Surgery during this period killed as many as it cured, mostly due to sepsis. It was in Europe, where the surgical arts were being perfected, at this time, specifically France, and new techniques flourished there and were quickly disseminated among European medical schools. However, even in Europe, sepsis [infection] was still a problem.
Most surgeries in the US involved the treating of wounds, as well as battle wounds. Amputation was most probably the leading surgical procedure performed.
In 1809, Jane Todd Crawford (Lincoln’s wife’s—Mary Todd— cousin) was diagnosed with a very large ovarian cyst which had originally been diagnosed as a pregnancy. At the time, no tumor had ever been removed successfully. However, there was a visiting surgeon from Edinburgh who agreed to do the surgery. According to Gail Collins, he gave her opium and alcohol to ease the pain, and a month later she returned home cured.
Legend has it that an angry crowd surrounded the doctor’s home while he was treating Mrs. Crawford, threatening to kill him for his outrageous assault on a female body. [Collins]
It was not until mid century that anesthesia was being used, as is outlined in our tongue in cheek article, The History of Anesthesia. At this time Dr J Marion Sims began experimenting with his female slaves.
Females of this period had a rough time where medicine was involved, for doctors were determined to treat every facet of female passage, from puberty through menopause as a disease.
Many doctors believed that during their periods, women were deprived of blood to the brain, leaving them “idiotic” or temporarily insane. [Collins]
During childbirth, regulars bled women into unconsciousness, mainly to relieve their own anxiety at hearing the screams and moans accompanying most births. How woman handled menstruation at this time will remain a mystery because it was something that no one mentioned in private or public. Even diaries have no mention of this monthly visitor, though many have theories on the subject, with some guessing that the use of multiple skirts and petticoats was to hide the great variety of “napkins” women had developed and used at the time.
What we do know for sure is that personal hygiene was extremely poor. Diapers were not even washed till just prior to the Civil War. Bathing was considered unhealthy. Magazine articles exhorted people to brush their teeth, but again, accounts of visitors returning to Europe spoke volumes of the poor dental care in Americans of that time. Much of our tooth loss and gum disease, though, was attributable to mercury poisoning from traditional medicine.
Because of modesty, and no regular female physicians, doctors were not allowed to look upon the naked bodies of their female patients. Many palpated (felt around) under the skirts, while others examined women with the aid of a mirror (to avoid looking directly). Collins points out that one of the best obstetricians of that period, a Dr Degorges, was blind. Many a physician exhorted medical students in their care to avoid viewing a half naked woman (even giving birth) under their care for it could result in sexual perversion leading them to adultery and madness. Students had to learn from textbooks and manikins.
Things sexual were strictly taboo, leading to much ignorance on the subject of birth control and sexually transmitted diseases, though an efficient mail system supported our young entrepreneurial spirit in the trade of sexual goods:
… Americans could send away for birth control pamphlets, medical devices like diaphragms and syringes, condoms, spermicides for douching, and pills that promised to induce abortions. Ads for condoms, cures for venereal disease, aphrodisiacs, and abortion services were an economic mainstay of the urban newspapers. Agents distributed ads for birth control devices on street corners and mailed them to newlyweds. “French” was a code for a contraceptive, and “Portuguese” for something that induced abortion . . . . [Collins]
Abortions, performed early, were a socially accepted form of birth control. Even the Catholic Church looked the other way, as the fetus was not considered human till movement was perceived. Midwives hung flags out their windows signifying that they performed abortions. [Collins]
Infant mortality was high, even though, as Collins points out, “Americans were more likely to live to adulthood than ever before.” With husbands gone most of the time and no easy way to call for help, young wives were left alone to their superstitions. Everyone knew a handful of stories of a happy, bouncing baby struck by a sudden fever and dead before morning.
Traditional medicines at this time did more harm than good (history seems to repeat itself, e.g. Vioxx) and parents began to drug their children.
An 1833 guide used by southern women suggested daily doses of laudanum, an opium derivative—four drops for a nine-month-old and five to six drops for a toddler. [Collins]
American women, according to the European visitors, aged rapidly. Be it due to the ravages of raising a family or poor nutrition or poor medical care, one visitor penned this maxim:
"… charming and adorable at fifteen . . . faded at twenty-three, old at thirty-five and decrepit at forty." [Collins]
It was right around the mid 19th century that our personal hygiene habits began to improve. It became genteel to have a fresh water basin awaiting one’s morning ablutions. Babies where no longer swaddled (very tightly fitting clothing) in unwashed linens, but were loosely clothed and their diapers washed regularly, and not allowed to dry while the baby still wore them. The belief that children were born unsullied sprouted at this time, and since the mother was a child’s main influence, she often took all the blame should her child go astray. Women’s magazines, physicians, clergy, and neighbors offered plenty of unsolicited advice to raising the perfect child, but the perfect child was only to be found in books. The story of young George Washington still finds life in many an elementary school today.
Women were not allowed in medical schools, period. The reasons for this were varied, and today, quite comical. It took the Blackwell sisters to finally breach this barrier, though the barrier still remained sturdy for many, many years.
Elizabeth Blackwell was inspired to go into medicine because women had a hard time discussing their issues with male doctors. She’d had a close friend dying of uterine cancer who told her of her troubles communicating with her physician. Elizabeth applied at nearly every medical school available at that time, and was turned down time after time, with some faculty members even suggesting she disguise herself as a man and try Paris. [Collins]
As luck would have it, the faculty of a small medical school in upstate New York decided to ask the student body about admitting women, and boys being boys, particularly rowdy that day, cheered and hollered and yipped their approval (most assuredly along with gratuitous lewd gestures) and that was that. Wouldn’t you like to have been a fly on the wall the day Elizabeth Blackwell showed up for her first day of class? The student body thought it had been a joke, but, as the saying goes, the joke was on them. “A hush fell over the class as if each member had been stricken by paralysis.” [Jordan Brown, Elizabeth Blackwell, Physician (p.52)].
Learn more about 19th century women doctors and women's health at www.CivilWarRx.com