Monday, February 14, 2022

Medicine in the Old West


This week::Hygiene or lack of

By Jesse J Elliot    (aka Julie Hanks, Ph.D)


Photo by Doris McCraw

Here it is, Valentine’s Day, and I happen to choose the topic of HYGIENE for my new blog on Medicine in the Old West. Not very romantic, but a great starting place to discuss medicine and medical practices in the 19th Century. 

The practice of medicine in the Old West was primitive at best—especially in communities where there were no trained doctors. Although the Europeans (Pasteur and Lister 1852) had already discovered that microscopic creatures caused disease and infections, the idea didn’t catch on quickly for many doctors and the general population. Even in the teaching universities, doctors would go directly from their teaching labs--working on cadavers, to another operation or the delivery of a child without washing their hands. Though patients died, there remained a “disconnect” between the idea of bacteria and the onset of disease—the need for proper hygiene.  

Now, picture yourself in a country made up of peoples from Europe and Africa, each bringing in their unique diseases, conditions, and habits. Now put them on a crowded wagon train, in a busy brothel, and/or using the same outhouse—if they used it at all.  The chances of having a major medical outbreak are definitely possible, mostly probable, and most of these diseases could have been prevented with proper hygiene.

Personal hygiene was challenging in the West. Lack of water, modesty, strong lye soaps, the fear of bathing too often, and the laborious task of heating and carrying water were deterrents that made bathing inconvenient and undesirable. 

Men were worse than women. Their jobs entailed a lot of physical labor, and the availability of a bath was often inconvenient let alone impossible.  Some men who worked in mines, who drove cattle, or served in the military, would bathe, if available, in a stream or river.  But, it wasn’t unusual to go an entire season or longer without a bath. Besides, the belief that too many baths were dangerous to one's health was still prevalent. 

Women would, if they could, bathe more frequently, but lack of accessible water often made a bath out of the question. One woman settler on a wagon train described bathing in her clothes due to modesty. As she stood in the moving waters of the river, she undid her belt and peeled back the waistline of the skirt she had worn for the duration of the trip. In it were minute, moving insects and their eggs. In her hair, she had to use the small comb and remove lice and their progeny. She washed herself as well as she could, using a lye soap that burned her skin. She had refused to use the yucca root soap that a group of Indians had given the settlers to use for their hair. 

Unlike the good old lye soap, the root of the yucca left hair soft and didn’t dry it out. The Native Americans and the Mexican women used the yucca root. Some men, for lack of anything else, used whiskey. Later, egg whites, perfumes, and oils were added to enhance shampoos. But since one didn’t bathe too often, the problem of washing one's hair wasn’t a major concern.

Once people were settled, bathing was generally relegated to Saturday night, a day before church. The tub was filled, and the adults went first, then the older children, then the infants. Thus, came the old adage: “Don’t throw the baby out along with the bathwater.”  Sometimes, the same water would be used to wash clothes or even be kept for the following week’s baths. Once again, hygiene was not a priority.

Oral hygiene was also a challenge.  Although the toothbrush was invented years ago by the Chinese, Americans generally employed cloth and knives as cleaning utensils. Bristled tooth brushes, from as early as 1800 were excavated in the West, so they were available, but not frequently bought and used.  

Instead of toothpaste, early Americans brushed (if they brushed at all) with tooth powders. To clean teeth, these powders contained abrasives like alum, ground seashells, bone, eggshells, brimstone, baking soda, and even gunpowder. To freshen breath, powders included cinnamon, musk, or dragon’s blood (a plant).

Fillings were either lead or gold. Although there were schools of Dentistry (Doc Holiday went to Pennsylvania College of Dental Surgery in Philadelphia), often the local dentist was the town’s blacksmith or barber. Tools were primitive—a small plier was used to pull the teeth.

Rotten teeth were not unusual, and serious bacterial infections could travel to the eyes or even the brain, causing serious infections, blindness, and even death.

Cholera was a major cause of death during the Civil War and later the Western Movement. Overcrowded areas with outhouses leeching into the drinking waters or the groundwater and other diseases caused more deaths than bullets in the Civil War. In the settlements or on the large wagon trains, cholera reared its ugly head, and other than ginger or tea, no one knew how to stop the virulent diarrhea that it caused. Cholera was spread through contaminated water and caused severe dehydration and diarrhea. It could be fatal within days or even hours of exposure to the bacteria.

And talking about outhouses: Since toilet paper was not available, everything from soft leaves to corncobs were used to “clean” one’s self. The outhouses themselves were never cleaned, and under the wood that comprised the toilet, a host of flies and black widow spiders often awaited the unsuspecting user. Though lime and other agents were thrown in to cover the smell, the pile of waste often mixed in with the groundwater, causing serious diseases like cholera.

Dishes were washed, but apparently, the effort to keep things clean wasn’t enough to prevent dysentery. Dysentery is a digestive problem characterized by loose and watery stool containing blood. It is accompanied by intestinal inflammation and stomach cramps. Even today 1.1 million people die of dysentery in the world. The most common cause of dysentery is poor sanitary conditions. Stale food, contaminated water, and exposure to human excreta are other causes of dysentery.

All right.  Enough about hygiene! The next article is a list of what you would pack in your medicine kit if you were heading out on a wagon train or a pony express ride.  Lots of surprises there! Oh, yes, HAPPY VALENTINES DAY!


  1. Fascinating. It wasn't easy traveling west back in the day, that's for sure. Doris

    1. I'm with you, Doris. Though I'd still give anything to have been able to try it.

  2. It is a wonder they survived at all.

  3. Absolutely, and then add the difficulties in giving birth!

  4. I'd have died as a child if I'd lived back then!

  5. I'm with you--scarlet fever. It's amazing anyone survived!