| Summary: | In this address, Dr. Bodemer outlines the history of medicine in the Pacific Northwest of the United States from early exploration by Europeans to the pioneer days of the nineteenth century, ending with the death of Doc Maynard in 1873, writing, "With the time of Maynard's death in 1873 we arrive at the modern beginnings of medicine in the Pacific Northwest." EARLY DEVELOPMENT OF MEDICINE IN THE PACIFIC NORTHWEST Address given to University of Washington Department of Medicine Fourth Annual Conference Seattle, Washington 18 February 1977 by Charles W. Bodemer Professor and Chairman Department of Biomedical History University of Washington School of Medicine Seattle, Washington i1I llKpIG-^; PG T!i3HP0.nV3q:|Y:J'^AP - n?>vr!^ ri-Ac^nv'-Y-trrn^ no:tnrr3a rn^I . ;;- /• ^:'::i; 'Vv^!ioC. rsyri^piA • • • r;;"!'"• • .':?'• y. 7 niT;u hn;;^ !.; :?n r'•/rjrCV^ •1 f}ip;:;ii';i;riv !H!£- : Y . npff'nrnB:^!'! to yy^p.ievynU • •• ••. • 91; io)rhoK 'in' rooibS; •nojD/:n'2BK • . . :arly developmcmt of hedicime in the pacific northwest Address given to University of Washington Department of Medicine Fourth Annual Conference 18 February 1977 by Charles W. Bodemer Thousands of years ago the first hunters crossed into America to settle on the Northwest coast. The tribes eventually developed a culture in which much attention was devoted to elaborating artifacts and highly complex patterns of behavior, and the men jockeyed for social rank by demonstrating their prov/ess as hunters. Pelts of the mild, but elusive, sea otter were the preferred dress for warriors of pretension. It was sea otter pelts and the native skill at securing them, combined v/ith dreams of empire and the lure of trade v/ith the Orient that led to the sudden eruption of Europeans into the North Pacific area during the eighteenth century. The northv/estern edge of North America vjas the last temperate zone coast line to withhold its secrets from European explorers. Spanish mariners played I a principal role in eliminating that hiatus of knowledge during the early modem period, in the process carrying Spain's empire to its greatest expansion. Con-quistadores reached the Pacific shore of New Spain in 1522, and within the year Cortez was instructed to search in the north for the Strait of Ami an, believed to connect the Pacific and Atlantic Oceans. This was consistent with the activi tics of most New World explorers at this time. Europeans of many nationalities dreamed of finding a more direct route to the Orient than around Afr ca, and the search for the fabled Northwest Passage dominates the early history of the Pacific Northv/est. 2. / The Spanish niaritiine expeditions dispatched to the Northwest coast during the sixteenth century reached no farther than the present southern boundary of Oregon, but their experience and that acquired through the trade route developed between the Philippines and Mexico helped to establish the opinion that scurvy v/as most likely in the cold and v/et higher latitudes. Spanish expeditions along the Pacific Coast during the seventeenth and eighteenth centuries always included priests, but rarely medical personnel. 'This v/as consistent v/ith the fatalistic instructions provided Spanish explorers to the north by their leaders, who remained in the south, that, should the men become ill, "They must suffer." And suffer they did. Few Spanish expeditions reached northern California before the ships* crew was too reduced by scurvy to continue, and no expedition returned from the Northwest v/aters with as much as a quarter of its crew fit for duty. This seemed proof that the northern climate was indeed dangerous, that scurvy was related to v/et and cold fog. The Spanish v/ere not the first to be discouraged by Northwest weather. Francis Drake sailed the Oregon coast in 1579, but the cold, rain, and what he passionately described as "ye stinking fogges" drove him southward to California, and for several centuries thereafter European nations essentially ignored the Pacific Northwest coastline. Spain, however, didn't exploit its early advantage, and increasingly overextended and demoralized by the efrects of scurvy on its northern expeditions, it turned elsewhere. Scurvy thus profoundly affected the extent of Spanish exploration and settlement, contributing to the evencual decline of Spain's influence in western North America. Scurvy affected also the course of Russian empire. In 1741, Vitus Bering undertook an expedition to ascertain the relation to America of the strait he had discovered earlier. The medical chest of the ship's naturalist and physician, George Steller, contained no remedies for scurvy. This might not have been dis astrous had Stcller's personality been different. The Russian expedition v/as 3. * plagued with trouble even before it departed the Kamchatka Peninsula. Squabbling among explorers was not uncommon, particularly on expeditions haunted by failure, but the Great Northern Expedition suffered from more than its share of the hard ships, frustrations and abrasive personnel differences. Steller deserves much of the blame. His relations with the Russian naval officers hindered and clouded the expedition, contributing to its disastrous conclusion. Steller was a good scientist and a competent physician. He \ms also impatient, •overbearing, pompous, egotistical, status conscious, pathologically hypei sentive, rudely arrogant, and supremely contemptuous of his fellows. He v/as scarcely more desirable as a travelling companion than a cholera bacillus. From the outset he quarreled v/ith the government, scientific bodies and the expedition s officers. The cause of his ire v/as usually the same: colleagues didn't shov/ him enough respect, i.e., they neither consulted him duly nor follov/ed his tendered advice." Steller was not a reticent man, and he offered advice to everyone on every sub ject. The naval officers reacted to his abrasive manner and lofty disdain for their knowledge and capabilities by thwarting his efforts, mocking his judgements and ignoring his advice. The effects of this attitude v/ere apparent by mid-summer, at which time disease and illness had begun to debilitate the expedition. In August a party went ashore to get water on Nagai Island, lying southeast of the Alaska Peninsula. Steller, who had bullied his v/ay into the landing paity, objected when hc'-observed the seamen filling the v/ater casks from stagnant puddles. They disregarded his remonstrations, an obstinancy that v/as of fatal consequence. Equally fatal v/as a subsequent event on Magai. Stellei wanted to gather berries and anti-scorbutic herbs, but his demand for assistance v/as re fused. He thereupon abandoned his medical obligations, petulantly recording in his diary: "When I saw my opinion concerning the water spurned and coarsely contradicted and had to hear myself like a surgeon's apprentice ordered to gather herbs, work not considered worth the labor of a fcvi sailors, I resolved that in the future I would only look after the preservation of my ov/n self." 5. % dent, and v/hen a trading ship cast anchor in Nootka Sound in 1787, he was among the first to clamber aboard. Emaciated, dirty, and dressed in greasy sea otter skins, McKay was indistinguishable from the natives. His Gaelic charm and gift of blarney had not rusted in the Northwest climate, however, and he was able to wangle a position as medical officer, soon departing Hootka and passing into history as the first resident practicing physician on the Pacific Northwest coast. ******** The Great Fur Rush had a determining influence upon the international balance of power and shaped the subsequent history of the Northwest. In the late eighteenth century the North Pacific lay open to the most aggressive pov/er. Ihe Spanish presence checked Russian expansion until the end of the century, but by 1810 the Spanish American empire was an edifice in ruins. As the v/estern portion of the continent slipped from Madrid's grasp, American leaders moved to prevent Britain and Russia from assuming control. The region that the Spanish had not appreciated enough to name more than '"the coast to the North of California" be came "Oregon," and Britain and the United States competed for its coast and hinterland. During the Spring of 1792 Captain Robert Gray, a Nev/ England trader in command of the Columbia, and Captain George Vancouver, commanding the British warship Discovery, sailed a few days apart along the Northv/est coast, Vancouver ostensibly on a voyage of exploration. Gray in search of furs. Interestingly, it v/as Gray, not Vancouver, who risked the bar and wall of breakers to enter the Columbia River. Gray's cool /ankee blood was not easily heated by explora tion without profit, and ho seems to have rejoiced more in the number of furs he acquired through his act of daring seamanship than the discovery of the mightiest river west of the Mississippi. But, recognizing Spain's receding pretensions,-he landed and, v/ith characteristic New England clarity, resolved the ambiguous ov/nership of the territory by claiming the entire valley of the Steller may be considered one of the reasons that in November, its rigging rotten and its deck strev/n with dead and dying men, the barelv-manned-St. Peter ran aground, and the crew was castaway on what is now Bering Island in the western Bering Sea. Bering, and perhaps some of Catherine's imperial ambitions, succumbed to scurvy on that island, but Steller survived to record his compre hensive picture of the natural life of the Bering Sea. He is remembered for his accomplishments as a naturalist, and he deserves eminence as a pioneer scientist. Steller is less praiseworthy, but noteworthy also as the first physician in the Northwest between California and the Arctic Circle. As Spanish influence north of San Francisco v/eakened and a Russian presence became manifest in the North Pacific, England became more aggressive in western North America. Eighteenth century Britain sought steady profits through peaceful trade. Hence it was not an unalloyed probe for discovery and glory, but calcu-- lated commercialism that brought Captain James Cook to the Northv/est in 1778. It's appropriate, then, that the great navigator made no discoveries, but stumbled into the Chinese market for Northwest furs. The accidental discovery that beaver skins purchased for trinkets sold for hundreds of dollars in Canton produced a rush for pelts and profits and launched the Pacific Northwest into new prominence. James Strange was one of the entrepeneurs stimulated to make an expedition in search of furs. His expedition arrived at liootka Sound from Bombay in July, 1786, complete with a scorbutic crew and an Irish surgeon named John McKay. When the expedition departed three weeks later both the disease and the surgeon were left behind. Strange had selected McKay to remain among the natives, instructing him to cultivate their friendship, study their language and customs, and convince them to save their pelts for his return a few months later. But Strange never returned, and the stranded McKay functioned as physician, colonist, trader and anthropologist among the Indians of Vancouver Island for more than a year. This was hardly the fashionable Dublin practice McKay had envisaged as a medical stu- 6. • / Columbia for the United States. Gray's action was"later exploited fully to pro vide the United States frontage on the Pacific Ocean and convert the young republic into a transcontinental power. Gray's expedition had no physician, and when the Columbia arrived at Mootka Sound from Boston the crew was suffering grievously from scurvy. The sick v/ere soon buried up to their necks in the soil of Vancouver Island in accordance with a quasi-magical treatment for scurvy. Vancouver's men, however, escaped this sub terranean remedium, their health reflecting the Royal Navy's adoption of kind's anti-scorbutic regimen and the ministrations of the Discovery's surgeon, Archibald Menzies. Menzies was trained and skilled in both medicine and botany. During Vancouver's four-year expedition Menzies allowed no crew member to succumb to disease and carried out extensive studies of Morthv/est flora. Menzie's name is associated with many Northwest plants, and he is renovmed 7s a naturalist. He is also notev/orthy as the lar-t physician known to have been on the Northv/est coast between 1792' and the second decade of the nineteenth century. Gray's voyages established the Yankee trade triangle, v/hich sent ships from Boston to the Northwest, where Massachusetts gimcracks were exchanged for furs later traded in Whampoa for silks, porcelains and tea for transport to Boston. The Revolution had deprived Americans of their trade, relations v/ith England, and, in need of a market, they flooded into the China trade, soon supplanting the British traders who had first developed it. The Yankee sea peddlers operated against a backdrop of an international contest of exploration, colonization and diplomacy in the Northv/est. Americans now glimpsed their destiny on the Pacific Ocean, and Jefferson spoke of developing a continent occupied by "a people speak ing the same language, governed in similar forms, and by similar lav/s." Indeed, events seemed to be moving quickly in that direction. The Louisiana Purchase, the Lewis and Clark expedition, and the establishment of the John Jacob Astor's fur_ enterprise, Astoria, at the mouth of the Columbia all broadened the American claim to the Columbia Valley. . • 7. % But the British v/ere busily strenthening their claims to the Pacific Horth-v/ est north of the 49th parallel, and they soon regained control of the Morthv/est country as a result of the overland fur trade. The overland fur traders entered the Oregon country from the East in search of beaver skins. Toward this goal independent British traders, organized as the North West Company, guided by the explorations of their men, Eraser and Thompson, established a chain of trading posts in the upper Columbia country. The Astorians competed with the Mor' Westers briefly, developing their own inland trading posts, but American fur enterprises v/ere doomed, and during the V/ar of 1812 Aster posts were abandoned and/or sold to the British. Its main competition a casualty of war, the North West Company expanded in all directions, and when the Company merged with Hudson's Bay Company, British dominance of the territory was complete. The merger of the two Beaver Kingdoms brought about the entrance of the first physician into the Morthv/est during the nineteenth century, the first resident physician after McKay of Van-couver Island. Dr. John McLoughlin v/as appointed Chief Factor for the Hudson's v— Bay Company territories west of the Rockies. Like the Company itself, McLoughlin dominated the history of the Pacific Northwest during the period 1824-1840. McLoughlin entered into a medical apprenticeship at the age of thirteen, yearning all the v/hile for the adventure and romance of a fur trader's life. When he completed his training, he associated himself v/ith the North West Company, and, practicing his profession as little as possible, demonstrated those adminis trative and trading skills leading to his appointment as head of the Columbia Department. It v/as not, then, a Marcus Vielby v/ho brought medicine into the Pacific Northwest in 1824, but a reluctant healer v/hose Magnificent Obsession was the fur trade. One of McLoughlin's first actions v/as moving the Company's main post from Astoria to a site designated Fort Vancouver on the north side of the Columbia. Several reasons underlay this action: Britain v/as v/illing to sacrifice the rest 8. of the territory in order to hold tlie region north of the Columbia, and it v/as therefore politic to locate the main post there; the location satisfied all other purposes of a post; and it v/as strategically situated relative to Puget Sound, the Willamette Valley, and the fur country through which the Columbia and Snake rivers flov/ed. * —^ Under McLoughlin's direction. Fort Vancouver developed into a large establishment of about 700 residents. He served as administrator and the only physician.- His first medical duties were relatively minor and not too distract ing. But it wasn't long before McLoughlin v/as seriously distracted by a patient load of impressive proportions. In 1829 the first of a series of epidemics spread along the Columbia and its tributaries. This epidemic v/as most violent in 1830 and persisted through 1832. McLoughlin was kept busy attending to both native and white sick. A clerk wrote that "the fever and ague v/as very prevalent at Vancouver, and as there v/as no other physician at the Fort, Dr. McLoughlin himself had to officiate in that capacity, although he greatly disMked it." And a disgruntled McLoughlin, his administrator's eyes on the account books, complained, "for a time, it put an entire stop to our business." The Spokane trading post still enjoyed its reputation as "a delightful place, celebrated for fine women and a pure and dry air most congenial to horses," but the epidemics in the Lower Columbia region during the 1830s gave Vancouver a reputation as "the greatest ague hole in Oregon," and its women and horses aren't even mentioned. It's difficult to identify the diseases McLoughlin and others at Fort Vancouver faced during these epidemics. Contemporary accounts consistently mention chills and fever, or ague, and the tever is referred to as intermittent or remittent. These terms, however, merely describe symptoms, and the accounts are meager in medical detail. One author refers to "chills and fever ending, in a low typhoid;" another says the symptoms consisted of "general coldness, soreness and stiffness of the limbs and body;" yet another includes a 9. % skin rash in the symptomatology. Accounts of the efficacy of specific thera peutic agents do little to clarify the issue. One author remarks that "quinine and other ague remedies had no effect upon the sick," whereas another, writing at the same time, says that they "were wonderfully aided by the medicines." In brief, it's not possible to designate precisely the diseases ravaging the lower • Columbia region during the 1830s. The available evidence suggests, hov/ever, that, with influenza and dysentery lurking in the background, in the early epidemics typhus and malaria were the main killers, and malaria was the primary moiety of the later epidemics. It's quite unlikely that McLoughlin concerned himself with the nosological niceties of distinguishing typhus from malaria in those years when he was the only physician at Vancouver. Intermittent fever and fever and ague included both diseases at the level of practical therapeutics, and he treated the fever with quinine or a decoction prepared from dogwood bark. Vlhat he did concern him self v/ith was relief from the immediate concerns of medicine, urging the Company to send qualified medical personnel to assist in meeting the medical needs of the Columbia Department. The Hudson's Bay Company responded by dispatching Drs. William Tolmie and Meredith Gairdner, and after they arrived from London in 1833, I the only contact McLoughlin had with medicine was the title before his name. It's uncharitable to assume a causal relationship, but after McLoughlin-stopped practicing medicine, epidemic disease in the Vancouver region declined, and by 1841 the Willamette Valley was considered quite healthy. It was also quite empty, for the epidemics h?d, in one author's words, "raged v/ith such virulence as wholly to depopulate certain sections. The epidemics had caused great suffering and death among the v/hite population; they exacted a terrible toll among the Indians and substantially influenced the subsequent development of the region. For oven as the Indian population v/as rcourned by disease and McLoughlin eagerly awaited the arrival of Drs. Tolmie and Gairdner, the fur 10. trade v/as declining, and events determining the future of the Pacific Northv/est •• * were unden-zay. ******** Christian missionaries had long been in the forefront of New World settle ment, and seldom had the impulse to heed the Macedonian Call been felt more keenly than early in the nineteenth century. Thus it was that the vast, un settled Oregon country became an arena where gladiators of the cloth struggled for the souls of the Far Western Indians, and, while they were about it, under took to relieve them of the responsibilities of real estate management. I A visit of some Northwest Indians to St. Louis catalyzed action during the 1830s. The Indians were probably in search of magicians wfio v/ould help them acquire the material elements they associated with v/hite culture, but their visit was interpreted as a plea for Christian missionaries and spiritual salvation. The Methodists v^ere the first to atone for their apparent negligence, sending a Oason Lee and a small group to found vhe first Protestant mission in the Willa mette Valley in 1834. This mission became the nucleus of American colonization and the center of attraction for future settlers. Lee believed devoutly in God's design, and he was convinced that God was in favor of good, sound majorities. Hence, he worked toward advancement of the settlement and in the East promoted the wonder of the Oregon country and the desperate need for Christian settlers. Soon Americans were crossing the plains to establish v/hite Christian civilization in the Willamette Valley, where it is rumored to exist even today. The eventual impact of this development upon McLounglin's life was unfor tunate. Some of the new settlers were determined to set up a competitive fur trade, and McLoughlin's generosity in meeting their needs eventually caused the Company to request his resignation. Accordingly, he left Hudson's Bay Company in 1846 and established a general merchandise store in Oregon City. McLoughlin had wisely laid claim to some fertile land in that area, but some immigrants laid n. successful counterclaims, maintaining that as a Canadian he was not entitled to that land. Thus John McLoughlin, whose labors enabled settlement of the Oregon country, who had helped many hungry and ragged immigrants to survive, the first truly resident physician in the Pacific Northv/cst, and a man considered by many as the father of Oregon, died in Oregon City in ICS?, with few possessions and no land in his name. Some /Americans headed for Oregon after reading The Far Vfest, by the Reverend Samuel Parker, who, like Lee, subscribed to the principle that civilization follows Christianity. Parker v/as a persuasive man, who had opportunity to display his peerless recruiting abilities in 1834, v^hen he encountered Marcus Vlhitman, then practicing medicine in Viheeler, New York. Whitman had previously been rejected as a medical missionary for reasons of health, but Parker recommended him to the American Board of Commissioners for Foreign Missions. The Board, representing the Presbyterian, Congregational and Dutch Reform Churches, appointed Vlhitman as a missionary to the Indians of the Oregon country. In a neighboring village Parker encountered Marcissa Prentice, a young v/oman interested in missionary v/ork among Indians. Parker considered her a potentially outstanding missionary, but the Board wanted to establish white settlements among the Indians and therefore opposed appointing unmarried missionaries. The obvious solution to this dilemma resided in Parker's suggestion that Whitman visiv Miss / Prentice. Marcus did introduce himself to Marcissa, and within days, with true missionary zeal, she agreed to marry and accompany him to the Oregon country. Parker and Whitman set out immediately with a company of fur traders to deteniiine whether the Indians west of the Rockies were indeed eager to embrace Christianity. At a rendevous with Flatheads and Mez Perc(^ at the Green River, Vlhitman.was easily convinced that the Indians desired missionaries, and without further investigation, he returned Fast to marry Marcissa. The following year^ 1836, the Whitmans established a-station among the Cayuse Indians at Vlaillatpu, 12. / near Walla Walla. Whitman practiced much medicine 'and considerable dentistry at his mission. He v/as alv/ays busy attending the sick, and," constantly on call to treat the Indian sick, he competed.with their medicine man. This posed certain problems. With that clarity of self-interest often characteristic of shamanism, the native practitioner refused what he considered incurable cases; Whitman, hov/ever, considered such action un-Christian and undertook their treatment, thus providing the more suspicious Indians ample opportunity for impunging his m.otives or skill. In 1840, the first immigrant v/agon reached Waillatpu with a small" group of American settlers. The follovnng year 24 people arrived, and in 1842, 114 im migrants stopped at the station. Waillatpu was a rest stop for the immigrants^ who usually arrived exhausted and without food. Thus it disturbed Vihitman to learn in 1842 that the American Board intended to close the station. He went East to dissuade the Board, convincing them that the station v/as essential to immigrants, -v/ho were, in turn, vital to transmission of v/hite Christian civili zation to the Indians. Proceeding to Westport, Missouri, where the 1843 migra tion 'was assembling. Whitman gathered about a thousand people into a train bound for Oregon. Although one might disagree with enthusiasts who maintain that Oregon v/ould have remained permanently in British hands if llhitman had not brought the huge group to the Territory in 1843, it is undeniable that this migration opened the Oregon Trail. For America the nineteenth century was the time of Manifest Destiny. To many Americans the map of the United States at mid-century looked incomplete. This disquiet, the easy availability of land, and official encouragement to settle the wilderness, combined to provide philosophical justification for the Westward movement. As stated in a newspaper editorial of 1846, the*massive migration and occupation of the V/est, "seems to be completing a more universal design of pro vidence by extending the power and intelligence of an advanced civilized nation 13. over the whole face of the earth, by penetrating into those regions which seem fated to immobility, and by breaking down the barriers of the future progress of knowledge of the arts and sciences." To the Nez Percd and Cayuse near Waillatpu the concept of Manifest Destiny was painfully manifest in a flood of white immigrants. Already apprehensive of the future, the Indians were dismayed v/hen fifteen hundred people arrived at Waillatpu in 1844, and they were enraged when twice that number appeared the follov/ing year. This anger v/ould contribute to the subsequent events that would determine the fate of the Indians, Whitman, and the Oregon Territory. In 1844 a white man killed one of a group of Waillatpu Cayuse Indians searching for. cattle in California. When, upon their return, no action followed their demand for justice, a war party departed for California to avenge the Indian death. En route almost thirty of the party died from measles, and the survivors returned without accomplishing the purpose required by custom. All the tribes in the V/aillatpu region were furious, and Whitman became a potential surrogate victim. The arrival of the 1847 migration a few months later signalled the beginning of an unusually severe measles epidemic that sealed Whitman's fate. The Indians noticed that most of the whites recovered from the measles, whereas most of the afflicted Indians died, and they concluded that V-'hitman was poisoning them in the guise of treatment. This final grievance catalyzed action, and thus it v/as that in Nuveinber, 1847, the V/hitmans and fourteen other whites at the Waillatpu station were killed in an Indian attack. The Mission stations of the American Board were abandoned permanently after the Vlhitman massacre, and the missionary period in Northwest history came to a close. One might argue the effect of '.'hitman's and other Protestant missions upon the Indians. There is little doubt, however, about the effects of Whitman's aid to the American immigrants or the encouragement provided the westward move ment by his demonstration that families could reach Oregon overland. VJhitman's 14. * death, too, had its effect. In 1846 the 49th parallel was established as the boundary between Western Canada and the United States, but the question of free and slave territories delayed establishment of a government in Oregon. Reaction to the Whitman Massacre of 1847 was highly instrumental in activating the dead locked Congress to creation of the Oregon Territory the following year. The Roman Catholic Church, with three centuries of New World m.issionary experience, was not idle during the period of Protestant proselytism. To meet the spiritual needs of the many French Canadians in the Oregon country and to share with the Protestants in planting the faith among the natives, the Church sent Fathers Blanchet and Demers to Oregon in 1838, where they established (j[L^ } ^ . missions onthe Cowlitz and Vlillamette Rivers, extending their activities east ward into the Cayuse country and northward to Vancouver Island. Also heeding the call were the black-robed Jesuits, who entered the Oregon country in 1840. Among the latter was Anthony Ravalli, v/ho had studied medicine at the University of Padua and had come to the Pacific Northwest via Cape Horn in 1843. He settled ultimately at St. Mary's Mission in western Montana, where he became widely known for his medical treatment of Indians and v/hites. Medical missionaries were more common within the Protestant denominations. Father Ravalli was the exceptional Jesuit, and generally Roman Catholic missions had no medical orientation at all. But as the population grew, there was a clear need to provide some social services in the Northwest, and the Jesuits enlisted the aid of the Montreal Sisters of Charity of Providence, five of whom began their ministry at Fort Vancouver in 1856. Two years later the Sisters were asked by a community group to care for a homeless and tubercular young man. The Sisters were willing, but they had no place to house him, and so was conceived the idea of building a small hospital. The lead fell to Mother Joseph of the Sacred Heart, the Superior of the small band of Providence Sisters. This remarkable woman, the daughter of a Quebec 15. farmer and carriage maker, could liandle more than a rosary. With equal facility she could do iron woric, v/ood carving, and delicate embroidery, perform carpentiy, lay bricks, and make candles. Examples of her v/ood-carving still decorate many Providence hospitals, schools and chapels. In 1953, the American Institute of Architects designated her as the first architect in the Pacific Northwest, and she has been recognized as the first northwestern artist to work in the medium of wood. Certainly she v.'as an early advocate of do-it-yourself: if she didn t 'have it, she designed it, and she built it. Energetic and strong in body and will, Mother Joseph designed most of the early schools and hospitals and worked alongside the builders. The personality bciiind Washington Territory's first hospital emerges in a description of her style as architect and general contractor: "Every evening after the workers went home, Mother Joseph made a meticulous inspection of the day's work, climbing ladders to test the beams .or prying under flooring to check the foundation. She was always k*nov/n as a taskmaster. It had to be well done; there was no sucn thing as tawdry or mediocre construction. She had been known to disassemble brick chimneys not built according to specifications, and to reconstruct them herself from the foundation, to the amazement of the workers who returned the next day." At Vancouver, with one workman. Mother Joseph installed a timber ceiling in a small building she had just built to serve as a laundry and bakery. The walls and ceiling were covered with muslin fabric and wallpaper; four beds, four bedside tables and a couple of chairs were installed, and, in June, 1858, St. Joseph Hospita/opened its doors. The combined efforts of humanitarian people and a religious order in a frontier community had created the first oerinanent hospital in the Pacific Northwest. ******** . . 16. Among the immigrants arriving in the Oregon Territory in 1B44 Was a black man, George Washington Bush. Soon learning that the Oregon provisional govern ment had enacted a law excluding blacks from its jurisdiction, Bush and the wagon train leader, Michael Simmons, assisted by McLoughlin, crossed the Columbia River to settle in Tumwater and begin settlement of v/hat is now Washington State. It v/as lonely for a while. The V/hitrnan Massacre and the discovery of gold in Cali fornia in 18^8 so interr^upted the flow of settlers northward that in 1849 only •304 v/hite people resided north of the Columbia. Later that year, however, un successful prospectors returning from California told of the great need for lumber and food in the Gold Fields, and people hurried to the Puget Sound area in such numbers that the census for 1850 showed 1,049 white inhabitants north of the Columbi a. Aphysician was there to urge them on. In 1848 Richard Landsdale departed o/tMs for California and gold. Physicians generally used their medical skills to under-v/ rite the expenses of the transcontinental trip. But to Landsdale, professional fees were little more than "seed money" for financial dealings on a more grand scale. His were the perceptions of the urban planner and the instincts of the real estate developer, and he therefore bought land, platted towns, and sold lots to people ready to settle along the route to the Pacific. In keeping with this pattern, Landsdale crossed the Columbia in 1850, bought 160 acres and platted the town of Vancouver, selling the lots and opening an office for medical practice. He subsequently helped to organize several counties and. held various public offices, maintaining also a general practice until 1854, when he v/as appointed Indian Agent. Afew years later, while on government business, he attended lec tures at the City College of New York, receiving the>^e the H.D. degree, an item he had Tacked during His thirty years of medical practice. Landsdale retired to manage his substantial real estate holdings, a good example of the successful physician-entrepeneur whose intelligence, energy and business acumen gave spirit to the inniigration patterns and the early organization of the Far West. 17. Once westward migration was underweigh the Prairc Schooner replaced the China Clipper as the primary shaping element of the Pacific Northv;est. Few wagon trains included physicians, and the thousands of emigrants relied upon their own skill, books, and assorted medical kits. "Every man," wrote a physician accompanying a train in the 1850s, "had a package of drugs and nos trums. with written directions for use. sometimes consisting of blue pills, a little ipecac and opium, together with a bottle of peppermint, pain killer and somebody's sovereign remedy for all ills." Some wagonmasters v/ere famous for their medical abilities. Tetherow. who relied heavily on wild ginger tea to effect his cures and advised on dosage, "Always git all you can, but use what you can git." And when achild's rasping cough troubled the night, Sol spooned in his mixture of boiled licence root, syrup of skunk cabbage root, tincture of lobelia and Balm of Gilead, a truly wondrous amalgam of expectorant, diaphoretic, antispasmodic and sedative properties, confident that his little patient, dosed to the gills, v/ould soon doze off, allowing the rest of the wagon train to get some sleep. Physicians, like others who took the trails west, did so for various reasons. Some looked for adventure. Some traveled west for their health. Others sought gold and land. Some looked for quick profit. Dr. desse Cunningham, for example, drove 4,000 sheep, purchased at IH a head, across the Oregon Trail and sold for a $40,000 profit. Some searched for aMew Start. Such was David Maynard. one of the most colorful and important physicians in the history of the Pacific Northv/est. Maynard was a Verraontcr. who used his marriage in 1828 as a signal to move to Clevel.,nd. then acity of 5,000. Intelligent and energetic, Maynard was sus ceptible to grand profit schemes and he undertook avariety of financial enter prises in Ohio, including the establishment of amedical school. The financial crash of 1837 caused bank closures, bad trade conditions, and a money shortage. 18. » Unfortunate conditions for most people, for men like Maynard, impulsively gener ous and rather careless of the morrow, these v/ere catastrophic conditions. Typically, Maynard, who hated to bill his patients, but was curiously receptive to co-signing their promissory notes, had endorsed other men's business enter prises, and their failure in the crash ruined him financially. Fifty thousand dollars in debt, he looked tov/ard California as a region of hope and future wealth, his wanderlust fortified by what he deemed the increasingly shrewish behavior of his v/ife. Thus in April, 1850, Maynard gathered a mule, a rifle, a buffalo robe, some books, a few medicines and his surgical instruments, and left Ohio, recording a single entry in his diary: "Left home for California." ^ The transcontinental journey was a difficult one for everyone, challenging •the physical resources of men and animals, and accompanied by constant suffering, dirt, and disease. One physician v/ho made the trip v/rote, "Sickness, often visited the emigrants. The preva-Hing diseases were bilious fever, which often assumed a typhoid character, pleurisy, pneumonia, and scurvy, and besides them vvere many other incidental ailments which were excited into action by exposure, insufficient and improper food and overexertion. Many suffered from rheumatism and ophthalmia. Scurvy was a prevailing disease, often as a complication, and diarrhoea and dysentery were prevalent." The dreaded scourge of the v/agon trains, however, was cholera. In 1850 it accounted for approximately three thousand deaths on the Oregon Trail alone, and there were several stretches of about sixty miles where the markers of cholera graves lined the Trail like a picket fence. Few physicians suspected the v/ater supply; the prevailing assumption was that the disease resulted from contagious atmospheric miasmata. V/hatever the presumed etiology, treatment was generally crude. Among the emigrants a most popular treatment was brandy and cayenne pepper; the more scientific physicians used v/hiskey or Perry Davis Pain Killer with the cayenne, and some mixed this nostrum with calomel. Maynard provides some idea of the efficacy of these treatments in 19. / % his diary notation that v/hen he contracted cholera on the Trail, he dosed himself with calomel, and added v/ith the realism born of practice that he recovered be cause nobody meddled v/ith him. The forty-two year old Maynard bore the Transcontinental journey well, but instead of arriving at the California Gold Fields he ended up at the southern tip of Puget Sound. Maynard was no Magellan, but the navigational dislocation of approximately a thousand miles in this case was deliberate. His diary entries provide the clue to his change of direction. On 7 June 1850, near Fort Kearny, Maynard stopped to attend some cholera victims in another wagon train. Nonetheless, three of the afflicted died before morning, one leaving a comely widow, whom i • Maynard described as "ill both in body and mind," and in need of "doctoring." Thus, after rejoining his own party during the morning, Maynard returned to the other train and travelled with it until night. Maynard's next diary entry reads, "I made arrangements to sfiift my duds into the widov/'s v/agon in the morning. Maynard clearly intended to provide a variety of medical care which is perhaps best termed comprehensive.' The I'/idow Broshears, to whose v/agon Maynard shifted his duds, was travelling to join her brother, Michael Simmons, v/hom we last encountered accompanying George Bush across the Columbia. The good doctor was obviously smitten, and • there, on the plains of Nebraska, he forsook the gold and sunny skies of Cali fornia for the Widow Broshears and the soggy skies of Puget Sound, confident, with the poet, that "love is nature's second sun." Maynard accompanied the Widow to the Simmons farm in Tumv/ater, where he enjoyed sleeping in a bed, eating good food, and talking with the Vlidow Broshears, who was beautiful, or to her sister-in-lav/, who was not. Simmons, h-Mvever, disturbed this scene of bucolic sublimity. He reminded Maynard that he was married, and suggested forcefully, once from the butt-end of a shotgun, that Maynard hurry south before all the California gold was gone. Considering this 20. an offer ho couldn't refuse, Maynard canoed north, in search of a gold strike. He succeeded only in losing a skillet, and "broke, busted, tired and disgusted," he returned to the lower Puget Sound, bought an axe and cut wood through the summer of 1851. In the autumn, the physician and four hundred cords of wood were on a ship bound for San Francisco and a new venture. Maynard sold the wood and with the proceeds bought damaged goods at auction. He then returned to Tumwater and sold the goods at half rates. Maynard's concept of business v/as unusual, even by frontier standards, and he had long subscribed to the injunction, "Drink no longer v/ater, but use a little v/ine for thy stomach s sake." This often resulted in the exotic business practice of giving away his goods tov/ard the end of the day, when the full effect of the grape was upon him. The competing merchants of Tumwater shed no tears v/hen Maynard left in 1852 to help found the future city of Seattle. The first building erected there was Maynard's log cabin, from which he practiced capitalism, boosterism, and medicine. The first year Maynard undertook to supoly San Francisco with Puget Sound fish, packing and shipping a hundred barrels of salmon to that city. They were, however, badly spoiled when they reached California, and Maynard's dreams of profit came to an odoriferous end. He gained some historical distinction, though: "With this venture Maynard became the first salmon packer and the first business failure in the northern Puget Sound. When the Territory of Washington v/as created, Maynard, v/ho had been a delegate at the convention, was named Auditor and Notary Public of King County, and his Seattle claim was designated the county seat. Thus, duly invested with new offices and, by virtue of a dubious Territorial divorce bill, duly divested of his Cleveland wife, Maynard married the Widow of the Vlagon and began to occupy himself with various administrative matters, marriages, prosecutions, trials, supervising the school district, managing a store, practicing medicine, opeiating 21. a hospital, and manning a blacksmith shop. It's not surprising, then, that Seattle originally developed on Maynard's claim. Despite his vigor and various activities, Maynard's fortunes fluctuated between calamity and cataclysm. He had a tendency to give away his land, especially when he viev;ed the world through booze-colored glasses. Once, Maynard, whose total agricultural experience v/as acquired on the Oregon Trail viewing the eastern ends of oxen pulling a wagon v/est, sold most of his Seattle land and attempted to farm three hundred acres outside town. There, with a beautiful view of Puget Sound, he almost starved to death, and he had to sell the land at great loss and return to Seattle. He now practiced medicine, operated a hospital, and a few doors down the street, maintained a law office. Still he didn't fare well, and he became increasingly dedicated to the bottle. His sobriety was not advanced v/hen his Cleveland wife arrived one day to contest the "no-questions-asked" Territorial divorce and moved in with Maynard and the second Mrs. Maynard. For some months he managed to survive this menage § trois with some humor, but his claim to ownership of the little bit of land still in his name didn't survive the divorce litigation. When he died, appropriately enough from liver disease, he was a poor man. None- • theless, it was recognized by then that Maynard was an important force in the development of the Washington Territory, the Puget Sound region, and Seattle. With the time of Maynard's death in 1873 we arrive at the modern beginnings of medicine in the Pacific Northwest. The area once so shrouded in secrecy, silence and ignorance that Swift located Brobdingnag of Gulliver's Travels there, and even in the nineteenth century could accomodate Jules Verne's 500 millions of the Begums, now began to develop toward its modern form. American society gradually transformed from a collection of rugged, often eccentric, individualists to the homogeneity of mass man, and the day 22. of the entrepreneur who also, perhaps Incidentally, dispensed medical care of varying quality, came to an end. In slightly less than one hundred and fifty years medicine in the Pacific Northwest developed from isolated men associated directly v/ith the fur trade into a wide-spread health care system involving thousands of physicians alone. En route, medical care was provided by men of God, who were equally concerned with the salvation of men's souls and bodies, and by frontier physicians, men of dissimilar backgrounds and varying medical abilities, not totally disinterested in gold or glory. Assessed by some as drunken scoundrels, the American equivalent of the British remittance men in India, the frontier physicians, many of v/hom were admittedly inspired by thoroughly non-Hippocratic motives, brought organization and leadership, and sometimes culture, into the burgeoning Far West where there was precious little of these commodities. One can't honestly ascribe to the majority of them an impressive medical savoir-faire. But medicine in the mid-nineteenth century was hardly triumphant anyv/here, and it shouldn't detract from the recognition of the genuine contri bution these pioneers made to the establishment of medicine in the Far Western United States. They provided care'for the sick, created hospitals, and organized the medical profession, preparing the ground for the establishment of modern medicine and its facilities during succeeding decades. Furthermore, the non-medical activities of these pioneer physicians v/ere often more vital than their professional activities. It's safe to say that scientific medicine developed quite independently of these men; their western communities might well not have. We mentioned only several such men, but there are few, if any, older Northwest communities that don't locate a physician in a prominent position in their early history. The role of the early physicians was much greater than that of healer. They brought to the emerging frontier intelligence, energy, leadership and vision. The fact that their species v/on't be seen again is scarcely a mortal blov/ to medical science. And, yet, their total contri bution was such as to suggest paraphrasing the words spoken at Dr. Maynard's funeral: "Without them the Northv/est will not be the same; without them the Northwest would not be the same; indeed, without them the Northwest might not be." 23 <y irn /L<. Js6: /^/^ V^*-V»< «*-««- ^ ^yi,aU /H YI ^ C-K^ Ayzf'i- tA^' C=/5^ c^ C'-dy^ 0It trw £»Tcy/ e-v* <"r— /a^ A-
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