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+Project Gutenberg's Medicine in Virginia, 1607-1699, by Thomas P. Hughes
+
+This eBook is for the use of anyone anywhere at no cost and with
+almost no restrictions whatsoever.  You may copy it, give it away or
+re-use it under the terms of the Project Gutenberg License included
+with this eBook or online at www.gutenberg.org
+
+
+Title: Medicine in Virginia, 1607-1699
+
+Author: Thomas P. Hughes
+
+Release Date: March 22, 2009 [EBook #28390]
+
+Language: English
+
+Character set encoding: ASCII
+
+*** START OF THIS PROJECT GUTENBERG EBOOK MEDICINE IN VIRGINIA, 1607-1699 ***
+
+
+
+
+Produced by Mark C. Orton and the Online Distributed
+Proofreading Team at https://www.pgdp.net
+
+
+
+
+
+
+MEDICINE IN VIRGINIA, 1607-1699
+
+
+
+By
+
+THOMAS P. HUGHES
+
+Assistant Professor of History, Washington and Lee University
+
+
+
+VIRGINIA 350TH ANNIVERSARY CELEBRATION CORPORATION
+WILLIAMSBURG, VIRGINIA
+1957
+
+COPYRIGHT(C), 1957 BY
+VIRGINIA 350TH ANNIVERSARY CELEBRATION
+CORPORATION, WILLIAMSBURG, VIRGINIA
+
+Second Printing, 1958
+
+Third Printing, 1963
+
+
+Jamestown 350th Anniversary
+Historical Booklet, Number 21
+
+
+[Transcriber's Notes: Research indicates the copyright on this book was
+not renewed.
+
+The Table of Contents was not printed in the original text but has been
+added here for the convenience of the reader.]
+
+
+
+
+CONTENTS
+
+
+CHAPTER ONE
+European Background and Indian Counterpart to Virginia Medicine     1
+
+CHAPTER TWO
+Disease and The Critical Years At Jamestown                        12
+
+CHAPTER THREE
+Prevalent Ills and Common Treatments                               31
+
+CHAPTER FOUR
+Education, Women, Churchmen, and The Law                           60
+
+CHAPTER FIVE
+Conclusion                                                         73
+
+Acknowledgements and Bibliographical Note                          77
+
+
+
+
+CHAPTER ONE
+
+European Background and Indian Counterpart to Virginia Medicine
+
+
+EUROPEAN BACKGROUND
+
+The origins of medical theory and practice in this nation extend
+further than the settlement at Jamestown in 1607. Jamestown was a seed
+carried from the Old World and planted in the New; medicine was one of
+the European characteristics transmitted with the seed across the
+Atlantic. In the process of transmission changes took place, and in the
+New World medicine adapted itself to some circumstances unknown to
+Europe; but the contact with European developments in theory and
+practice was never--and is not--broken.
+
+Because of this relationship between European and American medicine, an
+acquaintance with seventeenth-century European medicine makes it
+possible to give additional support to some of the information in the
+early sources about medicine in colonial Virginia. In addition,
+knowledge of the European background allows reasonable speculation as
+to what happened in Virginia when the early sources are silent.
+
+In discussing the background for American medicine it is not necessary
+to make a firm distinction between England and the rest of Europe. As
+today, science--in this case, medical science--frequently ignored
+national boundaries. The same theories relative to the structure of the
+body (anatomy), to the functions of the organs and parts of the body
+(physiology), and to other branches of medical science were common to
+England and Europe. Medical practice, like theory, varied but in detail
+from nation to nation in Western Europe.
+
+Seventeenth-century Europe relied heavily upon ancient authority in the
+realm of medical theory. The European and colonial Virginia physician,
+surgeon, and even barber (when functioning as a medical man)
+consciously or unconsciously drew upon, or practiced according to,
+theories originated or developed by Hippocrates (460-377 B.C.) and
+Galen (131-201 A.D.). Hippocrates is remembered not only for his
+emphasis upon ethical practices but also for his inquiring and
+scientific spirit, and Galen as the founder of experimental physiology
+and as the formulator of ingenious medical theories. Most often
+Hippocrates was studied in Galen's commentaries.
+
+No longer do scholars or physicians scoff at the ancient authorities
+who dominated medical thinking for so many centuries. The
+seventeenth-century physician striving to reduce the frightful inroads
+that disease made into the colony at Jamestown may have been
+handicapped by the erroneous doctrines of the gossamer-fine _a priori_
+speculation of Galen, but the physicians to a large extent practiced
+according to a science rather than to superstition and magic--because
+the voluminous writings of Galen survived the centuries. Nor would the
+European physician, or his Virginia counterpart, have demonstrated the
+same appreciation for close observation if Hippocrates had not still
+been an influence.
+
+In the realm of pathology (the nature, causes, and manifestations of
+disease) the humoral theory, with its many variations, was extremely
+popular. The humoral doctrines stemming largely from Hippocrates were
+made elaborate by Galen but were founded upon ideas even more ancient
+than either thinker and practitioner. As understood by the
+seventeenth-century man of medicine, the basic ideas of the humoral
+theory were the four elements, the four qualities, and the four humors.
+The elements were fire, air, earth, and water; the four qualities were
+hot, cold, moist, and dry; and the four humors were phlegm, black bile,
+yellow bile, and blood. From these ideological building stones a highly
+complex system of pathology developed; from it an involved system of
+treatment originated. In essence the practitioner of the humoral school
+attempted to restore the naturally harmonious balance of elements,
+qualities, and humors that had broken down and caused disease or pain.
+
+The seventeenth-century, however, witnessed in medicine the trend,
+manifest then in so many fields of thought, away from an uncritical
+acceptance of the authority of the past. It also saw a defiant denial
+of ancient authority among those more radically inclined, such as the
+disciples of the sixteenth-century alchemist and physician, Paracelsus.
+Although some of his practices and teachings were based on the
+supernatural, Paracelsus stressed observation and the avoidance of a
+mere system of book-learning.
+
+Practice lagged behind new scientific theory in medicine but Virginia
+must have felt at least the reverberations caused by the clash of the
+ancient and the new.
+
+An important new school of medical theory was the iatrophysical or
+iatromathematical (_iatros_ from the Greek--physician). This medical
+theory--as is the case with many scientific theories-was borrowed from
+another branch of science. The seventeenth century, the age of Isaac
+Newton, Galileo Galilei, Gottfried Wilhelm von Leibnitz, Rene
+Descartes, and other giants of physical science, was a period of
+remarkable progress in the field of physics. It is not surprising then
+that theorists in the field of medicine, noting the truths discovered
+by conceiving of nature as a great machine functioning according to
+laws that could be expressed in mathematical terms, should have
+attempted to explain the human body as a machine.
+
+William Harvey (1578-1657), whose name looms great in the history of
+seventeenth-century medicine, explained the circulation of the blood in
+mechanical terminology. To Harvey, working under the influence of the
+great physicists, the heart was a mechanical force pump and the blood
+was analogous to other fluids in motion. How many physicians,
+practicing in the same intellectual environment as this Englishman,
+must have carried the mechanical analogy to the extent of thinking of
+the teeth as scissors, the lungs as bellows, the stomach as a flask,
+and the viscera as a sieve?
+
+The iatrochemical school existed alongside the iatrophysical. Whereas
+the iatrophysical thought primarily in terms of matter, forces, and
+motions, the iatrochemical thought chemical relationships were
+fundamental. One of the founders of this school, the Dutch scientist
+Sylvius (1614-72), explained diseases chemically (an approach not
+completely unlike the humoral of Galen) and treated them on the basis
+of a supposed chemical reaction between drug and disease. Another
+leading figure in the iatrochemical school, Thomas Willis (1621-75),
+was an Englishman. These two advocated the use of drugs at a time when
+their respective nations were developing great colonial empires rich
+with the raw materials of pharmacology.
+
+However, it would be an error to think of the medicine of the period,
+either European or Virginian, only in terms of rational or scientific
+theories. Treatment was too often based on magic, folklore, and
+superstition. There were physicians relying upon alchemy and astrology;
+the Royal Touch was held efficacious; and in the _materia medica_ of
+the period were such substances as foxes' lungs, oils of wolves, and
+Irish whiskey. Nor should it be forgotten that many of the sick never
+saw a medical man but relied upon self-treatment.
+
+With theories from the ancient authorities and from experimenting
+scientists to draw upon, the practicing physicians could deduce
+therapeutic techniques or justify curative measures, but the emphasis
+on theory brought with it the danger of ignoring experience and
+abandoning empirical solutions. Aware that many of his fellow
+physicians tended to overemphasize theory Thomas Sydenham (1624-89),
+who received his doctorate of medicine from Cambridge University,
+recommended personal experience drawn from close observation. He
+scoffed at physicians who learned medicine in books or laboratory, and
+never at the bedside. His study of epidemics, his emphasis on geography
+and climate as casual factors in the genesis of disease, make this
+Englishman's views and practices especially relevant to the medical
+history of Virginia where geography and climate did play such important
+roles in the life of the colony.
+
+The history of surgeons and surgery during the century is less
+distinguished than that of the physician and his practice. Surgery
+produced no individuals of the stature and significance of Sydenham nor
+any revolutionary theories as important as Harvey's. Dissections were
+made but the knowledge acquired was not applied; amputation was common
+but not always necessary or effective.
+
+Battle wounds and injuries lay in the province of the surgeon. While
+the surgeon was primarily concerned with the military, using mechanical
+force (cutting, tying, setting, and puncturing) in his treatment of
+body wounds and injuries, physicians on the Continent and in England
+also filled these functions. For example, physicians in Italy sometimes
+performed surgical operations they considered worthy of their dignified
+positions, and in England the licensed physician could practice
+surgery. On the other hand, surgeons licensed by Oxford University were
+bound not to practice medicine. Both in France and in England surgeons
+and barbers held membership in the same guild or corporation, and
+physicians considered them of inferior social status. The American
+frontier tended to reduce such professional and social distinctions.
+
+In Europe and England, where medical education was institutionalized to
+a far greater extent than in colonial Virginia, education explains much
+of the difference in social status between physician and surgeon. The
+surgeon learned by apprenticeship to an experienced member of his guild
+while the physician had to meet certain educational and professional
+requirements, depending upon local or national law. The best medical
+education of the period could be had at the great centers of Leyden,
+Paris, and Montpellier. Cambridge and Oxford also offered a degree in
+medicine.
+
+Englishmen preferred to study medicine abroad--according to a recent
+study made by Phyllis Allen and printed in the _Journal of the
+History of Medicine and Allied Sciences_--because a better education
+could be obtained there in the same number of years. The Doctorate of
+Medicine required fourteen years of undergraduate and post-graduate
+study at Oxford; the Cambridge requirement was similar. Despite reforms
+during the seventeenth century, education at these universities
+remained dogmatic and classical. Students usually found their studies
+dull and their social life stimulating. The more enterprising students
+could find the new ideas of the period in books not required in their
+course of study. Cambridge, Oxford, and the Royal College of Physicians
+all licensed physicians who had survived their education, met certain
+professional requirements, and passed an examination.
+
+That physicians in England did possess a high social status as well as
+more extensive formal education is evidenced by a precaution taken by
+the Virginia Company, to avoid causing displeasure among men of rank,
+in preparing letters patent. The Company requested of the College of
+Heralds, in 1609, the setting "in order" of the names of noblemen,
+knights, and Doctors of Divinity, Law, and Medicine so that their
+"several worths and degrees" might be recognized when their names were
+inserted on the patents. Surgeons received no mention.
+
+On the other hand, physicians and surgeons in England might well have
+come from similar social backgrounds and even on occasions from the
+same families. When there were three or four sons in the family of a
+country gentleman, he might have followed the custom of keeping the
+eldest at home to manage and eventually inherit the estate. The second,
+then, would be sent to one of the universities in order to follow a
+profession such as that of physician, lawyer, or clergyman. The third
+might be apprenticed to an apothecary, surgeon, or a skilled craftsman.
+This practice should be borne in mind when former medical apprentices
+are found in high offices in Virginia; their origins were not always
+humble.
+
+Although the physician enjoyed the greatest social and professional
+prestige, he received the most verbal abuse and criticism. Perhaps the
+most damaging and galling satire of the century flowed from the pen of
+the French dramatist, Moliere, who had a medical student--not
+completely fictitious--swear always to accept the pronouncements of his
+oldest physician-colleague, and always to treat by purgation, using
+clysters (enemas), phlebotomy (bloodletting), and emetics (vomitives).
+These three curative measures followed the best Galenic technique:
+releasing corrupting humors from the body. Moliere's _Le Malade
+Imaginaire_ confronted the audience with constant purgings and
+bleedings, and the caricature was not excessive.
+
+The diseases of the century did not allow for the inadequacies of the
+physician, and imparted a grim note of realism to the satire of the
+dramatist. Infant mortality was high and the life expectancy low.
+Hardly a household escaped the tragedy of death of the young and the
+robust; historians have sensed the influence omnipresent death had upon
+the attitudes and aspirations of the European and American of earlier
+centuries. School children today learn of such a dramatic killer as the
+bubonic plague, but even its terrible ravages do not dwarf the toll of
+ague (malaria), smallpox, typhoid and typhus, diphtheria, respiratory
+disorders, scurvy, beriberi, and flux (dysentery) in the colonial
+period.
+
+England, and especially London with its surrounding marshes, suffered
+acutely with the ague during the century. Englishmen arriving in the
+New World were well aware of the dangers of this disease and made some
+effort to avoid the bad air, and the low and damp places. In 1658 the
+ague took such a toll that a contemporary described the whole island of
+Britain as a monstrous public hospital. Unfortunately, Thomas Sydenham,
+whose prestige in England was great and whose works on fevers were
+influential, paid scant tribute to cinchona bark (quinine) which was
+known but thought of, even by Sydenham, as only an alleged curative
+offering too radical a challenge to current techniques. According to
+humoral doctrine, fever demanded a purging, not the intake of
+additional substances.
+
+Unfortunately, public hygiene and sanitation enlisted few adherents.
+Epidemics of the seventeenth century have been judged the most severe
+in history. In Italy physicians ahead of their times proposed the
+draining of marshes and pools of stagnant water, and recommended the
+isolation of persons with contagious diseases. But it was the great
+London fire of 1666 that rid that city of its infested and infected
+places, not an enlightened municipality.
+
+Therefore Virginia, a colony of seventeenth-century Europe, started
+life burdened with a heritage of deadly and widespread disease and
+inadequate medicine. Not only did the ships that brought the settlers
+to Jamestown Island bring surgeons and medical supplies but also
+medical problems frequently more serious than the men and supplies
+could cope with.
+
+The European or Englishman, however, did not originate the practice of
+medicine in Virginia for the Indian had had to struggle with the
+problems of disease and injury long before the seventeenth century.
+
+
+INDIANS AND THEIR MEDICINE
+
+Seventeenth-century Americans found the medical practices of the
+Indians interesting enough to include descriptions of them in their
+accounts of the New World. The attitude of the authors of these early
+observations is a mixture of curiosity, wonder, and--on
+occasion--admiration.
+
+Henry Spelman, one of the early colonists, wrote of Jamestown and
+Virginia as they were in 1609 and 1610. He described the manner of
+visiting with the sick among the Indians. According to Spelman, the
+"preest" laid the sick Indian upon a mat and, sitting down beside him,
+placed a bowl of water and a rattle between them. Taking the water into
+his mouth and spraying it over the Indian, the priest then began to
+beat his chest and make noises with the rattle. Rising, he shook the
+rattle over all of his patient's body, rubbed the distressed parts with
+his hands, and then sprinkled water over him again.
+
+Like the colonist, the Indian tried to draw out blood or other matter
+from the sick or wounded person. The method often used for releasing
+the ill humor from a painful joint or limb must have caused
+considerable suffering but may have offered certain advantages in
+preventing fatal infection. If the affected part could bear it, the
+Indian thrust a smoldering pointed stick deep into the sore place and
+kept it there until the excess matter could drain off. Another
+technique for burning and opening had a small cone of slowly burning
+wood inserted in the distressed place, "letting it burn out upon the
+part, which makes a running sore effectually."
+
+Still another method for treating a wound was for the priest to gash
+open the wound with a small bit of flint, suck the blood and other
+matter from it, and finally apply to it the powder of a root. A
+colonist in describing the practice wrote that "they have many
+professed phisitions, who with their charmes and rattels, with an
+infernall rowt of words and actions, will seeme to sucke their inwarde
+griefe from their navels or their grieved places." Judging by other
+accounts written during the century concerning Indian medicine, the
+powdered root may well have been sassafras, of which there was an
+abundance in the Jamestown area. The priest dried the root in the
+embers of a fire, scraped off the outer bark, powdered it, and bound
+the wound after applying the powder.
+
+Not only did the native American resort to a crude form of bloodletting
+but he practiced sweating as well--which was also common to
+seventeenth-century European medical practice. In Captain John Smith's
+description of Virginia it was noted that when troubled with "dropsies,
+swellings, aches, and such like diseases" the cure was to build a stove
+"in the form of a dovehouse with mats, so close that a fewe coales
+therein covered with a pot, will make the pacient sweate extreamely."
+
+Before lighting his stove, the Indian covered his sweating place with
+bark so close that no air could enter. When he began to sweat
+profusely, the sick Indian dashed out from his heated shelter and into
+a nearby creek, sea, or river. An Englishman commented that after
+returning to his hut again he "either recover[s] or give[s] up the
+ghost."
+
+The Indians, like Moliere's stage physician, believed in the value of
+the purge. Every spring they deliberately made themselves sick with
+drinking the juices of a medicinal root. The dosage purged them so
+thoroughly that they did not recover until three or four days later.
+The Indians also ate green corn in the spring to work the same effect.
+
+The Indian medicine man, like his European counterpart, frequently
+dispensed medicines or drugs. As has been the custom among many men in
+the medical profession, the medicine man would not reveal the secrets
+of his medicines. "Made very knowing in the hidden qualities of plants
+and other natural things," he considered it a part of the obligations
+of his priesthood to conceal the information from all but those who
+were to succeed him. On the other hand, the Indian priest showed his
+concern for the health of his people--and the similarity of his
+attitude to that of present day practices--by making an exception to
+his canon of secrecy in the case of drugs needed in emergencies arising
+on a hunting trip and during travel.
+
+According to one early eighteenth-century history of Virginia, the
+Indian in choosing raw materials for drugs preferred roots and barks of
+trees to the leaves of plants or trees. If the drug were to be taken
+internally it was mixed with water; when juices were to be applied
+externally they were left natural unless water was necessary for
+moistening. Whatever the drug and however utilized, the Indian called
+it _wisoccan_ or _wighsacan_, for this term was not a specific herb,
+as some of the earlier settlers thought, but a general term.
+
+Besides sassafras, medicinal roots and barks, the Indian believed in
+beneficial effects of a kind of clay called _wapeig_. The clay, in the
+opinion of the Indians, cured sores and wounds; an English settler
+marvelled to find in use "a strange kind of earth, the vertue whereof I
+know not; but the Indians eate it for physicke, alleaging that it
+cureth the sicknesse and paine of the belly." Insomuch as the Indian
+priest preferred to keep his professional secrets, the colonist was
+unlikely ever to learn the "vertue" of the clay.
+
+If the Indian medicine man had not believed that his gods would be
+displeased--or his prestige lowered--by revealing the nature of the
+_wisoccan_ he prescribed, it would have been possible for the early
+Virginians to have drawn upon the Indian knowledge of, and experience
+with, the simples and therapies of the New World. (Perhaps the
+"vertues" of the clay would have cured the "paines" of the Jamestown
+bellies.) As it was, the settlers make little mention of a reliance
+upon the Indians for medical assistance.
+
+
+
+
+CHAPTER TWO
+
+Disease and The Critical Years At Jamestown
+
+
+MOTIVES AND PROVISIONS FOR COLONIZATION
+
+In 1606 King James of England granted a charter to Sir Thomas Gates and
+others authorizing settlements in the New World. In 1609 this charter
+was revised and enlarged, granting the privileges to a joint-stock
+company. Among the merchants, knights, and gentlemen holding shares in
+the company and among those particularly interested in the more
+southerly areas of North America, including Virginia, were a number of
+physicians. The instructions given to the first settlers reflect the
+general concern of the London Company for the health of the colony and
+perhaps the particular interest of the physicians. One of the
+physicians, John Woodall, took especial care to urge that cattle be
+sent to provide the settlers with the milk he considered essential to
+their health.
+
+Not only did the Company wish to lessen the dangers of disease in the
+New World, but it also urged colonization as a means of reducing the
+plague in England. In 1609 the Company advised municipal authorities in
+London to remove the excess population of that great city to Virginia
+as the surplus was thought to be a cause of the plague. There was
+little danger of a surplus population during the initial years in
+Virginia.
+
+Before the colonists, or the Company, however, had to be concerned with
+dangers from disease in Virginia, the colonists had to undertake an
+extremely difficult and unhealthy voyage across the Atlantic.
+
+
+DISEASE AND THE OCEAN VOYAGE
+
+Ships plying the Atlantic at the beginning of the seventeenth century
+were small and the voyage was lengthy. Four months passed before the
+_Godspeed_, the _Discovery_, and the _Susan Constant_, carrying the
+first permanent settlers to Jamestown, sighted the two capes at the
+mouth of Chesapeake Bay in April, 1607.
+
+Although these small ships carrying the first permanent settlers had a
+stopover in the West Indies for rest and replenishment, there had been
+debilitating months at sea and more than 100 emigrants to provide for
+in addition to the crews. With limited cargo and passenger space, water
+and food supplies could hardly satisfy the demand created by a hundred
+persons at sea for hundreds of days. Several of the emigrants died on
+the first voyage and the remainder disembarked poorly prepared for the
+new tests their constitutions would soon endure.
+
+The sea voyage of these first settlers probably exacted no heavier a
+death toll and caused no more suffering because the ships went by way
+of the Canaries and the West Indies instead of by the more northerly
+route by-passing the islands. A contemporary described the advantages
+thought to be had from the stopover in the West Indies (at the island
+of Nevis):
+
+    We came to a bath standing in a valley betwixt two hills, where wee
+    bathed ourselves.... Finding this place to be so convenient for our
+    men to avoid diseases which will breed in so long a voyage, wee
+    incamped our selves on this ile sixe dayes, and spent none of our
+    ships victuall.
+
+Anchoring off other West Indian islands the ships were able to
+replenish their stores with fresh meat and fish and to replace the
+evil-smelling and foul water in their casks with fresh. By these
+measures the colonists demonstrated a concern not only for comfort but
+also for hygienic precautions.
+
+Later voyages during the century took anywhere from two to three
+months. Despite the precautions taken by some, of a rest, in the West
+Indies to bring about "restitution of our sick people into health by
+the helpes of fresh ayre, diet and the baths," the trip aboard the
+pestered ships continued to exact a heavy death toll and to discharge
+disease and diseased persons. Benefits resulting from the stopover in
+the Indies were countered by the considerable exposure to tropical
+infections. One convoy carrying colonists to Virginia in 1609 and
+running a southerly course through "fervent heat and loomes breezes"
+had many of the crew and passengers fall ill from calenture (tropical
+or yellow fever). Out of two ships so afflicted, thirty-two persons
+died and were thrown overboard. Another of these ships reported the
+plague raging in her.
+
+Irritated by frequent references to the unhealthy climate of Virginia
+and fearful that the bad publicity would increase the difficulties in
+obtaining colonists, officials of the London Company took pains to
+expose the part that the ocean voyage played in bringing about the
+deaths of newcomers. Musty bread and stinking beer aboard the pestered
+ships, according to a contemporary, worked as a chief cause of the
+mortality attributed falsely to the Virginia climate and conditions at
+Jamestown. In 1624 Governor Wyatt and his associates recommended to
+commissioners from England that "care must be had that the ships come
+not over pestered and that they may be well used at sea with that
+plenty and goodness of dyet as is promised in England but seldom
+performed." Others complained of the crowding of men in their own
+"aires," uncleanliness of the ships, and the presence of fatal
+"infexion."
+
+Insomuch as seventeenth-century medical theory paid scant attention to
+sanitation and hygiene in the study of the causes of disease, it is
+surprising to find the early Virginian rightly recognizing the ships as
+sources of sickness. On the other hand, observation could not help but
+lead passengers to conclude that sickness, such as flux or dysentery,
+with which they had to suffer aboard ship, might have a causal
+relationship to the ship. To have related the transmission of the
+plague from epidemic centers in England via infected shipboard rats,
+and transmission of tropical fevers, as well, by the medium of
+shipboard water buckets infected with mosquito larvae from the tropics,
+was beyond the capacity of both medical theory and of first-hand
+observation.
+
+Physicians or surgeons did ship aboard the seventeenth-century
+ocean-going vessels, but Doctor Wyndham B. Blanton, the chief authority
+on seventeenth-century Virginia medicine, concludes that most of them
+probably had poor educations and little more to recommend them than "a
+smattering of drugs, a little practice in opening abscesses and a
+liking for the sea." A seventeenth-century contemporary recommended
+that a ship's surgeon--surgeons went to sea far more often than
+physicians--be the possessor of a certificate from a barber-surgeon
+guild and be freed from all ship's duties except the attending of the
+sick and the cure of the wounded. The ship's surgeon, then, crossed the
+professional line between surgeon and physician, a line that necessity
+would soon force so many medical men to cross in America.
+
+Throughout the century ship's surgeons abandoned their shipboard duties
+to settle in the Virginia colony, and there seems little reason to
+doubt that those remaining aboard ship took advantage of the
+opportunity when in port to help meet the medical needs of the
+colonists, thus supplementing the medical talent which had taken up
+residence in Virginia.
+
+The labors of the ship's surgeon at sea, no matter how valiant, could
+not offset the miseries of the long sea voyage, and the sight of
+Virginia's coast greatly cheered all hands. After the foul air, crowded
+quarters, and inadequate provisions of the ship, many settlers must
+have reacted to the Virginia land as Captain John Smith did: "heaven
+and earth never agree better to frame a place for man's habitation." It
+is not surprising then that the first permanent settlers were somewhat
+less than careful when evaluating, against standards of health, the
+possible sites for settlement.
+
+
+THE SELECTION OF SITES FOR SETTLEMENT
+
+In a fairly extensive set of instructions "by way of advice, for the
+intended voyage to Virginia," the London Company, in 1606, took into
+account the part that disease and famine could play in the life--or
+death--of the colony. Probably knowing that the chances for survival of
+the Spanish conquistadors had been enhanced by their superhuman
+qualities in the eyes of the Indians, the Company urged that no
+information on deaths or sicknesses among the whites be allowed to the
+natives. More important, as the course of events was to demonstrate,
+was the advice not to:
+
+    plant in a low or moist place, because it will prove unhealthfull.
+    You shall judge of the good air by the people; for some part of
+    that coast where the lands are low, have their people blear eyed,
+    and with swollen bellies and legs: but if the naturals be strong
+    and clean made, it is a true sign of wholesome soil.
+
+The idea that climate had an influence upon human physiognomy did
+not originate with the London Company. In an essay dating back to
+the fifth century B.C. and preserved among the works of the
+Hippocratic school the ancient--but in the seventeenth century
+still influential--authorities argued that human physiognomies
+could be classified into the well-wooded and well-watered mountain
+type; the thin-soiled waterless type; the well-cleared and
+well-drained lowland type; and the meadowy, marshy type.
+
+The London Company's instructions to the first permanent settlers to
+avoid low-lying, marshy land, if followed, might have saved the
+colonists from some of the sicknesses they were to endure, but other
+considerations dictated the choice of the Jamestown site; the
+peninsular, about thirty miles upstream, provided natural protection
+and a good view up and down the river. The danger from the ships of
+other European peoples seemed more immediate and formidable than those
+from the mosquito, with its breeding place in the nearby swamp, and
+from the foul and brackish drinking water.
+
+As the century progressed, the settlers pushed inland from Jamestown
+and the low-lying coastal region, up onto the drier land. The danger
+from typhoid, dysentery, and malaria grew steadily less. In choosing
+home sites--once the confines of the peninsula were left behind and the
+fear of attack from Indian or European was less--the early planters
+took into consideration the dangers of the fetid swamp and muggy
+lowland.
+
+That the promotion of health did play a part in the selection of sites
+for settlement is borne out by the re-location of the seat of
+government from the languishing village of Jamestown to Middle
+Plantation or Williamsburg. After an accidental fire destroyed a large
+part of Jamestown at the end of the century, the people indicated a
+desire to move away from an environment, recognized as unhealthful, to
+Middle Plantation, known for its temperate, healthy climate as well as
+for its wholesome springs. The inhabitants had contemplated a move
+earlier in the century for health reasons but authorities in England
+and governors in Virginia acted to prevent the abandonment of the only
+community even approaching the status of a town.
+
+The move away from Jamestown would probably appear a wise measure even
+to the twentieth-century physician; to the seventeenth-century
+physician, who often saw a close relationship between climatic
+conditions and disease, the move seemed imperative. A man well-versed
+in science and medicine, living in Jamestown a decade or so before the
+town was abandoned, exemplified this medical theory when he wrote that
+an area was unhealthy according to its nearness to salt water. He had
+observed that salt air, especially when stagnant, had "fatal effects"
+on human bodies. In contrast, clear air (such as would be enjoyed at
+Middle Plantation) had beneficial effects.
+
+Considerations of health and the effects of disease not only influenced
+the settlers in their choice of living sites but also in many of their
+other activities. Political, economic, and social history in
+seventeenth-century Virginia was determined in part by health and
+disease.
+
+
+DISEASE AS A DETERMINING FACTOR IN THE EARLY YEARS OF THE COLONY
+
+Death from disease and incapacitation from disease are challenges to
+which every civilization--and human community--must successfully
+respond in order to survive. Historian Arnold J. Toynbee has emphasized
+the vital character of the challenge and response relationship in the
+history of all communities. A particular challenge to which early
+Jamestown almost succumbed was disease. The actions--or inactions--of
+the settlers under the London Company, 1607-1624, demonstrated
+especially well the influence of the challenge of disease upon the
+early history of Virginia.
+
+During the first year of the settlement at Jamestown, disease worked as
+an important factor in the realm of politics. In this connection,
+Edward Maria Wingfield, chosen first president of the governing council
+in Virginia, found himself removed from office, imprisoned, and sent
+home by the spring of 1608, all as a result of charges brought against
+him that for the most part were petty and contradictory. Pettiness and
+contradictions, in this instance, were rooted in the miserable
+conditions which the colonists had to endure their first summer: famine
+and sickness not only demoralized the colonists but were killing them
+faster than they could be buried.
+
+Wingfield left office as president of the council after the first
+summer spent in Jamestown. The sickness that caused much tension during
+his tenure was probably the malady loosely described by early
+Virginians as the "seasoning." The complex of symptoms ascribed to the
+seasoning bothered the settlers throughout the seventeenth century.
+Even as late as 1723 a recent arrival in Virginia wrote that "all that
+come to this country have ordinarily sickness at first which they call
+a seasoning of which I shall assure you I had a most severe one."
+During the first two summers, 1607 and 1608, however, this seasoning
+inflicted the most distress, judging by the seriousness with which
+contemporaries described it.
+
+One of these contemporary accounts, written by George Percy who sailed
+to Virginia with the first settlers in 1606-07, described the distress
+caused by seasoning and famine during the summer of 1607. The awfulness
+of that summer is made more dramatic by the manner in which Percy
+introduced the subject. Having described the voyage over, which was
+relatively pleasant with the stopover in the beautiful West Indian
+islands, and having entertained the reader with startling accounts of
+the habits of the savages in Virginia ("making many devillish gestures
+with a hellish noise, foming at the mouth, staring with their eyes,
+wagging their heads and hands in such a fashion and deformitie as it
+was monstrous to behold"), Percy abruptly began listing the names of
+the dead as his narrative moved into the late summer months:
+
+    The sixt of August there died John Asbie of the bloudie flixe. The
+    ninth day died George Flowre of the swelling.... The fifteenth day,
+    their died Edward Browne and Stephen Galthorpe. The sixteenth day,
+    their died Thomas Gower Gentleman. The seventeenth day, their died
+    Thomas Mounslic....
+
+The remainder of the description of the significant events of the month
+of August is given over entirely to the listing of the deaths. Seldom
+did Percy give the cause of individual deaths, but as the narrative
+moved into September and near the end of the seasoning period, Percy
+stopped his grim listing to comment in general terms upon the unhappy
+experience.
+
+According to his diagnosis--and perhaps he was enlightened by Thomas
+Wotton and Will Wilkinson, the two surgeons who arrived with the first
+settlers--the heavy death toll of August resulted from such ailments as
+fluxes, swellings, and burning fevers as well as from famine and
+attacks by the Indians.
+
+Percy was of the opinion that the colonists at Jamestown suffered more
+during the summer and winter of 1607 than any other Englishmen have
+during a colonization venture. Weakened by the debilitating summer and
+unable during that period to make the necessary provisions for the
+winter, the settlers, their ranks depleted, also fared poorly during
+the next five months.
+
+In describing their distress, he revealed the conditions that bred the
+diseases and illnesses to which the colonists fell prey. They lay on
+the bare ground through weather cold and hot, dry and wet, and their
+ration of food consisted of a small can of barley sod in water--one can
+for five men. Drinking water came from the river which in turn was salt
+at high tide, and slimy and filthy at low. With such food and drink,
+the small contingent within the fort lay about for weeks "night and day
+groaning in every corner ... most pittifull to heare."
+
+Fortunately during the course of the winter the Indians did come to the
+relief of the colonists with provisions, but before this help was
+substantial, Percy observed:
+
+    If there were any conscience in men, it would make their harts to
+    bleed to heare the pitifull murmurings and out-cries of our sick
+    men without reliefe, every night and day, for the space of sixe
+    weekes, some departing out the world, many times three or foure in
+    a night; in the morning, their bodies trailed out of their cabines
+    like dogges to be buried.
+
+Over one-half (approximately 60) of the original settlers perished
+during the summer of 1607 and the seasoning was to prove a hazard
+throughout the remainder of the century. Its effects became less
+serious, however, as the Company and the colonists, profiting from the
+earlier experiences began to plan departures from England so that the
+immigrants would arrive in Virginia in the fall: another example of the
+influence of disease.
+
+Governor Yeardley, writing some years later--in 1620--reminded the
+Company's officials in England of the advantages of a fall arrival. He
+had just witnessed the distress of immigrants from three ships that had
+arrived in May:
+
+    had they arrived at a seasonable time of the year I would not have
+    doubted of their lives and healths, but this season is most unfit
+    for people to arrive here ... some [came] very weak and sick, some
+    crazy and tainted ashore, and now this great heat of weather
+    striketh many more but for life.
+
+At least twenty more immigrants died during the second summer (1608)
+and the misery and discontent of the survivors of the summer's
+sicknesses account--in part, at least--for the disposal of another
+council president, John Ratcliffe. Returning to Jamestown after an
+exploratory trip up Chesapeake Bay, Doctor Walter Russell, one of the
+company, found the latest arrivals to Virginia "al sicke, the rest,
+some lame, some bruised, al unable to do any thing but complain of the
+pride and unreasonable needlesse cruelty of their sillie President."
+The wrath of these sick--and doubtless somewhat querulous and
+irrational men--was appeased by the removal of the "sillie" president.
+
+The ability of Captain John Smith, who succeeded to the presidency of
+the council in the fall of 1608, to impose his strong will upon the
+inhabitants of the peninsula, and to exert such a great influence upon
+the course of events is explained, in part, by the depletion of ranks
+and the demoralization of spirit caused among them by the dreadful toll
+of disease. When other members of the council died, Smith did not
+replace them and, rid of strong opposition, he ruled as a benevolent
+despot.
+
+Smith's departure from the colony in October, 1609, had as its
+immediate cause--according to Smith--the impossibility of his obtaining
+proper medical attention in Virginia for burns acquired from a
+gunpowder explosion. When Smith sailed, his enemies, of which there
+were a considerable number, breathed freer air, but the colony
+subsequently suffered without his strong, authoritative voice.
+
+Supporters of Smith argued that if that "unhappy" accident had not
+occurred, he could have stayed on and solved the many problems that
+were to beset the colony. On the other hand, it is pointed out that the
+wound would have been better treated at Jamestown than on board ship,
+and that Smith used the wound, which was not too serious, as an excuse
+to escape from the administrative troubles that plagued him.
+
+The powder blast was described by friends of Smith as tearing a nine or
+ten-inch square of flesh from his body and thighs, and as causing him
+such torment that he could not carry out the duties of his position.
+The wound was probably complicated by the fact that the accident had
+occurred when Smith was in a boat many miles from Jamestown. He had had
+to cover the great return distance after having plunged into the water
+to ease his agony, and without having the assistance of either
+medicines or medical treatment. Whatever the seriousness of the wound,
+supporters of Smith maintained that he was near death and had to leave
+Jamestown in order to secure the services of "chirurgian and
+chirurgery... [to] cure his hurt."
+
+Twice in 1608, Captain Newport had brought immigrants and supplies to
+the colony and, in the summer of 1609 about 400 passengers had landed
+at Jamestown. These new arrivals, some of them already afflicted with
+the plague, others victims of various fevers, and all suffering from
+malnutrition, needed strong leadership to force them to plant busily
+and to lay in food supplies for the winter ahead. Supplies brought over
+aboard the ships could not possibly furnish nourishment for the coming
+months. Malnutrition as a factor contributing to sickness, and sickness
+as a factor preventing the labor necessary to circumvent starvation,
+constituted a vicious relationship.
+
+The winter of 1609-10 after Smith's departure is remembered as the
+"Starving Time." During this period the number of colonists dropped
+from 500 to about sixty. Men, women, and children lived--or
+died--eating roots, herbs, acorns, walnuts, berries, and an occasional
+fish. They ate horses, dogs, mice, and snakes without hesitation after
+Indians drove off hogs and deer belonging to the colonists. The Indians
+also kept the settlers from leaving the protection of Jamestown to go
+out and hunt for food. When hunting was not made impossible by Indians,
+the settlers' own physical weaknesses often precluded energetic action.
+
+The notorious, and possibly untrue, incident of the man whom hunger
+drove to kill and to eat the salted remains of his wife, is from the
+accounts of the Starving Time. Although this story had the support of a
+number of colonists, others maintain that it, and the entire episode of
+the famine, came out of the exaggeration of colonists who abandoned the
+venture and returned to England. Yet the verdict of historians
+establishes a Starving Time, and the high mortality of the winter must
+have an explanation.
+
+To argue that all those who died, died of starvation would, on the
+other hand, be a distortion. Food deficiencies did not always lead
+directly to death but in many cases to dietary disease. These dietary
+diseases often terminated in death, but their courses might well not
+have been fatal if proper medical attention could have been given. In
+other cases food deficiency resulted in so weakened a physical
+condition that the body fell prey to infectious diseases which, again,
+could not be cured with the limited medical help available.
+
+The Starving Time did not stand out as a time of want to be contrasted
+with a normal time of plenty. For many the winter of 1609-10 only
+brought to a crisis dietary disorders of long standing. One account of
+the early years describes the daily ration as eight ounces of meal and
+a half-pint of peas, both "the one and the other being mouldy, rotten,
+full of cobwebs and maggots loathsome to man and not fytt for
+beasts...."
+
+Nor was the Starving Time the last time that the colonists would have
+to endure famine and privation. Although written to discredit the
+administration of Sir Thomas Smith as head of the Company during the
+years from 1607-19, an account of the hunger of these twelve years
+should be accepted as having some basis in fact. The account, written
+in 1624, reported as common occurrences the stealing of food by the
+starving and the cruel punishments meted out to them (one for
+"steelinge of 2 or 3 pints of oatemeal had a bodkinge thrust through
+his tounge and was tyed with a chaine to a tree untill he starved");
+and the denial of an allowance of food to men who were too sick to work
+("soe consequently perished").
+
+The starving colonists during these twelve years, according to the
+report, often resorted to dogs, cats, rats, snakes, horsehides, and
+other extremes for nourishment. Many, in those hungry times, weary of
+life, dug holes in the earth and remained there hidden from the
+authorities until dead from starvation. Although the report maintained
+that these events occurred throughout the twelve-year period, it is
+likely that many were concentrated during the Starving Time.
+
+Famished, disease-ridden, demoralized, with many mentally unbalanced,
+the settlement at Jamestown languished in a distressful condition after
+the winter of 1609-10. Jamestown, in May, 1610 appeared:
+
+    as the ruins of some auntient [for]tification then that any people
+    living might now inhabit it: the pallisadoes... tourne downe, the
+    portes open, the gates from the hinges, the church ruined and
+    unfrequented, empty howses (whose owners untimely death had taken
+    newly from them) rent up and burnt, the living not hable, as they
+    pretended, to step into the woodes to gather other fire-wood; and,
+    it is true, the _Indian as fast killing without as the famine and
+    pestilence within_.
+
+The Indians, however, would not make a direct assault on the fort; they
+waited on disease and famine to destroy the remaining whites. How many
+of the graves now at Jamestown must have been dug during that terrible
+winter? The Starving Time has been characterized by historian Oliver
+Chitwood as "the most tragic experience endured by any group of
+pioneers who had a part in laying the foundations of the present United
+States."
+
+By spring of 1610 the challenge of famine, pestilence, and disease had
+proven too great; the warfare of Europeans and savages, for which the
+settlers had made provisions in the selection of the Jamestown site,
+had not proven as great a threat as disease and famine. Under the
+command of Sir Thomas Gates and Sir George Somers, who had only just
+arrived with plans for the future of the settlement, the small band of
+survivors boarded ship to abandon an abortive experiment in European
+colonization.
+
+Before leaving, the survivors of the winter had had a consultation with
+Gates and Somers about future prospects for the colony. Chiefly fear of
+starvation determined the decision to abandon the settlement: the
+provisions brought by Gates and Somers would have lasted only sixteen
+days. The colonists could hold out no hope of obtaining food from the
+Indians. ("It soone then appeared most fitt, by general approbation,
+that to preserve and save all from starving, there could be no readier
+course thought on then to abandon the countrie.")
+
+After embarking, the settlers, with Gates, Somers, and the new
+arrivals, had reached the mouth of the river when they met Lord De la
+Warr, the new governor of the colony, coming from England with fresh
+supplies and settlers. Heartened, the survivors of the Starving Time
+turned back to try the New World again.
+
+In Lord De la Warr's company was Dr. Lawrence Bohun, a physician of
+good reputation, who subsequently distinguished himself serving the
+medical needs of the settlement. He could not, however, even in his
+capacity of personal physician, prevent Lord De la Warr from falling
+victim to the common ailments.
+
+In 1610, Lord De la Warr wrote: "presently after my arrival in
+Jamestowne, I was welcomed by a hot and violent ague, which held mee a
+time, till by the advice of my physician, Doctor Lawrence Bohun I was
+recovered." Bohun, in the seventeenth-century tradition of treatment by
+clysters, vomitives, and phlebotomy, resorted to bloodletting. The
+letting, believed to free the body of fermented blood and malignant
+humors, probably gave the governor a psychological lift, if only a
+temporary one.
+
+De la Warr, who blamed the distress of the colony upon the failures of
+the settlers, soon had another taste of the illnesses which so many of
+the colonists endured during their first months in the New World. In
+his report to the Company explaining his early departure from the
+colony, he included one of the fullest surviving accounts of sickness
+at Jamestown during the first few years of settlement:
+
+    That disease [the hot and violent ague] had not long left me, til
+    (within three weekes after I had gotten a little strength) I
+    began to be distempered with other greevous sicknesses, which
+    successively and severally assailed me: for besides a relapse into
+    the former disease, which with much more violence held me more than
+    a moneth, and brought me to great weakenesse, the flux surprised
+    me, and kept me many daies: then the crampe assaulted my weak body,
+    with strong paines; and afterwards the gout (with which I had
+    heeretofore beene sometime troubled) afflicted mee in such sort,
+    that making my body through weakenesse unable to stirre, or to use
+    any maner of exercies, drew upon me the disease called the scurvy;
+    which though in others it be a sicknesse of slothfulnesse, yet was
+    in me an effect of weaknesse, which never left me, till I was upon
+    the point to leave the world.
+
+When a person of strong constitution, living under the best conditions
+the colony could provide, and accompanied by a well-trained physician,
+found himself thus incapacitated, it is no wonder that the rank and
+file of the colony failed to pursue energetically by hard work and
+exemplary conduct their own best interests.
+
+The firmness of De la Warr, who was much more indulgent of his own than
+of others' disorders, brought additional stability to the colony, but
+the attack of scurvy, which current opinion believed could be relieved
+only by the citrous fruits of the West Indies, caused him, accompanied
+by Dr. Bohun, to set sail from Virginia in the spring of 1611 for the
+same island of Nevis praised so highly for its baths by the first
+settlers of 1607. Disease had robbed the colony of another outstanding
+leader during a period when strong leadership on the scene was
+imperative.
+
+Although the colony had experienced its worst years of hardship before
+De la Warr departed and the worst years in the New World had been
+caused by famine and disease, sickness and starvation were still to
+have a noteworthy effect. Disease no longer threatened the colony's
+life, but it shaped its history.
+
+In 1624 the charter of the Company was annulled and, in explaining this
+major development, account must be taken of the cumulative effects of
+sickness and hunger upon the Company's fortunes; the first summer's
+seasoning and the Starving Time, for example, had long-term economic
+repercussions as well as short-term results in human suffering.
+
+The Company had been in financial difficulties for some years and by
+1624 the treasury was empty and the indebtedness heavy. If the
+mortality rate had not been so high and the level of energy of the
+colonists so reduced, the Company might have prospered. For example,
+local trade with the Indians necessitated small ships for the effective
+transportation of cargo, but several attempts by the Company to send to
+America boatwrights to construct such ships failed because of the
+deaths of the boatwrights. The Company had hoped in 1620 to better its
+financial condition by developing an iron industry in the colony, but
+this project suffered from the effects of disease, too, as the chief
+men for the iron works died during the ocean voyage. The remainder of
+the officers and men sent to establish the works died in Virginia
+either from disease or at the hands of the Indians. The high cost to
+the Company of the labor and services lost because of the early deaths
+of persons still indentured for a period of years cannot be estimated.
+Nor can the number of goals set by the colonists and the Company but
+never fulfilled because of sickness be tabulated. As late as 1623 a
+colonist wrote that "these slow supplies, which hardly rebuild every
+year the decays of the former, retain us only in a languishing state
+and curb us from the carrying of enterprise of moment."
+
+In suggesting the part that famine and disease played in the annulment
+of the Company's charter, the effects of one more period of intense
+suffering must also be considered. In March, 1622, a bloody Indian
+massacre occurred in which more than 350 white men, women, and children
+died. Not only did the massacre cause a subsequent period of disease,
+famine, and death among the survivors, but the heavy casualties
+inflicted directly by the Indians can be explained, partially, by the
+weakened condition and depleted ranks of the colonists before the
+massacre.
+
+So tenuous was the colony's ability to maintain an adequate and
+healthful living standard, that the destructive and disrupting impact
+of the massacre brought a period of severe famine and sickness. After
+the raid the surviving colonists had to abandon many of the outlying
+plantations with their arable fields, livestock, and supplies. And
+having had the routine of life interrupted, the settlers--their numbers
+unfortunately increased by a large supply of new immigrants, sent by
+ambitious planners in England--came to the winter of 1622-23 poorly
+provisioned.
+
+Toward the end of this winter, famine reduced the settlers to such
+conditions that one wrote to his parents that he had often eaten more
+at home in a day than in Virginia in a week. The beggar in England
+without his limbs seemed fortunate to the Virginian who had to live day
+after day on a scant ration of peas, water-gruel, and a small portion
+of bread. Another wrote that the settlers died like rotten sheep and
+"full of maggots as he can hold. They rot above ground." As in 1609-10,
+inadequate diet weakened the body and made it easy prey to infection.
+
+During this winter the colonists--in addition to suffering from want of
+food--had to endure a "pestilent fever" of epidemic proportions matched
+only by the seasoning of 1607. About 500 persons died in the course of
+the winter.
+
+The origin of the winter's epidemic, according to contemporaries, lay
+in the infectious conditions of numbers of the immigrants who had been
+poisoned during the ocean voyage "with stinking beer" supplied to the
+ships by Mr. Dupper of London. It is more likely that the pestilent
+fever of the winter was a respiratory disease rather than a disorder
+resulting from "stinking beer." Another commentator on the winter
+called attention to the continued "wadinge and wettinge" the colonists
+had to endure, bringing them cold upon cold until "they leave to live."
+
+Whether continual wadings and wettings brought on respiratory diseases,
+or bad beer dietary, is debatable, but the critics of the Company used
+the dreadful winter of 1622-23 to discredit its administration. They
+pointed out that the Company had sent large numbers of immigrants to
+Virginia without proper provisions, and to a colony without adequate
+means of providing food and shelter for them. Many of these persons had
+subsequently died during the winter of 1622-23.
+
+The Company, embarrassed by failures in Virginia--many of which
+resulted directly from unhappy combinations of famine and disease--and
+plagued by political dissension and economic difficulties, had its
+charter annulled in May, 1624. One of the most adversely critical--and
+somewhat prejudiced--tracts written against the Company summed up
+conditions in the colony after fifteen years under its direction:
+
+    There havinge been as it is thought not fewer than tenn thousand
+    soules transported thither ther are not through the aforenamed
+    abuses and neglects above two thousand of them at the present to be
+    found alive, many of them alsoe in a sickly and desperate estate.
+    Soe that itt may undoubtedly [be expected that unless the defects
+    of administration be remedied] that in steed of a plantacion it
+    will shortly gett the name of a slaughterhouse....
+
+The Company did not live on after 1624 to acquire such a name, but
+during its short--and unhealthy--existence the effects of disease on
+history were manifest. Company instructions gave attention to health
+requirements; ocean sailings depended upon health conditions; famine
+and disease almost caused the early abandonment of the colony; strong
+administrators left, for reasons of health, a Virginia sorely in need
+of leadership; poor health conditions resulting in lowered morale
+undermined local leaders; and the over-all economic welfare of the
+colony suffered from the long-term and short-term effects of famine and
+disease. The intimate or personal hardships endured by the individual
+settlers because of disease and famine cannot be enumerated, but the
+persistent influence that the summation of all the individual suffering
+had on the general spirit and ethics of early Virginia cannot be
+overlooked.
+
+Disease and famine did not cease to influence Virginia history in 1624,
+but their great importance during the first two decades has been
+emphasized because they were then a factor exerting a major influence,
+perhaps the predominant one.
+
+
+
+
+CHAPTER THREE
+
+Prevalent Ills and Common Treatments
+
+
+COMMON AND UNCOMMON DISEASES
+
+As has been noted, the seasoning caused great distress and a high
+mortality among the new arrivals to the colony throughout the
+seventeenth century. These Virginians--authorities on medicine or
+not--had, for the origins of this malady, their own explanations which
+furnish clues for more recent analysis. The general term "seasoning" is
+of little assistance to the medical historian attempting to understand
+three hundred year-old illnesses in twentieth-century terms.
+
+According to seventeenth-century contemporaries, the pathology of
+seasoning might be described as follows. The immigrants disembarked
+from their ships tired and underfed--generally in poor health. From
+their ships they took up residence in a Jamestown without adequate food
+supplies of its own, and without shelter for the new arrivals. Many of
+the new settlers had to sleep outside, regardless of the weather, for a
+number of days after arrival. Then they exposed themselves to the
+burning rays of the sun, the "gross and vaporous aire and soyle" of
+Jamestown, and drank its foul and brackish water.
+
+The foul and brackish drinking water would seem to be the most probable
+casual agent in the opinion of more recent medical authority. In this
+water, Dr. Blanton believes, lurked the deadly typhoid bacillus--the
+killer behind the mask of the seasoning. Typhoid is not the only
+possibility, but burning fever, the flux (diarrhea), and the
+bellyache--symptoms listed in the early accounts--indicate typhoid.
+Other diseases that may have caused the seasoning were dysentery,
+influenza, and malaria; and these may have been the seasoning during
+some of the later summers of the century.
+
+Whatever diseases may have caused the seasoning, it plagued the colony
+summer after summer. A Dutch ship captain wrote of it as it was in
+Virginia in the summer of 1633:
+
+    There is an objection which the English make. They say that during
+    the months of June, July, and August it is very unhealthy; that
+    their people, who have then lately arrived from England, die during
+    these months like cats and dogs, ... when they have the sickness,
+    they want to sleep all the time, but they must be prevented from
+    sleeping by force, as they die if they get asleep.
+
+Sir Francis Wyatt, twice governor of Virginia wrote, "but certaine
+it is new comers seldome passe July and August without a burning
+fever--this requires a skilful phisitian, convenient diett and lodging
+with diligent attendance." The skillful physician could not limit
+himself, however, to the curing of the seasoning; he had many other
+maladies in Virginia with which to contend: dietary disorders, malaria,
+plague, yellow fever, smallpox, respiratory disorders, and a host of
+other diseases.
+
+Beriberi and scurvy, both dietary diseases, handicapped the colony
+throughout the century, and probably had acute manifestations during
+the Starving Time of 1609-10. The colonists during the early years at
+Jamestown often boiled their limited rations in a common kettle, thus
+destroying what little valuable vitamin content the food may have had;
+eggs, vegetables, and fruits which would have countered the disease
+were not available. The swellings and the deaths without obvious cause
+described by the early commentators may have resulted from beriberi
+(the disease did not have a name until the eighteenth century).
+
+Another dietary disease troubling the colonists but, unlike beriberi,
+known by name and at times properly treated, was scurvy. Mention has
+been made of the outbreak of this disease aboard the ships, and of the
+stops made in the West Indies to eat the health-restoring citrus
+fruits, but in the case of the colonists at Jamestown the fruit was
+non-existent. A belief, also held, that idleness caused the disease did
+little to bring about measures to promote proper treatment. Because the
+incapacitating aspects of the disease could produce the appearance of
+idleness, numerous ill persons must have been innocently stigmatized.
+Their situation became hopeless when denied rations because the
+authorities wished to discipline the apparently lazy.
+
+Insomuch as the ague (or malaria) exacted a high toll in
+seventeenth-century Europe--especially in England--it would be
+reasonable to assume that, with typhoid and dietary disorders, this
+disease caused most of the illness in Virginia. When emphasis has been
+placed, by authorities, upon the location of Jamestown as a
+disease-producing factor, the implication has often been that the
+swampy area was a mosquito and malaria breeding place. A number of
+historians have asserted that malaria produced the highest mortality
+figures at Jamestown. Much is also made of the tragic circumstance that
+the arresting agent for the disease, cinchona bark or quinine, was
+known on the European continent by mid-seventeenth century but that
+little use was made of it.
+
+Dr. Blanton, the authority on seventeenth-century Virginia medicine, in
+contrast argues that "there is not evidence ... that malaria was
+responsible for a preponderating part of the great mortalities of the
+Seventeenth Century in Virginia." He bases this conclusion on a number
+of facts: he has been able to find only five or six references to the
+ague (malaria) in the records of the century; because the ague was
+well-known he does not believe its symptoms, such as the racking chill,
+would have escaped notice. On the other hand, he does not doubt the
+presence of the ague in Virginia throughout the century even though it
+did not cause the most distress.
+
+As in the case of the ague, a reasonable assumption would be that the
+plague existed in seventeenth-century Virginia. The Great Plague of
+London (1665) carried away 69,000 persons, and other cities of Europe
+had even more disastrous epidemics. During the two years before the
+first settlers arrived at Jamestown, over 2000 victims were buried in
+London. The accounts of the ocean voyage indicate rat-infested ships.
+Ships of the London Company reported plague and death aboard.
+Virginians took pains to describe their illnesses, and there would have
+been little difficulty in recognizing this well-known killer. Yet
+little evidence of the presence of the plague appears in the
+seventeenth-century Virginia record; cases are reported but the number
+is small. Why Virginia should have been spared--especially in view of
+the known rat-infestation aboard ship--remains a question.
+
+The evidence relative to yellow fever, or calenture, during this period
+in Virginia is contradictory. Early sources do make reference to
+numerous deaths from it at sea and even to an epidemic of it at
+Jamestown before 1610, but subsequent notices are infrequent and of
+questionable validity. Prevalence of the disease in the earlier years
+and its comparative infrequency in later is not a likely circumstance
+because with the increase of commerce, especially from tropical ports,
+an increase of the disease should have followed.
+
+Smallpox, the mark of which is seen in early portraits, emerges from
+the colonial record with a more reasonable history. Its incidence in
+Virginia during the first half of the seventeenth century was small,
+and this might be expected in view of the fact that there were few
+children in the colony and that most of the adults had been infected
+before they left the Old World. The number of smallpox epidemics in
+Virginia did increase--again, as might be expected--later in the
+century as the number of children and of native-born unimmunized adults
+multiplied.
+
+Smallpox caused such a scare in 1696 that the assembly, in session at
+Jamestown, asked for a recess--another example of the influence of
+disease upon political history. Earlier, in 1667, a sailor with
+smallpox, if the contemporary account can be accepted, landed at
+Accomack and was solely responsible for the outbreak of a terrible
+epidemic on the Eastern Shore of Virginia. A measles epidemic during
+the last decade of the century may actually have been smallpox as the
+two diseases were often confused by contemporaries.
+
+Respiratory disorders, as has been noted, caused much distress for
+great numbers of early Virginians during the winter months. Influenza,
+pneumonia, and pleurisy must have reached epidemic proportions on
+numerous occasions in Virginia as elsewhere in America (influenza
+epidemics are recorded for New England in 1647 and in 1697-99). One
+note from a Virginia source for the year 1688 describes "a fast for the
+great mortality (the first time the winter distemper was soe very
+fatal... the people dyed, 1688, as in a plague... bleeding the remedy,
+Ld Howard had 80 ounces taken from him...)." (If "Ld Howard" gave
+eighty ounces, it means that he lost five pints of blood from a body
+that contained approximately ten--perhaps the "letting" was over an
+extended period.)
+
+In a century in which numerous diseases had not been identified, many,
+known today, must have occurred that were diagnosed in general terms.
+Appendicitis, unrecognized until later, must have been common, and
+heart disease probably went undiagnosed. Distemper, a general term,
+often was used when the physician could not be more specific ("curing
+Eliza Mayberry and her daughter of the distemper").
+
+Other prevalent disorders were over-eating ("hee died of a surfeit");
+epilepsy ("desperately afflicted with the falling sicknesse soe that he
+requires continuall attendance"); and the winter cold ("our little boy
+& Molly have been both sicke with fever & colds, but are I thanke God
+now somewhat better").
+
+The continued presence of deadly disease throughout the century shows
+itself in the population figures for the period. Over 100,000 persons
+migrated to Virginia before 1700 and numerous children were born, but
+only 75,000 people lived in Virginia in 1700. Many returned to Europe,
+many emigrated to other parts of America, and Indians accounted for
+some deaths, but the chief reason for the decline in population was the
+high mortality prevailing throughout the century.
+
+Health conditions, however, did not deteriorate as the century passed.
+By 1671 Governor Berkeley could report generally improved health
+conditions; for example, newcomers rarely failed to survive the first
+few months, or seasoning period, which had formerly exacted such an
+awful toll. How much these improved conditions were due to better
+provisioned ships, to a better diet in Virginia, and to the movement of
+the settlers out from Jamestown is open to question, but in any
+consideration of the explanations for the promotion of health,
+prevention of illness, the restoration of health, and the
+rehabilitation of the sick, the seventeenth-century Virginia physician
+or surgeon must be considered.
+
+
+PHYSICIANS AND SURGEONS IN SEVENTEENTH-CENTURY VIRGINIA
+
+The first English medical man to set foot on Virginia soil visited the
+Chesapeake Bay area in 1603. Henry Kenton, a surgeon attached to a
+fleet exploring Virginia waters, joined the landing party that perished
+to a man at the hands of the Indians. Next to arrive in Virginia were
+the two surgeons who accompanied the first settlers in 1607 and
+attended their medical needs.
+
+One of these, Thomas Wotton, was classed as a gentleman, while the
+other, Will Wilkinson, was listed with the laborers and craftsmen, a
+reminder of the varied social backgrounds of surgeons. Captain John
+Smith complimented Wotton in the summer of 1607 for skillful diligence
+in treating the sick; but Edward Maria Wingfield, when council
+president at Jamestown, criticized him for remaining aboard ship when
+the need for him ashore was so great. Because of this reputed
+slothfulness, Wingfield would not authorize funds for Wotton to
+purchase drugs and other necessaries. The colony could only have
+suffered from such a misunderstanding.
+
+Further activities of Wotton and Wilkinson have faded into the mist of
+time past, but Captain John Smith recorded for posterity the names and
+deeds of other surgeons and physicians who came to Virginia before
+1609. Dr. Walter Russell, the first physician--as distinguished from
+surgeon--to arrive, came with a contingent of new settlers and supplies
+in January, 1608. Post Ginnat, a surgeon, and two apothecaries, Thomas
+Field and John Harford, accompanied the physician. Also in Smith's
+record is the name, Anthony Bagnall, who has been identified as a
+surgeon and who came with the first supply.
+
+Unfortunately, neither contemporaries of Russell, Ginnat, Field, and
+Harford--nor the men themselves--found reason to record the medical
+assistance they rendered during a time of great need. Russell is
+remembered only for the assistance he gave Smith when the Captain was
+severely wounded by a stingray, Post Ginnat and the apothecaries leave
+their names only, and Bagnall is remembered for his part in the
+adventures encountered on one of Captain Smith's exploratory journeys.
+
+Russell's services to Smith deserved note because the Captain was
+expected to die from the stingray wound. It is an interesting comment
+on the medicine of the time that Smith's companions prepared his grave
+within four hours after the accident. "Yet by the helpe of a precious
+oile, Doctour Russel applyed, ere night his tormenting paine was so wel
+asswaged that he eate the fish to his supper."
+
+The same stingray also assured the surgeon Bagnall a place in history.
+Mention of Bagnall by Captain Smith followed the surgeon's exploits on
+another expedition when he went along to treat the Captain's same
+stingray wound. The party, attacked by savages, shot one Indian in the
+knee and "our chirurgian ... so dressed this salvage that within an
+hour he looked somewhat chearfully and did eate and speake."
+
+How unfortunate that other exploits of these physicians and surgeons,
+not involving Captain Smith--or the stingray--did not cause him to make
+a record. Dr. Lawrence Bohun, however, who accompanied Lord De la Warr
+to the colony in 1610, evoked comments of a more general nature in the
+accounts of contemporaries.
+
+Dr. Bohun ministered to the settlers who had been ready to abandon
+Jamestown in 1610. A letter from the governor and council to the London
+Company, July 7, 1610, describes his problems and his efforts to meet
+them. Insomuch as the letter gives one of the fullest accounts of early
+Jamestown medical practices and because Bohun is one of the most
+renowned of seventeenth-century Virginia physicians, it deserves a
+lengthy quotation:
+
+    Mr. Dr. Boone [Bohun] whose care and industrie for the preservation
+    of our men's lives (assaulted with strange fluxes and agues), we
+    have just cause to commend unto your noble favours; nor let it, I
+    beseech yee, be passed over as a motion slight and of no moment to
+    furnish us with these things ... since we have true experience how
+    many men's lives these physicke helpes have preserved since our
+    coming, God so blessing the practise and diligence of our doctor,
+    whose store has nowe growne thereby to so low an ebb, as we have
+    not above 3 weekes phisicall provisions; if our men continew still
+    thus visited with the sicknesses of the countrie, of the which
+    every season hath his particular infirmities reigning in it, as we
+    have it related unto us by the old inhabitants; and since our owne
+    arrivall, have cause to feare it to be true, who have had 150 at a
+    time much afflicted, and I am perswaded had lost the greatest part
+    of them, if we had not brought these helpes with us.
+
+Dr. Bohun sought medical supplies from abroad, but he also experimented
+with indigenous natural matter such as plants and earths in an effort
+to replenish his dwindling supplies and to discover natural products of
+value in the New World. Judging by a contemporary account, Bohun,
+professionally trained in the Netherlands, used drugs therapeutically
+according to the conventional theories of the humoral school. Despite
+the disfavor in which frequent purgings are held today, it must be
+allowed that those being treated then sounded a plaintive call for more
+of Bohun's "physicke."
+
+The colony lost his services when he left to accompany Lord De la Warr
+to the West Indies. His connection with the London Company and its
+colony did not lapse, however, for Bohun received an appointment as
+physician-general for the colony in December, 1620. At sea, on the way
+to fill his post, the physician-general found his ship engaged with two
+Spanish men-of-war. In the course of battle, an enemy shot mortally
+wounded the man who had survived great hazards at Jamestown.
+
+After the departure of Bohun with Lord De la Warr, no physician or
+surgeon of equal stature or reputation took up residence in Virginia
+until Dr. John Pott arrived almost ten years later. It is likely that
+there was a shortage not only of outstanding medical men during these
+years, but also of medical assistance in general. Sir Thomas Dale,
+acting as deputy governor in the absence of De la Warr, wrote in the
+spring of 1611 that "our wante likewise of able chirurgions is not a
+little." Other requests for physicians and for apothecaries were
+dispatched to the London Company during this period.
+
+However, despite the seeming shortage of medical assistance, the
+colonists survived such disorders as the summer seasoning much more
+frequently than in the first years at Jamestown. An account of Virginia
+written between 1616 and 1618 noted of the settlers that:
+
+    They have fallen sick, yet have recovered agayne, by very small
+    meanes, without helpe of fresh diet, or comfort of wholsome
+    phisique, there being at the first but few phisique helpes, or
+    skilful surgeons, who knew how to apply the right medecine in a new
+    country, or to search the quality and constitution of the patient,
+    and his distemper, or that knew how to councell, when to lett
+    blood, or not, or in necessity to use a launce in that office at
+    all.
+
+Bohun died in March, 1621, and the Company named his successor as
+physician to the colony in July. The conditions under which Dr. John
+Pott accepted the post reveal the qualifications and needs of the
+seventeenth-century medical man on his way to the New World, and the
+inducements offered by the Company. He was a Cambridge Master of Arts
+and claimed much experience in the practice of surgery and "phisique."
+In addition, he made much of his expertness in the distilling of water.
+The company allowed Pott a chest of medical supplies, a small library
+of medical books, and provisions for the free passage of one or more
+surgeons if they could be secured.
+
+Additional economic inducements helped persuade Pott--and other
+physicians--to make the arduous journey to America. In the eyes of the
+Company, physicians could render especially valuable services to the
+colony, and ranked with other persons of extraordinary talent such as
+ministers, governors, state officers, officers of justice, and knights.
+These individuals received special compensations in the form of land
+and profits, in accord with the estimated value of services to be
+rendered. In 1620, Dr. Bohun had had a promise--for taking the position
+of physician-general for the colony--of an allotment of 500 acres of
+land and ten servants; Pott accepted the job under about the same
+conditions as had Bohun.
+
+These inducements offered physicians to persuade them to go to Virginia
+indicate the great need for, and the high value attached to, their
+assistance in the seventeenth century. With the population in the
+colony growing so great Dr. Pott's services were in considerable
+demand; several years after his arrival a certain William Bennett built
+the doctor a boat as he by then had a relatively large area to cover
+and most of the outlying plantations stood on the rivers and creeks.
+
+In the colony, Pott won recognition for his professional proficiency.
+Even a political enemy, Governor Harvey, described him as skilled in
+the diagnosis and therapy of epidemic diseases. Because he alone in the
+colony was considered capable of treating epidemic diseases, a court
+sentence against him for cattle theft stood suspended early in the
+1630's and clemency was sought on his behalf.
+
+Pott had become involved in other legal difficulties before 1630. In
+1625, a case having medical and humorous implications brought him into
+court. A Mrs. Blany maintained that Doctor Pott had denied her a piece
+of hog flesh, and that his refusal had caused her to miscarry. The
+court accepted Mrs. Blany's contention that she believed the denial of
+the hog flesh caused her distress, but did not hold Pott guilty of
+willful neglect.
+
+Since the biographical material on Pott's non-professional life reveals
+so many intellectual and political interests, it would be surprising if
+he had not occasionally neglected his medical practice. He gave
+considerable time to the colony's administration and he served in 1629
+as the elected temporary governor of the colony after having previously
+been on the governor's council. His activities in politics and affairs
+brought him political enemies and explain, in part, the cattle theft
+charge and the court's finding of "guilty" (although this was later
+found "rigorous if not erroneous"). He died in 1642, having been
+intimately involved in the life of the colony for twenty years.
+
+Pott was the last of the outstanding figures who practiced medicine
+under the direction of the Company, but Dr. Wyndham B. Blanton has
+found mention of over 200 persons who served as physicians or surgeons
+during some portion of the century. With only one exception, however,
+none of these achieved as prominent a place in history as Bohun,
+Russell, or Pott. Not only is the number of outstanding individuals in
+the field of medicine less, but the general quality of medical
+practice, in the opinion of Dr. Blanton, was not as high again during
+the last three-quarters of the seventeenth century as it had been
+during the administration of the Company (1607-1624) when Virginia
+medicine included a representative cross-section of English medicine.
+
+Any survey--no matter how brief--of the medical profession during the
+century, however, should include mention of a man who, although not a
+full-time professional physician, proves to be the exception to Dr.
+Blanton's generalization about the prominence of individual medical men
+and the quality of medical practice during the late 1600's. This man,
+the Reverend John Clayton, is a noteworthy example of the intellectual
+level an individual could attain and maintain while living in an area
+that was still remote from European civilization.
+
+Clayton, who is known to have been at Jamestown between 1684 and 1686
+as a clergyman, also practiced medicine in addition to pursuing his
+scientific interests. As a prolific writer he has left some of the
+fullest and most interesting accounts of contemporary treatment and
+diagnosis. His knowledge and methods cannot be taken as typical,
+however, because his intellectual level was considerably above the
+average in the colony.
+
+This minister-scientist-physician wrote an account of his treatment of
+a case of hydrophobia resulting from the bite of a rabid dog. With its
+accomplished style, Clayton's account of his treatment of hydrophobia
+is worthy of attention as an example of contemporary theory and
+practice of the more learned kind. He wrote:
+
+    It was a relapse of its former distemper, that is, of the bite of
+    the mad-dog. I told them, if any thing in the world would save his
+    life, I judged it might be the former vomit of volatile salts; they
+    could not tell what to do, nevertheless such is the malignancy of
+    the world, that as soon as it was given, they ran away and left me,
+    saying, he was now certainly a dead man, to have a vomit given in
+    that condition. Nevertheless it pleased God that he shortly after
+    cried, _this fellow in the black has done me good_, and after the
+    first vomit, came so to himself, as to know us all.
+
+Subsequently, Clayton "vomited him" every other day and made him take
+volatile salt of amber between vomitings. The patient also drank
+"posset-drink" with "sage and rue," and washed his hands and sores in a
+strong salt brine. Cured by the "fellow in the black," the patient had
+no relapse.
+
+Clayton reveals more of his medical theory in another passage from his
+writings. He observed:
+
+    In September the weather usually breaks suddenly, and there falls
+    generally very considerable rains. When the weather breaks many
+    fall sick, this being the time of an endemical sickness, for
+    seasonings, cachexes, fluxes, scorbutical dropsies, gripes, or the
+    like which I have attributed to this reason. That by the
+    extraordinary heat, the ferment of the blood being raised too high,
+    and the tone of the stomach relaxed, when the weather breaks the
+    blood palls, and like overfermented liquors is depauperated, or
+    turns eager and sharp, and there's a crude digestion, whence the
+    name distempers may be supposed to ensue.
+
+In this passage Clayton's medical theory resembles closely the orthodox
+medical beliefs of the century. The great English practitioner
+Sydenham, for example, emphasized the relationship between the weather
+and disease. Also the analogy between the behavior of blood and wine
+was then conventional, and the supposed connection between the "sour"
+blood and indigestion with the resulting acid humors is in accord with
+Galenism. The remedy--and a most logical one--was medicine to combat
+the acidity and to restore the tone or balance to the stomach. Acid
+stomach has a long history.
+
+The reasonableness of Clayton's pathology is impressive, but reason did
+lead to some bizarre--in the light of present-day medical
+knowledge--conclusions. Aware of the value to the scientist of close
+observation and of the necessity to reason about these observations,
+Clayton was in the finest seventeenth-century scientific tradition.
+Observing a lady--for example--suffering from lead poisoning, he noted
+that her distress, judging by her behavior, varied directly with the
+nearness and bigness of the passing clouds; the nearer the clouds, the
+more anguished her groans. Reason dictated to Clayton that such a
+phenomenon stemmed from a cause-effect relationship.
+
+Although the twentieth-century physician would deny the cloud-suffering
+association, he would not deny Clayton's propensity for observation and
+his attempts to discern relationships. The approach of the better
+seventeenth-century Virginia physician can be labeled scientific even
+if his facts were few.
+
+
+DRUGS AND OTHER REMEDIES
+
+No seventeenth-century physician could function without a variety of
+drugs (medicines) to dispense. Dr. Pott made special arrangements--for
+example--to have a chest of drugs transported with him from England to
+America, and the effectiveness of Dr. Bohun's "physicke" drew the
+praise of the colonists. Drugs were essential to the physician and a
+valuable commodity for export, as well. The subject of drugs must then
+include a discussion of their use as medicines and their importance as
+items of trade.
+
+A study of the drugs in use and the occasions of their utilization
+makes manifest the great part that freeing the body from corrupting
+matter played in the treatment of disease. The theorists and clinical
+physicians of the century placed such faith in the humoral doctrine
+that, on the basis of this predilection, much of the opposition to
+cinchona, or quinine, in a period greatly troubled by malaria, can be
+explained. Cinchona, discovered in Spanish America and known in
+seventeenth-century Europe, had demonstrable effects in the treatment
+of malaria but, because it was an additive rather than a purgative,
+physicians rejected it on theoretical grounds. Its eventual acceptance
+later revolutionized drug therapeutics, but this revolution did not
+affect seventeenth-century Virginia.
+
+The emphasis that the contemporary medical men placed upon the purging
+of the body--the vomiting, sweating, purgings of the bowels, the
+draining, and the bleeding--cannot be considered irrational or quaint.
+In the light of observation and common sense, to purge seemed not only
+reasonable and natural but in accord with orthodox doctrine as well.
+Observation revealed that illness was frequently accompanied by an
+excess of fluid or matter in the body, as in the case of colds,
+respiratory disorders, swollen joints, diarrheas, or the skin eruptions
+that accompanied such epidemic diseases as the plague or smallpox.
+Common sense dictated a freeing of the body of the corrupt or
+corrupting matter; drugs were a means to this end.
+
+The use of drugs for vomiting, sweating, and other forms of purging
+seems excessive in the light of present-day medical knowledge, and at
+least one seventeenth-century Virginia student of medicine also found
+such use of drugs by his contemporaries open to criticism. In the
+opinion of the Reverend John Clayton, Virginia doctors were so prone to
+associate all drugs with vomiting or other forms of purging that they
+even thought of aromatic spirits as an inferior "vomitive." He
+concluded that these physicians would purge violently even for an
+aching finger: "they immediately [upon examining the patients] give
+three or four spoonfuls [of _crocus metallorum_] ... then perhaps
+purge them with fifteen or twenty grains of the rosin of jalap,
+afterwards sweat them with Venice treacle, powder of snakeroot, or
+Gascoin's Powder; and when these fail _conclamatum est_."
+
+The list of drugs used was extensive and each drug had a considerable
+literature written about it explaining the various sicknesses and
+disorders for which it was a curative. Libraries of the Virginia
+physicians and of the well-to-do laymen usually included a volume or
+two on the use of drugs. Among the most popular plants, roots, and
+other natural products were snakeroot, dittany, senna, alum, sweet
+gums, and tobacco.
+
+Dittany drove worms out of the body and would also produce sweat
+(sweating being another popular method of purging the body of
+disease-producing matter). The juices of the fever or ague-root in beer
+or water "purgeth downward with some violence ... in powder ... it only
+moveth sweat." (Following Galen's system of classifying by taste, this
+root was bitter, therefore thought dry. The physician would administer
+such a drying agent when attempting to reduce excess moistness in the
+body--and thus restore normal body balance, in accord with contemporary
+humoral theory.) Snakeroot, another of the popular therapeutics,
+increased the output of urine and of perspiration; black snakeroot,
+remedying rheumatism, gout, and amenorrhea, found such wide usage
+during the last half of the seventeenth century that its price per
+pound in Virginia on one occasion rose from ten shillings to three
+pounds sterling. Although King James I of England saw much danger in
+tobacco, others among his subjects attributed phenomenal curative
+properties to it. One late sixteenth-century commentator on America
+recommended it as a purge for superfluous phlegm; and smokers believed
+it functioned as an antidote for poisons, as an expellant for "sour"
+humors, and as a healer of wounds. Some doctors maintained that it
+would heal gout and the ague, act as a stimulant and appetite
+depressant, and counteract drunkenness.
+
+The full significance of these drugs in the medicine of the period can
+be better appreciated by reference to a prescription for their use, in
+this instance a remedy for rickets, thought typical by historian Thomas
+Jefferson Wertenbaker:
+
+    Dip the child in the morning, head foremost in cold water, don't
+    dress it immediately, but let it be made warm in the cradle & sweat
+    at least half an hour moderately. Do this 3 mornings ... & if one
+    or both feet are cold while other parts sweat let a little blood be
+    taken out of the feet the 2nd morning.... Before the dips of the
+    child give it some snakeroot and saffern steep'd in rum & water,
+    give this immediately before diping and after you have dipt the
+    child 3 mornings. Give it several times a day the following syrup
+    made of comfry, hartshorn, red roses, hog-brake roots, knot-grass,
+    petty-moral roots; sweeten the syrup with melosses.
+
+But drug therapy was not always as simple as that recommended for
+rickets, although the evidence is that in Virginia the high cost of
+importing the rarer substances inclined local physicians toward the
+less elaborate compounds. Venice treacle, recommended by the Reverend
+Clayton's imaginary purge enthusiast consisted of vipers, white wine,
+opium, licorice, red roses, St. John's wort, and at least a half-dozen
+other ingredients.
+
+Because their use was so extensive in Europe and because many brought a
+good price, any discussion of drugs in seventeenth-century Virginia
+should take note of the efforts in the colony to find locally the raw
+materials for the drugs both for use in Virginia and for export. The
+London Company actively supported a program to develop the drug
+resources of the New World, and the hope of finding them had originally
+been one of the incentives for the colonization of Virginia. Even as
+early as the sixteenth century, authors and promoters in England of the
+American venture had held up the promise of a profitable trade in
+drugs--sassafras, for example--as a stimulus for exploration and
+colonization. Sassafras had market value as it was widely used in cases
+of dysentery, skin diseases, and as a stimulant and astringent; French
+warships searching for loot off the shores of the New World had often
+made it the cargo when richer prizes were not to be had.
+
+Like gold, sassafras diverted labor during the crucial early period at
+Jamestown from the tasks of building and provisioning. Sailors and
+settlers, both, took time off to load the ships with the drug which
+would bring a good price in England.
+
+The belief that the exporting of drugs would prove profitable for the
+colony in Virginia and for the Company may explain why two apothecaries
+accompanied the second group of immigrants who arrived in 1608. Someone
+had to search out and identify possible drugs, and a layman could not
+be expected to perform a task requiring such specialized knowledge. The
+apothecaries could further serve the new settlement by helping to
+supply its medicinal needs.
+
+Before the drug trade in Virginia could be developed, and at the same
+time adapted to the over-all needs of the colony, attention had to be
+given to the use of drugs to meet the immediate needs of the settlers.
+Dr. Bohun, who had brought medical supplies in 1610 and soon found them
+exhausted, turned resourcefully to an investigation of indigenous
+minerals and plants. He investigated earths, gums, plants, and fruits.
+A white clay proved useful in treating the fevers (the clay of the
+Indians used for "sicknesse and paine of the belly"?); the fruits of a
+tree similar to the "mirtle" helped the doctor to face the epidemics of
+dysentery.
+
+The colonists also needed a wine which could be produced cheaply and
+locally. Many of them, accustomed to beer and wine regularly,
+complained of having to rely upon water as a liquid refresher.
+According to one of their number, more died in Virginia of the "disease
+of their minds than of their body ... and by not knowing they shall
+drink water here." One enterprising alchemist and chemist offered to
+sell the London Company a solution for this problem: the formula of an
+artificial wine to be made from Virginia vegetables.
+
+After the colony seemed no longer in danger of perishing from its own
+sicknesses--or going mad from having to drink water--the Company urged
+the settlers to develop an active trade in medicinal plants, in order
+to help cure the diseases of England and the financial ills of the
+Company. The London Company, in a carefully organized memorandum,
+advised the colonists what plants had export value and how these plants
+should be prepared for export:
+
+    1. Small sassafras rootes to be drawen in the winter and dryed and
+    none to be medled with in the sommer, and it is worthe 50 lb. and
+    better per tonne.
+
+    2. Poccone to be gotten from the Indians and put up in caske is
+    worthe per tonne 11 lb. 4. Galbrand groweth like fennell in
+    fashion, and there is greatest stoare of it in Warriscoes Country,
+    where they cut walnut trees leaste. You must cut it downe in Maye
+    or June, and beinge downe it is to be cut into small peeces, and
+    brused and pressed in your small presses, the juice thereof is to
+    be saved and put into casks, which wilbe worthe here per tonne, 100
+    lb. at leasts. 5. Sarsapilla is a roote that runneth within the
+    grounds like unto licoras, which beareth a small rounde leafe close
+    by the grounds, which being founde the roote is to be pulled up and
+    dryed and bounde up in bundles like faggotts, this is to be done
+    towards the ende of sommer before the leafe fall from the stalk;
+    and it is worthe here per tonne, 200 lb. 6. Wallnutt oyle is worth
+    here 30 lb. per tonne, and the like is chestnutt oyle and
+    chechinkamyne oyle.
+
+The Company's plan for the gathering, storing, and shipping of drugs
+was supplemented by a project indicating foresight and an early form of
+experimental research for the development of new products. In 1621 it
+planned thorough tests of an earth sent from Virginia in order to
+determine its value as a cure for the flux. In addition, the Company
+planned to test all sweet gums, roots, woods, and berries submitted by
+the colonists in order to ascertain their medicinal values.
+
+In regard to the sale and dispensing of drugs in Virginia, whether
+found locally or imported, frequent references to the apothecary
+supplies and utensils in the possession of Virginia physicians lead to
+the conclusion that they were usually their own druggists.
+
+As has been noted, the sale and dispensing of drugs usually culminated
+in their use--in accordance with the theory of the period--as means of
+purging the body. Drugs, however, did not have a monopoly in this
+greatly emphasized aspect of medical practice because the clyster
+(purging of the bowels, or enema) and phlebotomy (bleeding of the vein)
+could be used as well. These two methods might be classified as
+mechanical in nature as contrasted with the essentially chemical action
+of the drugs.
+
+Moliere, in his seventeenth-century satires on the European medical
+profession, ridicules the excessive use of the clyster. The popularity
+of the phlebotomy then is attested to by the notoriety of this
+technique today. (Rare is the schoolboy who does not think that George
+Washington was bled to death.) There is no reason to doubt that the
+clyster and phlebotomy enjoyed as wide usage in colonial Virginia as in
+Europe, but the evidence surviving to prove this assumption is slight.
+
+Dr. Blanton, the historian of medicine, could find only meager
+references to the use of clyster (or glyster) and he sums them up as
+follows:
+
+    Among the effects of Nathaniel Hill was '1 old syringe.' In York
+    County records we find that Thomas Whitehead in 1660 paid Edmond
+    Smith for '2 glysters.' George Wale's account to the estate of
+    Thomas Baxter in 1658 included a similar charge. George Light in
+    1657 paid Dr. Mode fifty pounds of tobacco for 'a glister and
+    administering.' John Clulo, Francis Haddon and William Lee each
+    presented bills for similar services.
+
+The survival of such meager evidence for what was probably a common
+practice indicates the difficulties confronting the historian of
+medicine. Nor has Dr. Blanton been able to find, as a result of his
+research, any more evidence of phlebotomy although, again, its
+utilization must have been widespread. Blanton sums up his evidence for
+bleeding as follows:
+
+    Dr. Mode's bill to George Light includes 'a phlebothany to Jno
+    Simonds' and 'a phlebothany to yr mayd.' Dr. Henry Power twice bled
+    Thomas Cowell of York County in 1680, and Patrick Napier twice
+    phlebotomized 'Allen Jarves, deceased, in the cure of a cancer of
+    his mouth.' Colonel Daniel Parke in 1665 rendered John Horsington a
+    bill for 'lettinge blood' from his servant; and we find Dr.
+    Jeremiah Rawlins and Francis Haddon engaging in the same practice.
+
+The horoscope often determined the proper time for bleeding and
+notations have been found in an early American Bible recommending the
+days to, and not to, bleed. Although medicine today looks askance at
+astrological medicine and bloodletting, it remains difficult to explain
+the widespread popularity of such practices unless the patients enjoyed
+some beneficial results, psychological or physical.
+
+Drug therapeutics, clysters, and bloodletting did by no means exhaust
+the seventeenth-century physician's treatments and remedies. The works
+of European painters of the century remind us of uroscopy or urine
+examination. One of the outstanding paintings illustrating the
+technique is by artist Gerard Dou who has the young doctor intently
+examining the urine flask while taking the pulse of a pretty young
+lady. Unfortunately, such revealing pictorial representations of life
+and medicine in colonial Virginia do not exist.
+
+On the other hand, in Virginia, the Reverend John Clayton displayed a
+distinct flair for the scientific method in his analysis of urine. It
+is safe to assume that his techniques were of a higher order than those
+usually associated with uroscopy. Clayton, not satisfied to practice
+just the art of observation, utilized the science of comparative
+weights hoping to find diseases distinguished by minute variations in
+the specific gravity of the liquid. He thought he could find
+manifestations of "affections in the head" by his careful weighing and
+study; manifestations not uncovered by visual observations alone.
+
+In Gerard Dou's painting, it is to be remembered, the doctor not only
+examined the urine but also took the pulse--another common practice.
+This is not surprising insomuch as Galen--the great and ancient
+authority--had written enough to fill sixteen books on the subject of
+"pulse lore." Despite the facts that physicians centuries later
+continue to take the pulse, they would not find the theories behind the
+seventeenth-century practice acceptable. Galen's deductions have since
+been described as fantastic, and his attempt to associate a specific
+type of pulse rate with every disease futile. Yet the Virginia
+physician, when he did take his patient's pulses, certainly did not
+lose his or her confidence by gravely considering the mysterious
+palpitation.
+
+The physician with his many techniques and remedies did not restrict
+himself solely to the illnesses of the sane for--contrary to popular
+belief today--some effort was made to treat and cure the mentally ill.
+America's first insane asylum was not established until 1769, but the
+insane had received, even before this, medical attention. If the case
+did not respond to treatment and took a turn toward violence,
+confinement under conditions that would now be considered barbarous
+often resulted. Before this extreme solution of an extreme problem
+recommended itself, however, the mentally ill might be purged. The
+intent was to relieve the patient of insanity-producing yellow and
+black bile. The belief that this type of sickness would respond to
+conventional treatment, however, did not completely dominate the
+theories on insanity; some seventeenth-century authorities considered
+insanity not an illness but an incurable, disgraceful condition.
+
+One of the fullest accounts of a case of insanity in
+seventeenth-century Virginia describes the plight of poor John Stock of
+York who kept "running about the neighborhood day and night in a sad
+distracted condition to the great disturbance of the people." The court
+authorities ordered that Stock be confined but provided such "helps as
+may be convenient to looke after him." The court, in a sanguine mood,
+anticipated the day when Stock would be in a better condition to govern
+himself.
+
+
+HOUSING OF THE SICK
+
+If the doctor, surgeon, or nursing persons could come to the patient's
+home, little advantage could have been obtained in the seventeenth
+century by moving the patient. The need did arise, however, to care for
+persons outside the home. For example, an individual without family or
+close friends might find it more convenient to move in with those who
+would care for him on a professional basis, or newly arrived immigrants
+and transients might need housing.
+
+Quite in harmony with the needs of the period were the men and women
+willing to take in a sick person in order to supplement their incomes.
+Illness forced one colonial Virginian to offer in 1686 to grant his
+plantation and his home to the person who would provide a wholesome
+diet, washing, and lodging for him and his two daughters. The
+beneficiary was also to carry the sick man to a doctor and to pay all
+of his debts. It is probable that the man provided these services only
+on this particular occasion, but by such special arrangements the
+century housed its sick. The number of ill persons provided for by
+relatives under similar arrangements or even without any compensation,
+must have been even greater in a period without hospitals and nursing
+homes.
+
+On occasions, in the seventeenth century, the physician took the
+patient into his own home, but not always without some reluctance. Dr.
+Wyndham B. Blanton, in his search of the Virginia records for this
+century, found an interesting account of Dr. George Lee of Surry
+County, Virginia, who in 1676 had an unfortunate experience in letting
+accommodations to a pregnant woman. Living in a house she considered
+open and unavoidably cold, and having only one old sow for food, the
+sick and feverish woman pleaded with the doctor to take her to his home
+for the lying-in period. The doctor argued that the house could be made
+warmer, suggested that neighbors bring in food, and protested that he
+had only one room fit for such occupancy and that he and his wife used
+it. Dr. Lee said he would not give up the room for anyone in Virginia.
+
+Offering the opinion that the room was large enough for her, Dr. Lee,
+and his wife, the expectant mother had her servant take her by boat to
+Lee's where she remained, taking great quantities of medicine, until
+she delivered. The doctor then had to bring suit to collect his fees.
+
+Another example of a medical man's housing the sick, is that of a
+surgeon promised 2,000 pounds of tobacco and "cask" if he cured the
+blindness of a person he had housed--but only modest compensation if he
+failed. The same surgeon received 1,000 pounds of tobacco in 1681 by
+order of the vestry of Christ Church parish for keeping "one Mary
+Teston, poore impotent person."
+
+Much earlier, Virginia had what some authorities consider to be the
+first hospital built in America. While the colony was still under the
+administration of the London Company (1612), a structure was erected
+near the present site of Dutch Gap on the James river to house the
+sick. The hospital, which had provisions for medical and surgical
+patients, stood opposite Henrico, a thriving outpost of the settlement
+of Jamestown.
+
+Evidence that the building was primarily designed for the sick and was
+not simply a public guest house is to be found in the statements of
+contemporaries. One described it as a "retreat or guest house for sicke
+people, a high seat and wholesome air," while another wrote that "here
+they were building also an hospitall with fourscore lodgings (and beds
+alreadie sent to furnish them) for the sicke and lame, with keepers to
+attend them for their comfort and recoverie." The use of the word
+"hospital," which had then a general sense, does not indicate any
+similarity to a present-day hospital as does the other information.
+Nothing more appears about this establishment for the sick and wounded,
+and it may well have been destroyed during the Indian uprising of 1622.
+
+Plans for similar institutions in each of the major political and
+geographical subdivisions of the colony came from the London Company.
+Unlike the Henrico structure, these buildings bore the name "guest
+house" and were to harbor the sick and to receive strangers.
+Specifications called for twenty-five beds for fifty persons (which was
+in accord with custom in public institutions); board partitions between
+the beds; five conveniently placed chimneys; and windows enough to
+provide ample fresh air.
+
+The Company repeatedly recommended and urged the construction of these
+guest houses not only as a retreat for the sick but also as a measure
+to prevent illness among the newcomers. In addition, the guest houses,
+if they had been built, would have saved the old settlers from being
+exposed to the diseases of the new arrivals who were taken into private
+homes. The colonists always had some excuse for delaying construction,
+and the Company in 1621 entreated to the effect that it could not "but
+apprehend with great grief the sufferings of these multitudes at their
+first landing for want of guest houses where in they might have a while
+sheltered themselves from the injuries of the air in the cold season."
+
+That the London Company should have had the Henrico hospital built
+during its administration and made plans for the guest houses can be
+explained by the situation existing during the earlier days of the
+colony. The Company, engaged in a commercial venture and realizing by
+its own statement that "in the health of the people consisteth the very
+life, strength, increase and prosperity of the whole general colony,"
+had sufficient reason to shelter and care for the colonists. Also,
+during the early days the number of incoming colonists was high
+relative to the number settled and with lodging to give or to let. The
+Company, in addition, knew that new arrivals fell victim most easily to
+seasoning and other maladies, and needed protection from the elements.
+Finally, the Company had to fill the void created by the absence of
+religious orders which, during prior European colonization and
+occupation of distant lands, had provided shelter and care. These
+hospitals are no longer mentioned after the dissolution of the London
+Company, nor were any other comparable measures taken during the
+century to institutionalize care for the sick.
+
+
+SURGICAL PRACTICE
+
+Much has been made of the lower status held by the surgeon as compared
+with that of the physician--during the seventeenth century. On the
+continent and in England, at this period, membership in separate guilds
+in part distinguished doctor and surgeon; in England, after 1540 and
+until 1745, surgeons held common membership with barbers in one
+corporate organization. In America, historians agree, the differences
+based on specialization of practice between surgeons and physicians
+soon tended to disappear, a superior education often being the only
+attribute or function of a physician not shared by the surgeon. Barbers
+held a unique position, but in performing phlebotomies, a minor
+operation, they retained associations with health and disease. Both
+barber and surgeon shared a certain expertness with tools, as they do
+today.
+
+Evidence abounds in the earlier records that the scarcity of medical
+men may have compelled surgeons in Virginia to practice internal
+medicine: surgeons prescribed medicine with the same frequency as
+doctors. The surgeons, however, did not abandon the treatment of
+wounds, fractures, and dislocations; notes on amputations during the
+century also exist.
+
+Nor is it reasonable to assume that the isolated physician of the
+Virginia countryside would always insist upon referring a patient to a
+surgeon. Dr. Francis Haddon, who had a large practice in York County,
+Virginia, and who is not identified as a surgeon, left recorded the
+course of treatment for an amputation--cordials, a purge, ointments,
+and bloodletting--and a dismembering saw, as well.
+
+Other recorded surgical treatments include care of dislocated
+shoulders; wounds in various parts of the body; sores of the feet and
+legs; cancerous ulcers in the instep; ulcers of the throat, and dueling
+wounds. One of the most unusual surgical measures of the period was the
+application of weapon salve for battle wounds; the salve was applied to
+weapon, not wound.
+
+Surgery has long been associated with the military, and much of the
+outstanding surgical work done in Europe during the fifteenth and
+sixteenth centuries was performed by military surgeons. Ambroise Pare
+(c. 1510-1590), remembered especially for the use of the ligature in
+amputations and the abandonment of the burning-oil treatment of wounds,
+held a position as a surgeon for the French army. Other surgeons of the
+period contributed to the improvement of medical practice by
+enlightened measures of quarantine to prevent contagious diseases from
+decimating armies.
+
+Insomuch as the first settlers at Jamestown greatly feared attack from
+Indians and Spaniards and because the initial landings had the
+character of a military expedition, it is not surprising that the first
+two medical men to arrive, Will Wilkinson and Thomas Wotton, were
+surgeons. Captain John Smith on three occasions, it is to be
+remembered, emphasized the importance of the surgeon to pioneer
+settlers and explorers in the New World. When injured by the stingray
+in 1608, Smith's first thought was of his need for a surgeon and
+"chirurgery"; so the success of physician Russell's soothing oils came
+as a pleasant surprise. On a subsequent expedition he included the
+surgeon, Anthony Bagnall, rather than Dr. Russell, to treat the
+stingray wound; and in 1609 when he received the powder burn, he left
+Virginia "seeing there was neither chirurgeon nor chirurgery in the
+fort to cure his hurt."
+
+Throughout the century surgeons rendered services to colonists engaged
+in fighting with, or defending themselves against, the Indians. When
+the Indian massacre of 1622 occurred, costing the lives of more than
+350 colonists in the settlements, it is possible that the two surgeons
+who sailed to Virginia with Dr. Pott in 1621 gave assistance to the
+wounded. In 1644, when a retaliatory attack on the Indians was made by
+the settlers because of a recent massacre, the General Assembly
+provided for a surgeon-general to accompany the militia, at public
+expense.
+
+Again, later in the century, the General Assembly gave evidence of
+recognizing the importance of surgical care for soldiers when it voted
+for supplying a surgeon with "a convenient supply of medicines &
+salves, etc. to the value of five pounds sterling for every hundred
+men" to each of eight forts planned to protect the settlements against
+Indian attacks. Throughout the last half of the century references were
+made to surgeons ministering to companies of soldiers or to various
+garrisons and forts. Judging by the consistent employment of surgeons
+for military duties, it would appear that the profession of surgeon
+during the century was much more intimately associated with the
+military than was that of physician. The relationship between the
+surgeon and the military is similar to the early one between civil
+engineer and the army in Europe.
+
+
+HYGIENE
+
+The restoration of the patient to health is not the only important
+aspect of medical practice; the prevention of illness is also vital to
+the health of a community. Much more attention is given to preventive
+medicine in the twentieth century than in the seventeenth, but the
+value of cleanliness, fresh air, and quarantine was known. Hygienic
+measures taken, or recommendations made, by public authorities make
+clear the fact that the cause of disease was not commonly thought to be
+supernatural by the educated and responsible. Contemporary accounts
+make known the widespread disapproval of foul ships, crowded quarters,
+marshy land, stagnant air, bad food and drink, excessive eating, and
+exposure to a hot sun.
+
+Lord De la Warr laid down regulations for Jamestown designed to
+eliminate the dangers of dirty wash water ("no ... water or suds of
+fowle cloathes or kettle, pot, or pan ... within twenty foote of the
+olde well"); and of contamination from sewage ("nor shall any one
+aforesaid, within lesse than a quarter of one mile from the
+pallisadoes, dare to doe the necessities of nature"). The order argued
+that if the inhabitants did not separate themselves at least a quarter
+of one mile from the palisaded living area that "the whole fort may be
+choaked, and poisoned with ill aires and so corrupt." The colonists by
+the same order had to keep their own houses and the street before both
+sweet and clean.
+
+Any doubt that an awareness existed of the dangers of infection by
+contact, at least from diseases with observable bodily symptoms, should
+be dispelled by the quarantine measures taken by the colonel and
+commander of Northampton County in 1667 during an epidemic of smallpox.
+He ordered that no member of a family inflicted with the disease should
+leave his house until thirty days after the outbreak lest the disease
+be spread by infection "like the plague of leprosy." Enlightened
+authorities in Europe took similar precautions.
+
+
+
+
+CHAPTER FOUR
+
+Education, Women, Churchmen, and The Law
+
+
+THE PLACE OF WOMEN IN MEDICINE
+
+Women played a part in treating and caring for the ill and distressed
+in a number of ways during the century. A few women dispensed medicine
+and enjoyed reputations as doctors, but it was in the field of
+obstetrics and as midwives that they made their most important
+contributions. Although women did what might be described generally as
+nursing, their contribution in this area was relatively insignificant
+when compared with the importance of the female nurse today. Any
+discussion of the place of women in seventeenth-century medicine should
+note the relationship between women, witchcraft, and medicine.
+
+Although the references leave no doubt of the existence of female
+doctors and dispensers of medicines, the mention of them is infrequent.
+Mrs. Mary Seal, the widow of a Dr. Power, for example, administered
+medicine to Richard Dunbar in 1700. The wife of Edward Good was sought
+out in 1678 to cure a head sore and another "doctress" impressed the
+Reverend John Clayton, who had some insights into medical science
+himself, with her ability to cure the bite of a rattlesnake by using
+the drug dittany. In the same year that Good's wife was sought to treat
+the head sore, a Mrs. Grendon dispensed medicine to an individual who
+had injured his eyes in a fight. The exact status of these women,
+however, is unknown; it is highly unlikely that the female practicing
+medicine enjoyed the professional standing of a Dr. Pott or a Dr.
+Bohun--an old female slave also appears in the record as a doctor.
+
+With medical knowledge limited and antisepsis unknown, the expectant
+mother of the seventeenth century fared better with a midwife than she
+would have with a physician. The midwife, whose training consisted of
+experience and apprenticeship at best, allowed the birth to be as free
+from human interference as possible and did not do a pre-delivery
+infection-producing examination.
+
+Both the fees and the prestige of the midwife, judging by contemporary
+records from other colonies, were high. Unfortunately, the early
+Virginia sources throw little light on the activities of the midwife in
+this colony. Among the scattered references from Virginia records are
+found charges of 100 pounds of tobacco for the service of a midwife;
+the presence of two midwives assisted by two nurses and other women at
+a single birth; the payment of twelve hens for obstetrical services;
+and the delivery of a bastard child by a midwife.
+
+Nursing duties were probably taken on by both men and women in addition
+to their regular occupations. The duties consisted not only of tending
+the sick--and there is no reason to believe this was done under the
+supervision of a physician--but also of burying the dead and arranging
+the funerals. While the patient lived, the nurse prepared food, washed
+linen, and did other chores to make the patient comfortable. When death
+came, the nurse was "the good woman who shall dress me and put me in my
+coffin," and who provided "entertainment of those that came to bury him
+with 3 vollys of shott & diging his grave with the trouble of his
+funeral included."
+
+The medical ramifications of witchcraft have been suggested. One of the
+most interesting Virginia court cases of the century had as its
+principal subject a woman accused of the power to cause sickness. In an
+age when weapon salve was wiped on the weapon and not the wound, and
+when astrology was intimately associated with the practice of medicine,
+it is not surprising to find, also, the witch and her power to cause
+disease. Goodwife Wright stood accused of such powers in the colony's
+general court on September 11, 1626.
+
+Goodwife Wright had caused, according to her accusers, the illness of a
+husband, wife, and child out of a spirit of revenge; and she was able
+to prophesy deaths as well. The details of the case brought against
+this woman accused of witchcraft reveal the more bizarre medical
+practices of the time. Goodwife Wright expected to serve as the midwife
+but the expectant mother refused to employ her upon learning that
+Wright was left-handed. Soon after affronting Wright in such a manner,
+the mother complained that her breast "grew dangerouslie sore" and her
+husband and child both fell sick within a few weeks. With
+circumstantial evidence of this kind, suspicion had little difficulty
+in linking the midwife with the sicknesses.
+
+Testimony revealed that on another occasion she had used her powers to
+counter the actions of another suspected witch. Having been informed
+that the other witch was causing the sickness, Wright had the ill
+person throw a red-hot horseshoe into her own urine. The result,
+according to witnesses was that the offending witch was "sick at harte"
+as long as the horseshoe was hot, and the sick person well when it had
+cooled.
+
+
+CHURCHMEN AND MEDICINE
+
+Medicine was associated in many minds not only with the powers of evil
+but also with the forces for good. The clergyman in colonial America
+often practiced medicine, and the layman in some localities of Virginia
+could turn to the local parson for medical assistance.
+
+Throughout the early Christian era and the medieval period, medicine
+and religion had had a close relationship. The New Testament had
+numerous references to the healing of the sick by spiritual means, and
+a casual relationship between sin and physical affliction had been
+assumed by many persons for centuries before the seventeenth. The hand
+of God was still seen by many in physical phenomena, whether disease or
+the flight of a comet. Not only was there a supernatural relationship
+seen between the God of the church and disease, but also a natural one
+between medicine and the church clergy, for they had staffed the
+medical schools for centuries. It is not surprising, then, that the
+parson-physician was no stranger to the Virginia colony.
+
+As early as 1619, Robert Pawlett, known to be a preacher, surgeon, and
+physician, came to Virginia. He was followed by other parson-physicians
+in Virginia and in other colonies. As late as the end of the eighteenth
+century, the wife of George Washington called on the Reverend Greene,
+M.D., for medical advice.
+
+Among the most interesting in this long tradition of ministers who
+practiced medicine is the Reverend John Clayton whose activities have
+been noted. Other persons residing in Virginia and combining the role
+of clergyman with a considerable interest in medicine were Nathaniel
+Eaton, who had a degree in medicine, and John Banister who was an
+active naturalist. As a naturalist, he made an important study of the
+plants of Virginia (_Catalogue of Virginia Plants_) which added to
+the literature available for the dispenser of medicinal drugs. One of
+the founders of Presbyterianism in America, the Reverend Francis
+Makemie, who came to America in 1681 and died in Accomack County,
+Virginia, was described as a preacher, a doctor of medicine, a
+merchant, an attorney--and a disturber of government by the governor of
+New York.
+
+
+LAW AND MEDICINE
+
+Although the Crown did not follow the lead of the Company in providing
+care for the sick and unsheltered, the authorities after 1624 did have
+the state take an interest in medicine to the extent of passing laws
+dealing with medical problems and situations. These laws were primarily
+concerned with the collection and charging of fees, but also provided
+for the censure of the physician or surgeon neglecting his patient.
+
+On four occasions during the century the Assembly attempted to regulate
+the excessive and immoderate rates of physicians and surgeons. The
+chief example used to convey the injustice of fees for visits and drugs
+was that many colonists preferred to allow their servants to hazard a
+recovery than to call a medical man. Although an inhumane attitude, the
+colonists reasoned that the physician or surgeon would charge more than
+the purchase price of the servant.
+
+The act of 1657-58 reveals this attitude and throws some light on the
+medical practice of the century. (Similar acts had been passed in 1639
+and in 1645 and would be passed in 1661-62.) By the will of the
+Assembly, the layman had the right to bring the physician or surgeon
+into court if the charge for "paines, druggs or medicines" was thought
+to be unreasonable. The surgeon or physician had in court to declare
+under oath the true value of drugs and medicines administered, and then
+the court decided the just compensation.
+
+The law went on to declare that:
+
+    Where it shall be sufficiently proved in any of the said courts
+    that a phisitian or chirurgeon hath neglected his patient, or that
+    he hath refused (being thereunto required) his helpe and assistance
+    to any person or persons in sicknes or extremitie, that the said
+    phisitian or chirurgeon shall be censured by the court for such his
+    neglect or refusall.
+
+The legislators also gave the physician or surgeon protection by
+providing that their accounts could be pleaded against and recovered
+from the estate of a deceased patient--suggesting that patients were
+not prompt enough in paying their bills (or perhaps did not survive
+treatment long enough to do so). Court records show that the medical
+men often took advantage of this provision for collection.
+
+A measure enacted in 1692 indicated a more sympathetic attitude on the
+part of the legislators toward the physicians and surgeons. While in
+the earlier acts preventing exorbitant fees the court had been ordered
+to decide upon just compensation, the later act allowed the physician
+or surgeon to charge whatever he declared under oath in court to be
+just for medicines. Nor did the act of 1692 make reference to "rigorous
+though unskilful" or "griping and avaricious" physicians and surgeons
+as had the earlier laws.
+
+References by the colonial Assembly to exorbitant fees were not without
+a basis in fact. The conventional charge for the physician's visit,
+according to Dr. Wyndham Blanton, was thirty-five to fifty pounds of
+tobacco and on occasions the physician, or surgeon, must have exceeded
+this fee. An approximate estimate of the value of these visits in
+present-day terms would be between twenty and twenty-five dollars. The
+cost of medical care was even greater when an unusually large amount of
+drugs was dispensed. It is not surprising that many masters did not
+provide the services of a physician or surgeon for their servants; nor
+that medical attention was given by persons without professional
+status. Although these charges seem high, it must be taken into account
+that because of the great distances between communities and even
+between homes, the physician or surgeon could make only a small number
+of visits each week.
+
+County records give many examples of the fees of physicians and
+surgeons. Of 145 medical bills entered in the York County records
+between 1637 and 1700, the average bill was for 752 pounds of tobacco,
+or a little less than one laborer could produce in a year. Other fees
+were: 400 pounds of tobacco for six visits; 300 pounds of tobacco for
+three visits and five days attendance; 1,000 pounds of tobacco for
+twenty days of attendance "going ounce a weeke ... being fourteen
+miles"; and 600 pounds for twelve daily visits. At the time these
+charges were made, tobacco brought between two and three cents per
+pound, or the equivalent of approximately fifty cents today.
+
+The surgeon administering the clyster or phlebotomy, those commonly
+resorted to "remedies," could be expected to charge thirty pounds of
+tobacco for the first and twenty pounds for the second. The surgeon,
+and the physician, often charged from twenty to fifty pounds of tobacco
+for a drug prescription.
+
+In 1658, Dr. John Clulo presented a bill to John Gosling in York County
+which he itemized as follows (in pounds of tobacco):
+
+    For 2 glisters [clysters]          040
+    For a glister                      030
+    For a potion cord.[ial]            036
+    For an astringent potion           035
+    For my visitts paines & attendance ...
+    For a glistere                     030
+    For an astringent potion           035
+    For a cord. astringent bole        036
+    For a bole as before               036
+    For a purging potion               050
+    For a [cordial julep]              120
+    For a potion as before             036
+
+Not only does Dr. Clulo's bill give examples of fees charged, but it
+supports the contention that the substance of medical treatment during
+the century was bloodletting, purging, and prescribing drugs.
+
+Although the physicians of colonial Virginia did charge well for their
+services, it should be noted that they were in demand. Their patients,
+this would indicate, considered their services of great value, any
+subsequent protests notwithstanding.
+
+
+THE EDUCATION OF PHYSICIANS AND SURGEONS
+
+Since the physicians and surgeons did make substantial charges and
+since the educated layman could buy his own books on medicine and
+practice what he read or since the uneducated could turn to a neighbor
+with medical knowledge or to a quack, the question arises as to why the
+services of professional surgeons and physicians were in such demand.
+Part of the answer lies in the professional's experience, but even in a
+colony without a medical school it also lies in the education and
+training received by the professional.
+
+There were several ways in which a seventeenth-century Virginia
+physician could acquire his education or training. He could have
+received a medical degree in England or on the continent and then gone
+to America. On the other hand, he might have learned without formal
+education--perhaps by attending lectures and by experience--and then
+established himself in Virginia where he was accorded professional
+status. A man born in Virginia could return to the Old World for
+training or formal education and then practice in Virginia. Also, a
+common manner of becoming a physician or surgeon in Virginia, which was
+without medical schools, was by apprenticeship. Finally, the importance
+of books--imported from Europe--as a means to medical education should
+not be minimized.
+
+To be officially licensed for practice, the requirements in England
+were high--those in London especially so. The following excerpt from
+the statutes of the College of Physicians of London demonstrates how
+demanding the educational standards for seventeenth-century English
+physicians could be:
+
+    First, let them be examined in the physiologick part, and the very
+    rudiments of medicine, and in this examination let questions be
+    propounded out of the books concerning elements, temperaments, the
+    use of parts, anatomy, natural powers and faculties, and other
+    parts of natural medicine.
+
+    Secondly let him be examined in the pathologick part, or concerning
+    the causes, differences, symptoms and signs of diseases, which
+    physicians make use of to know the essence of diseases; and in this
+    examination let questions be proposed out of books concerning the
+    art of physick, of the places affected, of the differences of
+    diseases and symptoms, of feavers, of the pubes, of the books of
+    prognosticks of Hippocrates, &c.
+
+    Thirdly let him be examined concerning the use and exercise of
+    medicine, or the reason of healing; and let that be done out of the
+    books concerning preservation of health, of the method of healing,
+    of the reason of diet in acute diseases, of simple medicines, of
+    crises, of the aphorisms of Hyppocrates, and other things of that
+    kind, which relate to the use of healing; for example sake, what
+    caution to be observed in purging? in what persons? with what
+    medicine? and in what vein, those things ought to be done?
+    Likewise, what is the use of narcoticks and sleeping medicines? and
+    what caution is to be observed in them? what is the position and
+    site of the internal places? and by what passages medicines come to
+    there? what is the use of clysters, what kind of vomits, the
+    danger, kind and measure?
+
+Under the London Company, the physicians and surgeons in Virginia had
+the same education, training, and met the same standards as their
+counterparts in England. This was, in part, because the Company had
+good reason to supply adequate medical service, and because the men
+sent were but Englishmen transplanted to America. Walter Russell, who
+came to Virginia in 1608 was a "Doctour of Physicke" and Lawrence
+Bohun, De la Warr's physician, had the same degree. Pott, who succeeded
+Bohun as physician-general of Virginia in 1621, came recommended as a
+Master of Arts well-practiced in surgery and physics.
+
+After the Company's charter was annulled, few physicians or surgeons
+with the advanced medical degrees came to Virginia. Some of the
+persons, however, who practiced medicine in Virginia without medical
+degrees had acquired skills and knowledge in Europe or England before
+coming to the New World.
+
+Patrick Napier who came to Virginia about 1655 as an indentured servant
+and subsequently had a large medical practice, probably learned his
+profession in England or on the Continent, as might have Francis
+Haddon, another who came under terms of indenture and who later, also,
+had a considerable medical practice. To these two examples of persons
+with training and experience acquired prior to their arrival in America
+might be added the similar experiences of John Williams and John Inman.
+
+Medical knowledge and practices brought over from England were
+cross-fertilized with the European even in the New World. While the
+majority of newcomers were Englishmen, French, German, and other
+European physicians and surgeons came to Virginia. These European
+medical men appear, in general, to have prospered in Virginia and were
+anxious to become naturalized "denizens to this country."
+
+George Hacke, born in Cologne, Germany, settled in Northampton County,
+Virginia, in 1653 and was known as a doctor and practitioner of
+medicine. He was typical of the European-trained medical man settling
+in Virginia in becoming naturalized and in leaving a considerable
+estate, including thousands of acres of land. Little is known of his
+medical activities and interests except that he was summoned to treat
+the victim of a duel and that he left a large library which probably
+included volumes on medicine.
+
+Paul Micou, a young French physician who seems to have acquired his
+education abroad, settled on the shores of the Rappahannock river, near
+a place afterward called Port Micou, during the last decade of the
+seventeenth century. Cultured and educated, he soon won prominence and
+wealth as a physician (and surgeon), attorney, and merchant. County
+records in Virginia make numerous references to suits brought by him
+for nonpayment of fees, suggesting an extensive practice.
+
+Because so many of the doctors and surgeons of seventeenth-century
+Virginia are given only slight mention in the records, it is impossible
+to know whether, in most cases, they had acquired their skills and
+educations before coming to Virginia, or even whether they were born in
+the New World. Nor is it known how many young men born in Virginia went
+back to England or Europe to study medicine; a reference made by the
+famous English surgeon, John Woodall, indicates that a Virginian named
+Wake may have studied under him in London.
+
+Within the Virginia county records, however, can be found evidence
+indicating that a common method of learning the profession was by
+apprenticeship. One interesting example of the contract between
+apprentice and surgeon survives in the records of Surry County,
+Virginia; made in 1657, it bound Charles Clay to Stephen Tickner,
+surgeon, for a term of seven years. Clay swore to serve his master in
+whatever surgical or medical duties he was assigned, and Tickner
+promised to use his best skill and judgment to teach his apprentice
+whatever he knew of the art. Another contract for apprenticeship was
+made between Richard Townshend and the London Company's well-known Dr.
+Pott. This relationship included a breach of contract that occurred not
+infrequently between master and apprentice: Townshend argued in court
+that Pott was not teaching him the "art & misterye" for which he was
+bound.
+
+As an apprentice, the would-be physician or surgeon could gather herbs
+for his master and assist him in treating the sick. If the apprentice
+could read, or if the master would teach him, then the novice could
+study the medical books in the doctor's library. Not only were volumes
+on medicine available, but in the libraries of the better-educated
+medical men, the apprentice could also familiarize himself with other
+fields of learning.
+
+Dr. Pott had a reputation for knowing Latin, Greek, and Hebrew, and
+must have imparted much of his learning to Richard Townshend, his
+apprentice. Such would seem to be the case in view of the facts of
+Townshend's life. He became an apprentice to Pott in 1621 and by 1636
+he was a member of the colony's highest political body, the council,
+and at the time of his death he possessed a considerable amount of
+land. In a day when schooling was hard to come by, apprenticeship to an
+educated man held great advantages.
+
+Unfortunately catalogues of the libraries of medical men have not
+survived. There is proof, however, that physicians and surgeons did not
+neglect opportunities to collect volumes on medicine published in
+England and Europe. If utilized, these books could have helped offset
+the lack of a formal education in a university or medical school. Dr.
+Henry Willoughby of Rappahannock County, Virginia, left forty-four
+books on "phisick" in his estate. Dr. John Holloway, a leading
+physician of Accomack County, Virginia, from 1633 until his death in
+1643, left thirteen books on surgery and medicine, all in English or
+Latin. Dr. Henry Andrews of York County had twenty books in Latin on
+medicine.
+
+A great number of Virginians--some of them prominent--who did not
+practice medicine had, nonetheless, large collections of books on the
+subject. This would indicate that many persons resorted to medical
+treatment without the help of a professional. With fees high, distances
+great, and well-trained doctors scarce, self-reliance is not
+surprising. Many planters and their wives must have made a superficial
+study of medicine; certainly the mistress of the house visiting sick
+servants and slaves is a familiar historical picture.
+
+Among the medical books in such libraries were volumes on the general
+subjects of medicine (physick) and surgery, anatomy, gout, scurvy,
+distillation, and natural magic. Common in the libraries of the laymen
+were books recommending specific drugs for various symptoms of
+diseases. The long title of one volume in a Virginia library read,
+"Method of physick, containing the causes, signes, and cures of inward
+diseases in man's body from the head to the foote. Whereunto is added
+the forme and rule of making remedies and medicines, which our
+physitions commonly use at this day, with the proportion, quantity, and
+names of each medicine."
+
+The importance of medical volumes to the lay library is indicated by
+the inclusion of two in the supplies provided by a London agent for a
+Virginia plantation in 1620-21. William S. Powell, in a recent study of
+books in Virginia before 1624, found that the agent chose _The French
+Chirurgerye_, published in English in 1597, and the _Enchiridion
+Medicinae_, first published in 1573.
+
+In spite of medical books, the apprenticeships, training in Europe or
+England, and the demand for medical services despite a high fee, it is
+possible to overestimate the competence of the seventeenth-century
+Virginia doctor even by the standards of his own century. An
+observation made by William Byrd II early in the next century tends to
+reduce the stature of the medical man.
+
+"Here be some men," Byrd wrote, "indeed that are call'd doctors; but
+they are generally discarded surgeons of ships, that know nothing above
+very common remedys. They are not acquainted enough with plants or
+other parts of natural history, to do any service to the world...."
+Byrd may have been prejudiced by his father who, although believing
+himself facing death, still did not call a physician.
+
+
+
+
+CHAPTER FIVE
+
+Conclusion
+
+
+PORTRAIT OF A SEVENTEENTH-CENTURY VIRGINIA PHYSICIAN
+
+Historical evidence does not support Byrd's description of the typical
+physician as a discarded ship's surgeon. In contrast, the physician,
+whatever his competence may have been, emerges from the sources as a
+respected member of the colony who, besides his medical practice,
+engaged in farming sizable holdings of land and took part in the civic
+life of the colony. His private life was not unlike that of the other
+planters who enjoyed some wealth and professional standing. The
+reputable surgeon, who could also supplement his income from farming,
+probably enjoyed an existence not unlike that of the physicians,
+considering that the distinction between them in the New World was
+slight.
+
+Dr. Blanton, in his volume on medicine in Virginia, created a lively
+portrait of what he imagines from his researches to be the
+seventeenth-century Virginia doctor. The doctor is seen:
+
+    dressed in knee breeches and jerkin, perhaps adorned with periwig
+    and cap; not given to church-going, but fond of ale, horse-racing
+    and cuss words; husband of a multiparous wife; owner of a log cabin
+    home or at best a frame cottage which he guarded with gun, pistol
+    and scimitar; his road a bridle path and his means of conveyance a
+    horse or boat ... reading ... by candle light, without spectacles;
+    writing with a goose quill pen; sitting on a rough stool or bench;
+    eating at a crude table from pewter dishes, without fork or table
+    knife; having no knowledge of bath tubs; keeping his clothes in
+    trunk or chest; sleeping, night-capped, on a flock bed in a bedroom
+    shared by others; dividing his time, which he measured with
+    hour-glass and sundial, among medicine, politics and farming; often
+    in court, often a justice, member of Council or Burgesses, and
+    subject, like his neighbors, to military service.
+
+
+SUMMARY
+
+Englishmen and Europeans planted Virginia in the New World and brought
+the Old World's medical knowledge and medical practices with them. In
+Europe and England, the seventeenth century witnessed the perfection of
+new and scientific theories in medicine--it was the century of
+Harvey--but little original and fruitful in the field of practice--Dr.
+Sydenham might be considered an exception.
+
+In Virginia, the prior occupants had accumulated medical knowledge,
+too, and the Indians practiced in a manner not completely unlike that
+of the whites: bloodletting, purging, and sweating (all to the end of
+relieving the body of ill humors or morbid matter). The Indians,
+however, did not believe it right or good to impart their knowledge to
+the layman, Indian or European; therefore, cross-fertilization between
+the two schools of medicine was limited.
+
+In planning for the colony, the London Company took into account that
+health would influence the fortunes of the new settlement. The Company
+warned the original settlers to choose a site in a healthful location,
+but the colonists elected Jamestown Island which was low and moist.
+Provided two surgeons by the Company, the original settlers needed not
+only more surgeons but physicians as well: the surgeons could treat the
+wounds, sprains, and breaks of a military-colonizing expedition, but
+physicians were needed to meet conditions that developed in Jamestown.
+
+In subsequent boatloads of settlers, physicians did come--and some were
+well-trained and experienced--but the small number that arrived during
+the period when the London Company administered the colony (1606-24)
+could not meet the demands of disease and famine. During the first
+summer more than one-half the original settlers perished: during the
+Starving Time (1609-10) the population dropped from 500 to 60 and in
+the spring these 60 almost abandoned Virginia. A deadly combination of
+new environment, famine, and epidemic disease, such as typhoid, played
+a major part in determining the course of events during the first two
+decades of the colony's life, and near death.
+
+After Virginia became a Crown colony, famine and disease no longer
+influenced affairs so greatly, not because of the wise administration
+of the Crown, but because the colonists had better learned what was
+necessary to cope with health conditions in the New World. No longer
+did they consider disease and famine minor threats compared to those
+from the Indians and Spaniards. They planned their ocean voyages so as
+to arrive in the fall and thus avoid the dread summer sickness while
+still too weak from the voyage to resist it; they located their outer
+settlements on higher and drier land, at the end of the century even
+moving their capital to Williamsburg, known for its temperate and
+healthful climate.
+
+The physicians and surgeons, however, who came later in the century
+were not as distinguished as their earlier counterparts. As the century
+passed, many men trained by apprenticing themselves in Virginia.
+Whether immigrant or indigenous, the medical men used orthodox European
+techniques: they bled and purged, sweated and dispensed drugs, to
+obtain these ends. Some of the drugs were native to Virginia and the
+colonists exported them for a profit, but the more expensive--and
+efficacious--had to be imported. There is evidence that the level of
+medical excellence in Virginia lowered during the century; many of the
+planters avoided the expensive visits and drugs, even passing laws to
+regulate fees and chastise lax and inadequate practitioners.
+
+Women, clergymen, and laymen all treated the sick and wounded of the
+period, with the women especially active as midwives; with the clergy
+producing such an outstanding medical man as the Reverend John Clayton;
+and with the laymen acquiring enough information, perhaps from a few
+medical books, in order to practice, themselves, in case a doctor were
+unavailable or undesired.
+
+
+
+
+ACKNOWLEDGEMENTS AND BIBLIOGRAPHICAL NOTE
+
+
+Dr. Wyndham B. Blanton kindly gave permission for the use, in the
+preparation of this booklet, of his definitive and authoritative volume
+on the history of seventeenth-century Virginia medicine. Dr. Blanton's
+work--based on extensive research in the sources--has proved of great
+value, but he should not be held responible for any weaknesses in this
+essay, as the author assumes full responsibility. The author also
+wishes to take this opportunity to express his appreciation for the
+numerous suggestions and improvements made by his wife who spent many
+hours assisting in the preparation of the manuscript.
+
+The books and articles that proved most helpful were:
+
+Allen, Phyllis, "Medical Education in 17th Century England," _Journal
+of the History of Medicine and Allied Sciences_, I (January, 1946),
+115-143.
+
+_American History Told by Contemporaries_. Edited by Albert B. Hart.
+New York and London, 1908-1909. 4 vols.
+
+Beverley, Robert, _The History of Virginia_.... (Reprinted from the
+author's 2d rev. ed., London, 1722.) Richmond, 1855.
+
+Blanton, Wyndham B., _Medicine in Virginia in the Seventeenth Century_.
+Richmond, 1930.
+
+Brown, Alexander, _Genesis of the United States_. Boston and New York,
+1890. 2 vols.
+
+Castiglioni, Arturo, _A History of Medicine_. Translated from the
+Italian and edited by E. B. Krumbhaar. New York, 1941.
+
+Chitwood, Oliver P., _A History of Colonial America_. New York, 1948.
+
+Craven, Wesley F., _Dissolution of the Virginia Company: the Failure of
+a Colonial Experiment_. New York, 1932.
+
+_Southern Colonies in the Seventeenth Century_, 1607-1689. Baton Rouge,
+1949.
+
+Duran-Reynals, Marie Louise, _The Fever Bark Tree_. New York, 1946.
+
+Garrison, Fielding H., _An Introduction to the History of Medicine_....
+Philadelphia, 1929.
+
+_Narratives of Early Virginia_, 1606-1625. Edited by Lyon G. Tyler. New
+York, 1907.
+
+Packard, Francis R., _History of Medicine in the United States_. New
+York, 1931. 2 vols.
+
+Sigerist, Henry E., _American Medicine_. Translated by Hildegard Nagel.
+New York, 1934.
+
+Smith, John, _Travels and Works_. Edited by Edward Arber. Edinburgh,
+1910. 2 vols.
+
+Tyler, Lyon G., "The Medical Men of Virginia," _William and Mary
+College Quarterly_, XIX (January, 1911), 145-162.
+
+Wertenbaker, Thomas J., _The First Americans, 1607-1690_. New York,
+1944.
+
+
+
+
+
+
+End of the Project Gutenberg EBook of Medicine in Virginia, 1607-1699, by
+Thomas P. Hughes
+
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