| Summary: | In this address, Dr. Bodemer outlines the history of medicine in the developing Pacific Northwest, from early European exploration, through its exploration by the Russian empire in the 18th century, to the time of American westward migration in the 19th century. He writes, "Medicine in the developing Pacific Northwest, like medicine anywhere at any time, reflected the social milieu in which it occurred. It passed through stages appropriate to those of the emerging territory, and, like the region itself, at the beginning of the twentieth century, its modern character was established. The explorers, the mountain men, the missionaries, the gold-hungry doctors, and the pioneering physicians were all part of medicine in the developing Pacific Northwest, and they all made their contribution--something else we all too often forget." MEDICINE IN THE DEVELOPING PACIFIC NORTHWEST An address to the North Pacific Society of Internists 14 September 1979 Salishan, Oregon by Charles W. Bodemer, Ph.D. Professor and Chairman Department of Biomedical History School of Medicine University of Washington Seattle, Washington 98195 MEDICINE IN THE DEVELOPING PACIFIC NORTHWEST An address to the North Pacific Society of Internists 14 September 1979 Salishan, Oregon by Charles W. Bodemer Historically, the Pacific Northwest has tended to run according to a different clock than the rest of the world, and, like the White Rabbit, has always been a little late. Indeed, it can be argued that on the day the world ends, the Pacific Northwest will have another year to go. It's appropriate, then, that the northwestern edge of North America was the last temperate zone coastline unknown to European explorers. The Spanish were the first to attempt to eliminate this gap in geographical knowledge, for soon after reaching New Spain in 1522, Cortez initiated a search for the northern Strait believed to connect the Pacific and the Atlantic Oceans. Europeans wanted a route to the Orient more direct than around Africa, and the search for the fabled Northwest Passage, beginning with the Spanish, dominates the early history of the Pacific Northwest. Disease influenced the course of exploration and empire in the Northwest. More concerned with souls than symptoms, Spanish maritime expeditions included priests, but seldom any medical personnel, This was consistent with the instructions given explorers to the north by their leaders, who wisely remained in the south, that, should the men become ill, "They must suffer." And they did suffer. Few Spanish expeditions reached northern California before the ships' crew was too reduced by scurvy to continue, and no expedition returned from Northwest waters with even one-fourth of its crew fit for duty. This seemed proof that the northern climate was dangerous, that scurvy was associated with wet and cold fog. The Spanish weren't the first, nor the last, to be discouraged by Northwest weather. Francis Drake sailed the Oregon coast in 1579, but the cold, the rain, and what he passionately described as "ye stinking fogges" drove him southward to California. For several centuries after that European nations essentially ignored the Pacific Northwest coastline. But Spain didn't exploit its early advantage, and, increasingly over extended and demoralized by the effects of scurvy on its northern expeditions, it turned elsewhere. Scurvy profoundly affected the extent of Spanish exploration and settlement, and the disease contributed to the eventual 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 determine the relation to America of the strait he had discovered earlier. The medical chest of the ship's physician, George Steller, contained no remedies for scurvy. This might have been unimportant had Steller's personality been different. Squabbling among explorers wasn't uncommon, particularly on expeditions haunted by failure, but the Great Northern Expedition had more than its share of personnel differences. Steller deserves much of the credit. Steller was a good scientist and a competent physician. He was also impatient, overbearing, pompous, egotistical, status conscious, pathologically hypersensitive, rudely arrogant, and supremely contemptuous of other people. As a traveling companion he was scarcely more desirable than a cholera bacillus. From the beginning he quarreled with the government, scientific bodies and the expedition's officers. The cause of his anger was usually the same: he wasn't shown enough respect; that is, his colleagues neither requested nor followed his advice. Steller was not a reticent man; he had opinions on everything, and he offered advice to everyone on every subject. The Russian naval officers responded to his abrasive and superior manner by ridiculing his judgments, frustrating his efforts, and ignoring his advice. The results of this attitude were apparent by mid-summer, when disease and illness began to weaken the expedition. In August a party went ashore to get water on an island near the Alaska Peninsula. Steller, who had bullied his way into the group, objected when he saw sailors filling the water casks from stagnant puddles. The officers disregarded his objections, and later that day they refused his demand for assistance in gathering berries and anti-scorbutic herbs. Steller then abandoned his medical duty, 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 few sailors, I resolved that in the future I would only look after the preservation of my own self," Steller is one reason that in November, its rigging rotten and its deck covered with dead and dying men, the barely-manned St, Peter ran 4 aground, and the crew was castaway. Bering and some Russian imperial ambitions died from scurvy on what is now Bering Island. Steller survived to write a comprehensive account of the natural life of the Bering Sea. He is recognized as an important naturalist. He's never been a candidate for the medical Hall of Fame, but Steller deserves some note as the first physician in the Northwest between California and the Arctic Circle, * * * As Spanish influence north of San Francisco weakened and a Russian presence grew in the North Pacific, England became more aggressive in western North America. Eighteenth-century Britain was interested in steady profits through peaceful trade, and it was this that brought Captain James Cook to the Northwest in 1778. Cook made no discoveries, but stumbled into the Chinese market for Northwest furs. His accidental discovery that beaver skins purchased for trinkets sold for hundreds of dollars in Canton produced a rush for pelts and profits that launched the Pacific Northwest into new prominence. One expedition arrived at Nootka Sound from Bombay in 1786, complete with a scorbutic crew and an Irish surgeon named John McKay. When the expedition left three weeks later, both the disease and the surgeon were left behind. For more than a year the stranded McKay functioned as physician, colonist, trader and anthropologist among the natives of Vancouver Island. This was hardly the fashionable Dublin practice McKay had pictured as a medical student, and he was the first aboard the first ship arriving in Nootka Sound. McKay left Nootka, entering history as the Pacific Northwest's first, if involuntary, resident physician. The Great Fur Rush, of which McKay was a part, had a determining Influence upon the subsequent history of the Northwest. In the late eighteenth century the North Pacific lay open to the most aggressive power. The Spanish presence checked Russian and at least tempered British expansion until the end of the century. But by 1810 the Spanish-American empire was In ruins, and American leaders moved to prevent Britain and Russia from assuming control of the western portion of the continent. Thus, the region that the Spanish had not appreciated enough to name more than "the coast to the North of California" became "Oregon," and Britain and the United States competed for Its coast and hinterland. * * * In 1792 Captain Robert Gray, In command of the Columbia, and Captain George Vancouver, commanding the British warship Discovery, sailed a few days apart along the Northwest coast. Interestingly, It was Gray, not Vancouver, who risked the bar and huge breakers to enter the Columbia River. Gray was pleased more by the furs he acquired through his daring seamanship than the discovery of the mightiest river west of the Mississippi. But, recognizing Spain's receding pretentlons, he landed and, with char acteristic New England clarity, resolved the ambiguous ownership of the territory by claiming the entire valley of the Columbia for the United States. His action was later exploited fully to convert the young republic Into a transcontinental power. Gray's voyages established the Yankee trade triangle, which 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 Yankee sea peddlers operated against a backdrop of an international contest in the Northwest. Americans now saw their destiny on the Pacific Ocean, and Jefferson spoke of developing a continent occupied by one people. Events did seem to be moving in that direction, as the Louisiana Purchase, the Lewis and Clark expedition, and the establishment of the Astor fur enterprise at the mouth of the Columbia all broadened the American claim to the Columbia Valley. The British, however, soon gained complete control of the Northwest country as a result of the overland fur trade. The Lewis and Clark Expedition had revealed the lucrative resource of the far Northwest, reporting that the area "is richer in beaver and otter than any country on earth." There was new reason for British and American interests to compete for control of the Oregon country and what was shown on maps as the Great American Desert. The Northwest Company early established a British presence,its network of trading posts extending west beyond the Rockies into the Lower Columbia Basin giving them control of the Upper Columbia fur trade. In 1821 the Company merged with Hudson's Bay Company, and the newly organized Columbia Department included what is now Oregon, Washington and northwestern Montana. As an instrument of empire the fur trade gave the British control of most of the Oregon country. Until 1846, when they ceded to the United States land below the 49th parallel, British dominance of the Pacific Northwest was virtually complete. It was personified In Dr. John McLoughlTn, Chief Factor of the Columbia Department from 1821 to 1846. For a time McLoughlin was the only bona fide physician In the entire Pacific Northwest. His presence, however, was entirely Inconsequential to the fur trappers scattered throughout the immense wilderness. In fact, few things were consequential to these free souls. The average fur trader was a businessman with the charisma of an adding machine, but the trappers--the beginning point of the system producing the beaver hats, fur linings and trimmings of nineteenth century fashion—they were colorful. The exploits of mountain men like Jedediah Smith, Kit Carson and Hugh Glass captured the public imagination and placed them in the national mythology. They spent most of their lives alone or in small parties hundreds of miles from civilization and provided their own medical care. Their medicine was as rough-and-ready as their tumultuous--one might say bacchanalian—annual rendezvous at such places as Grande Ronde, the Upper Green, Snake or Bear Rivers. The trappers adopted some Indian medicine, but whiskey was the sovereign remedy, 100 proof against the common cold, rheumatism, and impure thoughts. It was also the routine anesthetic. Herbs, poultices, sweat-baths, a hunting knife, and, especially, whiskey: with these and an incredible sang-froid the mountain men faced disease and injury, generally alone in the wilderness. It seems not much more was necessary. Ashley reported that the mountain men suffered only from "slight fevers produced by colds or rheumatic afflictions." Their isolation certainly promoted their health; the influence of their diet can only be estimated. Mountain men substituted cherry root tea for coffee and ate thinly sliced bread root sprinkled with gunpowder. Their primary diet was fresh meat. This meant, an early physician wrote, "Panther meat, then beaver tails boiled, unborn buffalo calves before they hair over, rattlesnakes like a long chicken neck only thinner, skunks and goats. Then there is buffalo. 8 The whole critter, mind you, barring hide, hair, horns and hoofs, the cow's insides for choice marrow, lights, heart and tongue, warm liver spiced with gall, and best of all, guts—plain guts--and raw at that." The mountain men thrived on such a diet. In one four-year fur expedition in the Northwest, Ashley didn't lose "a single man by death except those who came to their end prematurely by being shot or drowned." Garden-variety disease was apparently no match for the mountain man, * * * McLoughlin was the first truly resident physician in the Pacific Northwest, but it was no Marcus Wei by who brought medicine into the territory. It was, instead, a reluctant healer, whose true love was pelts rather than pills. McLoughlin's grandfather dragged him kicking and screaming into a medical apprenticeship at the age of fourteen. He had always dreamt of the romance and adventure of the fur trade and thus, when he completed his training he associated himself with the Northwest Company. Practicing his profession as little as possible, he quickly demonstrated the business skills leading to his appointment as head of the Hudson's Bay Company Columbia Department. McLoughlin established the Company's main post on the north side of the Columbia, and Fort Vancouver soon developed into an establishment of about seven hundred residents. At first, McLoughlin's medical duties were not distracting. It wasn't long, however, before he faced a patient load of impressive proportions, for in 1829 the first of a series of typhus and malaria epidemics spread along the Columbia and its tributaries, A clerk wrote that "as there was no other physician at the Fort, Dr. McLoughlin himself had to officiate in that capacity, although he greatly disliked it." McLoughlin's major comment on the epidemic was typical; "For a time," he said, "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 1830's gave Vancouver a reputation as "the greatest ague hole in Oregon," and its women and horses aren't even mentioned. McLoughlin, however, was more concerned about relief from his medical obligations, and he repeatedly requested medical personnel for the Columbia Department. Drs. Tolmie and Gairdner arrived from London in 1833, and after that McLoughlin's only contact with medicine was his title. It had taken thirty years, but he was finally out of the profession. It's uncharitable to assume a causal relationship, but after McLoughlin stopped practicing medicine, epidemic disease declined in Vancouver. By 1841 the Willamette Valley was considered quite healthy. It was also quite empty. The epidemics had ravaged the Indian tribes and virtually depopulated vast areas. This was significant, because the fur trade was dying, and in the East events were underway which would determine the further development of the Pacific Northwest. * * * Christian missionaries had long been in the forefront of New World settlement, and the missionary impulse was especially lively early in the nineteenth century. Thus the vast, unsettled Oregon country became an arena where gladiators of the Cloth struggled for the souls of the Far 10 Western Indians, and, while they were about it, relieved them of the responsibilities of real estate management. Following a visit of some Northwest Indians to St. Louis, the Methodists sent Jason Lee and a smafl-.l group to found the first Protestant mission in the Willamette Valley in 1834. This mission became the nucleus of American colonization and the center of attraction for future settlers. Lee, like Napoleon, was convinced that God favored numerical majorities, and in the East he promoted the need for Christian settlers in the Oregon country. Soon Americans were crossing the plains to establish white Christian civilization in the Willamette Valley, where it is rumored to exist even today. Some Americans headed for Oregon after reading The Far West, by the Reverend Samuel Parker, who also subscribed to the principle that civilization follows Christianity. Parker displayed his peerless recruiting abilities in 1834, when he persuaded the American Board of Commissioners for Foreign Missions to appoint Dr. Marcus Whitman as a missionary to the Indians of the Oregon country. Parker encountered Narcissa Prentice at this time, and considered her to be a potentially outstanding missionary. There was one problem: the Board opposed appointing unmarried missionaries. The obvious solution to this dilemma lay in Parker's suggestion that Dr. Whitman visit Miss Prentice. Marcus introduced himself to Narcissa, and with true missionary zeal, she agreed to marry him and go to the Oregon country. The next year, to confirm the desire of the Northwest Indians for Christian salvation, Parker and Whitman went up the Missouri with Fontenelle's 11 brigade of fur trappers. The trappers were amused by Parker's demeanor, appropriate to his schoolmaster coat and plug hat, and they were amazed by Whitman's teetotalling religiosity. Both men were subjected to considerable abuse. The trappers' attitude toward the physician changed in June, however, when they were faced with cholera, and he so managed the outbreak that only three of the fifty-odd men died. Whitman's reputation rose to even greater heights after the party crossed the Continental Divide. They reached the Green River just in time for the annual rendezvous of the mountain men. Amidst a typical rendezvous scene, which surely impressed the two missionaries as a reenactment of the last days of Sodom and Gomorrah, Whitman was asked to remove an arrowhead from the back of the legendary mountain man, Jim Bridger. Bridger had carried this memento of Blackfeet affection for three years. Parker wrote that "It was a difficult operation because the arrow was hooked at the point by striking a large bone, and a cartilaginous substance had grown around it." But Whitman was able to extract it with the aid of his surgical instruments and an ample supply of whiskey-qua-anesthetic. The many trappers watching the procedure may not have known that they saw the first operation west of the Rockies performed by an American-trained physician. Many .knew, however, that they, too, carried extraneous objects in their bodies and could provide the necessary jugs of anesthetic. Whitman was kept busy removing bullets and arrowheads from the tough hides of the mountain men, but he managed to meet with some Flathead and Nez Perce Indians and convince himself that they indeed wanted Christian missionaries. In 1836 Marcus and Narcissa Whitman established a mission among the Nez Perce and Cayuse at Waillatpu, near Walla Walla, Whitman practiced 12 much medicine there, but his greatest influence was in encouraging westward migration. The mission became an important rest stop for immi grants to the Northwest, and Whitman contributed decisively to the Westward movement in 1843, when he led a train of about a thousand people to Oregon from Missouri, thus opening the Oregon Trail. The later flood of immigrants was one reason for the Indian attack upon the mission in 1847, during which the Whitmans were killed. This event marked the end of the missionary period in Northwest history. It had other significance: reaction to the Whitman Massacre helped activate Congress into creating the Oregon Territory in 1848. * * * The Roman Catholic Church wasn't idle during the missionary period. The Church sent Fathers Blanchet and Demers to Oregon in 1838, where they established missions on the Cowlitz and Willamette Rivers, extending their activities northward to Vancouver Island and eastward into the Cayuse country. Further east, DeSmet and two other Jesuits started St. Mary's Mission in the Bitterroot Valley. Four years later they were joined by Anthony Ravalli, the first physician making Montana his field of medical service. To provide social services, the Vancouver Jesuits in 1856 enlisted the aid of five Montreal Sisters of Charity of Providence. The sisters entered the medical field two years later, when they built a small hospital. The lead fell to the Superior, Mother Joseph of the Sacred Heart. This remarkable woman could handle far more than a rosary. She was equally facile at iron work, carpentry, brick-laying, and delicate embroidery. Her woodcarving decorates many Providence hospitals, schools 13 and chapels. She has been recognized as the Pacific Northwest's first arthitect, the first northwestern artist to work in the medium of wood, and she was recently selected as Washington's second representative in the National Statuary Hall. The other is Marcus Whitman. At Vancouver, Mother Joseph and one workman installed a ceiling and covered the walls in a small building she had just built as a laundry. Four beds, four tables, and two chairs were installed, and in June, 1858, they opened the doors of St. Joseph's, the first permanent hospital in the Pacific Northwest. * * * Around mid-century the population density was not great anywhere in the Northwest, and the region offered little attraction to physicians. This soon changed. The California Gold Rush and those in Nevada, Colorado and, later, Montana brought many people to the West, including physicians. Fifteen hundred physicians joined the California Gold Rush, not to practice medicine, but to strike it rich. So it was in the Northwest gold areas, where almost all physicians were prospectors who followed the settlements accompanying the discovery of gold. Very few physicians came to the gold camps for purely professional reasons. Most were seeking their fortune, some adventure; some were escaping financial, domestic and other troubles. They told nothing of themselves or their training. Ordinarily no one inquired; a man only had to say he was a doctor and to display a medical kit. His reputation was determined by success with his first patients. If he failed, he was strongly encouraged to occupy himself fulltime panning and sluicing. 14 There was usually work for the mining-camp physician. Violence was routine in the gold fields. It's indicative that between 1849 and 1856 miners extracted six hundred million dollars in gold from the California Mother Lode, and spent a million dollars on Bowie knives and pistols— which they used. During the first five years of the Gold Rush there were forty-two hundred murders and fourteen hundred suicides in the California gold fields alone. A mining-camp physician lived with trouble, and his practice tended toward appropriate specialization. He was most concerned with injuries sustained at the mining sites, gunshot and knife wounds sustained almost anywhere, and venereal disease sustained in the social setting of the hurdy-gurdy girls. The gold rush physicians moved frequently, some never becoming identified with a specific community. Their transience notwithstanding, these physicians were distinctive personalities, each with special problems and functions in the gold camps. Each made some contribution to his community, even if it was little more than helping to maintain the high per capita alcohol consumption. * ★ * Once westward migration began, the covered wagon became the primary shaping element of the Pacific Northwest. Few wagon trains included physicians, and thousands of emigrants relied upon their own skill, books, and assorted medical kits. Some wagonmasters, like Sol Tetherow, were famouij for their medical abilities. Sol's favorite remedy was wild ginger tea, but when a child's coughing disturbed the quiet night, he'd spoon in a mixture of boiled licorice root, syrup of skunk cabbage root, tincture of lobelia and Balm of Gilead, a truly wondrous cocktail guaranteed to 15 straighten the child like a ruler and let the rest of the wagon train get some sleep. The transcontinental journey was physically punishing, and it was accompanied by constant suffering, dirt, and disease. Scurvy was common, but cholera was the scourge of the wagon trains. 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. The cause of the disease was unknown, and treatment was crude. The emigrants treated themselves with brandy and cayenne pepper; physicians used whiskey or Perry Davis Pain Killer with the cayenne, some mixing this nostrum with calomel. The slight difference between self-treatment and that administered by a physician is indicative of the nature of medical care on the nineteenth century frontier. I've applied the term "physician" to those individuals who called themselves "doctor" and practiced medicine. This is misleading, for the Northwest was populated by unorthodox and irregular practitioners, quacks and curealls. The frontier "doctor" didn't necessarily have formal training, and if he did, it wasn't necessarily in orthodox, or allopathic, medicine. Around the middle of the nineteenth century orthodox medicine in the United States assumed an "heroic" form. It presumed symptoms must be treated and when the symptoms were no longer apparent the disease was cured. Heroic medicine relied upon bloodletting, sweating, calomel, and the indiscriminate use of drugs in large dosages. It was the indescribable polypharmacy and routine administration of dosages more 16 appropriate to hippopotami than humans that provoked Oliver Wendell Holmes' remark that "if all the medicines were thrown into the sea, it would be so much the better for mankind and so much the worse for the fishes," Not all patients were heroic enouqh for heroic medicine, and the reaction aqainst it gave rise to many unorthodox medical sects. Homeopathy was the larqest unorthodox medical sect on the Northwest frontier. The homeopath's primary therapeutic regimen was the administration of drugs in infinitesimal dosages. The eclectics were also well represented. They opposed use of calomel and abuse of the lancet and advocated specific medication, replacing many regular drugs with others with the same physio logical effects. There were also Thomsonians, who rejected bloodletting and cupping and swore by steam baths and herbs, especially lobelia and sage. There were many hydropaths who relied upon the curative effects of copious quantities of water, internally and externally. The frontier also harbored galvano-therapists, physiomedical. therapists, mental therapists, sanitarians, and yet others who didn't subscribe to any particular medical doctri ne. The allopath was the dominant medical man on the Northwest frontier. His bag held emetics, diaphoretics, cathartics, diuretics, alteratives, tonics and stimulants. It might also include narcotics and sedatives, such as opium, camphor, ether, musk, castor and henbane. Interestingly, frontier physicians seem to have distrusted anesthetics and tended to rely upon whiskey, even when ether or chloroform were available. Innovations in medical practice often lost something in translation to the frontier. Thus one avant-garde Northwest physician, proudly applying Lister's antiseptic method, religiously scrubbed with carbolic acid after surgery. 17 With his medicines and a surgical kit the frontier physician attempted to cope with a variety of diseases. He was faced with many fevers. Whatever the clinical manifestations, the treatment of fevers varied only slightly. The sovereign remedy for fevers was quinine, and purgation with calomel and the exhibition of quinine was the most popular regimen. Bleeding was often performed, especially if the physician perceived "an excess of arterial action." Tincture of opium in doses of 30 or 40 drops followed by quinine for a day or two was popular. Emetics such as ipecac were commonly employed, as were diuretics and diaphoretics such as potassium nitrate. The supply of drugs was limited and shipments were uncertain on the Northwest frontier, so the physician tried to maintain a stock. Frequently he owned or had an interest in a drugstore, and he usually had available proprietary remedies. The drugstore played an important part in frontier settlements. A community of any size generally had at least one drugstore, always stocked with many popular patent medicines. There the customer could select among the serried bottles such proprietary remedies as Hotstetter's Celebrated Stomach Bitters> Parr English Pad, Certain Cure for All Malarial or Contagious Diseases, Ham!in's Wizard Oil for Liver Complaint, Constipation, and All Disorders of the Stomach and Digestive Organs, and Dr. Goodman's American Anti-Gonorrhoea Pills. ★ * * During the second half of the nineteenth century, many hospitals were established throughout the Northwest. In those institutions physicians could treat patients more effectively than before. It was not simply the existence of hospitals that made this possible. Medicine itself had 18 undergone revolutionary changes. The cell theory and the concept of cellular pathology were established; anesthetics and antisepsis were in common use. The germ theory of disease and the concept of immunity were in the process of formulation, and the X-ray would soon supplement already improved diagnostic, analytic and surgical techniques. The hospital was the setting in which the physician of the late 19th century could most effectively apply the advances in medicine, and at this time the hospital began to evolve from an institution of care into an institution of cure. * * * The medical profession, too, began to evolve into its modern form toward the end of the nineteenth century. For decades the Northwest's medical world had been one of laissez-faire, laissez-passer, and only caution protected the patient from the fraudulent or dangerous healer. The medical profession had little respect, and physicians and laymen alike recognized the need for improvement. Physicians were thus anxious to separate the competent medical men from the incompetent. People with meaningless credentials practiced throughout the Northwest during the second half of the nineteenth century. There were also many foreign-trained physicians whose degrees were worth no more than a diploma from the shabbiest American proprietary school. During the last decades of the nineteenth century, medical associations throughout the Pacific Northwest worked toward and were effective in securing legislation regulating the medical profession. The various Medical Practice Acts were instrumental in reducing the number of individuals 19 playing the role of physician and encouraged immigration of well-trained physicians to the Far West. * * * At the beginning of this century, medicine in the Northwest rested upon an organized base, and the conditions, existing institutions, and-- importantly—the desires of the profession, favored continued development and improvement. Those of us who live in the Pacific Northwest often forget how recently our region entered onto the stage of history. It wasn't that long ago that the region was so shrouded in secrecy, silence and ignorance that Swift could locate Brobdingnag of Gulliver's Travels here, and it could accommodate Jules Verne's 500 Millioh of the Begums. We frequently forget also the truly remarkable developments of medicine during the nineteenth century. In that century, medicine in the Northwest developed from a fur trapper treating himself with Indian remedies and whiskey into an increasingly respected and effective profession supported by a network of institutions. Medicine in the developing Pacific Northwest, like medicine anywhere at any time, reflected the social milieu in which it occurred. It passed through stages appropriate to those of the emerging territory, and, like the region itself, at the beginning of the twentieth century its modern character was established. The explorers, the mountain men, the missionaries, the gold-hungry doctors, and the pioneering physicians were all part of medicine in the developing Pacific Northwest, and they all made their contribution—something else we all too often forget.
|
|---|