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Despite such firmly held beliefs, which may seem ridiculous to the modern reader, these physicians and surgeons were intelligent and highly capable practitioners. Lacking most of the benefits of modern science, especially the knowledge of germ theory and the etiology of diseases, they attempted to unravel complex medical mysteries the best way they knew how. They relied on an Enlightenment appreciation of the physical world which emphasized reason and logic; they were emminently practical. Within the constraints of their philosophy and knowledge, they did the best they could to explain complex medical phenomena which have often baffled much better trained and equipped practicioners. If James Lind thought tetanus and lock-jaw were brought on by warm weather, and were native to the tropics, he was not being irrational; rusty metals, contaminated instruments, and bare feet were more common in Bombay than in Birmingham. 46 Lind was therefore simply fitting empirical observations to his own logical framework. And the able physician Benjamin Rush might not have known precisely why crowding twenty feverish soldiers into a single hospital room was unhealthy, but he certainly knew it was, and he advised George Washington to do something about it. 47
Contemporary cures also seem strange to modern readers, but they were administered in accordance with accepted medical reasoning. As J. Worth Estes wrote in 1985 about Dr. Peter St. Medard's prescriptions aboard the U.S.S. New York,
these drugs were not designed to counteract specific disease processes, as is usual today, but to adjust the body's internal equilibrium, its balances. St. Medard's medical practice was as logical as our own, but it was based on physiological assumptions that have since been abandoned. 48
One can but wonder how subsequent scholars, flush with cures for cancer, AIDS, and multiple sclerosis, might view the ignorant healers and technicians of the backwards twentieth century.
In the eighteenth century, however, the ability of a surgeon to diagnose diseases generally exceeded his ability to cure them. Empirical logic applied to observable pathologies was the doctor's guide, and however practical this approach seemed at the time, it often led the unsuspecting doctor astray. The most infamous archaic remedy was probably venesection, the notorious bleeding that still conjures up images of the medieval barber and his bowl of leeches. Bleeding by lancet or cupping glass remained popular well into the nineteenth century, although the practice was endorsed more enthusiastically by some than by others. Lind, for example, recommended against general venesection, though he thought it useful in some circumstances. 49 In this, as in other respects, Lind was somewhat ahead of his times, though even he found leeches at the temples "serviceable" for the relief of violent delirium. 50
On the other hand, in Minorca George Cleghorn thought it appropriate to take ten to twelve ounces of blood from the patient at the start of a tertian fever, before the patient weakened. 51 Commenting upon Cleghorn's methods, Benjamin Rush heartily endorsed them and cited his own experiences in treating a yellow fever epidemic in Philadelphia in 1793. 52 Practicing naval surgeons too, like Peter St. Medard of the U.S.S. New York, considered bleeding to be a valuable weapon in their hippocratic arsenal. 53 Perhaps if these well-meaning doctors had realized that the human body contained only six quarts of blood, instead of the twelve they supposed, they might have thought twice about excessive bleeding. 54
 Opium was another staple in the medicine chests of the eighteenth century, especially popular for treating dysentery, which most doctors called the flux. When the American frigate Essex fitted out in 1799, her medicine cabinet included one pound of "gum of opium." 55 In his proposed list of stores for an American ship of the line, Barton listed 1 pound and eight ounzes of opium or a derivative. 56 Similarly impressed with its restorative and healing powers, Cleghorn found opium useful for treating his dysentery patients. 57 While duly noting that opium and bleeding had opposite effects and that the surgeon must be careful to correctly prescribe for the appropriate ailment, Lind still recommended opiates for the treatment of violent dysentery. 58 Rush went even further by suggesting that opium was not only good for treating dysentery but was also less addictive and damaging than alcohol. 59 Contemporary surgeons sometimes used opiates in the form of anodynes to relieve the horrendous pain associated with amputations, which were all too often the surgeon's sovereign specific for battle wounds. 60
 The
Ladies Medicine Chest
Naval Medicine in 1812 pages 1 | 2 | 3 | 4 | 5 | 6 | 7
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