Dying to Head West

By Marc S. Micozzi,
who teaches pathophysiology at the Georgetown University School of Medicine
Wednesday, January 7, 2009


From the Atlantic to the Pacific, 1492-1941

By David Dary

Knopf. 381 pp. $30

Among the first things exchanged by European settlers and Native Americans were diseases and medical treatments. The Europeans gave the natives measles, yellow fever and smallpox; when the Indians tried to cure these contagions with traditional methods, such as bringing people together in sweat houses, they only spread the diseases more rapidly. But Native American remedies did seem to help with other maladies. In "Frontier Medicine," his entertaining and informative history of medical care on America's westward-moving frontier, David Dary recounts the story of German physician John Lederer, who was bitten on the finger by a venomous spider while exploring the Appalachian Mountains in 1670. His Indian guide treated Lederer by sucking out the poison and applying a plaster made from the root of the plant now called snakeroot. Lederer recovered and, a few days later, became the first recorded European to see the Shenandoah Valley.

Though some were inclined to view Indians as savages, settlers were not surprised to find native remedies effective; after all, Europeans in the 16th and 17th centuries believed in a Law of Correspondences, which held that cures could be often found in the same locales where diseases occur. Among the native medicines adopted by many colonists, according to Dary, were a combination of animal grease and powdered hellebore root for wounds and the dried root bark of the wahoo tree as a mild purgative and heart stimulant.

Many of the earliest books to come out of the English colonies between 1670 and 1740 were natural histories documenting medicinal plants. The first American self-help manual may have been "Every Man His Own Doctor; Or, The Poor Planter's Physician," published in 1734 by John Tennent, who had arrived in Virginia's Spotsylvania County from England just 10 years earlier. It described many Native American herbal remedies, including chewing willow bark for headaches, applying witch hazel to sore muscles and eating raspberries to control diarrhea. But the most enduringly popular of these books was "Gunn's Domestic Medicine, or Poor Man's Friend," which remained continuously in print from 1830 to 1920 and is mentioned in both Mark Twain's "Huckleberry Finn" and John Steinbeck's "East of Eden."

Of course, medical knowledge also moved in the opposite direction, from the Europeans to the Indians. In the 1530s, the Spanish explorer and physician Alvar Núñez Cabeza de Vaca treated an Indian wounded by an arrow in the shoulder; by Cabeza de Vaca's account, he cut out the arrow point and sewed up the incision with a deer-bone needle, after which the Indians danced in celebration.

But from 1492 until as late as 1942, people living on America's western frontier often found themselves without a doctor -- and often, Dary shows, that was not such a bad thing. The rarity of physicians in the rural West reduced the use of such common European practices as bleeding by lancet or leeches, blistering with noxious substances such as mustard plaster, induced vomiting (called puking) and forced diarrhea (known as purging) -- a battery of treatments of which Francis Bacon had said, "The remedy is worse than the disease."

By the 1850s, natural remedies were a well-established form of health care in America. During the Civil War, the Confederacy had difficulty obtaining manufactured medicines and published a pamphlet listing treatments with plants, including snakeroot, sassafras, partridgeberry, lavender and dogwood. Toward the end of the war, Confederate medical kits routinely contained such remedies.

"Frontier Medicine" is fast-paced and engaging, rich with colorful events and characters, including a semi-autobiographical chapter about the author's grandfather, a physician in rural Kansas at the turn of the 20th century.

But Dary stops short of presenting a thesis about what can be learned from these stories. Particularly disappointing is the chapter titled Quacks (from the German "quacksalver," or mercury), in which the author ducks the main issues. After 12 chapters describing the usefulness of natural remedies from the 1500s to the 1850s, "Frontier Medicine" suddenly begins to label practitioners of natural medicine as quacks, indiscriminately lumping them with true charlatans like Thomas Alva Edison Jr., the famous inventor's son, who marketed a "Magno-Electric Vitalizer" as a cure for everything from deafness to rheumatism.

The great, unexamined assumption for today's reader is that the natural healing of frontier medicine somehow became quackery at around the same time the American Medical Association was organized, in 1847. This attitude betrays something of a triumphalist approach to the wonders of modern medicine.

In today's economy, many Americans may find themselves back on the medical frontier. This book illustrates that it is often ancient knowledge and wisdom about healing that, adapted to new circumstances, provides truly innovative approaches to health problems.

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