetts to form a

state board of health that would encourage and promote local efforts› The Massachusetts State Board of Health actually came to in

1869 and became a role model for other states People that were very influential of the time period:

› J. Marion Simms (1813-1883) contributions to gynecology was very highly criticized for his inhumane surgeries he would perform

on African American slave women without anesthetic

› William T. G. Morton (1819-1868) surgical anesthesia

› Joseph Leidy (1823-1891) contributions to paleontology studies on undercooked meat using microscopes encouraged society to thoroughly

cook meat, or risk getting a parasitic infection› Joseph J. Woodward

(1833-1884) contributions to microscopy and photomicrography used aniline dyes to color tissues after death attended Abraham Lincoln's autopsy

› S. Weir Mitchell (1829-1914) work in clinical neurology experimented extensively with animals

published 25 works and essays

Surgeon General Joseph Lovell started what would become the National Library of Medicine› 1818

started what would become the National Library of Medicine. It first began as a small, personal collection of books and today is its own building in Washington, DC.

is called the "father of gynecology" today. There is a book titled J. Marion Sims: Man or Monster – Can We Judge a 19th Century Scientist By 21st Century Standards? which just proves how controversial his experiments and practices were and are.

1. Temperance- a movement in which a person completely gives up alcohol

2. Photomicrography-a photograph that has been taken through a microscope

3. Paleontology-the science of the forms of life existing in former geologic periods, as represented by their fossils.

4. Aniline Dyes-the science of the forms of life existing in former geologic periods, as represented by their fossils.

5. Massachusetts State Board of Health- established in 1869 and became a role model for other states

Which of the following is NOT a sanitation disease?

a. typhusb. cholerac. the flud. yellow fever

Cholera killed _____ people in 1849 and the early 1850's.

a. 1,000b. 1,500c. 2,000d. 500

Joseph Lovell had his collection of books that would become the National library of Medicine in what year?

a. 1847b. 1818c. 1765d. 1899

___________ men were brought in to work with British and Americans because of their great sailing skills, but most of them died from natural causes.a. Ethiopianb. Chinesec. Koreand. Hawaiian

More than ___ gallons per capita in 1830 of hard liquor.

a. 7b. 3c. 10d. 5

Joseph Leidy worked in which of the following fields?

a. gynecologyb. neurologyc. pediatricsd. paleontology

Which of the following was a reason the farmers would cross the Overland Trails?

a. the California Gold Rushb. Cholera was a big problem where they were

coming fromc. both of the aboved. none of the above

Which of the following was NOT a symptom of cholera?

a. spread by contaminated waterb. causes vomiting and diarrheac. blindnessd. led to extreme dehydration to death often

in a single night

Which of the following was true about 18th century living conditions in the city?

a. they had garbage collectionb. they had sewersc. wild dogs were a serious issued. hoards of roaming pigs came and ate

leftovers in street

In the mid 1840's, which is NOT a reason the per capita for hard liquor drop to 2 gallons?a. drinking became socially unacceptableb. they found out heavy drinking hurts their liversc. the temperance movement claimed to bring

them closer to Godd. They are all true

Faragher, J, Buhle, M, & Czitrom, D. (2003). Out of Many: A History of the American People. Upper Saddle River,

NJ: Prentice Hall U.S Department of Health, Education,

and Welfare, National Institutes of Health. (1976). 200 years of american medicine (76-1069). Retrieved from http://www.nlm.nih.gov/hmd/pdf/200years.pdf

Chapter 16 Robert Fitzgerald caught Typhoid Fever 5 months after enlisting

› 117 members of his regiment died of disease but only 7 in battle › later discharged for poor eyesight

antiseptics in "infancy" during war men died of minor wounds that got infected gangrene a common cause of death overcrowding and unsanitary conditions bred small pox, dysentery, typhoid,

pneumonia, and malaria in the summer McClellan's Peninsular Campaign

› among 130,000 men, 1/4 of the unwounded were sick in July, 1862 › because disease is highest in August and September, Lincoln recalled McClellan and

his army 24 hours after battle of Shiloh, many wounded still lay on the battlefield in rain

› some died of exposure, others drowned because they couldn’t move Confederate prison camp of Andersonville in Northern Georgia was made to

hold 10,000 men › by midsummer, it was holding 33,000 men › In the worst weeks of summer, 100 prisoners died of disease, malnutrition, or exposure

each day

Army Nurses › medical supplies armies couldn’t provide were usually donated by the

United States Sanitary Commission in the North and by women's volunteer groups in the South

› usually taking care of the sick was women's work, but when it came to wounded soldiers, some found it "unseemly" for a respectable woman

› wartime necessity trumped objections from doctors, who didn’t want women no different than their wives or daughters to give them orders, and women became army nurses

› hospital nursing previously considered a job for a disreputable woman now considered a suitable job for middle-class women under leadership of Dorothea Dix with the Sanitary Commission by war’s end, 3,000 northern women worked as paid nurses, and many more

volunteered South had army nurses too, but were not as organized

during the Seven Days Battles, the women established the first "roadside hospitals" because there was no more room in hospitals

Dentistry in the Civil War About 500 dentists in the South before the war Jeffery Davis (secretary of war) advocated for dentistry corps

› Confederate army had a dental program› Similar idea rejected by Union Army

Toothbrushes rare and diet inadequate Recruits turned down if they didn’t have 6 opposing upper and

lower front teeth› Considered necessary to bite off the end of power cartridges used to load

rifles Battlefield Surgery Most common surgery was amputation Slow moving Minie bullet used caused catastrophic injuries

› Ex- the 2 minie bullets that hit John Bell Hood’s leg at Ceickamauya destroyed 5 inches of his upper thigh bone, leaving surgeons no choice but to amputate

The closer to the body the amputation was done, the more the increase in the wound being fatal› An upper arm amputation had a mortality rate of 24%

In North, out of 11,000 doctors, only 500 had performed surgery

In South, there were 3,000 doctors and only 27 had performed surgery

People wounded in the head, stomach, or chest were usually put aside because they were probably going to die

Use of antiseptics unknown, doctors wore blood and pus spattered clothes

If something fell on the floor during surgery, they’d rinse it off in cool water and use it as if it was clean

Operators wouldn’t wash hands or wear gloves and would often probe wounds with their fingers

Chloroform administered if available A good surgeon could amputate a limb in under 10 minutes George Otis’ 5 principal advances of the Civil War:

› Surgeons learned “something” about head injuries

› How to deal with “ghastly wounds”› Learned how to litigate arteries› Information on vertebrates and spines “augmented”› “theory and practice” of chest wounds forwarded

Surgical Fevers:› Because they were so focused on speed and not

cleanliness, fevers were common› Most common pyemia

Mortality rate of 90% Form of blood poisoning Means literally “pus in blood”

› Also tetanus- mortality rate of 87%› Erysepilas

Hospital gangrene- now extinct

1. Break bone Fever- An infectious disease which is characterized by severe pains in the eyes, head, and extremities and accompanied by catarrhal symptoms. Transmitted by the bite of a mosquito. AKA dengue

2. Minie bullets-a conical bullet with a hollow base that expanded when fired

3. Pyemia-a diseased state in which phylogenic bacteria are circulating in the blood, characterized by the development of abscesses in various organs

4. Erysipelas- a very contagious skin disease due to areas being infected with a strep germ. It is characterized by redness and swelling of the affected areas. It generally lasted between 10 and 14 days. Most infections of wounds were more likely not this disease and actually cellulitis

5. Osteomytelitis- inflammation of bone. A common surgical fever

U.S. philanthropist who organized the American Red Cross in 1881

head of army nurses in the North. Was very strict, but not out of harshness. She just didn’t want to deal with women becoming army nurses just to find husbands.

An upper arm amputation had a mortality rate of ____%.› 75› 24› 36› 80

The most common surgical fever was ______.› Pyemia› Tetanus› Erysipelas› Malaria

The US Sanitary Commission did all of the following EXCEPT:› provided help to poor African Americans› oversaw army nursing in the North› provided medicinal supplies to the North› integrated antiseptics into the Southern army

Which of the following was a common anesthesia medicine of the Civil War?› None› Propofol› Chloroform› Calomel

A good surgeon could finish an amputation in under ___ minutes.› 5› 20› 60› 10

The bullets used in the war were not…› Minie bullets› damage causing› easy to remove› explosive upon contact

The head of the army nurses in the North was _________.› Clara Barton› Dorothea Dix› Abraham Lincoln› Jeffery Davis

Which of the following is untrue about pyemia?› It literally means ‘pus in the blood’› A blood poisoning› Had a mortality rate of 90%› Was not usually an issue while recovering

from amputations

The _____ to the body the amputation was done, the more the increase in the wound being fatal.› Closer› Father away› More parallel› None of the above

Which of the following was NOT one of the things George Otis said doctors learned from the Civil War?› How to litigate arteries› How to treat ghastly wounds› How to treat infections› Learned about head injuries

Faragher, J, Buhle, M, & Czitrom, D. (2003). Out of Many: A History of the American People. Upper Saddle River,

NJ: Prentice Hall Goellnitz, J. (n.d.). Civil war battlefield

medicine. Retrieved from http://www.ehistory.osu.edu