Public Health and Community Health

Every time Dr. Shadrach Ricketson is found in the press, of public or professional origin, he is engaged in some sort of medical or public health issue that is somewhat controversial.  His name first came appeared in a local newspaper due to an autopsy he performed with two of the elders in medicine inr Dutchess County for the time, Dr. Jonathan Prosser, a noted Revolutionary War physician, and Dr. Benjamin Anthony, a Revolutionary War Ship Surgeon assigned to the Ship Montgomery and who served as Ricketson’s preceptor several years after the War ended.  Dr. Ricketson was just 20 years old when the results of an autopsy were performed of a Quaker elder in order to detail the cause for his death, to demonstrate the value of autopsies and human body dissection, and to prove that this practice was netiher demeaning or desecrative in nature, these results, in all their anatimocal and pathological detail, were published in The Country Journal and Poughkeepsie Advertiser.  

Dr. Ricketson’s name again comes to the press several years later due to a unique self-engaging experiment he decided to perform on the values of locally grown opium, for comparison with the Turkish grown in order to determine whether or not it had special values in the kind of medicine he preferred to practice as a Quaker.   During the decade that followed this publication, we know little about what sort of medicine and medical endeavors Shadrach Ricketson was opting to engage in.  It is possible, although highly unlikely, that he wasn’t practicing medicine at all during this time.  The unlikely nature of this sort of life is made clear in 1806 with the publication of his book on “Preserving Health and Preventing Disease.”  The publication of this book in itself was again an incredible success on Ricketson’s behalf. It was a significant improvement on several other books covering the same topic, published more than 50 years and a century earlier in Europe.  Ricketson’s book was in fact better than either of these due to the information he covered in his book, in combination with its brevity and yet completeness. 

At the time his book was published, Dr. Ricketson was now 32 years of age, and about to enter a new period in his professional life as a physician, and hopefully as a medical school professor.  The county of Dutchess at this time was politically speaking conveniently close to New York City.  It was just one or two counties up the Hudson valley, and relatively speaking fairly close to the New York medical school.  By the time he made his way into New York and was associated with the Medical Journal published out of New York City, the Medical Repository, Ricketson was not only an expert in the types of topics covered by his book, he was also trained in epidemiological research including the earliest forms of disease surveillance practiced in this country.  His country life made him an expert in medical climatology for the rural setting.  And as if these specialities were not enough for Dr. Ricketson, he also published several articles on several medical conditions, producing his own essay on the history and local causes for fevers within this region.   

Throughout all of these years of working as a physician, Dr. Shadrach Ricketson was also a community man.  Like most Quakers, his interests focused on the needs of the poor, and the services that as a physician he could provide to the poor at both the local and county level.  For this reason, Dr. Ricketson took on one or more community leadership roles outside his Quaker setting.  By 1806 he joining and served as an administrator for the local medical society.  This led him to be in charge of the storage, upkeep and record keeping when it came to keeping track of the county’s expensive medical and surgical tools and devices, equipment that might otherwise never be available to county physicians and residents.  The evidence for this responsibility he undertook even suggests he may have had to manage some of the new obstetric equipment that was then becoming available.  As a Quaker physician, he was responsible for managing cases that the typical midwife was unwilling to provide her services to.   These services as a physician important to the community may have continued on and off over the next decade or so, so much that by the time he reached 47 years of age (1815), Dr. Ricketson had developed one of the first steady immunization programs for the time to be active in the more rural parts of New York state.  This program helped to replace inoculation practices with the now 15 year old practice of using kine pox vaccinations as a replacement for varicella due to its milder effects upon the body.   By this time Dr. Ricketson was affiliated with the local schools where he monitored the health of the children,

Each one of these events in Dr. Ricketson’s life reveals more about his persona that just a single writing would tell us.  By delving into these writings further, in an atempt to read between his lines and begin to understand his personality and devotions in life as a Quaker, even the smallest lines and briefest paragraphs reveal to us something about him that can be easily overlooked, if one weren’t ready to interpret Shadrach Ricketson and a person, and not just as a physician.  There are several examples of this that need to be pointed out.  One of the most important of his personal statements published as part of his work in his reference to vis medicatrix naturae in his article on opium, published when he was just 21 years of age–a philosophically- and metaphysically-based reference to natural medicine.  At such a young age, Ricketson was already into medicine as a philosophy and as a scientist, with neither taking center stage during the entire time that he engaged in this learning and working process at the personal level.

Shadrach Ricketson’s book reviews topics that are even more convincing of his devotion to this part of his Quakerhood.  But it is the form and content of his work that reveals the most to us regarding his philosophy and spirit.  The chapters of this book are set up in such a way that they deal with the details of day-to-day life, ranging from food and diet behavior, to exercise and recreation, to seeking out and receiving the appropriate forms of medical care, to living a healthy life in the home and work environments.   But more importantly there is a certain Renaissance, Shakespearean nature of the writing style that Ricketson practiced that has to be mentioned.  Writers like Ricketson have an affinity for demonstrating their respect to their God or the Creator by the way in which they create their prose.  The use of trine philosophy in particular is a popular method for detailing this devotion as a part of your method of presentation.  To some of the most devoted trinitarian physicians for the 17th and 18th century, this included how sentences, paragraphs, pages, and the entire outline of a book were designed.  Ricketson does not let us down regarding this part of his personal philosophy. 

Ricketson engaged in the latter of the trinity options, by writing his book in three parts, and allowing trine-related sub-parts to be produced for these three major sections.  One might normally consider this form of writing a “coincidence” in the numerological sense, after all, there is a one in three chance that any number selected for the final number of words, sentences, paragraphs or chapters could be right one that is divisible by three, symbolizing the trinity.  According to Quaker philosophy writers, the Quakers were just a devoted to the unity by the way their constructed their belief system as they were to the trinity.  Ricketson’s book very much suggests that he in fact tried to adhere somewhat to this rule of everyday life as part of his book as well.  And there is much evidence supporting the notion that many religiously devoted individual, leaders or not, engaged in such practices, even during the nineteenth century

So why engage in such a process when designing your book?  You do it because this is what you believe.

The application of this style of writing had its applications to both the most religiously devouted readers and the most agnostic or atheistic of readers at this time.  Those who were anti-religious still had their personal philosophies to centend with.  One such philosophy that was used to replace religion was applying the notion of natural philosophy to non-religious applications.  This is exactly what many scientists did during the 1700s and continue to be one of the most important driving forces for alternatives to regular medicine to be in charge for decades to come during the 1800s. 

Now, some people are going to contest this claim that I present which states that Ricketson’s book had some sort of underlying trinity symbolism to it.   Such arguments I believe come about due to a few reasons: the first is that trinity writing seems to be fairly hard to do; however designing an entire book based on some trinity layout is much easier; the trinity message is in the book and its contents, their order and meaning, not the individual words and phrases.  Secondly, this method is in fact easy to engage in as a habit to resolving and writing about any issues that arise.  We find many examples of reasoning defined in groups of threes in medicine and science during this time, and this was also a very common practice even during non-trinitarian times, in non-religious places, and amongst agnostic and atheistic groups.  We find this happening in later medical journals, with authors that seemed adamantly against the mixing of philosophy and religion when certain medical concerns or issues were of primary concern.  Thirdly, this use of trinity perhaps seems so ordinary that seeing this phenomenon is just not significant to researchers at first, unless they are exposed and practiced in detecting such concepts as a writer or artisan, and can make sense and know the reasons why such a practice was engaged in by the person they are studying.

So again, this can lead one to ask:  why haven’t we heard much about this in the medical journals, and found enough evidence in the journals to state such beliefs are points-in-fact? 

The answer to this consists of two parts.  Historians and researchers sometimes don’t care to look for the obvious, especially when this is a form of human behavior that is a common as pouring salt over you right shoulder for luck, after spilling some on the floor or table.  This picky little nuance in life is something that historians and professionals never  devote much time to in their writings, as if it really isn’t that important.   For example, we don’t hear about superstititous thoughts as being the basis for important discoveries that are made, unless superstition is the core of the work being presented.  In past writings, this might entail discoveries related to studies of some form of practice of witchcraft or some engagement in some metaphysical event such as chanelling, seancing, performing some form of communication through sound, color or music; but even in recent times, this type of thinking is how and why some physicists and physical chemists have made their discoveries, such as one theory of light as a substitute for the other.  (It ended up that both were right.) 

Likewise, we rarely learn much about the numerological characteristics of medical practices, although they are inherently there, such as the duality of matter and electricity some scientists strongly adhered to, the tetrality of  humors and compass directions, the trinity and pentality of alchemy when it was practiced by Paracelsus, and again when the French revolution led to a philosophy that adhered strongly to the use of the “essence” as the fifth element.   In both past and present forms, medicine and physicians have their inherent numerologic methods of reviewing and interpreting health and disease, the numbers hidden deeply within other more explicit details such as bacterial type and strain, detailed genetic findings, the particular stage that a form of cancer is in, or the amount and kind of drugs in one of several classes that need to be used to treat a particular medical condition.

Dutchess County and Hudson Valley medical practices are not that different from the practices that preceded them.  It was mostly the efforts of scientists trying to halt the traditional natural theology practices in medicine, in exchange for replacing them with some form of natural philosophy based almost completely on the physical world and the effects of its energy as we see these events come to be, that resulted in this separation of church and hospital, physician and patient.  There is substantial evidence for a numerologic basis for medicine that is heavily trinity-based or trine/triune dependent.  Much of the evidence needed to support this notion need not be mentioned in detail for the moment (it is extensively reviewed elsewhere, especcially the review of Noah Webster and Benjamin Rush’s takes on Yellow fever).  Suffice it to say that it exists, and those who contest this are either unwilling to accept the discovery of such an onbvious human practice, or unwilling to accept it because many of them thought much in the same way but never took the time to find the evidence that such thinking exists.

It is fairly difficult to find documentable evidence for superstition in professional writings.  But this evidence does exist, only in smaller amounts and forms, and often nested within the professional context of a writing produced for another purpose, or contained within the more personal writings produced without the intention of ever being revealed as some sort of past correspondence between one professional and another.  For this reason, the place to find evidence for the trinity is contained in personal documents, lettes, and even court records, where it had to be confessed either as a modern day behavior or as a reason for past “misbehaviors.”  The single most best example of this will be stated however, because it pertains directly to the Hudson Valley, Dutchess County and the nature of the practice of medicine in New York during the 1820s and 1830s.  Within a court proceedings, trying to obtain legal exemptions regarding the rules for licensing physicians, John Thomson, a son of the famous Samuel Thomson, the founder of Thomsonianism ca. 1812, confesses this past belief and its impacts on Thomsonian practice around 1845.  The bulk of these questions posed to him in writing, were responded to in much the same fashion, in writing, but only with nearly all of John Thomson’s responses expressed in some sort of trinitarian sentence structure.  Whether or not this was performed as a result of habit, for subliminal symbolic statements meant mostly for the Attorney General to see, or as a sign of devotion to this rule to other Thomsonians who might learn about this legal event, the use of the trinity writing style is undeniable, and openly confessed to as a response to the last question that had to be answered.  Medicine and natural philosophy go hand in hand to some, to Thomsonian agnostics and religious healers, as well as to other early natural medicine thinkers like Sylvester Graham’s following, the Hudson Valley’s water curers, and even some of Wooster Beach’s eclectic practitioners.  Twenty years earlier, during Shadrach Ricketson’s years practicing as a physician, such a behavior could have been performed as a sign of personal devotion to his Quaker-based interpretation of natural theology.  Ricketson wrote his book in trinity form, because this is what he thought it was meant to be.

Ricketson book had a tremendous impact at numerous levels in medicine and the types of health care practice, epidemiological surveillance, and education methods that were developed in the Hudson valley between 1785 and 1837, the year of his death.   The following list serves to recapitulate these impacts, all of which are reviewed elsewhere in this biography of his life.

  1. Demonstrating the importance of disease surveillance methods such as implementing surveys with other clinicians, thereby introducing to others this method practicing epidemiology as a physician.
  2. Demonstrating the the public the importance of the cadaver dissection process as a way to improve physicians knowledge pertainign to specific cause for death and the impacts of disease and aging on the vital organs.
  3. Defining the differences in disease patterns from one small area or community to the next, based upon detailed observations involving local climate and environmental conditions
  4. Developing a way to better understanding the ways to prevent diseases that are seasonal and/or weather-related by monitoring daily temperature patterns.
  5. Detailing the value of exercise, such as engaging in periodic outdoor sports activities in numerous shapes and forms
  6. Describing the importance of diet maintenance with regard to health, especially pertaining to such conditions as diabetes and obesity.
  7. Defining the different times in which a diet consisting mostly or entirely of “vegetable matter” may followed for health related purposes (early examples of prescribed vegetarianism).
  8. Listing the numerous reasons one should practice good food and clothing habits that are essential to good health
  9. Produced a comprehensive review of pregnant and post-partum dietary practices for women who are engaged in breast-feeding, and on the process of converting from breast-milk to regular foods.
  10. Defining the need for adequate household maintenance practices related to cleanliness and ventilation, and having an exceptionally clean privy and living area for each of these due to local land surface, groundwater, wind and solar features.
  11. Engaging in exploratory research on the effects of opium upon the body, the related sanative and/or vis medicatrix naturae philosophy regarding this use,  and the relationship of these effects to the source of the product, its history of preparation and methods of packaging and delivery, and the conditions under which it is grown and prepared for use.
  12. Identifying and avoiding the problems with blood-letting or the unneccessary use of the lancet.
  13. Identifying the problems with drug misuse, misapplication or misprescribing by a physician, and the problems with erroneous claims for treatment provided by local physicians and other healers.
  14. Assisting schools and other public places in the development of health prevention programs, such as by providing services as a school physician and assisting in the management of childrens’ endemic and epidemic problems as they occur within local school settings.
  15. Assisting, if not leading, in the development of the local Small Pox inoculation and vaccination programs for the county, through the introduction of a kine pox program to be managed out of a work setting.
  16. Aiding in the development of local medical groups devoted to meeting specific local needs.
  17. Assisting in the developing new classes and improving the content and presentation of traditional classes in health and well-being provided at the time by several of the first New York medical schools.
  18. Serving as a regular author of Quaker decent for the local trade journal Medical Repository.
  19. Assisting in defining the rights of physicians to practice according to their own philosophy and related methods so long as these fits individual and community needs and do not compete with techniques allowed by the local medical group or team and profession as a whole. 
  20. Helping to eliminate the problems that exist when individuals are able to practice medicine without a valid license.
  21. Bringing the relationship between religion and medicine into “the modern era” by integrating science and religion in such as way as to enable a more comprehensive review to be performed about the relationships between physical healing and spiritual healing practices, two forms of healing common to the Quaker physician’s or non-physician healer’s obligations to his/her patients.

Ricketson’s other experiences and roles played in life suggest he is an excellent example of what is today known as the Family Practice professional in medicine.  Ricketson has been provided several patches of honor by writers in the past, ranging from being the perfect Hygienist like Moses, to the best example of an early promoter and practitioner of the new field of Sport Medicine or the practice of a form of health care  that includes such new methods as engaging in regular exercise and the appropriate dietary practices.  In one of my reviews of his practice, Ricketson’s behaviors as an epidemiologist suggests he a great example of an early highly meticulous epidemiologist who paid exceptional attention to details.  He is one of the first to promote and prove the values of these various health maintenance procedures in the United States, at a time when scientific methods had yet to be solidified into a standard method of research and at a time when disease prevention had as much importance as disease treatment.   

These multiple examples of how Ricketson 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’.   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, but had numerous neighbors and fellow Quakers in need of his help and assistance as a physician.  Ricketson’s midlife years were spent trying to find work as a professor and observor of natural history in relation to disease promoting and disease prevention factors.  Finally, 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.