4 Things You Probably Never Learned About Health in Colonial America


July 2, 2020

Last year, we published an article comparing medicine and healthcare in colonial America to the healthcare system of today in honor of July 4th. 

It’s probably a no-brainer that medicine in the 21st century looks completely different from what it did at the dawn of the American Revolution.

Today, we have effective treatments, standards in medicine and rigorous training programs that produce highly capable physicians. People live about twice as long today as they did in 1776. And common everyday ailments like diarrhea aren’t usually a death sentence.

But in some ways, our modern healthcare system looks eerily close to the one George Washington and his pals knew at the end of the 18th century.

Curious? You can read the full text of that article here.

But if you don’t have time to wander through a history lesson right now, then save it for later. In the meantime, check out these 4 things that you probably don’t know about healthcare in colonial America.

#1) Women practiced medicine in more ways than one.

Let’s be clear upfront: women didn’t practice medicine in the way we think about “practicing medicine” today. 

Then again, no one did. (More on that in the next section.)

But for the time period and for what people understood about healthcare, laywomen actually took on the bulk of everyday healthcare needs.

That’s because women in colonial America were primarily keepers of the home. That meant that along with chores and childrearing, women knew how to address health problems that cropped up for their families — everything from minor wounds and burns to common illnesses of the day. They kept “receipt” (recipe) books full of medicinal concoctions based on experience and family lore. 

Plus, women served as midwives for neighboring friends and family members during delivery. Childbirth happened at home in the 18th century, with no need for a doctor in most cases. 

They may not have donned white coats and had a title before their names, but colonial women in America took care of their families using what they had on hand: herb gardens, practical knowledge and instinct.

#2) The term “doctor” didn’t mean much.

Unlike the women taking care of their households, men could actually call themselves “doctor” — though it didn’t mean much. In the 18th century, it’s not a big stretch to say that anyone could set up shop as a doctor. There were no standards in medical training or expectations from the general public. 

In fact, plenty of colonial Americans distrusted physicians of the day. 

And frankly, they had good reason to be suspicious.

Doctors in colonial America opted for apprenticeships if they had any training at all. They spent a few years working under a practicing physician before opening their own practice. Wealthier men might have gone to Europe to learn at an established medical school. 

The first American medical school opened in Philadelphia in 1765, but most colonial doctors didn’t bother with degrees. In fact, of the 3,500 to 4,000 practicing physicians at the time, just 10% had formal training. And about half of those held medical degrees.

By and large, physicians of the era relied as much on personal beliefs as anything else. 

#3) Treatments were based on symptoms.

George Washington famously died of bloodletting — except he didn’t. He likely died from asphyxiation due to a bacterial throat infection. Bloodletting, a common colonial treatment for inflammation, just hastened the inevitable. 

But our country’s first president wasn’t unique in this unfortunate regard.

Lots of patients died from accepted medical “treatments” of the day. That’s because colonial doctors largely believed in heroic medicine. And if the word “heroic” makes you think of big, bold action, then you’re on the right track. 

Colonial physicians treated what they could see using extreme measures to restore the body’s balance. This took the form of bloodletting, vomiting, leeching, sweating and blistering depending on the offending bodily function.

Case in point? More soldiers died of illness than of bullets during the American Revolution. 

Thanks to close quarters, lack of sanitation and a prevailing belief in the power of castor oil — i.e., a laxative — American soldiers faced even bigger threats in their tents than they did on the battlefield. An uncomfortable medical problem that most people can treat today using an over-the-counter medicine, diarrhea ranked number one on the list of killers for soldiers in the Continental Army.

At the time, doctors didn’t understand underlying causes of diseases. They tried to address the symptoms instead. 

But it’s one thing to try and ease a headache using herbs from your garden. It’s another thing entirely to try to stem a smallpox outbreak with no concept of germ theory. And with vaccines a relatively new concept in the late 18th century, people didn’t trust them. 

Colonial Americans — doctors and layfolk alike — fought illness and injury at a surface level. And they paid dearly for it, both figuratively and literally.

#4) Healthcare was just as expensive then as it is today.

What we think of as “healthcare” didn’t exist in 1776. There were no emergency rooms treating anyone who walked in the door. Most people stayed home when they got sick, and families treated themselves using remedies readily available in their cabinets. 

For the wealthy, though, on-demand doctors existed. And the key word here is wealthy.

Like today, there were no standard rates when it came to medical care in colonial America. Doctors charged what they liked for their services. And because becoming a doctor was expensive with little reward for their efforts, colonial physicians targeted wealthy clientele. 

That’s not to say that doctors were in it for the money. 

But some fields, like obstetrics, shifted from home-based midwifery to a professional class of men handling deliveries for affluent patients. It’s not hard to see why, either. Delivering a baby is relatively simple compared to treating, say, smallpox. 

One doctor in 1792 charged a patient $4,100 (in today’s money) for 13 days’ attendance for smallpox. Given that many treatments of the time didn’t even work, the high price of medical care seems even more absurd than it does in 2020.

Medical care today looks wildly different from what our colonial ancestors experienced during the Revolutionary War. Some things, like cost, haven’t changed. 

But we now have access to a wide range of treatments from people with proper, standardized training. We live longer, wash our hands and know more about bodily threats than our founding fathers ever imagined. Our country still has work to do in so many areas, but the pursuit of life, liberty and better health is always worth celebrating.