History of medical practice in Illinois - Bushnell Historical Society

The General Practitioner 1051877, therefore, anyone who wanted to practice medicine in Illinois couldhang out his shingle and start to work. When the 1877 law went into effect,half of the 7400 doctors in the state were nongraduates, and 490 wereusing fraudulent credentials, and some were practicing under assumednames. 1Prior to 1875, every doctor was a physician and surgeon. Surgeons andophthalmologists were the only specialists of any standing, and these menalmost always carried on a general practice along with their specialties.Surgical procedures were operations of necessity following accident or weresurgical emergencies, usually performed by local practitioners who had,or claimed to have had, the necessary surgical experience. Since almostevery locality of any size had a practitioner who had served as a surgeonor assistant surgeon during the Civil War, many of these surgical emergencieswere in fairly competent hands. Difficulties in transportation weregood reasons also for doing the operation on the kitchen table. Hospitalswere not available outside the larger cities so the patient had to be treatedat home. The writer can remember when there was not a hospital alongthe Baltimore and Ohio Railway between St. Louis and Cincinnati. Thedictum in the days before Lister was "never touch the peritoneum," andthis was strictly followed with the exception of operation for ovarian tumorswhich were seldom removed until their size compelled the procedure.Penetrating injuries to joints by gunshot wounds or otherwise were alwaysfatalvery high.without amputation, and the mortality following amputation wasLittle had been heard about inflammation of the appendix until it wasdescribed by Fitz in 1886. Before that, a patient with a severe pain andtenderness in the right lower quadrant had "cramp colic," "inflammationof the bowels" or "locked bowels." When physics of various sortsto produce results or made matters worse, quicksilver was given asfaileda lastresort, and it usually was just that. As a small boy in the i8go's, the writercan remember hearing members of his family discussing relatives or neighborswho had died of these diseases and talking about the remedies whichhad been tried. Surgeons at that time were just beginning to operate forappendicitis.Puerperal fever took many lives in Illinois. Watson in 1865 described 5various epidemics of this disease and insisted that it was contagious. Hesaid: "The hand which is relied on to assist the mother in the perilous hourof childbirth may literally become the innocent cause of her destruction.... In these days of ready invention, a glove, I think, might be devisedwhich would be impervious to fluids, and yet so thin and pliant as not to6Watson, Thomas D.: Lectures on the Principles and Practice of Physic. Philadelphia.Lea & Blanchard, 1844.