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Nineteenth-century medical practices sometimes worse than none at all

While Mariano Vallejo was managing Sonoma in 1837, appearing in the provincial capital of Monterey was Edward Turner Bale, an Englishman usually referred to as a “physician and surgeon.” Bale’s arrival was rather spectacular, since he was rescued from the wreckage of the ship Harriett, which crashed with considerable loss of life. Vallejo, who among other titles was commander of the Mexican Army in California, promptly appointed Bale “Surgeon-in-Chief of the California Forces.” Actually there was no one else around who could claim any medical expertise.
Bale became a Mexican citizen and married Vallejo’s niece, Maria Soberanes. He set up an office in Monterey and dispensed medicines, but got into trouble by also selling liquor, which was illegal. It was healthier for him to move to Sonoma, or so he thought. Always somewhat erratic and quarrelsome, he soon got into a dispute with Salvador Vallejo (Mariano’s younger brother), whom he accused of making a pass at Maria. Salvador administered a whipping on Bale, who responded by taking two wild shots at Salvador.
Bale fled and was tracked down by Chief Solano and placed in Sonoma’s porous little jail. Charges were dropped, but Mariano got him out of town by arranging a 17,962-acre land grant in Napa Valley where the town of St. Helena now exists. Bale also built the still-standing Bale Mill, where the Bear Flaggers gathered the day before they invaded Sonoma in June, 1846.
What sort of medical training Bale actually possessed has always been a mystery. The same was also a question about Dr. Nicolas Den, another frontier medico, serving Santa Barbara. The real answer lies in the primitive level of medical treatment in the western world
I was fortunate to receive a new book entitled “Humane and Heroic,” which is the biography of John Storrs, my great-great-grandfather, who practiced medicine in central England at almost exactly the same period as Edward Bale was a physician first in England and then in California — 1820s to the late 1840s.
To become a physician and surgeon, who might also be an apothecary, a young man studied as an apprentice to a physician sometimes starting as early as 16 years old, for a period of five years and then worked in a hospital for two years, walking the wards and performing light surgery. There was a required examination before the physician and surgeon could be turned loose on the public.
A physician might also study the composition of medicines and if he passed an apothecary exam could compound the pills and liquid doses himself. To be called a “Doctor” in Great Britain required attending a university medical school for two years. In the United States there were almost no medical schools until the second half of the 19th century. Standardized training was urged in 1847 by the newly-formed American Medical Association, but the movement was slow in making progress.
In the first half of the 1800s, there was no use of anesthetics. Amputations, eye operations, surgery of various sorts, setting of bones, and mastectomies were all performed with nothing more than a shot of whiskey. Ether was used for the first time at Massachusetts General Hospital in October, 1846, and for an amputation in London in December, 1846 and chloroform was first used in January, 1847. Storrs died later that year from typhus while fighting to save patients during a typhus epidemic. Bale died in late 1849.
Amputations were common in order to prevent gangrene from spreading from wounds and bone fractures. Doctors had become somewhat skillful in pinching off veins. Since they believed that most illness was caused by “humors” in the body, it was generally considered worthwhile to purge the system by use of laxatives and emetics. Other medical treatments often did more harm than good. Top of the list was “bleeding” – either by lancing a vein or sucking by live leeches–on the theory that reduction of the amount of blood would lower blood pressure and clean out the system. Instead, bleeding brought on anemia and had little effect on blood pressure — it had killed George Washington. Almost all the potions and mixtures were useless, and often harmful. Some use of opium, belladonna and other more powerful drugs could alleviate anxiety, but were not cures.
Broken bones were set by manipulation without pain killers. By the first half of the 19th century splints and plaster casts were employed to hold the bones in place. If the patient were lucky, the placement had been accurate, avoiding permanent disability and infection. Amazingly, physicians could remove eye cataracts by breaking up the clouded lens, which Storrs did on several occasions.
Worst of all was the failure to realize that the unsanitary conditions in hospitals, at bedside or in surgery were contributing to the infection and death rates. Only near the end of his life did Storrs begin to study the possible connection of cleanliness to infection. He was particularly concerned with the deaths of new mothers from childbed fever. Actually the physicians, midwives and nurses were the source of the contagion. In 1847, for the first time an Austrian obstetrician suggested the medical staff was spreading the disease.
Frenchman Louis Pasteur proved in the 1860s the existence of germs (microbes) as the source of diseases. Joseph Lister (as in Listerine) advocated sterilization of wounds, incisions and instruments, as well as overall cleanliness, to reduce infections and deaths. The first use of Lister’s program began in the late 1860s in Europe, but only became applied in British and American hospitals in the 1880s. Amazingly, surgical masks for doctors, nurses and attendants were not used until about 1900. Eventually the death rate of new mothers dropped substantially.
Public health, particularly in crowded cities, was tragically neglected. The number of privies (outhouses), lack of indoor plumbing, limited bathing, crowding, horse manure everywhere, and inability to halt epidemics of diseases like whooping cough, tuberculosis, typhus and diphtheria added to the dangers of early deaths and invalidism. Another factor was the lack of family planning, a situation that resulted in young women producing veritable litters of children. Martha Storrs, John’s wife, was perpetually pregnant, giving birth to 13 children (only one did not survive), as did Benicia Vallejo.
“Humane and Heroic” was written by John Tooth, also a descendant of John Storrs, who lives in Hobart, Tasmania, Australia. The well-written book is remarkable in that it is based on the letters and the extensive medical case notes and essays of Storrs. These papers were handed down eventually to Kenneth Storrs, a California accountant. After his death the records were meticulously organized by his widow, Lynn Storrs, the genealogist of the Storrs family, and presented to author Tooth.

Gerald Hill is co-author with his wife, Kathleen Thompson Hill, of six books on regions of the West Coast, Sonoma Valley, Napa Valley, Santa Barbara and the Central Coast, Monterey and Carmel, Victoria and Vancouver Island, and Northwest Wine Country, as well as The People’s Law Dictionar,y The Encyclopedia of Federal Agencies and Commissions and several other books and numerous articles.