Book: Charleston & SC 18th c. Health & Medicine, Ramsay SC Vol II

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Abstract:  \Research\Ramsay vol II Hist of SC – Public Health

Doctors prescribed medical evils to bad air and foul smells.  They understood that illness was often associated with proximity to bodies of stagnant water.  At one point, Ramsay points out that those living three miles outside of proximity to bodies of standing water are much less likely to contract intermittent fever.

At first, the backcountry was far healthier than the low country.  But as land became cultivated in the backcountry, presumably for rice production, that went hand in hand with intermittent fevers. 

Fevers prevail in places contiguous to fresh, and especially stagnant water. The heavy rains generally commence in June and July. While they flow, and until their waters by remaining stagnant have putrefied, the health of the lower country is not particularly affected. But when weeds and vegetables are rankest, and putrefaction is excited by the operations of heat and moisture, the atmosphere becomes delete rious. Like effects being produced by the same causes in Georgia and East-Florida, winds from these coun tries in autumn are much charged with mephitic qualities. Hence south-westwardly winds increase all summer fevers.

The high hills of Santee was reputed to be the healthiest area of South Carolina in the 18th c.  

Fever Season June to Oct.

Charleston itself, which contained numerous areas of marsh and standing water, was particularly unhealthy in the months June through Oct.  That gradually improved, particularly over the last half of the 18th c., as these areas of marsh and standing water were drained and buildings built up.

George Chalmers, in his political annals of the united colonies, printed in 1780, page 541, 542, observes that " Charlestons was long unhealthful. From the month of June to October, the courts of justice were commonly shut up. No public business was transacted. Men fled from it as from a pestilence, and orders were given to inquire for situations more friendly to health."

This statement is corroborated by tradition from the elder citizens, who inform us that in the time of their fathers the sick were sent from Charlestown to expedite their recovery in the more wholesome air of the country ; and that the country was preferred on the score of health as a place of summer residence.

Improvements In Charleston Reduced Malaria, but eventually increased Yellow Fever

This is by no means improbable. The site of Charlestown in its natural state was a slip of land stretching south-eastwardly, between two, rivers, and projecting into the harbor formed by their junction and divided into a number of peninsulas by creeks and marshes; indenting it on three sides so as to leave but little unbroken high land in the middle.  

The first buildings extended along East Bay-street, and had a marsh in their whole front. A considerable creek, named Vanderhorst's creek, occupied the foundation of Water street; and passing beyond Meeting-street, sent out a branch to the northward nearly to the presbyterian church. Another creek stretched northwest-wardly nearly parallel to East Bay-street, from the neighborhood of Macleod's lots, through Longitude lane, and to the north of it. 

The same kind of low grounds ran up Queen-street, then called Dock- street, beyond the french church, and through Beresford's alley till it approached Meeting-street. (The north end of Union-street was planted with rice about the middle of the 18th century.
Another very large creek occupied the site of the present central market, and extended westwardly beyond Meeting-street, which diverged southwardly almost ' to the independent church, and northwardly spread ing extensively, and then dividing into two branches ; running to the north-west and to the north-east so as to cover a large portion of ground. Besides the marsh and these creeks which nearly environed three sides of the improved part of Charlestown, there was another creek a little to the southward of what is now Water- street, which stretched westwardly over Church-street ; and another which ran northwardly up Meeting-street, and then extend ed across westwardly nearly to King-street.  

A creek ran from the west near where Peter Smith's house now stands, and nearly parallel to South Bay till it approached the last mentioned creek, and was divided from it by King-street and a slip of land on each side. Six other creeks ran eastwardly from Ashley river, three of which stretched across the pe ninsula so as to approximate to King-street.

There were also ponds and low grounds in different parts of the town. One of these extended on the east side of King-street almost the whole distance between Broad and Tradd streets. This was granted to the French church in 1701, but being useless in its then state was leased out by them for 50 years. In the course of that period the tenants improved and built upon it.

There was also a large body of low grounds at the intersection of Hasell and Meeting- streets The elder inhabitants often mention a large pond where the court house now stands. It is believed that this, though real, was artificial.

It is probable that the intrenchments attached to the western fortifications of Charlestown, which extended up and down Meeting-street from the vicinity of the independent church to the vicinity of the presbyterian church, were dug so deep as to cause a constant large collection of water at that middle part of the lines*. It was the site of Johnson's covered half moon, and of a drawbridge over which was the chief communi cation between the town and the country.  

No prudent engineer would erect such works as these in a pond, though when they were erected in the moist soil of Charlestown they would be very likely to produce one. Whether this was a natural or artificial collection of water, there was enough in other parts of the town to make it unhealthy. Such, with some small alteration was the situation of Charlestown for the first 70 years after its settlement! 

To reduce such a quagmire as a great part of Charlestown originally was, to a firm, high, and dry state, required time, labor, and expense. Much has been done, but much remains for future enterprise.

The pond at the south end of Meeting-street was filled up and built upon by Josiah Smith in the years 1767, 1768, and 1769, at an expense of about £ 1 200 sterling.

Vanderhorst's creek was turned into a firm, solid land, between the years 1788 and 1792, and ob tained the name of Water-street.

The creek running under the governor's bridge was finally obliterated and turned into a market be tween the years 1804 and 1807.

The extensive marsh-land and low ground to the north and west of this creek had been filled up and built upon some years before by John Eberley, Anthony Toomer, and others.
The time when the other creeks were converted into solid land and improved, cannot be exactly ascertained. As Charlestown extended, and land became more valuable, industrious enterprising individuals, by draining marshes and filling up creeks, advanced their private interest and contributed to the growing salubrity of the town.

In addition to what has been effected by indivduals, for converting marsh into solid land, several incidental causes have contributed to a similar result. Every vault, cellar and well, that has been dug in Charlestown for 128 years past, brought to the surface a part of a sandy soil which, when laid on soft, low ground, promoted its induration and elevation. 

. . . With the exception of the more frequent recurrence of the yellow fever, Charlestown is now more healthy than it was 30 or 40 years ago. The frequent recurrence of that disease is an exception to the generality of this remark more in appearance than reality. For though it is distressing and fatal to strangers, yet, as they are but a very small part of the whole population, the aggregate mass of disease for several years past, even with that addition, would nevertheless be inferior to what it formerly was.  

Bilious remitting autumnal fevers, have for some time past evidently decreased. Pleurisies, which were formerly common and dangerous, are now comparatively rare ; and so easily cured as often to require no medical aid. The thrush in children, the cholera morbus, iliac passion or dry belly ache, have in a great measure disappeared. April and May used to be the terror of parents ; but the diseases which thirty years ago occasioned great mortality among children in the spring, have for several years past been less frequent and less mortal.  

Consumptions on the other hand have become more common ; but this is not chargeable on the climate but results from the state of society and the growing wealth of the inhabitants, in conjunction with new dresses, manners, and customs. It is also in part to be accounted for from the accidental circumstance that several, every year, die in Carolina of that complaint who had recently arrived with it in its advanced stages from the West- India islands or the more northern states. Their unparalleled increase in 180S, is the consequence of the influenza of 1 807, and the present fashionable dresses.

Smallpox Outbreaks

The years 1700 and 1717 are the dates of the two first attacks of the small-pox in Charlestown. In both it proved fatal to a considerable proportion of the inhabitants. It returned in 1732, but effectual care was taken to prevent its spreading. In the year 1738 it was imported in a guinea ship, and spread so extensively that there was not a sufficiency of persons in health to attend the sick ; and many perished from neglect and want. There was scarcely a h»use in which there had not been one or more deaths.

1738 Smallpox Outbreak

From a manuscript in the hand-writing, and found among the papers of the venerable Thomas Lambou who died in 1775, the following particulars are collected relative to this disease. " It first attracted public notice in May 1738. In the next month a fast day was appointed by proclamation. Soon after the disease commenced, a report was circulated that tar water was not only a good preparative for receiving, but a preventive of the small-pox. Many barrels of tar were sold and used for that purpose ; but the author soon after took the infection and died, and his empiristn died with him. "

By an account dated September 30th of the same year, it appeared that the whole number of deaths was 411 ; and the whole number which had taken the small-pox was 2112, of which 833 were whites, and 1279 blacks.

Of the whites, 647 took the disease in the natural way, and of them 157 died. Of 188 whites who took the disease by inoculation, 9 died.  Of the 1279 blacks who took the disease 1028 had it in the natural way, and of them 138 died.

The remainder 253 were inoculated, and of them 7 died."

From these facts as stated by Mr. Lambou, it appears that of the white persons who took the small-pox in the natural way, nearly one in four died [25%]; but of such as took it by inoculation, the deaths were only one in twenty [5%].

Of the negroes who took the disease in the natural way, nearly one in seven died [15%]; but of such as took it by inoculation, the deaths were only one in 36 [3%].

It is well known that negroes have the small-pox as bad if not worse than white people where the treatment of both is the same. That they fared better than their owners in this occasion must be referred to their being under less restraint with regard to cold air. In treating the small-pox, an excess of care and confinement is much worse than no care or confinement whatever.

From the same manuscript it appears that on the 21st of September, an act of assembly passed at Ashley ferry against inoculating for the small-pox in Charlestown, or within two miles of it after the 10th of October 1738. 

[When the outbreak first began,] Doctor Moybray, surgeon of a british man of war then in the harbor, proposed inoculation; but the physicians opposed it at first. With the exception of doctor Martini they afterwards came in to it. Mr. Philip Prioleau was the first person in, Charlestown who submitted to the operation. The success which attended this first experiment encouraged several others to follow the example. * The disease soon after abated.

1760 Smallpox Outbreak

About the beginning of the year 1760, the small pox was discovered in the house of a pilot on White- Point — guards were placed round the house, and every precaution taken to prevent the spreading of the disease ; but in vain. When the persons first in fected at White-Point were either dead or well, the house in which they had lain was ordered to be cleans ed. In doing this a great smoke was made which, being carried by an easterly wind, propagated the disease extensively to the westward in the line of the smoke. Inoculation was resolved upon and be came general. 

When this practice was first introduced, and for several years after, the inoculators loaded their patients with mercury and tortured them with deep crucial incisions in which extraneous substances impregnated with the variolous matter were buried. There were then able physicians in Charlestown ; but they were so mistaken with regard to the proper method of treating the disease that it was no uncommon practice to nail blankets, over the shut windows of closed rooms, to exclude every particle of cool fresh air from their variolous patients whose comfort and safety depended on its free admission. The consequences were fatal.

Charlestown was a scene of the deepest affliction. Almost every family was in distress for the loss of some of its members, but so occupied with their attentions to the sick that they could neither indulge the pomp nor the luxury of grief. The deaths from the small-pox were nearly eleven twelfths of the whole mortality in Charles- town. Only eighty-seven died of other diseases, while the deaths from the small- pox amounted to nine hundred and forty.

Of these only ninety-two died under inoculation. Fifteen hundred persons are said to have been inoculated in one day ; and it is certain from the bills of mortality that 848 per sons died of the disease who were not inoculated. If we allow that only one in four died, as in the year 1738, the whole number who took the disease in the natural way must have been 3392. Precision in numbers is not attainable ; but enough is known and remembered by several persons still alive to prove that the year 1760 was one of the most melancholy and distressing that ever took place in Charlestown.

1763 Smallpox Outbreak

In the year 1763 the small-pox returned ; but as there were few to have it, and inoculation was gene rally adopted, its ravages were not extensive. For seventeen years after, the small-pox was seldom or never heard of.

1780 Smallpox Outbreak

During the siege of Charlestown it was introduced, and immediately after the surrender of the town on the 12th of May 1780, a general inoculation took place. As the cool regimen was then universally adopted, the disease passed over without any considerable loss or inconvenience.

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Yellow Fever

Ramsay writing in 1808: Though ordinary fevers since the improvement of Charlestown have been less frequent and less dangerous, yet for the last 16 years the yellow fever has recurred much oftener than in any preceding period. This has not been satisfactorily accounted for. If we refer it to some new state of the air, we virtually acknowledge our ignorance. No visible obvious cause can be designated why it should have recurred almost every year of the last 15, and not once as an epidemic disease for the forty years which immediately preceded the year 1792.

1699-1700 – Fire, Yellow Fever and Small Pox all visit Charleston, killing roughly half the inhabitants

In the year 16'99 or 1700, in addition to the calamities resulting from a desolating fire and a fatal epidemic small-pox, a distemper broke out in Charleston which carried off an incredible number of people ; among whom were chief justice Bohun, Samuel Marshal the episcopal clergyman, John Ely the receiver-general, Edward Rawlins the pro vost marshal, and almost one half of the members of assembly.

Never had the colony been visited with such general distress and mortality. Some whole families were carried off, and few escaped a share of the public calamities. Almost all were lament ing the loss either of their habitations by the de vouring flames, or of friends and relations by this dis ease or the small-pox. Anxiety and distress were visible on every countenance. Many of the survi vors seriously thought of abandoning a country on which the judgments of heaven seemed to fall so heavy. Dr. Hewatt, from whom the preceding ac count is taken, designates this malady by the general appellation of " an infectious distemper." It was generally called the plague by the inhabitants.

From tradition and other circumstances, particularly the contemporaneous existence of the yellow fever in Philadelphia, there is reason to believe that this malady was the yellow fever ; and if so was the first appearance of that disorder in Charlestown, and took place in the 19th or 20th year after it began to be built.

1703 Yellow Fever

The same author states, "that in 1703 an epidemical distemper raged at Charlestown, which swept off a vast number of inhabitants : and, as the town was threatened by the french and Spaniards the go vernor, who called the inhabitants to its assistance, held his head-quarters about half a mile distant from the town on account of the contagious distemper which then raged therein ; not wishing to expose his men to the dangerous infection unless from necessi ty." These circumstances make it probable that this was also the yellow fever. If so this was its second visit, and only three or four years subse quent to the first.

1728 Yellow Fever

The same author states, " that the summer of 1728 was uncommonly hot in Carolina; that in con sequence thereof the face of the earth was entirely parched — the pools of standing water dried up-— and the beasts of the field reduced to the greatest dis tress — and that an infectious and pestilential dis temper commonly called the " yellow fever," broke out in town and swept off multitudes of the inhabi tants both white and black. As the town depended entirely on the country for fresh provisions, the plan ters would suffer no person to carry supplies to it for fear of catching the infection and bringing it to the country. The physicians knew not how to treat the uncommon disorder, which was suddenly cat. ght and proved quickly fatal. The calamity was so general that few could grant assistance to tiit ir distressed neighbors. So many funerals hap pening every day while so many lay sick, white per sons sufficient for burying the dead were scarcely to be found. Though they were often interred on the same day they died, so quick was the putrefaction, so offensive and infectious were the corpses, that even the nearest relations seemed averse from the necessary duty."

More Yellow Fever Epidemics, 1732, 1739, 1745 ,1748

This is the first direct mention of the yellow fever in the history of Carolina. From the information of Dr. Prioleau, derived from the manuscripts of his accurate and observing grandfather the venerable Samuel Prioleau, who died in the year 1792 at the age of 74, it appears " that in the year 1732 the yellow fever began to rage in May, and continued till September or October. In the heighth of the disorder there were from eight to twelve whites buried in a day, besides people or co lor. The ringing of the bells w as forbidden and little or no business was done. In the year 1739, the yellow lever raged nearly as violently as in the year 1732. It was observed to fall most severely on europeans.

In 1745 and 1748 it returned, but with less violence ; however many young people mostly europeans died of it. It appeared again in a few cases in 1753 and 1755, but did not spread. In all these visitations it was generally supposed that the yellow fever was imported, and it was remarked that it never spread in the country though often carried there by infected persons, who died out of Charleston, after having caught the disease in it,"

In its visitations it extended from July to November, but was most ripe in August and September. With a very few exceptions, chiefly children, it exclusively fell on strangers. The unseasoned negroes were not exempt from its ravages, but they escaped oftener than other strangers ; and 'when attacked had the disease in a slighter degree, and if properly treated were more generally cured. ' Persons both black and white arriving from the West India islands enjoy similar exemptions from the yellow fever of Charlestown. In the years 1796 and 1799 it raged with its greatest violence, but has since considerably abated both in frequency and violence, This abatement is partly owing to the diminished number of subjects, for strangers have been cautious ot residing in or even visiting Charles- town in the warm months. It is also to be in part ascribed to a more judicious treatment of the dis ease ; for physicians now cure a greater proportion of their patients laboring under it, especially when they apply for relief in its first stage, than some years ago when it was a new disease in the practice of the oldest and most experienced of the faculty.

Yellow Fever Not a Contagious Disease

[Carolina law of 1808 treated] the yellow fever as an imported contagious disease. The uni form experience of the physicians in Charlestown, since the year 1792, proves that it is neither one nor the other ; for in no instance has a physician, nurse, or other attendant on persons laboring under this disease, caught it from them. Several after taking it in Charlestown carried it with them and died in the country, yet it never spread nor was communicated to any one who attended on them. In every such case of mortality the disease and the subject of it expired together.

Sore Throat

Diseases of the throat are common in Carolina. Its variable weather often produces inflammatory infections of that organ. A disease thereof accompanied with the scarlet fever frequently recurs but is rarely mortal. An apparently slight affection of the throat, accompanied with a laborious respiration resembling the croup, about the year 1785 proved very destructive to many children and in a few instances to three or four in one family. It has seldom recurred since that period.

Measles

The measles may be reckoned among the epidemic diseases of Carolina. They are sometimes direct ly and speedily fatal, especially when treated with heating remedies on the absurd theory of forcing a sweat and expediting their eruption, but oftener lay the foundation for slow wasting consumptions ; especially where bleeding and a low regimen has Been neglected. . . .

Our elder citizens recollect that the measles were not only epidemic, but frequently fatal in the year 1772; especially when they fell on the bowels or lungs. Tradition informs us that in the years 1747, 1759, 1775, or 1776, they were also common and fatal ; principally by the bowel complaints which followed them.

Flu

Influenza in like manner, though a serious and frequent epidemic, has seldom been the subject of record. Many persons remember that the influenza, after traversing the United States in 1789, reached Caro lina and spread extensively. It was very fatal on the plantations near the north-eastern line of the state, especially to prime full grown negroes. Wil liam Alston lost above 30 of that description. The whole mucous membrane, through all its recesses in the sinuses of the os frontis, was most grievously af fected. Deafness, loss of taste and smell, for a long period were among its consequences. More have reason to remember the influenza of 1807. Gradu ally advancing from the northern states, it reached Charlestown early in September*. It spared neither age nor sex, though children oftenest escaped alto gether; or if attacked, got through the disease with the least inconvenience.

The reverse was the case with aged persons. It soon became so general that in some large families there was not a sufficiency of persons in health to attend on the sick. In a few weeks it is supposed that 14,000 persons, or half the population of Charlestovvn, had been afflicted with that disease. Of these, forty-five died ; thirteen of whom were white persons and thirty-two negroes. The former were generally aged persons. The disease spread on all sides into the country. The mortality in Georgetown and Beaufort was considerably greater than in Charlestown. The disease in many cases was so mild as to preclude the necessity of application to a physician. In dangerous cases, when medical aid was required, bleeding, blistering, emetics, cathartics, and sudorifics were chiefly relied upon.

Whooping Cough

The whooping cough rages more or less almost every year, but its visits have not been generally re corded. The returns of yellow-fever, and of small pox in the early period of our history, made such strong impressions on the minds of the people as to form arras in the domestic history of private fami lies. But the whooping-cough though an epidemic disease, occasionally fatal, and one which attacks al most every person, yet it has been tor the most part soon forgotten. It is nevertheless recorded that in the year 1 804 it proved fatal to sixty-tour children in Charlestown.

Disease Incubation Period

It has been remarked that in seasons when Charlestown was healthy, the country was sickly. The reverse has also been noticed. Diseases are most ripe in the city in summer, but iu the country in autumn. A constitution of the air prevails in one which is different from that of the other. For three months, July, August, and September, a free intercourse between them is not with out danger. They fare best who keep steadily for that period either in the city or the country. These remarks always true, have been eminently so in 1808 ; for in that most healthy summer there were few, mortal cases of fever which originated in Charlestown, while excursions for a few days to the country in many cases proved fatal. The fevers which in summer and autumn attack the inhabitants of the city in consequence of their going to the coun try, lie dormant for some time, more or less ; tor a week, nine or ten days, and in some cases longer. That all danger is past cannot be certainly known in less than twenty- one days after returning to the city.

Malaria

Fevers are the proper endemics of Carolina, and occur oftener than any, probably than all other dis eases. These are the effects of its warm, moist climate, of its low grounds, and stagnant waters. In their mildest season they assume the type of intermittents ; in their next grade they are bilious remittents, and under particular circumstances in their highest grade constitute yellow fever [Interesting here that he thought yellow fever was a high-grade form of malaria]

The efforts of the inhabitants to guard against these diseases merit a place in medical history. Their first plan is said to have been retirement from Charlestown to the country. This may have answered for the first thirty or forty years ; for in that period very little of the swamps had been opened, and the high and dry pine lands were the chief spots both of residence and improvement. The increased cultivation of rice, the diffusion of marsh miasmata from the open cultivated low grounds, and the location of settlements near them in process of time turned the balance of health in favor of Charlestown. The wealthy planters who could afford the expenses of a double residence, spent their summers in town and their winters in the country.

Within the last six teen years the frequent recurrence of yellow fever in the crowded metropolis has induced numhers to adopt other plans.

The sea-islands, particularly Sullivan's and Beaufort, Eddings's bay, and the sea shore, generally has been resorted to as places of healthy retirement during the summer season. With the same views Walterborough, Springfield, Summerville, Pineville, and some other smaller establishments, have suddenly grown into villages.

A medical opinion, apparently well founded, has generally prevailed that the endemic diseases of Carolina were not the effect of heat alone nor exclusively of superabundant moisture ; but the result of both producing and combining with putrefaction. The conclusion followed that health might be enjoyed in any situation exempt from putrefaction and moisture, and at a sufficient distance from the miasmata to which they give birth. Experience had proved that these mias mata seldom extended their effects as far as three miles, even to the leeward of stagnant putrefying materials, and much less on the windward side.

Spots of high and dry land covered with pine trees, and at a sufficient distance from ponds, swamps, and other reservoirs of poisonous effluvia, have been diligently sought for and to them families have retired from their dwelling houses, injudiciously located in the vicinity of the swamps, and there passed the summers sociably with their neighbors allured to the same place with the same views. Advantages neither foreseen nor calculated upon have resulted from these temporary villages. They became the seats of schools and of churches, neither of which were with in the convenient grasp of the inhabitants when disease [was at issue]

Medical Society

A medical society for the advancement of the healing art was formed in 1789, and incorporated in 1794. At their monthly meetings they converse on the prevailing diseases ; examine and record their meteorological observations, and discuss some medical question or subject. The members are by their rules under obligations to furnish in rotation some original medical paper which, after circulating among the members, is made the subject of conversation and discussion at their next meeting. Of these papers, a few have already been published. Others remain sufficient both in number and importance to make a volume which probably will in time be brought forward to public view. In all cases' respecting the medical police of Charlestown application has been made to this society for their advice, and it has been cheerfully given and essentially contributed to form beneficial regulations for preserving the health of the inhabitants. Three institutions emanated from the medical society of great public utility, the Humane society — the Charles- town dispensary, and the Botanic garden.

The Humane Society [to help people removed from water without signs of life]

An ap paratus for the recovery of persons suffering under suspended animation was purchased by the society, and lodged near the most frequented wharves with directions how to treat the sufferers. The members tendered their medical services when called upon. They also applied to the city council for their aid, who directed that all articles used, and all assistance rendered should, if required, be paid by the city ; and that any retailer of spirituous liquors who refused the use of his house for trying the process of resuscitation should receive no new license for carrying on his business.

Note: More on the Humane Society here. It was an international movement that started with the Dutch about 1760 then made its way to the UK and the states. See PirateSurgeon.com

The second institution, or the Dispensary, was instituted for the medical relief of the poor in their own houses. Most of the physicians and surgeons of the society in rotation gratuitously attend and prescribe for the dispensary patients. These are admitted to the benefit of the institution by tickets from trustees. The city council appoints the trustees and also the dispensary apothecary. To the latter an annual salary is paid from the city treasury for his medicines and services. Thus medical advice and attendance can be obtained at their own habitations gratuitously by all the indigent inhabitants who apply for it ; and the whole expense has hitherto cost the city no more than 1000 dollars per annum.

The young physicians, when admitted members of the medical society, are classed into pairs ; and in monthly rotation', with the elder members, prescribe for and attend on the dispensary patients. In cases of difficulty, provision is made for consultations with some of the elder phy sicians appointed for that purpose by the medical society. In addition to the manifold advantages derived to the more indigent inhabitants from this institution it proves an excellent practical school for the younger physicians, and furnishes a conspicu ous opportunity for introducing their industry, talents, and acquirements to public observation.

Botanic society

The Botanic society was formed and incorporated in the year 1803. The Medical society gave to it three hundred dollars, fifty dollars per annum, and a large lot of land which had been generously given to them by Mrs. Savage, now Mrs. Turpin, to be used as a botanic garden. The inhabitants were invited to join the association, and on their annual payment of any sum between 4 to 1 0 dollars, at their option, they were entitled to privileges in proportion to their respective subscriptions, and became members of the Botanic society. An annual sum of 1176 dollars thus obtained from voluntary subscribers, has given activity to the project. The garden was opened in the year 1805, and has been superintended ever since by a committee, chosen partly by the medical society and partly by the other members of the Bo tanic society. This committee keep in constant em ploy an experienced practical botanist, and a few laborers under him. The institution has flourished beyond the most sanguine expectations of its friends. It is now enriched with a considerable number of plants, both indigenous and exotic, arranged accord ing to the Linneao system, and additions are constantly making to it by the citizens and from foreign countries.

From the proceeds of a lottery now pending, hopes are entertained that the society will be enabled to enlarge their plan so as to make their garden the repository of every thing useful, new, and curious in the vegetable world. A society of practitioners of physic from several surrounding districts has been lately formed, which now hold their meetings in Union district, under the name of the Esculapean society of South-Carolina. The duties and exercises imposed by this society are similar to those imposed by the medical society of South-Carolina. Their funds are intended for the purchase of a me dical library.

Medical Education in Charleston [apprenticeships]

[Almost all doctors in Charleston prior to 1760 were Europeans.] About- the year 1760 a few youths were put under the care of respectable physicians in Charlestown who, after spending five or six years in their shops, doing the duties of apprentices, and reading practical medical books, spent three or four seasons at the university of Edinburgh and then came home invested with the merited degrees of doctors of medicine. They were well received by their countrymen, and readily established themselves in business. This success encouraged others to follow their example and ever since a medical education has been more common. Anterior to the revolution nothing short of an european education was deemed sufficient to attach the confidence of the public to any medical practitioner ; but the growing reputation of the university of Pennsylvania resulting from the splendid talents of its professors, and the solid attainments of its graduates, has done away this impression. The convenience' of attending medical lectures in a neighbor ing city for some time past, and at present, draws three in four of the Charlestown medical students to Philadelphia in preference to Edinburgh at the distance of 3000 miles and in a climate often too cold for young carolinians. The study of medicine be comes daily more fashionable, and the first people in the state now educate their sons for physicians.

Backcountry Medicine and Slave Medicine on Plantations

In addition to the regular practice of medicine, there is much that may be called domestic. The distance of physicians, the expense, difficulty, and delay in procuring their attendance, has compelled many inhabitants of the country to prescribe for their familu s and sometimes tor their neighbors. Wesley's primitive physic, Tissot, Buchan, Ricketson Ewell, or some plain practical author is to be found in almost all their houses. With the aid of some family medicines, and of some well known vegetable productions, under the guidance of experience they prescribe for the sick and often succeed beyond expectation.

In cases of surgery they are more at a loss ; but even here by the aid of common sense and from the pressure ot necessity aiding invention, they some times perform wonders. The author of this work in the year 1779, examined the stump of a man living near Orangeburgh whose leg, after being horribly mangled, had been successfully amputated several years before by one of his neighbors with a common knife, carpenter's handsaw, and tongs. The last instrument was applied red hot to staunch the bleed ing. The stump was far from elegant, but with the help of a wooden leg the patient enjoyed all the ad vantages which are secured by the most dexterous performance of amputation. There was no surgeon within sixty miles of the sufferer.

Capital planters have their sick house or hospital — their medicine chest — their tooth drawer and bleeder — and often their midwife for family use. The negroes are the chief objects of these establish ments. From the simplicity of their disorders, resulting from their plain aliment and modes of life, the benevolent intentions of their owners are often carried into full effect. The pride of science is sometimes humbled on seeing and hearing the many cures that are wrought by these pupils of experience, who. without theory or system, by observation and practice acquire a dexterity in curing common diseases.

Famous Doctors of Charleston

Dr. Lionel Chalmers made and recorded observations on the weather for ten successive years, that list from 1 750 to 1 760. The same able physician furnished a particular account of the opisthotonos and tetanus which was communicated to the medical society in London in the year 1 754, and afterwards published in the first volume of their transactions. He also prepared for the press an account of the weather and diseases of South-Carolina, which was published in London in 1776'; but his most valuable work was an essay on fevers printed in Charlestown in the year 1767. In this he unfolded the outlines of the modern spasmodic theory of fevers. Hoffman had before glanced at the same principles ; but their complete illustration was reservved for Cullen and laid the foundation of his fame. .

Chalmer's 1776 Book at Google Books.

Doctor Garden, about the year 1764, gave to the public an account of the virtues of pink root and at the same time gave a botanical description of the plant. This truly scientific physician was much de voted to the study of natural history, and particu larly of botany, and made sundry communications* on those subjects to his philosophical friends in Europe.

In compliment to him, the greatest botanist of the age gave the name of Gardenia to one of the most beautiful flowering shrubs in the world.

William Bull was the first native of South Carolina w ho obtained a degree in medicine. He had been a pupil of Boerhaave, and in the year 1734 defended a thesis " de Colica Pictonum" before the university of Leyden. He is quoted by Van Swieten as his fellow-student, with the title of the learned Dr. Bull. ; John Moultrie was the first Carolinian who obtained the degree of Doctor of medicine from the university of Edinburgh where, in the year 1749, he defended a thesis " De Febre Flava." Between the years 1768 and 1778 ten more natives obtained the game honor. These were Isaac Chanler, Peter Fays- soux, Thomas Caw, Charles Drayton, Tucker Har ris, Robert Peronneau, James Air, George Logan, Zachariah Neufville, and Robert Pringle.

Licensing

Three attempts have been made to regulate the admission of candidates for practising the healing art in Carolina; but all failed. Clergymen and lawyers, before they are authorised to exercise their respective functions, are examined and licensed by competent judges; but the practice of physic is free to every man or woman who chooses to under take it.

Fashions and Health

;.A summary view of fashions, medical opinions, and practices which have at different periods af fected the health of the inhabitants and the practice of medicine in Carolina, shall close this chapter. The cocked hats which were common thirty years ago exposed the wearers of them to the action of the sun much more than the round, flat, and deep crown ed hats which are now fashionable. The substitu tion of silk for varnished umbrellas has also been advantageous. . The late increased general use of flannel next the skin, by adults, has defended them against the consequences of the sudden changes of the weather.

Females, thirty or forty years ago, by the use of tight heavy whalebone stays injured their health, and sometimes obstructed their regular growth. To this succeeded a moderate use of light er stays which were advantageous to the shape with out injury to the health. These gave place to as loose manner of dressing, which though unnecessary to health destroyed the elegance of their form.

Some by the use of suspenders to their petticoats ran the risk of inducing cancers by an unequal and con stant pressure on their bosoms. This mode of dressing, which obliterated all distinction between the blooming slender virgin and the fruitful wife, has been for some time changing in favor of lengthening waists and tighter bracing. The present danger is of their proceeding too far ; for such practices, carried to excess, endanger the health of single women ; and in the case of married ladies, in crease the pangs of parturition and lessen the pro bability of their terminating in the birth of living, well formed children.

The great revolution in favor of the health of females, is the laying aside the old absurd custom of shutting them up from the commencement of pains, introductory to real labor, m close rooms from which air was excluded; and continuing them in this confined state, not only during the pangs of child-birth, but for many days after their termination. Unreasonable prejudices against cool air were common thirty or forty years ago, and were acted upon to the injury and frequent deaths both of mothers and their infant offspring. The tight swaddling bands applied to the latter hastened the same event. A great reform has taken place : these mischievous practices have been laid aside. Cool air for several years has been freely admitted to the comfort of all parties in the chamber and the free expansion of their viscera, is no longer cramped by tight dresses. Most happy consequen ces have resulted — fewer women are lost— more children survive, and larger families are now raised than was common forty years ago.

Bathing and the Bidet

The Carolinians are indebted to the late french emigrants for the more frequent use of baths, both hot and cold, and also of the bidet. Long experience in the West-India islands had taught them that such practices, and also a more free use of vegetable aliment, were suitable to warm climates. Cold water as well as cool air were undervalued by the elder inhabitants. The author of all good has put both within the grasp of all men with little trouble Or expense ; but the cheapness of the gift has been the occasion of its being slighted. Its value has lately been appreciated. Experience has proved that water, judiciously applied, cold or warm as circumstances require, cures many diseases and prevents more.

Medical Advancements

The practice of physic about fifty years ago was regulated in Carolina by the Boerhaavian system,and that of surgery by the writings of Ileister and Sharp. Diseases were ascribed to a morbific matter in the blood. Medicines were prescribed to alter its qualiities, and to expel from it the cause of the disease. To insure its discharge through the pores, patients were confined to their beds and fresh cool air was excluded by closed doors and curtains. To hasten its expulsion much reliance was placed on sudorifics. Neutral mixtures and sweet spirits of nitre were often prescribed with this intention.

In cases of danger [? snake bite or spider bite?], recourse was had to saffron, Virginia snake- root, and camphor.

In pleurisies and acute rheu matisms the lancet was freely used, but very sel dom in other diseases.

The medical treatment of most febrile complaints, commenced with purees and vomits ; but after their operation the principal reliance was on sweating medicines.

The bark was freely administered in intermittents, but there were strong prejudices against it. So many believed that it lay in their bones and disposed them to take cold, that the physicians were obliged to disguise it.

Opium was considered as a medicine calculated to compose a cough, or to restrain excessive discharges from the system, but was seldom prescribed in sufficient doses and not at all in several cases to which it is now successfully applied. Like the bark it was the subject of so many prejudices as to make it necessary to conceal or disguise it. It was seldom given without the advice of a physician.

At present a phial of laudanum is to be found in almost every family, and it is freely taken, not on ly without medical advice, but frequently in cases in which no prudent physician would advise it.

To the lentor and morbific matter of Boerhaave, which regulated the practice of medicine in Carolina for more than 60 years of the 18th century, succeeded the spasmodic system of Cullen. These theories were more at variance than the practice of their res pective advocates. The attenuation of the lentor. and expulsion of the morbid matter in one case, and the resolution of spasmodic strictures in the other- w^'-e both attempted in a great measure by the same means ; but the followers of Cullen improved on the Borhaavians by the more free exhibition of antimonial remedies, which are much more powerful than the medicines which had been previously in common use. For several years, emetic tartar was the most fashionable medicine, and by varying its form and dose it was made to answer a variety of useful medicinal purposes. This has driven place to jalap and calomel [mercury chloride], which is the present favorite both in regular and domestic practice.

The old remedies, bleeding, blistering, mercury, opium, bark and wine, have been carried to a much greater extent formerly, and applied to diseases tor which they seldom if ever prescribed 50 years ago.

The medicines, digitalis [heart issues], lead zinc, arsenic, melia azederach or pride of India, muriatic [hydrochloric] acid, nitric acid, some of the gases, and artificial musk are now common remedies in the hands of the most judicious practitioners, though seldom used and scarcely to their predecessors. The practice of physic gone a revolution in Carolina as well government of the state. This is partly more important matters than dress ; but has a more solid foundation in a real change of the diseases of the country. Since 1792 these have been both in- degree and frequency more intlammatory than before that period, and required freer evacuations and more energetic prescriptions.

The improvements in surgery made by Monro, Pott, Hunter, Bell, DesauJt, Physick, Hey, and others, have all been transplanted into Carolina. The surgery of the early period of its history was far inferior to the present. Diseases of the eyes were then not well understood. Few operations on them were attempted and fewer succeeded. Fractures are now united — luxations reduced — and amputations performed with less pain to the patient, with more expedition, and with greater success, than 50 years ago. The inhabitants who from misfortunes need the performance of the most difficult and uncommon operations in surgery, are at present under no neces sity of seeking foreign operators; for what can be done for them in London or Paris can also be done in Charlestown.

The improvements made in mid wifery since the days of Smellie, are in like manner well known and practised in the state. These have been so great that instrumental delivery is now rare ly necessary and seldom performed. Deaths from pregnancy and parturition are at present more rare in Charlestown, than when its population did not exceed half its present number.

But few years have elapsed since there was any established regular dentist in Carolina. There are now 3 or 4 who find employment. The diseases of the teeth are not now more common than in former times ; but many of them were at that period frequently suffered to pro gress unmolested from bad to worse, which are now prevented or cured by the dental art which was one of the last transplanted into the state.

Carolina by her Lining, Chalmers, and Garden, has increased the stock of medical and philosophical knowledge ; but cannot like Pennsylvania boast that she has produced a Rush, a Barton, and a Physick, eminently raised up for the advancement of the healing art, and of the auxiliary branches of medical science.