Brian Altonen, MPH, MS

Introduction

Shadrach Ricketson is one of several Hudson Valley physicians to provide us with  important insights in early United States medical history.    Born in November of 1768, seven years prior to the Revolutionary War, we know little of his childhood years.  Since he was born a Quaker, we can pretty much define his life based on the Quaker tradition.  This would include his devotion to religion and church, the form of education he would experience during his childhood, his understanding and relationship with God and his general impressions of natural philosophy, and numerous societal values important to Quaker philosophy. 

Some of the most important philosophical beliefs of Quaker philosophy, still being practiced today, pertain to issues with an important sense of morality attached to the underlying social problems each of these represent.  These include such beliefs as being sensitive to the needs of the poor and suffering, the social problems related to war, the practice of slavery, the problem of jailing criminals, or the need to live and do things that are a symbol of one’s richness and lack of desire to experience a long and healthy lifespan.  In general, Shadrach’s earliest years would have produced one of the more important significant impressions upon him as a child, enough to influence his choice for a final career. 

It is for this reason that a number of details about Ricketson’s life and personality have to be defined prior to reviewing his life in gernal and as a physician.   The following aspects of Ricketson’s life may in themselves seem contradictory to Quaker belief, but they are nevertheless activities and practices Ricketson engaged in for a reason.  It is as if Ricketson was raised to believe,and then test, some of the Quaker traditions that he learned from the elders and then subsequently grew up with.

Since the beginning of Quakerism in the 1670s, pacifism has been one of their major social causes.  And yet, for whatever reason, Shadrach Ricketson learned medicine from a Ship Surgeon who served on the ship Montgomery during the Revolutionary War.   Was Shadrach’s preceptor sympathetic to his apprentice’s cause, taking Shadrach on because he was against the medical aftermath of the war as well?

Just a few years later, with the war over, Shadrach would be standing alongside his preceptor and another famous wartime physician who served at Fishkill hospital by his side, performing a dissection of a Quaker elder.  This was to demonstrate to the public the value in this surgical process which Ricketson himself was probably familiar with due to his preceptor’s experiences during the war.  Ricketson used this event to emphasize to others in the local community the important role human dissection served in helping physician develop a better understanding of the various diseases.  This even led Ricketson to have a report published on this process in the local newspaper, as part of the regular obituary, a communications practice not atypical for this time.   This was done to inform the public of the cause for the elder’s death and to set straight some popular beliefs that dissections were desecrative, a public belief which Ricketson referred to as simple “superstition.”

As a highly religious Quaker practicing medicine, Ricketson also had to contend with the notion of vis medicatrix naturae (practice medicine according to nature, nature heals, by allowing disease to take its natural course).  This was one of the most important religious concepts at the time in religion and medicine and played a heavy role in what methods of healing could be practiced and what methods could not.  When practicing medicine, the doctor had to be able to determine whether or not his or her process of treating the afflicted was “natural” or ‘in accordance with God’s will.’   To other Quaker healers, visiting the sick or holding hands and praying in silence were practices seemingly quite different from administering foreign substances to the body, such as inebriating beverages, drugs, scalpels and lancets.   The Quaker version of these methods had to be done in accordance with Quaker belief.  Such a tradition must have left Shadrach Ricketson wondering whether the use of a plant medicine was more natural than a mineral or chemical remedy extracted from soils and stone.  He had to decide whether or not putting one through an exposure to a disease like small pox, in the form of participating in an inoculation program, was natural, and/or whether or not the later alternative developed for this disease prevention process–the vaccination of uninfected children and adults with kine (cow) pox–was more or less effective and more or less natural than the small pox inoculation, all of these as substitutes for waiting for the disease to progress in its own way, shape, or form. 

As some plant and mineral medicines became better understood, Ricketson also had to decide whether or not this meant the use of a concentrated mineral remedy to treat heart disease, or the use of a concentrated by-product of Opium, was less natural?   When electricity became a popular cured for some diseases, this method of healing had to be linked in some way to his philosophy of vis medicatrix naturae, the natural philosophy behind the natural sources for this electricity (i.e. lightning), and the relation of these to the Creator (i.e. “Was God expressing his messages to me through nature?”).

Ricketson’s first goal in life as a physician was to try and learn the answers to these questions and more, in his own way, as a Quaker.

With all the local news about an imminent war passing through his neighborhood during the winters of 1774 and 1775, it would have been clear to his family, to others and to him that nationality or some sort of official identity was not yet fully established for the Hudson Valley region.  This left local residents including Shadrach with limited understanding of government during his earliest years of unbringing, and more of an understanding about the needs of the local community relating to guidance and leadership.  In some ways this left Shadrach Ricketson free to explore whatever was offered to him locally for occupational consideration. 

In general, Quaker social rules and laws, morees and taboos, did not exclude anyone from being more than just a religious healer.  So long as you following what you perceive to God’s course for you, you were taking the right path.  Since, according to Quaker tradition, God did not directly communicate or speak with you, except as ‘the Christ or God within’, you had to learn to receive and experience these messages.  Just what message Shadrach received is not known, but may have been some underlying event, state or condition that he experienced during his childhood that influenced him greatly.  This could have been a live being saved from a drowning in the Hudson River through resuscitation and the revival of his suspended state or animation.  It could have been the deaths he learned about or witnessed amongst an elder of his Society of Friends, or a member of his family.  Shadrach Ricketson may have even had a medical condition or experience himself, something we never learn about throughout his life.  Whatever the reason, Shadrach Ricketson decided to become a doctor near the end of the war, or quite soon after the Revolutionary War ended, at about the age of sixteen.

Just what was it that had the greatest influence upon Shadrach Ricketson in making his life choices is uncertain.  What we do know is that beginning with Shadrach Ricketson, Quakerism began to play an important role in medicine as a whole within the United States.  A number of Quaker leaders preceded him as important medical leaders and social activitists, helping to set the stage for Shadrach’s community efforts.  Those best known for these social impacts include:

• John Woolman (October 19, 1720 – October 7, 1772) of New Jersey, who was strongly against military draft and slavery and wrote Some Considerations on the Keeping of Negroes.
• William Tuke (1733-1822), who established the Retreat at York in England where psychiatric patients were treated more humanely without restraints; soonafter, similar retreats were set up elsewhere in European and the United States
• John Dalton (1766-1844), the scientist who created Dalton’s Theory used to explain the atomic theory of matter. 
• Peter Collinson (January 1694 – 11 August 1768), an associate of Cadwallader Colden, John Bartram, Ben Franklin, Linneaus, Mark Catesby, Sir Hans Sloane, and one of the first of several to document many of the North American medicinal plants.
• Dr. John Fothergill (1712—1780),  English Quaker physician and philanthropist, and writer of the important work Account of the Sore Throat attended with Ulcers (1748), the first detailed description of diphtheria.
• John Bartram (1699-1777), early American medical botanist, who produced one of the first medical plants collections of this country and who documented the use of plants for medicine by the specific low income social groups during the colonial, a mentor of botanist Jane Colden and colleague of her father Cadwallader Colden.
• Johns Hopkins (1795-1873), entrepreneur, philanthropist, and abolitionist residing in Baltimore.

Other more recent Quakers to play equally important roles in medicine include (see Wikipedia for more):

• Henry Gibbons Sr. and Jr., major leaders in the California botanical medicine movements ca. 1875, then serving both regular and “alternative” medicine physicians and pharmaceutical companies.   
• Susan B. Anthony (1820—1906), American suffragist, abolitionist, and pioneer of feminism and civil rights.
• Joseph Lister, 1st Baron Lister (1827-1912), the discoverer of the use of carbolic acid as an antispectic (Listerine) and promoter of sterile surgical procedures.
• Thomas Hodgkin (1798-1866), British physician who documented what it now called Hodgkin’s Lymphoma.

Ricketson’s Life

Due to the Quaker tradition, many physicians felt that the new forms of medicine being employed served a country in need of redefining its most deeply rooted philosophies.  Around the dawn of the 19th century, ca. 1800, the most important influences Quaker philosophy had on medicine related to the growing separation between science and religion.  Shadrach Ricketson learned medicine as a science, but practiced Quakerism as a religion.  To merge these two parts of his life’s purpose together, Shadrach must have taken some of his earliest teachings about God and Spirit to their utmost levels of understanding.

Throughout the Colonial years, the notion of God the way the Christian churches preached it was going rapidly into a state of complete abandonment, or so it seemed to the scientists trying to establish their own version of the religious philosophy.  These scientists at the time were in a dilemma themselves when it came to demonstrating their personal behavior in relation to medicine and religion.  Most doctors had to ask themselves the question ‘do I believe in God or am I an atheist?’  For the most part, the concept of agnostician was already there in plain sight for most physicians, fortunately for many this could be disguised somewhat  in the form of natural philosophy.  One could still go to church services and the like, but internally apply the church’s teaching to one own personal take on natural theology. 

This is exactly the route most scientifically-oriented physicians tried to take.  Beginning in the late 1600s, well after Galileo’s famous discoveries and immediately following Isaac Newton’s work, being able to argue this change in philosophy had become much easier to accomplish.  The study of God, church practices and natural philosophy was by now a well acknowledged route of study taken by many monks and religious leaders, so why not do the same as a physician?  This interest in natural philosophy/theology advanced more quickly during the 1700s as scientific discoveries continued to be made, and intellectual growth and dvelopment continued to increase alongside these discoveries during the early and mid-1700s.  By the end of the 18th century, were it not for the Revolutionary War about to take place, who knows what might have happened due to this rapid growth in theological intellectualism during the years of the War itself? 

It is possible that such a growth might not have changed at all had the Revolutionary War not taken place.  The most important  sociocultural factors helping to give rise to these changes in medical and natural philosophy occured as a result of advances in transportation, the onset of the French Revolution, and the migration of scientists from Europe to other parts of the world where they could share their uniquely different philosophies with other peers and comrades.   For this reason alone, the greatest changes in natural philosophy began to take place in America near the end of the post-Revolutionary War depression, during the 1790s and 1800s.   During this period of post-war depression followed by recovery, the Atlantic port-city urban settings grew quickly.  This meant that such a change in population sizes in the United States was inevitable.  It also meant that due to the inherent multicultural nature of these migrations into New York City followed by the Hudson Valley,  that ultimately the Hudson valley would become the most important place for some of these groups to settle.  Places where unique multicultural events could happen, in a region where due its Dutch heritage, no single culture ruled at the sociopolitical level.   

Along with an influx of philosophy came the influx of science, and its own religious lines of reasoning.  The core reason religion underwent this schism during the 1790s was the ongoing philosophical arguments promoted by Galileo and Isaac Newton, and the subsequent publications or their meaning and interpretations in philosophy and medicine.  This led to the publication of such works as George Adams’ “Essay on Electricity” (1784), “Essays on the Microscope” (1787), “Astronomical and Geographical Essays” (1789), “Essay on Vision” (1789) “Geometrical and Graphical Essays” (1791) and “Lectures on Natural and Experimental Philosophy” (1794).  Each of these writings in turn posed to readers the following philosophical question:  Was it possible that the “God” which controls the universe and its individual components actually be something related to all the energy and electric-magnetic concepts scientists were speculating upon?  To most of the readers, especially scientists, it was easier to imagine some sort of invisible energy holding the universe together, guiding the planets, moving the clouds about the sky, enabling life to be formed, operating in some fairly predictable way like a machine, than to try to reason that some great Creator was up there in some sort of human corporeal form controlling everything in his/her own way, such that everything takes its course throughout its life as it was “planned” or intended.   A scientist could even imagine this universal energy to be something that was philosophically related to the “animal spirit” concept, something traditionally thought to exist in the body and to be difficult to control, or the nervous energy or ‘spirit’ that exists within the nervous system itself, isolated from the ‘Animal Spirit’, a different part of the body first defined around the turn of the 17th century by neuroanatomist Willis. 

Likewise, since Vesalius first spent his time drawing up the particulars of the nervous system, the reasons for the form of the brain and the various organs or tissues proximal to it and the spinal cord have take on new meaning as well, based on the curiosity of both scientists and religious leaders.  These tissues and their forms helped to explain such things as the flow of “life” through the body via the nerves, and being that there was a unique set of nerves parallel to the spine, felt to possess some “sympathy” with the spinal chord and its nervous activities (the “Great Sympathetic nerve as these writers called it), there had to be part of the natural philosophy of medicine that would enable physicians and metaphysicians to make use of this knowledge for explaining the “grander scheme.”  Likened today to the split between the body and the mind, two parts of the same individual taken from each other when Renee Descartes writings came about, this ongoing split of the body from its spirit and the interrelationships of these parts remained the major focus of doctor’s attentions during the 17th and early 18th centuries.  The more science learned about the inner working of the world, the more others felt we knew about “God”, or at least the major plans that “nature” had in store for us.  All of these philosophies and methods of thinking and rationalizing the differences between Science and Medicine were a part of Shadrach Ricketson’s upbringing.  Later, as they became an essential core of the training he underwent to become a physician, they had to be put in perspective by Shadrach, in accordance with Quaker traditions. 

If we review the Quaker concept of “God”, we come up with terminology, phrasing and pronunciations that suggest Quaker philosophy pretty much managed “God” as an individual being in existence, in some form or state not really specified by the writings (“the Light within”), that is peaceful and loving, and capable of influencing individuals at a personal and/or fate-related level.  Quakers paid very little attention to the makings and workings of Jesus Christ as some religious entity of the highest Divine form, but did not necessarily take on the Mohammedist approach to viewing Jesus as some sort of gifted individual capable of making special contacts with the Creator.  Instead, it often seems as though Quaker philosophy was just as distinct and non-Christian like in discussing the nature of God as were some parts of the Jewish philosophies, which stated that God was some entity, perhaps even of non-physical energy form, that was often if not always there at some personal level.  The type of religion practices performed based on this philosophy are exactly what led Shadrach Ricketson to interpret some physical happenings or events as God or Natural Theology related events.  Although he never states this in his writings, one can surmise that since Shadrach was an important Quaker leader in Hudson valley history, that his personal philosophy must have stirred him to produce the book he wrote about medicine during the peak of his professional years.  Instead of rewriting the teachings of the Bible like Jesus, or proselytizing about the importance of various lifestyle practices in some religious law related way like Moses, Shadrach Ricketson became more like some Maimonides of early American and New York history.  He promoted what to him seemed to be the most obvious needs for the living body to remain healthy and stay alive, to serve as some sort of personal shrine symbolic of an individual’s devotion to this type of religious and physical cause.  Shadrach surpassed Maimonides by adding to his philosophy large pieces of information pertaining to the science of being, as part of the overall natural world and universe.  Shadrach added to his arsenal of thinking against disease a focus on the natural elements and events, and how they influence our health, promoting the traditional Quaker in him as well.  To Shadrach this was his most most pacifist way of being when treating the ill, not intervening with God’s will or direction, even though this meant some sort of relationship could developed within a warring set of medical professions.  Shadrach was into the people, the individual and the balanced environment, none of which to him seemed to be within the government’s domain in the end.

Shadrach Ricketson demonstrated his own personal and unique approach to disease with the title of his book: Means of Preserving Health and Preventing Diseases. . . .  This was not so much a book on how to treat and eliminate or reduce disease-related problems as much as it was a book on how to live a long and health life.    The layout of Ricketson’s book was laid out duiring the late 17th century, in Salerni’s book on natural medicine Medicinae Naturae.  Although the content is very different, the exact outline of this book is incredibly similar to another book which Ricketson most likely did read or see as a child–George Cheyne’s An Essay of Health and Long Life (1724).  If we review Ricketson’s book in context with the most popular readings for the time, we find his book was not only timely, for a part of the medical profession in need of some extensive updates,  but also more fitting for those residing in the American culture. 

A number of domestic medical guides published around this time also took on parts of the ideology of these classical writings, even expressing this by the titles of their subsections.  But Ricketson’s book was different.  Ricketson felt these differences were due to his different background and his lack of conformity that most of the domestic medical physicians who wrote these other family medical guides.  Prior to Ricketsons’ work, one of the most influence Domestic Medical guides was that of William Buchan, whose writings were very much traditional English-based, and to some not acclimable to the pseudo- or semi-Christian cultural lifestyle that many other of different faiths seemed to be establishing in the Hudson Valley, New York, and the United States.  Another major Domestic Medical guide for the time was that of Reverend and Medical Doctor Joseph Townsend, again of Christian training and descent, but more heavily influential in some political and social sense when it came to certain Quaker traditions such as issues pertaining to poverty, the troubles with how society treated its orphan population, and whether nor not certain people were deserving of their problems or not due to past behaviors and occupation, exerted an heavy influence upon the local social structures when his domestic medical guide was published and distributed by a Bostonian printer beginning around 1797, but having its greatest impact with the second edition printed and distributed around 1802/4. 

The other highly popular author in past history (during the mostly loyalist period in American colonial history no less), who Ricketson’s work directly mimics, was An Essay on Health and Long Life . . .  by George Cheyne, published in London in 1724.   Like most books published on such topics for nearly a century by that time, this books was essentially a series of short stories, commentaries, reflections of personal opinions and attitudes, along with the related sorts fo evidence needed to qualify the many subjective statements being made.  This book, although highly respected, had one serious flaw in its authorship.  George Cheyne himself in his later years was morbidly obese, and in the end experienced a number of diseases related to gluttony and his globe-like roundness of stature, ranging from diabetes and kidney problems to gout, richness, gluttony and early demise.  Cheyne was author with the gifted hand and productive, active mind, not the healthy heart, circulation or glandular make-up needed by an old-timer bearing wisdom and humility.  

As an interesting addition to this history of Ricketson’s book, it also is important to note that Ricketson had a major dispute with others in his profession regarding a book published for a member of the medical profession serving British  Royalty around 1805–Sir John Sinclair (1754-1835) and his The Code of Health and Longevity,  Or, a Concise View of the Principles Calculated for the Preservation of Health and the Attainment of Long Life (1806).    A book review was published for Sinclair’s book in the Medical Repository, effectively serving as an advertisement for this work.  The Medical Repository was the primary medical journal of this region and perhaps the entire country at the time.  For a book on healthy living, which was mostly a reiteration of previously written prose and verse from several much older writings, contained few if any discoveries according to Shadrach and those parts of the book that were unique, and penned by Sinclair, merely a series of lines representing more Sinclair’s opinions about the appropropiate manner of living, in Great Britain–not at all an essay on health in North America.  Due to the association of Sinclair with British Royalty, this book was priced rather extravagently for the time–20 dollars.  Ricketson’s book was priced at only 1 to 2 dollars.  Ricketson openly expressed his dissatisfaction with the fellow physicians publishing and promoting the more expensive book in their trade magazine.  This may even have been in part why Ricketson withdrew from the medical profession somewhat in terms of becoming a part of this professional team, most of whom were actively teaching at one or more medical school and clinical teaching settings.  Ricketson was invited by Lyman Spalding to teach at a newly forming medical school in upstate New York a few years later, but apparently refused this position and is never noted on any faculty listing seen for this school (as per personal communication with historian, see my 1806-the Book page for more on this). 

Ricketson’s Book

The Philosophy of the Book

There is a certain Renaissance-Shakespearean nature of Ricketson’s book that is worth mentioning.  Writers like Ricketson have an affinity for the use of trine philosophy when designing their methods of presentation.  To some of the most devoted trinitarian physicians, this included the designs of their practice, their engagement in trial and error treatment methods, their methods of practice, their methods of defining their methods of therapeutics in their log book.  It is perhaps for this reason that Dr. Ricketson’s book is written in three parts.  One might normally consider this form of writing a coincidence, but so much circumstantial evidence exists in which others from this time frame made it a point to note their value of this writing style, its application to their natural theology or natural philosophy, and in one case even a direct admittance of this practice by one group of practitioners when approached about their methods by the State Court in Albany, all suggest that this artistic style of writing was deeply either performed with some conscious efforts being made to be successful, or due to some more subconscious sort of habitual writing and thinking practice engained in these people since childhood.  As a sign of his own devotion to his natural theology and his practice of Quakerism,  Ricketson wrote his book as trinity form, as he thought was meant to be.

Ricketson’s numerous other practices and roles played in his life suggest he is an excellant example of what is today known as the Family Practice professional in medicine.  Ricketson has been given several patches of homor by writers in other medical professions over the years, ranging from the perfect Hygeine expert like Moses to the best example of an early promoter and practitioner of the new field of Sport Medicine in which health is produced through regular exercise and diet training.  In one of the reviews of his practice, I even suggested Ricketson is also a great example of an early epidemiologist, one of the first few to develop in the United States, who began making regular contact with others in the medical profession and documenting diseases patterns and behavior, like with his Influenza study. 

Still, these multiple examples of how he employed himself as a physician are best represented by the Family Medicine physician.  Being a Quaker, he was as a physician also a ‘family man” one might say.  Still, Ricketson lacked his own wife and kids, a symbol of his devotion to his work as well as to his other much larger “family”, his closest friends within the Quaker community, and his neighbors with this ongoing need for his help and assistance.  Ricketson also had an innermost devotion to his Creator, and so this is perhaps why he remained who he was once he began to practice spiritual, electrical and physical medicine.

Shadrach Ricketson died in 1837  and his obituary was provided to the Poughkeepsie Journal, written by one of his friends, more than like a physician and/or Quaker.