As in the case of the ague, a reasonable a.s.sumption would be that the plague existed in seventeenth-century Virginia. The Great Plague of London (1665) carried away 69,000 persons, and other cities of Europe had even more disastrous epidemics. During the two years before the first settlers arrived at Jamestown, over 2000 victims were buried in London. The accounts of the ocean voyage indicate rat-infested ships.

Ships of the London Company reported plague and death aboard.

Virginians took pains to describe their illnesses, and there would have been little difficulty in recognizing this well-known killer. Yet little evidence of the presence of the plague appears in the seventeenth-century Virginia record; cases are reported but the number is small. Why Virginia should have been spared--especially in view of the known rat-infestation aboard ship--remains a question.

The evidence relative to yellow fever, or calenture, during this period in Virginia is contradictory. Early sources do make reference to numerous deaths from it at sea and even to an epidemic of it at Jamestown before 1610, but subsequent notices are infrequent and of questionable validity. Prevalence of the disease in the earlier years and its comparative infrequency in later is not a likely circ.u.mstance because with the increase of commerce, especially from tropical ports, an increase of the disease should have followed.

Smallpox, the mark of which is seen in early portraits, emerges from the colonial record with a more reasonable history. Its incidence in Virginia during the first half of the seventeenth century was small, and this might be expected in view of the fact that there were few children in the colony and that most of the adults had been infected before they left the Old World. The number of smallpox epidemics in Virginia did increase--again, as might be expected--later in the century as the number of children and of native-born unimmunized adults multiplied.

Smallpox caused such a scare in 1696 that the a.s.sembly, in session at Jamestown, asked for a recess--another example of the influence of disease upon political history. Earlier, in 1667, a sailor with smallpox, if the contemporary account can be accepted, landed at Accomack and was solely responsible for the outbreak of a terrible epidemic on the Eastern Sh.o.r.e of Virginia. A measles epidemic during the last decade of the century may actually have been smallpox as the two diseases were often confused by contemporaries.

Respiratory disorders, as has been noted, caused much distress for great numbers of early Virginians during the winter months. Influenza, pneumonia, and pleurisy must have reached epidemic proportions on numerous occasions in Virginia as elsewhere in America (influenza epidemics are recorded for New England in 1647 and in 1697-99). One note from a Virginia source for the year 1688 describes "a fast for the great mortality (the first time the winter distemper was soe very fatal... the people dyed, 1688, as in a plague... bleeding the remedy, Ld Howard had 80 ounces taken from him...)." (If "Ld Howard" gave eighty ounces, it means that he lost five pints of blood from a body that contained approximately ten--perhaps the "letting" was over an extended period.)

In a century in which numerous diseases had not been identified, many, known today, must have occurred that were diagnosed in general terms.

Appendicitis, unrecognized until later, must have been common, and heart disease probably went undiagnosed. Distemper, a general term, often was used when the physician could not be more specific ("curing Eliza Mayberry and her daughter of the distemper").

Other prevalent disorders were over-eating ("hee died of a surfeit"); epilepsy ("desperately afflicted with the falling sicknesse soe that he requires continuall attendance"); and the winter cold ("our little boy & Molly have been both sicke with fever & colds, but are I thanke G.o.d now somewhat better").

The continued presence of deadly disease throughout the century shows itself in the population figures for the period. Over 100,000 persons migrated to Virginia before 1700 and numerous children were born, but only 75,000 people lived in Virginia in 1700. Many returned to Europe, many emigrated to other parts of America, and Indians accounted for some deaths, but the chief reason for the decline in population was the high mortality prevailing throughout the century.

Health conditions, however, did not deteriorate as the century pa.s.sed.

By 1671 Governor Berkeley could report generally improved health conditions; for example, newcomers rarely failed to survive the first few months, or seasoning period, which had formerly exacted such an awful toll. How much these improved conditions were due to better provisioned ships, to a better diet in Virginia, and to the movement of the settlers out from Jamestown is open to question, but in any consideration of the explanations for the promotion of health, prevention of illness, the restoration of health, and the rehabilitation of the sick, the seventeenth-century Virginia physician or surgeon must be considered.

PHYSICIANS AND SURGEONS IN SEVENTEENTH-CENTURY VIRGINIA

The first English medical man to set foot on Virginia soil visited the Chesapeake Bay area in 1603. Henry Kenton, a surgeon attached to a fleet exploring Virginia waters, joined the landing party that perished to a man at the hands of the Indians. Next to arrive in Virginia were the two surgeons who accompanied the first settlers in 1607 and attended their medical needs.

One of these, Thomas Wotton, was cla.s.sed as a gentleman, while the other, Will Wilkinson, was listed with the laborers and craftsmen, a reminder of the varied social backgrounds of surgeons. Captain John Smith complimented Wotton in the summer of 1607 for skillful diligence in treating the sick; but Edward Maria Wingfield, when council president at Jamestown, criticized him for remaining aboard ship when the need for him ash.o.r.e was so great. Because of this reputed slothfulness, Wingfield would not authorize funds for Wotton to purchase drugs and other necessaries. The colony could only have suffered from such a misunderstanding.

Further activities of Wotton and Wilkinson have faded into the mist of time past, but Captain John Smith recorded for posterity the names and deeds of other surgeons and physicians who came to Virginia before 1609. Dr. Walter Russell, the first physician--as distinguished from surgeon--to arrive, came with a contingent of new settlers and supplies in January, 1608. Post Ginnat, a surgeon, and two apothecaries, Thomas Field and John Harford, accompanied the physician. Also in Smith's record is the name, Anthony Bagnall, who has been identified as a surgeon and who came with the first supply.

Unfortunately, neither contemporaries of Russell, Ginnat, Field, and Harford--nor the men themselves--found reason to record the medical a.s.sistance they rendered during a time of great need. Russell is remembered only for the a.s.sistance he gave Smith when the Captain was severely wounded by a stingray, Post Ginnat and the apothecaries leave their names only, and Bagnall is remembered for his part in the adventures encountered on one of Captain Smith's exploratory journeys.

Russell's services to Smith deserved note because the Captain was expected to die from the stingray wound. It is an interesting comment on the medicine of the time that Smith's companions prepared his grave within four hours after the accident. "Yet by the helpe of a precious oile, Doctour Russel applyed, ere night his tormenting paine was so wel a.s.swaged that he eate the fish to his supper."

The same stingray also a.s.sured the surgeon Bagnall a place in history.

Mention of Bagnall by Captain Smith followed the surgeon's exploits on another expedition when he went along to treat the Captain's same stingray wound. The party, attacked by savages, shot one Indian in the knee and "our chirurgian ... so dressed this salvage that within an hour he looked somewhat chearfully and did eate and speake."

How unfortunate that other exploits of these physicians and surgeons, not involving Captain Smith--or the stingray--did not cause him to make a record. Dr. Lawrence Bohun, however, who accompanied Lord De la Warr to the colony in 1610, evoked comments of a more general nature in the accounts of contemporaries.

Dr. Bohun ministered to the settlers who had been ready to abandon Jamestown in 1610. A letter from the governor and council to the London Company, July 7, 1610, describes his problems and his efforts to meet them. Insomuch as the letter gives one of the fullest accounts of early Jamestown medical practices and because Bohun is one of the most renowned of seventeenth-century Virginia physicians, it deserves a lengthy quotation:

Mr. Dr. Boone [Bohun] whose care and industrie for the preservation of our men's lives (a.s.saulted with strange fluxes and agues), we have just cause to commend unto your n.o.ble favours; nor let it, I beseech yee, be pa.s.sed over as a motion slight and of no moment to furnish us with these things ... since we have true experience how many men's lives these physicke helpes have preserved since our coming, G.o.d so blessing the practise and diligence of our doctor, whose store has nowe growne thereby to so low an ebb, as we have not above 3 weekes phisicall provisions; if our men continew still thus visited with the sicknesses of the countrie, of the which every season hath his particular infirmities reigning in it, as we have it related unto us by the old inhabitants; and since our owne arrivall, have cause to feare it to be true, who have had 150 at a time much afflicted, and I am perswaded had lost the greatest part of them, if we had not brought these helpes with us.

Dr. Bohun sought medical supplies from abroad, but he also experimented with indigenous natural matter such as plants and earths in an effort to replenish his dwindling supplies and to discover natural products of value in the New World. Judging by a contemporary account, Bohun, professionally trained in the Netherlands, used drugs therapeutically according to the conventional theories of the humoral school. Despite the disfavor in which frequent purgings are held today, it must be allowed that those being treated then sounded a plaintive call for more of Bohun's "physicke."

The colony lost his services when he left to accompany Lord De la Warr to the West Indies. His connection with the London Company and its colony did not lapse, however, for Bohun received an appointment as physician-general for the colony in December, 1620. At sea, on the way to fill his post, the physician-general found his ship engaged with two Spanish men-of-war. In the course of battle, an enemy shot mortally wounded the man who had survived great hazards at Jamestown.

After the departure of Bohun with Lord De la Warr, no physician or surgeon of equal stature or reputation took up residence in Virginia until Dr. John Pott arrived almost ten years later. It is likely that there was a shortage not only of outstanding medical men during these years, but also of medical a.s.sistance in general. Sir Thomas Dale, acting as deputy governor in the absence of De la Warr, wrote in the spring of 1611 that "our wante likewise of able chirurgions is not a little." Other requests for physicians and for apothecaries were dispatched to the London Company during this period.

However, despite the seeming shortage of medical a.s.sistance, the colonists survived such disorders as the summer seasoning much more frequently than in the first years at Jamestown. An account of Virginia written between 1616 and 1618 noted of the settlers that:

They have fallen sick, yet have recovered agayne, by very small meanes, without helpe of fresh diet, or comfort of wholsome phisique, there being at the first but few phisique helpes, or skilful surgeons, who knew how to apply the right medecine in a new country, or to search the quality and const.i.tution of the patient, and his distemper, or that knew how to councell, when to lett blood, or not, or in necessity to use a launce in that office at all.

Bohun died in March, 1621, and the Company named his successor as physician to the colony in July. The conditions under which Dr. John Pott accepted the post reveal the qualifications and needs of the seventeenth-century medical man on his way to the New World, and the inducements offered by the Company. He was a Cambridge Master of Arts and claimed much experience in the practice of surgery and "phisique."

In addition, he made much of his expertness in the distilling of water.

The company allowed Pott a chest of medical supplies, a small library of medical books, and provisions for the free pa.s.sage of one or more surgeons if they could be secured.

Additional economic inducements helped persuade Pott--and other physicians--to make the arduous journey to America. In the eyes of the Company, physicians could render especially valuable services to the colony, and ranked with other persons of extraordinary talent such as ministers, governors, state officers, officers of justice, and knights.

These individuals received special compensations in the form of land and profits, in accord with the estimated value of services to be rendered. In 1620, Dr. Bohun had had a promise--for taking the position of physician-general for the colony--of an allotment of 500 acres of land and ten servants; Pott accepted the job under about the same conditions as had Bohun.

These inducements offered physicians to persuade them to go to Virginia indicate the great need for, and the high value attached to, their a.s.sistance in the seventeenth century. With the population in the colony growing so great Dr. Pott's services were in considerable demand; several years after his arrival a certain William Bennett built the doctor a boat as he by then had a relatively large area to cover and most of the outlying plantations stood on the rivers and creeks.

In the colony, Pott won recognition for his professional proficiency.

Even a political enemy, Governor Harvey, described him as skilled in the diagnosis and therapy of epidemic diseases. Because he alone in the colony was considered capable of treating epidemic diseases, a court sentence against him for cattle theft stood suspended early in the 1630's and clemency was sought on his behalf.

Pott had become involved in other legal difficulties before 1630. In 1625, a case having medical and humorous implications brought him into court. A Mrs. Blany maintained that Doctor Pott had denied her a piece of hog flesh, and that his refusal had caused her to miscarry. The court accepted Mrs. Blany's contention that she believed the denial of the hog flesh caused her distress, but did not hold Pott guilty of willful neglect.

Since the biographical material on Pott's non-professional life reveals so many intellectual and political interests, it would be surprising if he had not occasionally neglected his medical practice. He gave considerable time to the colony's administration and he served in 1629 as the elected temporary governor of the colony after having previously been on the governor's council. His activities in politics and affairs brought him political enemies and explain, in part, the cattle theft charge and the court's finding of "guilty" (although this was later found "rigorous if not erroneous"). He died in 1642, having been intimately involved in the life of the colony for twenty years.

Pott was the last of the outstanding figures who practiced medicine under the direction of the Company, but Dr. Wyndham B. Blanton has found mention of over 200 persons who served as physicians or surgeons during some portion of the century. With only one exception, however, none of these achieved as prominent a place in history as Bohun, Russell, or Pott. Not only is the number of outstanding individuals in the field of medicine less, but the general quality of medical practice, in the opinion of Dr. Blanton, was not as high again during the last three-quarters of the seventeenth century as it had been during the administration of the Company (1607-1624) when Virginia medicine included a representative cross-section of English medicine.

Any survey--no matter how brief--of the medical profession during the century, however, should include mention of a man who, although not a full-time professional physician, proves to be the exception to Dr.

Blanton's generalization about the prominence of individual medical men and the quality of medical practice during the late 1600's. This man, the Reverend John Clayton, is a noteworthy example of the intellectual level an individual could attain and maintain while living in an area that was still remote from European civilization.

Clayton, who is known to have been at Jamestown between 1684 and 1686 as a clergyman, also practiced medicine in addition to pursuing his scientific interests. As a prolific writer he has left some of the fullest and most interesting accounts of contemporary treatment and diagnosis. His knowledge and methods cannot be taken as typical, however, because his intellectual level was considerably above the average in the colony.

This minister-scientist-physician wrote an account of his treatment of a case of hydrophobia resulting from the bite of a rabid dog. With its accomplished style, Clayton's account of his treatment of hydrophobia is worthy of attention as an example of contemporary theory and practice of the more learned kind. He wrote:

It was a relapse of its former distemper, that is, of the bite of the mad-dog. I told them, if any thing in the world would save his life, I judged it might be the former vomit of volatile salts; they could not tell what to do, nevertheless such is the malignancy of the world, that as soon as it was given, they ran away and left me, saying, he was now certainly a dead man, to have a vomit given in that condition. Nevertheless it pleased G.o.d that he shortly after cried, _this fellow in the black has done me good_, and after the first vomit, came so to himself, as to know us all.

Subsequently, Clayton "vomited him" every other day and made him take volatile salt of amber between vomitings. The patient also drank "posset-drink" with "sage and rue," and washed his hands and sores in a strong salt brine. Cured by the "fellow in the black," the patient had no relapse.

Clayton reveals more of his medical theory in another pa.s.sage from his writings. He observed:

In September the weather usually breaks suddenly, and there falls generally very considerable rains. When the weather breaks many fall sick, this being the time of an endemical sickness, for seasonings, cachexes, fluxes, s...o...b..tical dropsies, gripes, or the like which I have attributed to this reason. That by the extraordinary heat, the ferment of the blood being raised too high, and the tone of the stomach relaxed, when the weather breaks the blood palls, and like overfermented liquors is depauperated, or turns eager and sharp, and there's a crude digestion, whence the name distempers may be supposed to ensue.

In this pa.s.sage Clayton's medical theory resembles closely the orthodox medical beliefs of the century. The great English pract.i.tioner Sydenham, for example, emphasized the relationship between the weather and disease. Also the a.n.a.logy between the behavior of blood and wine was then conventional, and the supposed connection between the "sour"

blood and indigestion with the resulting acid humors is in accord with Galenism. The remedy--and a most logical one--was medicine to combat the acidity and to restore the tone or balance to the stomach. Acid stomach has a long history.

The reasonableness of Clayton's pathology is impressive, but reason did lead to some bizarre--in the light of present-day medical knowledge--conclusions. Aware of the value to the scientist of close observation and of the necessity to reason about these observations, Clayton was in the finest seventeenth-century scientific tradition.

Observing a lady--for example--suffering from lead poisoning, he noted that her distress, judging by her behavior, varied directly with the nearness and bigness of the pa.s.sing clouds; the nearer the clouds, the more anguished her groans. Reason dictated to Clayton that such a phenomenon stemmed from a cause-effect relationship.

Although the twentieth-century physician would deny the cloud-suffering a.s.sociation, he would not deny Clayton's propensity for observation and his attempts to discern relationships. The approach of the better seventeenth-century Virginia physician can be labeled scientific even if his facts were few.

DRUGS AND OTHER REMEDIES

No seventeenth-century physician could function without a variety of drugs (medicines) to dispense. Dr. Pott made special arrangements--for example--to have a chest of drugs transported with him from England to America, and the effectiveness of Dr. Bohun's "physicke" drew the praise of the colonists. Drugs were essential to the physician and a valuable commodity for export, as well. The subject of drugs must then include a discussion of their use as medicines and their importance as items of trade.