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When the Scientific Revolution arrived on America's shores, the approach to medicine changed. Prior to the Revolutionary War, medical practitioners understood disease in terms of the body's fluids or humours. The four humours were blood, phlegm, choler, and bile, and each was associated with a psychological attitude and personality type. Blood was sanguine (optimistic) and associated with excitement. Phlegm was phlegmatic and associated with slow movement. Choler was choleric and associated with upset. Bile was melancholy and associated with the stomach. If a person was ill, doctors believed it was due to an imbalance among these fluids. Restoring the humours to a balanced state would restore the person to health. Restoration could be produced by bleeding (opening a vein), blistering (heating a glass that was then put onto the skin; the blister that was raised was then lanced), and purging (sweating and/or vomiting). Surgery was crude and amputation common. Much was unknown. There was no germ theory, no sterilization, no hand washing prior to handling a patient or before surgery, no antibiotics, no knowledge of insect-borne disease, and no knowledge of causes of epidemics. Several kinds of doctors existed. Regular doctors served an apprenticeship with an established doctor or attended medical school in Europe (especially Edinburgh, Scotland) to gain their medical knowledge. Those who attended school studied anatomy, which led to increased skills in performing successful operations. Folk practitioners and quacks were self-appointed doctors. Religious doctors based their practice on such cures as praying for the sick. Midwives tended primarily to women during birthing but they also often provided general medical help to those in need. The Scientific Revolution brought major changes to the medical profession. Physicians took a new approach to understanding disease. Instead of relying on humours theory, they began to look at symptoms and to put them into categories, and to treat the symptoms similarly. All fevers, for instance, would receive the same treatment. This approach was known as nosological treatment. Debates raged about whether heroic cures (assaults on the body) or gentle and caring cures were best for healing the sick. Homeopathy arose in the 1820s and promoted the use of herbal-based cures. Benjamin Rush (1745-1815), abolitionist and signer of the Declaration of Independence, was the leading doctor during the American Revolution. He was a proponent of heroic cures but also advised such modern ideas as cleanliness (washing one's hands) and moderation in consumption of food. Licenses became important. Those with licenses became viewed as true doctors. Those who practiced medicine without a medical license were viewed as false doctors and drifted into obscurity. Midwives, the most medically knowledgeable after regular doctors, found their services in less demand as birthing became more medicalized and less natural, and moved out of the home and into the hospital. Over the nineteenth century, American medicine was a multi-faceted profession with many different kinds of doctors. In the end, regular doctors became the primary medical care-givers in the twentieth century. Today, we have many choices for seeking medical help--from general practitioners to specialists, chiropractors, Eastern medicine, and herbal medicine, just to name a few--but licensed physicians remain the most common doctors in America. A Medical Miscellany for Genealogists by Dr. Jeanette L. Jerger is useful for anyone interested in old medical terminology. Formatted like a dictionary, the terms are listed in alphabetical order and cross-referenced when necessary. Dr. Jerger also includes terms related to myth and magic as they weave in and out of the healing arts. European, Asian, African and Native American folk wisdom further complements the more mainstream medical terminology.
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