A Pioneer Alabama Doctor’s Ledger reveals much about illness ca. 1820

A PIONEER ALABAMA DOCTOR’S LEDGER¹

edited by Rhoda Coleman Ellison

(Published in The Alabama Historical Quarterly, Vol. 43, No. 04, Winter 1981)

A ledger kept by a Bibb County doctor in the early days of settlement gives some authentic glimpses into pioneer life in central Alabama. Dr. David R. Boyd² of Centreville, Alabama, in the handsome shaded penmanship of the period inscribed his name and the date January 1, 1829, on the first remaining page of a large account book formerly the property of James M. C. Wiley and now labeled Ledger A. Dr. Boyd’s first entries are dated September 1828, but several items are carried over subsequently from 1826 and 1827 and one from 1824. Although Ledger A covers the years 1829 and 1830 most fully, it continues some records, especially of collections, into 1834. On the last pages a different and less legible hand makes entries for 1836, the year following Dr. Boyd’s early death. Thus these accounts describe, more or less completely, around a decade of medical service in an early Alabama community.

Dr. David Boyd (AlGenweb)

In 1829 seventy-eight lots were laid off

Possibly the beginning of a new book of accounts was inspired by the transfer of much of the town’s business district across the Cahaba River to its present hill location in 1829, when the third county court house was built there.³– At that time seventy-eight lots were laid off around a central court house square, and their sale by the county commissioners continued until 1832. Something of the hopeful and enterprising spirit of the new town must have entered into young Dr. Boyd’s opening of a new ledger on New Year’s Day of 1829. Around a century later this book has something to say about pioneer medical practice and the life of both the physician and the settlers he treated in the late 1820’s and early 1830’s.

Bibb County Courthouse in Centreville, Alabama.  Looking north. The structure was built in 1859 and was razed to build the current courthouse

The first interest of this volume lies in the remedies that the physician-pharmacist prescribed and furnished. Their range, of course, is quite limited in comparison with modern prescriptions. Many are still familiar in old-fashioned medicine cabinets: calomel, castor oil, Epsom salts, paregoric, blister plaster, mercurial ointment, digitalis. Yet many others, although often known to the country doctor through most of the nineteenth century, sound quaint today, for example hartshon (ammonia) and “sac. Saturni” (sugar of lead). For elucidation they require a pharmaceutical dictionary or, in many cases, a doctor acquainted with nineteenth-century folkways.⁴

Many medications for stomach disorders

A present-day pharmacist on examining the entire list is impressed by the large number of medications that treat stomach disorders. A sampling of the items reveals that, besides Epsom salts and calomel, such cathartics as folio senna, cream of tartar, and Olium Ricini (castor oil) were frequently prescribed. So also were such laxatives as magnesia and such emetics as elixir vitriol, nox vomica, ipecac, and wine antimony. The popularity of Lee’s Antibilious Pills was eclipsed only by that of the unidentified Bateman’s Drops.

Bibb County Courthouse ca. 2011

Although digestive troubles head the list, of course other ailments sent the settler to his physician, too. Prescriptions of nitre dulce probably imply kidney infection or blockage, while tincture digitalis suggests heart difficulties. To prevent the common cold, the pioneer doctor ordered gum foetid (the evil-smelling asafetida) to be worn in a small sack around the neck. His favorite remedy for colds was a blisterplaster, but other prescriptions included gum camphor, oil sassafras (an antiseptic for nose and throat), and a cough medicine concocted of.tincture musk and opium (laudanum). Oil of cinnamon was thought to be a cure for colic.

Bateman’s Drops were popular

The exigencies of frontier life required Seneca snakeroot nitre for snakebites and also possibly for what was judged to be high blood pressure in a period without instruments for checking pressure. This medication was usually accompanied by a cathartic or paregoric or the popular Bateman’s Drops. For malarial fever, so prevalent in this section, sulphate quinine and Peru bark, a cheap substitute for quinine, were available in Dr. Boyd’s medical satchel. He administered sudorific drops to cause sweat and febrifuge powder to reduce fever. Wormseed oil, along with a cathartic or emetic, was evidently considered effective in cases of intestinal worms, which, these records show, struck the planter’s wife and child as well as his slave. Balsam and nitre made a dressing for wounds and ulcers, and sprains and rheumatism were apparently treated with gum camphor or opodeldoc liniment.

Most antiquated was venesection

Of all the medical practices common in central Alabama in the early nineteenth century the one that seems most antiquated today is probably venesection, or the letting of blood. It was still prescribed generally in that period for reducing the number of infected blood cells present during various diseases, with the purpose of allowing healthy cells to form in their place. Dr. Boyd performed venesections regularly, although his successor was given more to the art of cupping, probably dry cupping, which required the pressing of a highly heated cup against the skin rather than an incision, as in venesection and wet cupping. Sometimes both methods were used on the same patient. Most often no medication accompanied venesection or cupping, but, when it did, the prescription was often for a cathartic or paregoric, sometimes followed by anodyne drops (for pain). Venesection occasionally preceded the delivery of a baby.

The pioneer doctor, like many of his later nineteenth century successors, performed other services besides those of physician and- pharmacist. He occasionally “cleansed teethe” and frequently extracted them, either in his office or on a house call. When necessary, he was a surgeon also. Dr. Boyd amputated two of a slave’s fingers and dressed the wounds regularly for ten weeks afterwards. He recorded “reducing a fractured femoris” for one citizen, a process of setting the hip bone probably accomplished by means of splints in those days.

Another settler’s son required his skill in setting both bones of his forearm, listed professionally as “radius and ulna.” The violence of the period is reflected in the manner of times the doctor was called on to sew and dress wounds, inflicted usually on the settler himself, though sometimes on his son or, more often, his slaves.

Thirteen visits to slaves of James B. Clarke

The treatment of slaves was no small part of a physician’s practice. Dr. Boyd paid thirteen visits to slaves of James B. Clarke during the month of January 1829, for such purposes as performing venesections or administering emetics, cathartics and blisterplasters. All of his five charges on Oliver Cleveland’s bill for December 1829 were incurred for slaves. During the first half of 1836, his successor made fourteen calls on the slaves of A. Stoutenborough, one of which is recorded as “visit negro child through rain.” Enough accounts include the item “visit negro accouchment” to raise some question about midwifery in the quarters. The term slave never occurs, of course; sometimes the personal name is given, as in “negro Nance” or “negro Sam,” but more often the designation is simply “negro” or “boy.”

Charges were modest

The charges for these medications and services were predictably modest, even if consideration is given to the difference in money values a century and a half ago. They vary from twelve and a half cents for gum foetid to eight dollars for certain accouchments, including one at this fee for a slave. Venesections were usually charged at a dollar and a half. A tooth extraction cost fifty cents in the doctor’s office but a dollar if performed on a house call. A “nocta visit” was fifty cents more expensive than a day call, which was usually listed at one dollar without a prescription. Even a “visit and attention for 8 hours” cost Ebenezer Leeth only six dollars. When the doctor was called on to ride his horse to a farm house that was some distance out in the country, fording creeks and possibly also either fording the river or crossing it by ferry, he expected a proportionately higher fee. Yet a round trip of sixteen miles below Centreville at night to the home of Bird Griffin, for whom he sewed up and dressed a wound and dispensed tincture of myrrh, Epsom salts with tincture opium and also one box of Lee’s Antibilious Pills, cost this settler only twelve dollars. In 1836 Vardy Johnson’s account included the simple entry “To ride 12 miles, $3.00.”

Yet, in spite of the modesty of the charges, bills were frequently not paid for months or years, if at all. Times were undoubtedly hard and money scarce in the new settlements in the late 1820’s and early 1830’s. Cotton receipts were accepted in lieu of cash, although at two cents a pound one settler had to produce a receipt for 820 pounds in 1829. Accounts were usually recorded as “paid by cash or full” or “paid by note in full,” and occasionally a bill was erased by a note from another citizen. Considering the high incidence of early death on the frontier, perhaps the number of cases in which the debt was settled by the executor or administrator of the patient’s estate should not be surprising. Sometimes obligations were satisfied by services. Jonathan Potts was allowed to pay more than half of his fourteen-dollar bill for medicine and such professional attentions as dressing his wounds “by hailing 876 pounds from [to?] Selma at 75 [cents], $6.59 and by storage in Selma, $2.00.” What item was hauled and stored is not recorded, but probably cotton en route to market.

Various methods of payment

Barter was common, and figured especially in delayed payments. John Tucker, who had incurred a bill of sixty-two and a half cents on December 29, 1830, began to meet the obligation on May 21, 1832, “by 1 venison Ham in part, 50 cents” Barney Kornegay, whose charges for 1829 and 1830 amounted to $3.50, came to his doctor in 1832 with sixty-two and a half pounds of beef valued at three cents a pound, producing the balance of his debt in cash. Pioneer women were able to make payments in kind, too, sometimes by their own handwork and sometimes by possessions that should have been necessities to them. Mrs. Berry, whose “fractured radius” Dr. Boyd had set, made a partial payment “by 2 pare of socks, $2,00,” although she never paid her bill in full. On the other hand, Mrs. Prudence Starling met her obligation of eighteen dollars and a half in full “by one work oxen,” a transaction that must have involved a real deprivation to a widow.

Ledger A records the sale of other items besides medicine and professional services. Tobacco was sold regularly along with drugs, priced in 1828 at three pounds for one dollar. Like most other settlers, Dr. Boyd was also engaged in farming some of the new land that had been opened for sale by the government only a decade earlier, and occasionally he listed items of his produce, some of which suggest a greater diversification in agriculture than was common later in central Alabama. In September 1829 Dr. Boyd sold to John Henry, Sr.⁵ two bushels of corn at seventy-five cents a bushel and four bushels of wheat at one dollar a bushel, receiving in part payment four pounds of wool at fifty cents a pound. On Henry Potts’ bill in 1830, between charges for green camphor and a cathartic there are listed three and a half bushels of seed oats at one dollar and seventy-five cents and two bushels of seed potatoes at one dollar. The versatile doctor was also enterprising enough to own a blacksmith shop, as his charges frequently indicate. He had other means of turning a penny, too. He had a load of cotton hauled for one of his patients at the fee of one dollar, and he charged another for the use of a stable at five dollars. To one patient he sold law books, possibly received earlier in lieu of cash, and to another a saddle. Still another citizen, apparently malarial, he took into his home for two days’ board at one dollar a day, while he was treating him with Peru bark and quinine.

Struggled to survive

All of these early settlers, physician and patients alike, were in a struggle to survive and prosper in the difficult conditions of the central Alabama frontier. The physician was regarded as one of the means of survival, as he diagnosed illnesses and dispensed prescriptions now mostly outdated. This volume of precisely written entries is ample evidence of the dependence of the community upon him. It also permits some glimpses into the life of both patients and physician. It records not only the old-fashioned medicines and treatments relied on but, by implication, the physical ailments most commonly recognized. In this central Alabama country, where both planters and yeoman farmers settled, the record affirms the medical care that slaveholders ordered for their servants and suggests the frugality or. lack of funds responsible for small farmers’ barter payments. The young doctor’s own struggle to survive financially and perhaps even to make his fortune is underlined by his attempts to manage both his practice and his new farming land, and also to sell, buy or barter as circumstances allowed. The period of settlement gains color and human interest from the record he left in this old leather-bound ledger.

About Donna R Causey

Donna R. Causey, resident of Alabama, was a teacher in the public school system for twenty years. When she retired, Donna found time to focus on her lifetime passion for historical writing. She developed the websites www.alabamapioneers and www.daysgoneby.me All her books can be purchased at Amazon.com and Barnes & Noble. She has authored numerous genealogy books. RIBBON OF LOVE: A Novel Of Colonial America (TAPESTRY OF LOVE) is her first novel in the Tapestry of Love about her family where she uses actual characters, facts, dates and places to create a story about life as it might have happened in colonial Virginia. Faith and Courage: Tapestry of Love (Volume 2) is the second book and the third FreeHearts: A Novel of Colonial America (Book 3 in the Tapestry of Love Series) Discordance: The Cottinghams (Volume 1) is the continuation of the story. . For a complete list of books, visit Donna R Causey

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