History of medical practice in Illinois - Bushnell Historical Society

CHAPTER VITHE GENERAL PRACTITIONER:HIS PREPARATION,ENVIRONMENT AND EXPERIENCESBy TOM KIRKWOOD, M.D.*IT isdifficult for the physician of the 1950's to imagine the handicapsfaced by the general practitioner in Illinois one hundred years ago. Butthe reasons are obvious: the equipment of that period was meagre and themethods were crude.In 1850, the stethoscope was just coming into general use. Like manynew instruments, it was not used very efficiently. Clinical thermometerswere ten inches long and were large, clumsy and hard to carry. By 1870they became more serviceable. While the hypodermic syringe was introducedin 1852, neither Dr. W. W. Keen nor Dr. James Tyson used eitherthis instrument or a thermometer during service in the Civil War yearsof 1862 to 1865. The microscope was still a curiosity, so far as the generalpractitioner was concerned, and remained so for many years. Blood countsand other blood examinations were unheard of. Urinalysis was only beginningto receive some attention but did not come into general use until yearslater. Ether and chloroform were being used only by the bolder and moreprogressive physicians and only in cases where the patients could be persuadedto permit it. Many drugs were available but were not standardizedand were not well understood. The most dependable were cinchona, mercuryand opium. Quinine was one of the few specific drugs available, butit cost six to eight dollars an ounce in 1846. Bacteriology was still far inthe future; belief in the unity of fevers still prevailed.The physician often compensated for his lack of equipment and knowledgeby his impressive manner. The successful doctor was positive, forcefuland definite in his statements, and had to be somewhat of a dictator tocontrol the people of that day. Instead of dressing like the average citizen,he often wore a swallow-tailed coat and high silk or beaver hat. Since theroads and streets were often muddy, it was perfectly proper to stuff the* Dr. Kirkwood is a well-known physician engaged in general practice in Lawrenceville,a small city in Lawrence County of Eastern Illinois. Recently he wrote a medical historyof his county, much of which data he now has inserted in this chapter.—Editor99