Learning Medicine

Shadrach Ricketson had several options on how to learn medicine during his early adult years.  Unlike the period before the Revolutionary War, one of the most drastic changes in learning was that apprenticeships no long typically made use of the long 6 or 7 year contract, since this requried that the parents turn over a child  to his preceptor at about 12-15 years of age.  Learning medicine was no longer just a choice between attending a few classes at Yale or Harvard to learn the most difficult parts and then completing the rest through an apprenticeship, learning everything you needed to known through just an officially and legally supported apprenticeship, or obtaining your training in a University settings in Europe, such as at Edinburgh, London, or Padua.  There was the option of going to a medical school in the New York city or Philadelphia setting beginning around 1787, and the options of learning through an apprenticeship under a highly respected local physician, respected enough to convince a Judge to provide you with a license in support of your skills and training.

Shadrach Ricketson opted to undergo an apprenticeship, which in the American setting probably enabled him to maintain a part of his personal life with his family a few years longer that before the war.  Shadrach Ricketson’s preceptor was Dr. Benjamin Anthony.  Dr. Anthony earned his rank as physician and surgeon and during the Revolutionary War was signed on as ship surgeon for the United Colonies Privateer Sloop Montgomery, which served the New York Harbor and Hudson River area beginning on of April 18th, 1776 [Documents relating to the colonial history of the State of New York, State Archives, see Document date:d New York, 18 April 1776, in vol. I, p. 533. Albany, N. Y., Weed, Parsons and Co., 1887].   Shadrach Ricketson completed this apprenticeship sometime between 1784 and 1788.  

The Practice

The first mention of Dr. Ricketson in the local press is in an obituary-like article published in the The Country Journal and the Poughkeepsie Advertiser, on February 26, 1788.  This obituary was produced for a fellow Quaker and member of the Nine-Partner’s Friends, James Germond, Senior, of the Nine Partners Patent. 

The ending of this obituary symbolized an ongoing issue in medicine at the time, the use of human cadavers for the purposes of dissection.  Soon after the signing of the Treaty of Paris, the reopening of the medical school in New York City resulted in a crisis due to a public riot that erupted after the public learned about the use of local elder’s body for purposes of  education in anatomy through the use of a cadaver for human dissections performed as part of a class taught within the Institution.  Elder Germond’s death occurred just a few years later.  Doctor Ricketson used this experience and his status as a young physician to try to amend local concerns that might erupt  concerning any future local practices that might ensue for similar purposes.   This public display of the results of a disssection were meant to prevent such events from recurring in the future due to local public outcries, and to open the door to allowing physicians to perform similar proceduresfor various legal and medical policing needs.   Assisting him were Drs. Anthony and Prosser.   Dr. Anthony was Ricketson’s previously identified preceptor and Dr. Prosser one of the physicians serving during the war at the Hospital built just southeast of Fishkill Village.  The results of the autopsy were meant to demonstrate to the public the value of this investigative process in medicine.  

The Researcher

Over the next decade, Ricketson continued to build his reputation as an outspoken medical and Quaker individual and continued with his practice in medicine.  His first and most important research project for that decade was his study of the opium poppy.  At this point in medical history, the primary source of opium and the opium poppy was Turkey, by way of any of several direct or indirect shipping routes bringing this precious medicine from Northern Europe through the main ports in Western Europe, and from there to the United States.  This most costly forms of opium came to the United States indirectly through other distributors, providing ample opportunities for additives and dilutants to be added to the natural latex and for substitions and counterfeiting processes to take place.  This along with the aging of the latex through commercial travels and packaging and shipping conditions made for some poor to good qualities with this valuable latex product.  This problem along with some of the new ideologies erupting amongst United States physicians led to the popularization of the notion of trying to produce the opium crops locally, with the goal of obtaining a stronger more effective latex-based medicine and in order to reduce the high import and export costs often linked to such complicated international shipping practices.  

A most popular belief erupting about this time as well with regard to plant medicines pertained to the Sanative nature and natural history of the plant from which thes drugs were being extracted.  One popular theory, around since the 1600s, but not so heavily reviewed and engaged in until the early 19th century, was the belief that plants residing locally provided the most applicable and best fitting medicines.  This belief was in part an extension of some of the natural philosophy beliefs often reviewed as part of one’s personal religious interpretation of local events, but it also fit very well into the medical climatology-medical topography approach being taken to defining the causes and effects of disease.  This latter belief states that local medicinal plants were more effective due to their place in the local natural history setting.  If this were in fact a true proposition for how to make a better opium for the United States citizens, then the best way to test this theory out was to try and grow effective strains of the medical plant in the local environment along the Hudson River.  This was perhaps the underlying ideology to a large part of Dr. Ricketson’s work on Opium cultivation. 

The following article was published by Ricketson following the completion of this work.  It was published in The American Museum or Repository of Ancient and Modern Fugitive Pieces, &c., Prose and Poetical, Volume 6, 1787, pp. 55-57, published in Philadelphia by Mathew Carey.

[Please note, Original Article follows.  This copy courtesy of Archive.org!]

A number of philosophical concepts are discussed by Ricketson in this article.  Vis medicatrix naturae refers to the natural philosophy premise applied to medicine that states that whatever medical procedures are performed, they are expected help the body take its most natural course towards healing (‘in accordance with God”).  This religious concept is often applied to medicine in modern day thinking by faiths that believe in this concept based on very different premises.  The modern groups believe primarily in some metaphysical or “spiritual” way of “healing” as a substitute for many regular of the medical practices.  Such groups avoid serious physical procedures such as surgery, often do not engage in vaccination programs, and even refuse to treat some forms of chronic disease, in which intervention can often avoid the increasing morbidity and ultimate mortality that such individuals have to endure. 

The tradition of vis medicatrix naturae as it was practiced by Quakers during Ricketson’s time as a part of medicine obviously did not adhere to this philosophy at the same extreme levels which modern day religions like to apply.  There is a considerable amount of evidence for this claim.  First, Shadrach Ricketson uses opium to treat his patients and wasn’t afraid to try it on miself to test and document its effects.  Second, as we will learn later as a part of this biography, Ricketson is in favor of medical electricity methods of application, a popular culture method of medical practice that had an exceptionally strong religious following involving several of the local religious groups, including Quakers.  Third, as discussed earlier on this page, Shadrach does not feel that human dissection processes involving bodies that are post-mortum are in any way dishonorable, diminishing in character, or desecrative to either spirit or soul.

The second important thing to note about Ricketson’s writings is his focus on the strength of Turkish versus local opium latex.  His his studies showed that an effective amount of activity could  exist for American-raised plants, so long as they are grown and harvested correctly and under the right agricultural and climatic conditions.  He also suggests that the decay of the power of the opium latex may be at fault for making the shipped product weaker in nature, although as suggested before, according to Pierre Pomet (Compleat History of Drugges . . . ), counterfeiting and substitution problems were a major problem with trade routes involving most of the rare, unique, popular and/or expensive medicines.

Finally, Ricketson’s work demonstrates the use of one very important requirement for a project to be substantial in nature and important in terms of the applicability and value of the findings to the medical profession.  Ricketson states that he began this work with a particular question: “Does the opium I have been describing, possess the same properties as the Asiatic opium?”  (p. 56, col. 2)  This important step in epidemiological work is an important indicator of how well developed his methodology for researching and his success of practicing as a physician are.   In his final Quaeritur [Latin: “the question is raised”], Ricketson poses an important question regarding his work, one that has yet to be fully answered by this study; thus the potential for his continuation of this work, a philosophical venture that may be performed in or out of academia, but more than likely within his work setting as a doctor. 

In many ways, this work gave Shadrach Ricketson another advantage as an apprenticed physician that many other physicians avoid.    This work that was published pretty much constitutes a thesis in content and format.  It was therefore an important step for him to take in order to improve upon his potentials as a physician during the decades to come.  As time will subsequently demonstrate to him, this long term goal will also be achieved.

Lower Hudson Valley Practice

Doctor Ricketson lived in Fishkill and practiced mainly in Lower Dutchess County and soon-to-be Putnam County (Putnam County was founded, described and named in the state papers, ca. 1811/12).  This placed him in proximity to New York City, as the crow flies, and made him an important intermediary in any professional communications with medicine taking place between the Medical School in New York City, and the upstate counties where plans to open one or two more medical schools were in the works.  As the community level, Ricketson’s activities were comprised of Quaker community events and Friends meetings which took palce at any of the local and semi-local Quaker settings (Wilson, 1907; Rogers, 1965). 

The Quaker community around this time was set up primarily in an area known as Quaker Hill close to Fishkill, and small sections of the Nine Partners, Beekman and Oblong Patents situated at the north end and eastern border of Dutchess County.   There is minimal evidence in the popular newspapers or medical journals about the health of these areas, except for occasional stories about epidemics that came through between 1790 and 1800.  The most common or primary infectious diseases to strike this part of the valley were small pox and measles, which were most likely followed by typical secondary infectious diseases such as consumption or phthisis (tuberculosis), mumps or chin cough, and possibly diphtheria.  Several seasonal diseases were noticeable, namely influenza and perhaps pneumonia.  A number of vectored epidemics came through the region repeatedly over the years as well, the most important of which between 1790 and 1800 was more than likely yellow fever. 

A number of fevers struck the Hudson Valley region on and off over the years.  Due to the local land use and water-related surface patterns, the local lands were very prone to developing any of a number of febrile diseases, some in an endemic, seasonal manner, and others in full blown epidemic patterns.  The most common endemic febrile disease to strike the lower and middle Hudson Valley time and time again was spotted fever (later termed typhus fever, followed by the most correct name typhoid fever).  This typhoid (not equivalent at all to the typhus, and related to a Salmonella strain), was a sign of bacterial problems beginning to occur at the local level for both people and livestock.  Another possible fever to strike the valley with its current population setting was perhaps palsy, the cause for which required many of the same features related to spotted fever. 

The epidemic fevers to strike the valley were no doubt mostly related to yellow fever, a mosquito-borne epidemic disease, but one which has its greatest impacts usually within moderate to heavy population settings, and small communities situated right alongside the major ship landings.  The geographic requirements for yellow fever were not there for Ricketson to pay special attention to and keep important notes on, due to his inland occupation upstream from Fishkill Landing, and the possible impact of the higher elevation settings he and his Friends on Quaker Hill resided in.

The same was true for the malaria or ague fevers that came in by ships bearing mosquitoes and infected people.  These fever areas were also close to chipping ports, but there was a little more leeway as to how the local mosquitoes could pick up and carry this disease to future victims.  It was not unusual for such diseases to be located next to low lying regions and shallow floodplains along creek and river edges.  Fishkill also had some of these topographic requirements for the ague to afflict its local village setting.  Since very little evidence can be found for this problem however, it is assumed that the two factors required for small outbreaks of the ague will be situated close to the landings and within or next to hemlets or villages.

The primary natural history of the region that Ricketson had to study and draw his conclusions from were the local topography and local weather and climatic features.  According to this later writings, and as suggested by his interpretation of how and why poppy can be grown to produce effective opium, Ricketson’s focus was on how weather and climate impacted all living things in the local communities or ecological (natural history) settings.  This would later cause Ricketson to begin frequent travels into New York City, and finally move there later in order to take advantage of the medical school and new medical journal being published there to advance his career.  From 1790 to 1800, Ricketson’s career in medicine was in its early stages of development.  These years gave him the experience to write his book beginning around 1804 or 1805, but perhaps led him mostly to just take notes and further define his pathway as part of the local medical profession.