Brian Altonen, MPH, MS

Washington’s Arch built as a Commemoration at the Washington’s Headquarter’s Site in Newburgh, New York

Once the war was over, there was a period of post-war depression as we recovered from our bitter memories of the war. The total number of deaths due to fighting were relatively few compared with the those due to other such as accidents, infection from everyday injuries, influenza, dysentery, small pox, fevers, chronic diseases, too much alcohol, lack of clothing, inadequate living quarters, poor sanitation, to name a few.
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The greatest task to the country was now recuperating from the financial losses we incurred due to the war. News about this appeared in the local paper as we began to pay back the major debts we accrued due to this venture. In the New York Packet published out of Fishkill by Samuel Loudon during the War there was notice given about the amount of money we owed France, which was well into the millions. As the city of New York was reclaimed from the British army who occupied the city since the first months of battle, the many buildings that were either ransacked or destroyed had to be repaired or rebuilt. A new hospital and medical school would ultimately result from this venture.
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This post-war recession lasted until about the mid 1790s. Signs of recovery appeared in the Packet appear in the form of a return to old mercantile relationships. The old stores were reopened. Physicians trained abroad reinitiated their advertising. None of the doctors who posted such ads bragged about being trained locally. These behaviors of New York city physicians took some of the patriots living in the countryside by surprise.
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The least patriotic of events to ensue following the war was a return to the old heavily British way of proposing different ways to keep your family and household healthy. The most offending of these anti-United States, pro-British works was the book by William Buchan, that in spite of its British origin tended to flood the United States book dealers’ stores over the next few years. William Buchan’s book must have been very offensive to those who worked hard to learn medicine and serve as American-trained physicians during these first years after the war. When reviewing Buchan’s chapter on mineral springs for example, Buchan had numerous opportunities to expand upon this section and make it as appealing to people in the United States as it was to his most loyal followers in Europe. But instead of expounding upon his chapter by adding a section on what was perhaps the most famous mineral springs of New York–Ballston Spa–he instead delved more into the Western European offerings. Further south in Virginia, there was an equally value mineral springs in what had become known as the County of Bath. Proven by Thomas Jefferson to be of important value for healing certain long-term sores like those from rheumatism or serious skin rashes, the exclusion of this information from Buchan’s book either meant Buchan was not concerned about the American experience or felt the British way of healing and curing more beneficial and so proven by experience and time. There is this one famous statement made by Buchan about the American herbs becoming popular as substitutes for the expensive imported herbal medicines that the United States was relying upon. He called an American herb a bastardization of its British rival, serving as a weaker medicine than the original, and the terms ‘Bastard’ and ‘False’ were tacked onto some of these American herb names.
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England was very different from the United States, and United States leaders began to recognize this. Their potential land would be many times larger in size than that of Great Britain. Their natural resources would be more plentiful, and their potential for discovering new products in the near future about to take on the new road to success. In part it was this discovery made by citizens and governmental leaders that helped draw this country out of its post-war depression and back to the global marketplace. However, new resources also meant that new troubles would develop off shore and at sea in the form of piracy and other countries laying claim to the holdings of ships at sea. This especially became a problem with our formal supporter during the Revolutionary War–France. Between 1795 and 1800, such events led to a change in the American way of thinking with United States Citizens, as patriotism was replaced by feelings of nationalism.
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The 1790s was also experiencing epidemics every year or two of yellow fever, and these epidemics were only impacting that side of the world. The British never experienced any considerable amount of deaths due to these epidemics the way the Americans did. This not only fed further into the anti-American thinking some Brits had, but also furthered the pro-American way of thinking that United States citizens had. Could it be that the yellow fever was impacting just the United States as a sign of dissatisfaction by God? Was this yellow fever another plague which newly developing parts of the world have to learn to contend with, much like Western Europe about 200 to 300 years earlier? A number of local writers speculated that we were only victims of yellow fever for a number of reasons, the major reason being the youth of our country and the rapid speed at which we were developing lands and penetrating the interior of the country. We had yet to go much beyond the boundaries of the 15 states then forming, and even the Adirondacks and Appalachia weren’t crossed by too many new settlers as of yet in American history. So the classic land claims of the Jacksonian Period had yet to really develop much into a political fight for unclaimed western territories. Western New York wasn’t yet settled. The Louis and Clark Expedition was not yet imagined. The purchase of lands out west from the French, in the form of the Louisiana Purchase, yet to be imagined in the late 1790s. The idea that lands possessed by Mexico should be settled was yet to be. From 1795 to 1799, the most we could do was begin to establish new plans for acquiring new lands out there in what we called the Great Northwest Territory, all of those lands positions near the two closest Great Lakes, adjacent to Canada.
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In terms of medical products, supplies and services, in spite of this strong pro-United States movement, some Americans were very much tied to our British products. This favoritism of British products and culture caused a strain in relations between the upper class who were very much pro-anglican, and the lower class, who were costing these others plenty. We never learn much about this part of United States history in the websites reflecting upon Revolutionary War and post-war medicine. But it is part of the reason tensions remained between the United States and Great Britain throughout the years of recovery from the Revolution and the earliest years of the 1800s. The potential for a war with Great Britain existed throughout this time, as evidenced by the ongoing monitoring of the U.S. shores by British vessels, the occasional disputes that happened at sea between ships of all nations, and the occasional bad news that would surface like attempts made by British government to not provide service for or make purchases from United States industries.

In medicine, the United States had few schools, and many physicians. The more honored of those doctors were those who were educated abroad. The leading doctors of the time were trained in Europe, or spent a few years in Europe soon after earning their college or medical school degree. To Western European onlookers and travelers who also served as journalists, the articles that resulted made the American doctor look like an undereducated, poor trained, colonial offshoot and apothecarian whose primary skills were in local herbs and the ability to conjure up new theories for disease in order to sell and administer their cures. The Aging Loyalists who remained in the States furthered this separation in the profession by continually catering to British writers, at times ignoring the first of the American medical book writers like Shadrach Ricketson.

In 1806, Ricketson promoted his new book on the local climate, lifestyle and disease, which he sold for only about 2 dollars. Meanwhile, down in New York City, the book of a famous British member of Royalty reviewing much the same philosophy, but only in the form of a reprint of a famous classic on this field, to which a little of the writer’s European experience was added, was marketed and sold successfully to the rich in New York for four times the price of Ricketson’s book, or more. Ricketson’s criticisms about this were written down and published in the commercial press, but apparently had a limited impact on the popularity of his book. This would later add stress to a relationship Ricketson had with the medical professionals in New York City, following his removal to the city soon after his book was published. Other physicians living in states to the north respected Ricketson for his accomplishments, and his book. Still later, they even encouraged him to consider taking on a professorship role at a new medical college opening in New York State up by Albany, which he may have tried, but never fully remained active with enough to be included in the advertisements for this school. So old-time loyalism was even having its effects upon medicine years after the war had ended and before the next war would come to light.

The other popular medical book author who added to this pressure within the medical profession was William Buchan. He had the personality of the popular press story teller and physician Tobias Smollett of the mid 18th century era, and was very much British in his linguistics as he expressed his pompous attitude throughout his Domestic Medicine book. Buchan usually fell short of being anti-United States in general, but did passively criticise the American way by simply not mentioning it in any of his writings. Through this passivity for the most part, he made it known that he respected anything British, and very few attitudes and products that were just American. His best display of this anti-United States spirit was his exclusion of United States herbs and mineral medicines (esp. mineral springs) from the many versions of his book printed, reprinted, updated, and reprinted even more for decades to some. Those favoring Buchanism and medicine were numerous, and even the printers of these books occasionally took on the task of adding to these promotions. This would ultimately lead to a redefinition of the British Whig attitude in substitution for Jeffersonian Republicanism and its alternative, early upstate New York Democratic philosophy. This latter political debate was at its peak in the Hudson Valley between 1802 and 1806, as told to use by the history of, and in the content of, the Balance and Columbia Repository, a newspaper published in Hudson, N.Y., the editor of which was brought to court due to such attitudes about Jefferson and the mock-Loyalists who supported his goals by favoring the rich at the expense of the poor, the Livingstons.

We could avoid Buchan’s book if we wished, but the British culture could still be found in the United States medical world between 1783 and 1805. Many United States citizens, living in towns and cities where physicians were few and far between, were mostly relying upon imported British patent and proprietary medicines. That which the Brits would not buy, such as those items they termed quackery, United States citizens bought by the case. British pamphlets and books, as well as translations of other medical works from other countries like France and Spain, also became a part of the United States retail medical industry. With just a few medical schools, and minimal regulations out there to control the medical industry, United States citizens became a most important consumer population for British import dealers, with the least knowledgeable and least trained of these people the most gullible at times and the main reasons these industries had taken hold in this country. It took the recurring yellow fever epidemic problem, a history not involving Great Britain, to separate the United States from Great Britain enough to impact the patent medicine world as well. The first cures successfully manufactured and sold in large amounts in the U.S., were those that treated yellow fever. Other patent medicines existed, and many had their regional salesmen and mercantile distributors, but only the yellow fever cures seemed to reassign control of this part of the marketplace to United States doctors and products. In some ways, the yellow fever was the reason the States were finally united.
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All of these events however helped set the stage for the changes that took place in American medicine between 1795 and 1799. The first such event was the establishment of state laws requiring United States doctors to develop associations and regulate their own field, in an attempt to avoid the suffocation of their industry by the addition of new healers from abroad who were poorly trained, not trained, or self-trained. This law made the licensure of doctors by the state required, turning this practice into a state monitored event, not just the result of community or county decisions. Even though such a law was passed by 1797, it was not as strong a move as many had hoped. For such a reason, Caleb Child, a graduate of Harvard with a Bachelors degree in theology and science, which included classes on natural philosophy, could be awarded a license to practice by local Justice Gilbert Livingston in March of 1798. His employment at the time–working as a school teacher and serving as the region’s Episcopalian Deacon up near Troy and Albany. His specialty as a medical doctor–medical electricity. Nevertheless, the first such law was there, and had an impact on the medical world and those who from this point on called themselves “doctors” in the medical sense.
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The first legislation of doctor’s in this country had limited effects on the common marketplace, which is where many of the members of former loyalist families held true to their family’s pre-War fame. There were these members of loyalist families being forced to make peace with the locals. This event was very successful for some of them it turns out, perhaps due to those families still residing in the rapidly growing cities, who were still fond of their grand parent’s former mother country. Even though some loyalists removed to the 14th colony, Nova Scotia, at the beginning of the war, and then returned to their hometown during the late 1780s and early 1790s hoping to reclaim what was once theirs, they were no longer as welcome as they would have hoped for.
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This contrasted greatly with the highly influential families who retained their loyalist parents’ land possession. At times it seems the loyalist families whose descendents at least stayed in their local setting had the opportunity to make peace with everyone from the moment the war was declared over on. For example, Loyalist Governor Cadwallader Colden, who died during the first months of war, had sons and family who remained behind in the States, and whom after the war became very important financiers for the new markets and business enterprises being developed. Cadwallader Colden’s son Alexander in fact became one of the most influential leaders of New York just a few years after the war. He had the money not only to tout his family’s fame, and so never lost possession of his family’s land holdings, due to which he was able to add some financial security to a recovering nation and in particular the Hudson Valley just to the north right after the war.
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Just south of the Colden estate and lands called Coldenhamia, sits one of George Washington’s favorite places to stay during the war. Known later as Washington’s Headquarters, a considerable amount of money, time and effort were spent converting this site to a permanent monument to this country’s success. Between 1787 and 1797, as George Washington’s fame and honor grew considerably, and he settled down in a part of this country much farther south, the Washington’s Headquarters up in Newburgh remained a local cultural value. New York City and the Valley were not about to forget the role it played in the war, commonplace knowledge now long forgotten by much of this country.
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By 1799, with the generation of the most elderly Revolutionary War Veterans reducing in number, George Washington died as well. The Medical Repository, being the medical journal for the region, posted the following about President Washington’s death, reminding its readers within the medical field about just how much medicine had changed since the war. The philosophy they were basing their practice upon was no longer a locally prescribed series of post-Boerhaavian, post-Helmontian, neo-Cullen series of theories devoted mostly to a mish mash of humoural, alkaline and solidist philosophies, all rolled up to form a single philosophy for treatment. The older doctors around this time were either apprenticed, family trained or self-trained with the assistance of another.
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In Washington’s final years, we saw all of this change as the new laws had their impacts and physicians had to be tested and approved by the state medical board in order to practice. There were no more family-trained physicians out there practicing what they learned and had been passed down by the family’s elders. What the first United States trained physicians learned came out of European published text books, with lessons and cases provided by American medical physicians and clinics. The predominant American theory for medicine to have during this time was Cullen’s solidist theory, which was about to be in direct competition with brunonianism, the belief in metaphysical causes for vitality and life’s energies or life’s spirit. But due to the war, there were also the local New York Climatologists.
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It was these doctors whose philosophy ultimately became the beliefs of the Hudson valley. These medical climatologists picked up on the theories for disease they learned from the French physicians who worked alongside them in the Revolutionary War hospital, field hospitals and battle camps. These French doctors had sensitized them to the role local climate and weather plays regarding disease, health and local epidemics. By the time george Washington was taken ill, American medicine had become its own entity, and was quite different from the form of medicine that Western Europe was promoting, most certainly during the pre-War period, but more importantly during the earliest post-war years.
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All of this means that the most patriotic post-war families would have probably thrown out William Buchan’s domestic medical guide, buying instead the locally written and printed book on the same by Quaker physician Shadrach Ricketson for just two dollars. As a leader in New York Medicine, Samuel Mitchell took the position of paying strong attention to the need for more complete studies of medical climatology, a philosophy which naturally led to his popularization of a similar occupational name–the medical geography he invented and published news about beginning in 1800. In these local physicians, be they medical climatologists, medical topographers or medical geographers, only United States Citizens best understood United States disease, the local causes for these diseases, and ultimately, the need for local doctors and local cures for these very local diseases.
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With the death of President Washington there began a climb into these fields of learning and practice for the first early 19th century physicians trained and practicing in the United States. This lifestyle and philosophy led us into several small battles and skirmishes with neighbors in the decade or two to come, along with a big battle or two with several stubborn old colonial leaders from the past trying to regain control of a continent that was no longer theirs from about 1812 to 1815. But in the end, for the next five decades United States philosophy ruled United States medical teachings, writings and practices. The westward expansion of this country that followed gave these scientists and doctors even more of these natural resources to study, and more observations to make about climate, weather, latitude, topography, geology and disease. New ways of living, new places, new medicines, and ultimately new diseases developed due to the expansion of this country between 1800 and 1850. The only way to fully cover this important part of American medical history was to publish it in American medical journals published in association with the first American medical schools.
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NOTES

Cynanche trachealis
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Many books refer to this as a term inferring croup or sore throat, or tonsillitis. Historical reviews of Washington’s death suggest his medical condition may be a simple infection that had abscessed between his mouth and his throat and larynx, thereby interrrupting his breathing and causing sepsis to set in.
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A Review of the Philosophies for this Time
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Pre-War Medical Philosophies

• Boerhaavism
• Van Helmontism
• Cullenism
• Early Domestic Medicine
  • William Buchan
• Traditional writings:
  • Robert James (obstetrics, see Osborn work)
  • Peter Shaw (apothecary, see Osborn work)
  • Samuel Sharp (surgery, see Osborn work)
  • Robert Huxham (fevers, esp. ague)
  • Daniel Turner (Discourse on Fevers, my copy to be reviewed)
• See also:
  • Thomas Sydenham (Peter Shaw’s translation of Works . . . )
  • Johann Christoph Homann, 1720 Medicinische-Geographicum
  • Friedrich Hoffman, Epidemics and Endemics
  • Riverius, Epidemics
  • Cornelius Osborn notes, especially reference to his ca. 1760 recipe book/manuscript
  • Cadwallader Colden – early climate and disease theory

Wartime Philosophies

• William Cullen’s Solidism
• Revolutionary War Dr. William Thacher
• Benjamin Rush
• Climate and disease theory (add page on Mitchell’s 3 part rendering)
• There are a few post-war reminiscences by physicians and/or biographies.

Early Post-War Medical Philosophies and Local Practitioners

• Solidism (William Cullen and Joseph Hamilton)
• Benjamin Rush
• Samuel Mitchell
• Mitchell’s Colleagues
  • Valentine Seaman
• Dr. Joseph Hamilton, Troy and Hudson, NY, pre-vaccines inoculationist, with publications for 1799-1803. [page link]
• Dr. Bartow White (Seaman’s apprentice), 1799 – 1805 – .
• John Brown’s Brunonianism — ‘nervous energy’ and its offshoot the ‘vital spark theory’ [page link]
• Thomas Gale’s Medical Electricity philosophy, Troy NY, 1802/4. [page links]
• Shadrach Ricketson’s Domestic Medicine philosophy, 1806 [page links]

Early Post-War “Alternative philosophies” (most have a separate page at this site)

• “Prince Quack Mannessah”, beg, ca. 1790.
• Puritan Arkalus Hooper, 1810/13 –
• Medical Electrician Caleb Child, 1797 –
• Dr. Min. Joseph Townsend, MD, 1797, 1804
• Elisha Perkins and following (Metalic Pointers, 1797-1800)
• var. Leydens jar/static electric healers, (Quakers, ca. 1799-1805)
• Livingstons and Watkins (land~health)