1. Colonial Medicine

2. The social contract of profession
The State of Massachusetts allows the Medical Society of …. A monopoly over the practice of Medicine
Rationale: because consumers are unable to judge quality, medical services cannot be a market commodity. Instead, it is in the public interest to allow a self-policing independent profession

3. American medical Profession
England
Physicians (RCP)
Surgeons (RCS 1745)
Apothecaries
Barbers
Chemist/druggists
Scottish doctors
Quacks
Licensed midwives
Colonies
Doctors
Healers – Martha Ballard

4. First Wave Professionalization 1760-1840
The Doctor as Midwife -- the rise of forceps delivery
? Who is a real doctor
? How do the real doctors get the gift of profession

5. Forms of training College + medical training (very rare)
College (30 % of 18th c. Mass pract)
Edinburgh
Apprenticeship (7 years UK, max of 5 MA; 36 % of 18th c Mass pract)
Family (20% of 18th c Mass pract)
Informal – “social medicine”

6. Diseases in colonial America
Epidemic: Smallpox, Diphtheria, Scarlet fever, Measles
Vs. European: typhus (typhoid), plague, dysentery, influenza, consumption
Endemic: worms, itch, burns vs the stone, gout, melancholia

7. Consider: M’s spiritual- Cotton Mather, Physical 1663-1728 Analogies
                                                                    Cotton Mather, circa 1700
Born
February 12, 1663)
Died
February 13, 1728 (aged 65)
Occupation
Minister
Consider:
M’s spiritual-
Physical
Analogies
M’s views
on the relation
of the physical
to the spiritual
M’s rhetorical
method and
Appeal to
authority
Cotton Mather,
Mather is not a doctor
Why is he writing a
Medical text?
Prosperity: soul or
Health?
Health as the most
Important temporal
prosperity
Image:

8. Mather’s diseases of the eye
Moral diseases
Envious, haughty, unchast
The centrality of tears
Eyes as danger portals – last to form, first to go
The grace of blindness
Eye cures
Spectacles
Eyebright
Celandine
copperas
Oysters
Betony (nose)
millipedes

9. Mather and Boylston vs Douglass and the doctors
Smallpox, deadliest of the child diseases: 90% infected, case mortality 20-30%
Boston in 1721: popu , c cases, 850 deaths (242 inoc., 6 deaths)
Sources of intellectual authority – old wives (slaves?) tales
Sources of political authority – justices, select-men, town meeting
Sources of propriety – who speaks for God?
Sources of acrimony – newspapers
Underlying tensions?