Seeking Medical Care
Feeling Sick in 1918?
If you became sick in nineteenth-century America, you might consult a doctor, a druggist, a midwife, a folk healer, a nurse or even your neighbor. Most of these practitioners would visit you in your home.
By 1918, these attitudes toward health care were beginning to change. Some physicians had begun to set up offices where patients could receive medical care and hospitals, which emphasized sterilization and isolation, were also becoming popular.
However, these changes were not yet universal and many Americans still lived their entire lives without visiting a doctor.
How Did Ordinary People View Disease?
In 1918, folk healers could be found all over America. Some of these healers believed that diseases had a physical cause such as cold weather but others believed it had a supernatural cause such as a curse.
Treatments advocated by these healers ran the gamut. Herbal remedies were especially popular. Other popular remedies included cupping, which entailed attaching a heated cup to the surface of the skin, and acupuncture. Many people also wore magical objects which they believed protected the wearer from illness.
During the influenza pandemic of 1918 when scientific medicine failed to provide Americans with a cure or preventative, many people turned to folk remedies and treatments.
In the 1880s, building on developments which had been in the making since the 1830s, a growing number of scientists and physicians came to believe that disease was spread by minute pathogenic organisms or germs.
Often called the bacteriological revolution, this new theory radically transformed the practice of medicine. But while this was a major step forward in understanding disease, doctors and scientists continued to have only a rudimentary understanding of the differences between different types of microbes. Many practicing physicians did not understand the differences between bacteria and viruses and this sharply limited their ability to understand disease causation and disease prevention.
Drugs and Druggists:
Although the early twentieth century witnessed growing attempts to regulate the practice of medicine, many druggists assumed duties we associate today with physicians. Some druggists, for example, diagnosed and prescribed treatments which they then sold to the patient. Some of these treatments included opiates; few actually cured diseases.
Desperate times called for desperate remedies and during the influenza pandemic, many patients turned to these and other drugs in the hopes that they would provide a cure.
Between 1890 and 1920, nursing schools multiplied and trained nurses began to replace practical nurses. Isolation practices, sterility, and strict routines, practices associated with professionally trained nurses, increasingly became standard during this period.
In 1918, nurses served as the physician’s hand, assisting doctors as they made the rounds. During the pandemic, many nurses acted independently of doctors, treating and prescribing for patients.
Throughout the eighteenth and much of the nineteenth centuries, pretty much anyone had the right to call oneself a physician. By the late nineteenth century, growing calls for reform had begun to transform the profession.
In 1900, every state in the Union had some type of medical registration law with about half of all states requiring physicians to possess a medical diploma and pass an exam before they received a license to practice. However, grandfather clauses which exempted many older physicians meant that many physicians who practiced in1918 had been poorly trained.
While access to the profession was tightening, women and minorities, including African-Americans, entered the profession in growing numbers during the early twentieth century.
What Did Doctors Really Know?
Growing understanding of bacteriology enabled early twentieth-century physicians to diagnose diseases more effectively than their predecessors but diagnosis continued to be difficult. Influenza was especially tricky to diagnose and many physicians may have incorrectly diagnosed their patients, especially in the early stages of the pandemic.
Bacteriology did not revolutionize the treatment of disease. In the pre-antibiotic era of 1918, physicians continued to rely heavily on traditional therapeutics. During the pandemic, many physicians used traditional treatments such as sweating which had their roots in humoral medicine.
Reflecting the uneven structure of medical education, the level and quality of care which physicians provided varied wildly.