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Oregon Trail medicine; or,
How Not to Die of Dysentery

In the first half of the 1800s, mainstream medical doctors were not very trusted; travelers on the Oregon Trail relied more on herbal remedies or cold water.

A cartoon from the first issue of The Thomsonian Botanic Watchman, published in 1834, illustrates frontier America’s critique of mainstream medicine. On the left is an M.D. bleeding a patient and bludgeoning a patient with a club labeled “Calomel” (a powerful, toxic purgative). The words on his jacket are “dieting,” “regulate system,” “depletion,” “lancet” and “nitre.” On the right is a man labeled “Thomson’s system,” “food,” “steam,” “Lobelia” and “capsicum leads another patient to safety, while in the middle a man labeled “reason,” “philosophy” and “common sense” tries to talk sense into the rabid M.D. (Image: www.medicalheritage.org)

Readers old enough to remember the Rex Morgan, M.D., comic strip – which actually still is in production, although not as widespread as it once was – will have a good sense of the glory years of medicine in Oregon, and across the country too. For the past 75 years or so, doctors have enjoyed probably the most prestigious position in American society.

But of course, 75 years is not all that long a time. You don’t have to go too much farther back to find a very different kind of medical profession – one shot through from end to end with sadistic vivisectionists, skulking grave robbers, incompetent dabblers, ruthless dogmatists, delusional amateurs – and, of course, plenty of predatory swindlers.

It’s hard for modern people to believe, but in the mid-1800s medical practice had much more in common with religion than science. Microbes were completely undreamed-of, and no one knew why people got sick; so everything from “too much blood” to the vengeance of an angry god got blamed for things like cholera and malaria. And, as is the case with religious instruction, followers of particular “sects” could get pretty fierce with one another.

Of course, the Native Americans had their own healing traditions, many of which are now lost. But back when the United States was founded, European medicine was still mired in the imagineerings of Galen, a Roman physician from the second century A.D. who claimed that a balance of “humours” – blood, phlegm, “black bile” and “yellow bile” – was the key to wellness, and that all sickness stemmed from an imbalance in these four simple things. To cure disease, one simply had to restore that balance by various combinations of bleeding and purging.

By the time the Lewis and Clark expedition showed up in Oregon back in 1805, European medicine had barely moved from this position. The main innovation had been a sort of mania for “heroic” application of the bleedings and purgings – forcing already-sick people to endure the loss of pints of blood and spend hours straining and retching over chamber-pots and outhouses. Naturally, this abuse killed plenty of people who otherwise would have survived. Everyday people had started to notice this, and the respectability of mainstream medicine was probably at its lowest ebb.

The dreaded final screen of the Oregon Trail videogame as rendered on an early-1980s-vintage Apple IIe computer. (Image: MECC)

And that was the kind of medicine that was being practiced by the members of the Lewis and Clark expedition, on its way to Oregon. Prominent in the voyagers’ first-aid kit were hundreds of beefy white tablets of mercury chloride, marketed as “Dr. Rush’s Bilious Pills” – a concoction of American founding father Dr. Benjamin Rush, a signer of the Declaration of Independence.

The pills were designed to restore a patient’s bile balance by inducing “heroic” purging, but mostly what they got used for was suppression of syphilis symptoms and as an emergency laxative. The men called them “Thunder clappers.”

But, of course, the lore of medical men like Dr. Rush was supposed to be good for more than just temporary relief of constipation. By Lewis and Clark’s time, the effective moral bankruptcy of mainstream medicine was common knowledge, and was leading to fresh approaches such as homeopathy (“like cures like”) and hydropathy (the hot-and-cold “water cure”), and to the witches’-brew formulations of herbalist Samuel Thompson. And it was those schemes that most characterized the state of the medical arts in early Oregon — especially Thompson’s ideas, which borrowed heavily from Native American traditions.

By the 1840s when emigrants started coming out to Oregon on wagon trains, most regular people had little use for mainstream medicine, and looked to Thompson’s folk remedies to get them through tough times.

The lucky participants in Sol Tetherow’s wagon train, back in 1845, got better medical treatment than most when they were sick, despite wagonmaster Tetherow’s lack of medical credentials. What he did have, though, was a little book of remedies, courtesy of a Thompsonian practitioner named Dr. William Dains.

Everyone who’s ever played the Oregon Trail educational videogame — that is, everyone who attended public school in Oregon in the last 30 years or so — knows what happened in the game when Little Sally got “dysentery.” Despite administrations of Epsom salts, the inevitable “You have died of dysentery” could never be too many turns away.

But if little Sally had been on Tetherow’s wagon train, she would have promptly been offered something called an “Ague and Liver Costive”:

“Dry beef gall to thick molasses thicking it with May Apple, equal Colycynth and Bloodroot ¼ of the above,” Dr. Dains instructs. “Role it out with flower (flour) into pils. Dose 2 tsp at bed time as often as the case needs.”

If that didn’t work, there was a more aggressive recipe that was probably the emigrants’ go-to formula for dealing with malaria:

“Dry beef gall to thick (molasses consistency). Thicken it with eaqul parts May apple, bloodroot, cayenne pepper, culver root, ½ part lobelia seed. Mix, role into pills with flower, common serve doses 2 to 6 a day as the case requires.”

Would this have cured little Sally’s dysentery? Probably not, but it sure would have beaten bleeding her to “restore her bile balance” or soaking her feet in Epsom salts.

Here’s what was offered to any wagon train participant who grew desperate enough to ask for help with a cough or sore throat:

“Cough Surrup: Boil the lickrish root to thick molasses. Take 1 fluid oz Balm Gilead buds, 1 gil vinigar, 1 gil strong sirrip of skunk cabbage root, ½ fluid oz tincter libelia. Take a tea spoon full or so as often as the case requires to keep the plegm loos to rais easy.”

You will have gathered that spelling and grammar wasn’t part of Dr. Dains’ medical education. This wasn’t uncommon on the American frontier of the mid-1800s. Many medical practitioners were, in fact, self-taught – especially the Thompsonians, who considered themselves to be populist “heal thyself” types, in contrast with the paternalistic “submit to my orders” tradition of mainstream medicine.

Possibly the most intriguing recipe in Dains’ book is something he calls “Mother’s Relief,” which is an elaborate concoction of extracts, including those of partridge berry vine, unicorn root, blue cohusk, spikenard, bayberry bark, birthroot, raspberry leaves, witch hazel leaves and lady slippers, given to women to ease the labor of childbirth. Reading the ingredients list, one has to wonder if it might have had any real therapeutic value.

Nonetheless, some frontier mothers seem to have had little need for anything of the kind. Here’s Mary Richardson Walker’s diary entry for the particularly eventful day of March 16, 1842:

“Rose about five. Had early breakfast. Got my housework done about 9. Baked six loaves of breads, made a kettle of mush and have now a suet pudding and beef boiling. My girl has ironed and I have managed to put my clothes away and set my house in order. May the Merciful be with me through the unexpected scene. Nine o’clock p.m. was delivered of another son.”

(Sources: Larsell, O. The Doctor in Oregon. Portland: Binfords, 1947; Bromberg, Erik. “Frontier Humor: Plain and Fancy,” Oregon Historical Quarterly, Sept. 1960)