Introduction
In 1806, Shadrach Ricketson published his first medical book. It was also one of the first medical books published by an American-born physician using an American printing press. Published at about the same time as f Thomas Paine’s important nationalist writings, this aspect alone made Dr. Ricketson a fairly well-known and favorite early American author, to the general public as well as his peers. About a year later this led Dr. Ricketson to remove to the urban setting of New York for a brief while, to make better use of his knowledge and empirical skills as a Dutchess County Quaker physician.
No doubt, Ricketson deserves a significant amount of respect for his accomplishments following the publication of his book in 1806. Aside from writing one this country’s first medical books, he was also engaged in some of the first studies on the use of locally grown varieties of Opium, with the goal of developing substitutes for the Turkish crops which the medical industry so heavily depended and found to be quite expensive at times due to import taxes and market values. Ricketson also had published at least one case history that he communicated with another physician affiliated with the New York medical school and its professional journal Medical Repository. In 1808, Shadrach demonstrated his best performance as a physician and an epidemiologist publically and professionally when he used a standard process established by staff at the medical school for evaluating the influenza epidemic that struck the had recently impacted New York State. This method consisted of the development of a survey tool for his comrades to respond to, in which he asked them about how much the recent influenza epidemic had impacted their part of New York State. The results of this epidemiological study were published by the Repository.
Still, Dr. Ricketson was perhaps best noted by the Medical Repository for his attentiveness to nature and weather and a strong advocate of the new and rapidly growing field of medical climatology, the underlying reason for his influenza research. Ricketson was one of the mainstays of this special field of study for medicine then quite popular amongst physicians practicing within the rural parts of New York State. As part of his practice in medicine in Dutchess County area, for example, Ricketson worked alongside a number of physicians developed to weath, climate and disease, as well as topography or landforms and disease. These studies of medical climatology and medical topography had by now become the two most important specialities in medicine that physicians outside the urban are could specialize in, and become more skilled providing important as part of their everyday practice. Shadrach Ricketson was also one of these types of physicians.
So what were the most important findings or beliefs that Shadrach Ricketson became devoted to?
Of Quaker raising, Ricketson was not against the use of medications to deal with disease, but was very much into any and all natural ways in which we could deal with out lifestyle habits and make the body healthier and more disease resistant. In recent years, a review of historians’ take on Ricketsons importance point to two single reasons as to why Ricketson is commonly cited for his work by historians, medical teachers and writers, and medical or public health professionals:
- the importance of exercise and health,
- the relationship of obesity to other diseases.
A personal review of Shadrach Ricketson’s other activities in the medical journals demonstrated that he was also important for:
- using a query (mailed survey) method to analyze and document the conditions required for influenza cases and epidemics to develop
- documenting the relations between wintertime local illnesses in the valley and local weather conditions, especially temperatures
- developing and having published his theory on the fever epidemics of the valley and county
Much needs to be said about Dr. Ricketson’s accomplishments as a physician. A number of the articles have therefore been reviewed for this work. His book is a personal belonging. Fortunately, most of Ricketson’s writings could be obtained in a format such that they can be included with this review (which will be placed as time allows).
Ricketson’s Book
The content of Ricketson’s book is as follows:
The similarity of Ricketson’s to Cheyne’s book is quite incredible. It is almost as if Ricketson had used Cheyne’s book to develop his own outline.
As for the differences between these two books, Ricketson is more detailed than Cheyne throughout his writings. In the first chapter, Ricketson rightly calls it “Air and Climate” , for Cheyne’s rendering of this relationship took a much simpler approach to the topic, failing to engage in much of any review on weather and climate as an important features related to the impacts of air upon health. Ricketson next separates Cheyne’s “Meat and Drink” chapter into their own chapters but in reverse order; also note in the above ‘Table of Contents’ for Ricketson’s book the details in which each of these different concepts was reviewed by Ricketson. Ricketson then moves Cheyne’s section on “Evacuations and Obstructions” (Chapter V) to the end, in order to improve the flow of the contents (no pun intended) for the book, since he planned to discuss these along with other physical medical skills in more detail at the end of his text. Finally, Ricketson also added his own Chapter 6 (VI) on Clothing, a topic which Cheyne paid little attention to except in the form of a very brief end comment in his chapter on Air, and a number of new sections in the Appendix on controversial methods of medical practice and new methods that can be used to prevent disease, improve health and increase longevity.
This evidence strongly suggests that Ricketson was so familiar with Cheyne’s writings that he must have used Cheyne’s book to design his own, with the goal of replacing Cheyne’s out-of-date presentation. Important to note are the two popular concepts about New York city versus Hudson Valley–the use of the valley to help remedy disease. In Ricketson’s book, the needs of this popular concept are met when he provides information on how to stay healthy for those who are healthy, versus those who are not, but are trying to live a healthier life as “valetudinarians”–Chapter IX. This separate chapter even mimics some of Cheyne’s approach somewhat. Whereas Cheyne ended each of his chapters with a section that he called “Rules of Health and Long Life”, Ricketson provides all this information at the end. Also note that in this section on health maintenance in Ricketson’s book, another two parts follow, each with 4 plus 5 chapters respectively (4+5=9). Note the underlying trinity concept or use of threes in the design of this book that is once again prevailing, a subconscious message to his readers, or an overtly obvious statement meant to satisfy the masses of local readers ‘in tune’ with this concept.
The last two sections go well beyond Cheyne’s level of work and knowledge on this topic. For each of the topics Ricketson added in the last two sections, fairly obvious value statements were added as well. The first part of the Appendix has sections on Bathing, Cleansing, Ventilation and Electricity. This section on bathing is a direct result of increasingly popular opinions people and physicians had about cleanliness and personal hygiene, and the relation of these to one’s “proximal” cause for becoming ill, such as unhealthy skin, blood, and other tissues or body parts, versus the local “distal” causes such as exposure to bad air, poor food, unhealthy weather, etc. The popularity of Bathing was beginning to reach a temporary peak in this era of local popular culture as well, as evidenced by the publication of a treatise on the medical uses of the bath and bathing by the popular Dr. Curtis around the turn of the century.
This topic was well promoted by the local Medical Repository and the related New York City medical school teaching’s staff. Adding still more to the popularity of Ricketson’s book as a writing project devoted to local issues was the applicability of this section to other health promoting features in close proximity to its readers. The development of fresh crisp mountain water springs all along the valley, a product of its combined geographic and geologic features related very well to Ricketson’s teachings, as did the hot springs in Ballston and Saratoga. This would even set the stage for a unique and fairly unknown piece of local Poughkeepsie history generated as a direct result of all of these popular culture events within the immediate Hudson valley region–the opening of a “New Ballston” at the edge of the Hudson River in a section at one time called “Carthage” on some Dutchess County maps, and the related heavy advertising of this and other natural health water sources by Livingston throughout the years ahead.
Attached to bathing there is of course Cleansing, the main topic for Ricketsons next discussion. In his section on Cleanliness. Adhering to his trinity-based concept in writing, Ricketson writes about Cleanliness:
“It is so well known, that it needs no to be described. It consists principally in three particulars: 1. In our persons; 2. In our clothes; 3. In and about our houses and furniture.”
The topics he reviews include the use of cleaning compounds, brushing out teeth, washing our eyes each morning with cold water, regular bathing and washing habits, wearing fabrics design to absorb our sweat and other offensive smells, keeping our home and clothes clean, tending to our “pits of privies”, raising the home on the right soil, cleaning the floors, whitewashing the walls, keeping our furniture “clean and sweet’, doing everything possible for “the preservation of health”, avoiding “All offensive vegetable and animal substances”, preventing them from forming in the pits by residing upon the healthiest soil, and avoiding the passage of “putrid, pestilential or contagious diseases” from one person or hosuehold to the next by way of contaminated clothing and fabrics. It is also important to note that these descriptions that Ricketson provided in writing are more vivid, more detailed and more applicable to day to day living than those provided in Cheyne’s earlier book.
Ricketson’s discussion of “Ventilation” is a direct consequence of discoveries and inventions made suring the Revolutionary War, an influential factor with direct local ties. The establishment of the War Hospital in Fishkill mroe than 30 years earlier is what led to the implementation and testing of ventilation methods for improving upon the outcomes of patients lying with in dank, damp setting of dozens of cots strewn across the floors of a hospital built within a fairly humid environmental setting. In the years that followed the war, the applications of engineered products designed to increase cross-breezes and complete airflow were designed to prevent any possible onset of ventilation-related disease problems. Ricketson himself stated in his books and other writings that the number of windows in a home were important to maintaining a health living environment. Important place and environmental condition features covered in his book on this topic included his inference that obvious differences exist between “cities and towns, and other confined places” versus the local rural settings many Hudson Valley and Dutchess county hamlets and farms were raised within. Ricketson suggests that houses have windows on every side, that the use of candles and lamps, stoves and fireplaces be taken into consideration, that even the type of fuel being used be kept in mind, such as wood versus charcoal. The reason for paying attention to these particular living practices, to avoid sleeping within some air that could result in poor health or even death.
As a Quaker, Ricketson perhaps had his issues with the practices and habits of the local town officials, especially the Sheriff with regard to the mistreatment of criminals. Ricketson’s review of Ventilation and health is just a 2-page, 6 paragraph essay. One of these paragraphs he devoted to a discussion of “hospitals, gaols and ships” and their “rooms where people are sick of putrid, contagious or pestilential diseases.” He recommends the applications of technology related to pumping purified air, “to render and preserve the air sweet, pure and wholesome” within these crowded settings. For those without ventilators, but in need of of some ventilation and vitiation of the inside air, he specifically states “A room may have the air in it considerable purified by pumping it; that is, by moving the door briskly backward and forward for some time, and by opening a window in the apartment opposite to it.”
To treat infected places, some of the methods Ricketson described are very reminiscent of traditional practices used since the Middle Ages to do much the same. The Old Nun’s Hospitals of the Dark Ages, the early 17th century Jesuit Nun’s hospitals in Quebec, most of the European towns and cities ravaged by the plague all made use of suffumigation or effumigation practices to prevent diseases from taking hold of an area or from being passed on from one region to the next. For this reason Ricketson recommended something similar by suggesting the local gardening of vegetables to help purfiy the “air in infected and pestilential places”. For herbs, he recommended the growing, cutting and then preparation of tansy, wormwood, rue and mint, “collected and spread in a fresh state.” Typical of the public health concerns for the plague, yellow fever, typhus, and other forms of pestilence impacting Europe and the Hudson valley about this time, Ricketson suggests “fumigating with juniper-berries and the steamd of vinegar”, by which “malignant and infectious disorders have been thought to be warded off”.
Published in New York in 1806, Ricketson made a significant effort to get the word out that his book was about to become available for purchase. He probably made contacts through a number of local medical committees to accomplish this, and requested annoucements and book reviews of his work be published throughout the months ahead. In a biography of Lyman Spalding told his grandson james Alfred Spalding and published in 1916, Dr. Lyman Spalding. The Originator of the United States Pharmacopoeia, (W. M. Leonard, Boston), the tale is told of the life of this important members of the staff at the for medical college to open in western New York around 1812, and the various communications he engaged in by other medcail school staff members. This provides us with a little more insight into Dr. Ricketson’s profession and reputation as a writer and physician. One of the first letters noted in this biography about Ricketson is a letter he sent to Dr. Spalding in order to initiate a series of sales on his book. This book would be in part Dr. Ricketson’s introduction to many of physicians involved with the local medical schools:
Several weeks later, after receiving a reply from Spalding, Ricketson sent the following:
Ricketson’s first months of sales of his book were perhaps fair to moderate, based on the fact that he still have a number of copies still in his possession by the end of the calendar year. During the months that had just passed, Ricketson learned about a physician who made his way to the United States from Europe and was recently assigned a position at the medical school providing classes on anatomy and surgery as each relate to medical cases shared with him by the medical students. The size of the classes about this time were quite variable, but could have as amany as 250 students attending a single session by a popular professor, with counts of annual senior students who planned to graduate from this program numbering as many as 50 to 55. Because of Dr. Alexander Ramsey’s popularity, Ricktson contacted him directly hoping to obtain some professional support. thereby increasing more sales of his book.
Shadrach Ricketson thought highly of his work by comparing it to the recently published work on diet, health and longevity written by Sir John Sinclair (1754-1835), 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). The content and writing style of Sinclair’s book was by no means similar to or resembling that of Ricketson’s, but it did have the effect of demonstrating to Ricketson and others the advantages or “priviledges” that some writers had over others, and the ongoing dilemma that American writers were trying to face with their writing regarding the applicability and hiigh costs for a popular book that in the end had little to do with American lifestyle and culture. The cost of Sir Sinclair’s book alone stated something about the importance of British Royalty heritage and political aristocracy when it came to being both successful and productive with a published writing. Ricketson’s book was sold and distributed to subscribers for a cost varying from $1.00 to $1.25 per book; Sir Sinclair’s book sold for $20. Yet, even another completely different political issue that had nothing to do with medicine was implied by this problem. The most loyal American patriot families could very well ahve been offended by a non-American writer like Sir Sinclair who, in spite of his British pompousness and overall reputation as a Britishman, surpass the accomplishments of one of the local community’s most respected physicians. To citizens still sensitized by the Revolutionary War, this was a formidable social issue. Both Buchan and Townsend’s books had already made this point fairly clear to New York physicians like Ricketson and others. Now, for some reason, this issue seems to remain a sensitive topic amongst medical school professors and administrators, even with the support of Dr. Fothergill of Philadelphia, a British-turned-American physician.
A Cultural Comparison
Setting aside the cross-cultural problems that existed when Sir Sinclair produced his massive tome on Health and Longevity, there was the overall applicability and social importance of each of these presentation that had to be considered to better understand the social context and meaning for each of these two writings. Although quite expensive, this alone wasn’t the reason Sir Sinclair’s book failed to meet the needs of most Americans. Like Reverend Joseph Townsend’s writing that was just over 600 pages in length, Sir Sinclair’s book was well over 700 pages in length, unlikely a book that would be commonly read by the less educated of readers. Second, Sir Sinclair’s book, due to its length, was actually published and provided to buyers as four volumes, making this set an impressive one to set on a bookshelf or mantle, but again perhaps too much to really peruse and apply to you life in some systematic, methodical manner. Dr. Ricketson’s book avoids these concerns and issues for both valetudinarians and the healthiest of readers.
A perusal of the content of Sir Sinclair’s book, to those who want a book of such great lengths regardless of its cost, would only read a form of writing that could be anything from unattractive to obtrusive and insulting to readers interested in the American way of thinking and reading, the American way of remaining or becoming healthy.
There is also a method to printing Sir Sinclair’s book that is very reminiscent of another medical book highly popular about this same time. Noel Webster’s History of Yellow Fever was also published in parts, with content in some parts remarkably identical in form and content to Sir Sinclair’s writing. A large portion of the book simply reviews numerous classics on the history of this health topic. This is followed by the most important section of this writing, Medicina Statica, or Rules of Health . . . by Sanctorius, chief Professor of Physic at Padua. Medicina Statica was published some time prior to 1676, with a translation and London edition produced in 1676. The contents of this book are most important to note, for they represent the content of many books on health, including thos published by Cheyne in 1722 and Ricketson in 1806.
The major differences between Cheyne’s and Ricketson’s works and Sanctorius’s Medicina Statica are: 1) the emphasis Sanctorius assigned to the relationship between disease and perspiration, and 2) the section “An Answer to the Staticomastix.” Cheyne and Ricketson removed Sanctorius’s section “Of Venery” including parts of this discussion elsewhere in the book such as in the Miscellany discussed at the end of Cheyne’s book and the parts pertaining to “Passion” in each. Other minor differences in the sections and their titles pertains to “Of Air and Water” and “Of Sleep and Vigilance”, more of a terminology difference than a main subject and content difference. Also important to note are the difference by which Ricketson versus Sir Sinclair manage to represent to the reader these different lengthy quotations of text taken from other primary information sources. Sir Sinclair for the most part relies mostly upon the classics, typically “antient” but also of international fame; Ricketson makes use of more locally recognizable physicians, medical writers, information sources, providing information that is locally more applicable and even pertinent and clinically or experientially valuable.
Reviewing the personal writings in Sir Sinclair’s wrok, we find a characteristic method of expression that seems too robust and too imaginative and redundant/ For example, one of the most important paragraphs in Sir Sinclair’s work in a subjective and very personal comment he includes about the inclusion of meat in one’s diet. This paragraph has been interpreted as Sir Sinclair’s important contribution to the promotion and establishment of vegetation dietary practices, eating habits which Sir Sinclair never engaged in himself unless the climate and seasonally related health concerns called for such a method of fasting and eating. This commonplace notion is also mentioned by Ricketson as well, but due to differences in notariety and aristocratic importance, Sir Sinclair’s mention of this manner of eating wins out for many historians.
In this first quote, Sir Sinclair discusses the meat eating habits of “The Tartars”, in comparison with the vegetarian matter diets of the Brahmin and Gentoo:
“The Tartars, who live wholly on animal food, possess a degree of ferocity of mind and fierceness of character which form the leading feature of all carnivorous animals. On the other hand, an entire diet of vegetable matter, as appears in the Brahmin and Gentoo, gives to the disposition a softness, gentleness, and mildness of feeling directly the reverse of the former character. It also has a particular influence on the powers of the mind, producing liveliness of imagination and acuteness of judgement in an eminent degree.”
The following, pulled from another reference to Sir Sinclair’s work, is a statement about the personality, temperament and social values of those who include meats in their diet, versus those who do not:
“The man who sheds the blood of an Ox or a Sheep will be habituated more easily than another to witness the effusion of that of his fellow-creatures. Inhumanity takes possession of his soul, and the trades, whose occupation is to sacrifice animals for the purpose of supplying the [pretended] necessities of men, impart to those who exercise them a ferocity which their relative connections with Society but imperfectly serve to mitigate.” (see Encyclopédie Methodique, vol. vii., part 1, and Code of Health and Longevity, vol. i, 423, 429, and vol. iii, 283.)
When we review Ricketson’s book for comments about when to eat meat and when not to eat meat, we get a series of dietary habits similar to those practiced by Sir Sinclair. He recommend a limited uptake of meat by “persons of irascable, or passionate predispositions” (p. 106) and avoiding meat during hot seasons due to its putrefaction (p. 108). Quoting the Kendall’s Encyclopedia he writes “With respect to the health of the Body, … animal food is liable to prove destructive by inducing, besides other evils, plethor and all its consequences, while vegetable, without the utmost indolence, and sharpest appetite, never does. (p. 117)” His quote about meats from a part of the Encyclopedia Britannica include “When the stomach is repeatedly overcharged with full meals of animal food, it will lose its natural tone by such frequent plentitude, and overdistention; and its contents being indigested, the chyle obtained from it will be crude, impure and insufficiently elaborated. (p. 121)” this note is possibly in reference to the dietary complications seen with over-indulgers, particularly those with a history of obesity, diabetes, gall bladder and liver disease, and the steatorrhea often associated with this sort of metabolic condition.
What is lacking in Ricketson’s writings are the highly prejudicial and personal or culturally directed statements that appear sometimes against specific lifestyles in British writing. Some early examples of this writing style appear in some of the earliest published travels by the Brits through Holland during the 1600s. It was not unusual for writer to comment about traditiona lDutch foodways or make fun of their unique foodtypes, such as the heavily processed cheeses (that even the British came to favor), their consistent use of greens and roots otherwise atypical to European food culture (due to the need for crops that could be grown next to brackish waterways located within lowlands fields), and their raising and use of pigs for the use in heavily treated and modified porcine and other heavily smoked and sured meat products. This ethnocentric writing style was not uncommon to British writers and travellers during this time, and prevailed much when words were put into press about the many non-anglican settlers that these travellers often visited during the British Colonial years. Also indicative of the British culture and this method of writing about food is the ongoing relationship drawn between “Drinks” and “Foods” that seem to prevail in many traditional British writings. Volume III of Sir Sinclair’s 4-volume set begins with a lengthy set of prose, in Latin in the left column of the page and translated into English by in the right column of the page, in which in the middle of this text are found the recommendations of alcoholic beverage use. 
Only wine is discussed in Salerni’s verses and so made a part of Sir Sinclairs reviews as well.
Unlike Sir Sinclair, Ricketson strongly advicss against the consumption of “Ardent or distilled Spirits” throughout his text and has numerous referenced quotes of other writers stating the same. Ricketson is less concerned about the consumption of wines, and very open to the uses of “Ales or Beers” noting that it is even possible to produce a beer or ale fitting for each community. During Colonial years, beers were produced as medicine as often as, if not more than they were made for recreational drinking uses. Due to the methods of preparation and varieties of medical applications that beers could have, it was not uncommon to find them used as tonics and medicines, made bitter by such plants as hops, gentian, hyssop, and other medicinal herbs.
Finally, with regard to vegetarianism, since this is really a minor part of Sinclair’s writings but his most important to some, Sir Sinclair’s impressions about eating meat, as this was told by Salerni, suggest anything but true vegetarianism. As Ricketson implies in his book, Sir Sinclair probably refered to this matter as a curious observation to which personal statements and philosophy were atached. The following verses define the typical thought and actions of Sir Sinclair and most of his associates. Far from vegetarian in nature, Sir Sinclair was very much an omnivore in prose, in text, and in food habits:
Synopsis
In later months and years, Ricketson’s book did develop a substantial readership. We know this because by 1807, this book along with Ricketson’s skills and reputation enabled him to begin work as a wroter for the local trade journal Medical Repository. This responsibility became Ricketson’s way to be involved with the medical school active in New York City, and provided him with enough of a reputation and opportunity to initiate attempts of becoming a professor. Over the next few years, Ricketson demonstrated his value to the overall profession through the steps he took to be published in such popular topics as:
- medical climatology
- physiology, pathology, and disease diagnosis
- disease prevention and the promotion of good health
- disease surveillance and epidemiology methods
By 1808, he was well on his way to becoming a physician of not only the Hudson Valley, but also of Southern, Middle and Western New York, and closer to working as a full time professor for the New York medical school. Examples of each of his accomplishments as a writer closely affiliated with the Medical Repository are provided in the next series of reviews of his work as a physician, and later his interactions with others working for the Repository and medical school for a potential professorship. Several detailed reviews of specific sections of his book are provided as well.
Brian Altonen, MPH, MS 
