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!

Author, Actor, and Oh Yes, A Doctor - Interview with Dr. Keith Souter

Dr. Keith Souter lives across the Atlantic, yet like many of us, has a love of Westerns, writing, and storytelling. I am constantly surprised at the backgrounds and passion the members of Western Fictioneers have for their craft and Keith is no exception. How he fits it all in is a mystery. 

On a side note, I made my library buy a copy of his "The Doctor's Bag" for their special collections section. It has been a wonderful resource for me.

 Dr. KEITH SOUTER     AKA    CLAY MORE

Firstly, thank you for inviting me to this excellent interview slot that you have developed. Being part of Western Fictioneers has been very helpful to me as a writer. There is so much writing talent and a wealth of knowledge about all manner of subjects that are useful to a writer of westerns. I hope there may be something of interest in my somewhat rambling answers!

Dr. Keith Souter
photo provided Dr. Souter

1. When did you realize you wanted to be a writer?

I don’t know whether other writers have had the bug as early, but I was actually bitten by it before I went to school and before I was taught how to write. 

I can remember it all vividly. As a very small kid in the early fifties, I was always aware of books in the house. I had two older brothers and I inherited their cast-me-down books as they developed as readers and moved on to bigger, longer, and thicker works.  There seemed to be a strange and mysterious ladder in reading, which I was keen to climb. From the wonderful multi-colored picture books, one went to books with black and white pictures and more of those strangely appealing printed words began to cover the pages. Then there were my father’s books, which were Westerns with brightly colored covers of heroic, powerful figures, which had lots of words, but no pictures inside. 

I was entranced by them all. I not only wanted those books, but I wanted to ‘write’ my own. I got paper, crayons, drew pictures of the stories that came into my head and I copied words from empty seed packets and cereal boxes and anything else that I was allowed to use. I had no idea what these strange signs and symbols meant except that they were words, and words were what you put into books. I folded them and even gave them little covers with pictures on them. My mother even stitched them together like proper books.

As I got a bit older, I pulled out other books from the shelves and wherever an illustration appealed to me I would copy it on a scrap of paper and leave my version in the book. An absolute favorite, which I came back to again and again was an old edition of The Universal Home Doctor. It was illustrated and I was fascinated by the anatomical drawings. As a six-year-old, I could tell you where all of the organs of the body were sited, much to my elder brother’s utter disgust. I still have that book in my library, and he is still squeamish about anything connected to anatomy or medicine. 

2. What was the nudge that gave you faith that you could and wanted to be published?

It was when I was at medical school in Dundee. It is a city in Scotland that was well known for ‘the three J’s.’ Those J’s were Jute (you’d call it hessian or burlap in the USA), Jam (especially marmalade. There is a legend that it originated in Dundee in the 18th century after a cargo of bitter oranges from Seville was bought by a local grocer, whose wife boiled them with lots of sugar and marmalade was born), and finally Journalism. Dundee is home to D C Thomson’s one of the most famous newspaper and magazine companies in the UK.

I submitted several short children’s stories to a section called The Children’s Corner in one of their family magazines called The People’s Friend. To my surprise, they were accepted, and then I found myself regularly contributing. I found writing these stories was a great balance to the study of medicine. In the hospital, I was seeing people with often harrowing medical problems, and in my writing, I could take myself completely away from reality and craft stories for preschool children.

When I qualified as a doctor and moved to Hull, a city in England to work in cardiology I started writing for the local telephone company. They had a ‘dial-a-bedtime story’ service. Essentially, for sixpence, which was the cost of a telephone call, parents could call up the exchange and their youngster could hear a tuck-me-up bedtime three-minute-long tale before they went to bed. I wrote about witches, fairies, gnomes, and ducks that couldn’t swim or bats that couldn’t fly. 

Those were certainly the nudges that made me want to one day write actual books. 

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3. Do your life experiences influence or hinder your writing?

My profession as a doctor most definitely influences my writing. I write non-fiction books, popular medical books, and fiction. I have penned a series of medical books on back pain, strokes, heart disease, diabetes, depression, dementia, Doctor’s Latin, and one all about the drug Aspirin. The latter is a subject I am enthusiastic about as I was involved in research into it, albeit as a very tiny cog in the process. 

For several years my writing consisted of scribbling doctor-style hieroglyphics on prescriptions. Yes, it is true that a doctor's handwriting tends to be illegible. That comes about from scribbling down notes in lectures as fast as you could. That is not a great thing in medical practice, though. When you consider how important it is to keep good case-notes, we have a responsibility to be legible. I think modern-day medical students probably write more legibly, as they have the benefit of keyboards and computers.

Writing medical papers was the next part of my writing career. Academic papers are not, of course, remunerated. They have to be written in crisp, clinical language and go through a rigorous screening and editorial process before they can be published in peer-approved medical journals. On the other hand, the medical press has many newspapers and magazines which do pay a fee for articles. My very first one was published in the UK and then republished in several other sister publications around the world. 

Photo provided by Dr. Souter

After doing several surgical and medical posts I embarked on training in psychiatry but abandoned it because British psychiatry at that time was heavily biased towards psychotropic medication and electro-convulsive-therapy, ECT. I switched tack and entered family medicine and worked as a general practitioner for the next thirty years. Soon after I started, I was asked to write a weekly column in the local newspaper. I have done that ever since and am currently in my 38th year. This has been a big part of my life because I have to research a new topic every week. It benefits me as it keeps me up to date and it satisfied my writing craving for so many years.

But in my fiction, my medical background always comes to the fore. When I was considering writing for adults, I was always a bit confused about the old chestnut of wisdom to ‘write what you know about.’  By that token it seemed to me that accountants should have accountants as their main protagonists, teachers should set their tales in school or college, and so on. I didn’t at that stage want to write about a doctor or a surgeon. Then I realized I didn’t have to. As long as I peppered my stories with medical details, using my background I could make those aspects of the story credible and believable. 

That is what I did in Raw Deal at Pasco Springs, my first novel. It is about a gambler and a reluctant lawman. He isn’t a doctor, but there is a doctor in the story and there are episodes that appertain to medicine. 

Later on, I wrote a biographical novel called The Doctor, in the West of the Big River series for Western Fictioneers. It is about Doctor George Goodfellow, the surgeon to the gunfighters, who practiced in Tombstone and later on in Tucson in the wild days of the Earps and Doc Holliday. He was the foremost expert on gunshot wounds and a surgical innovator who deserves his place in medical history. It is followed up by another in the series, The Dime Novelist, about the king of the dime novelists, Ned Buntline. 

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And I have to mention Wolf Creek, the brainchild of Troy Smith. This was the collaborative project that involved so many of the Western Fictioneers. My character was Doctor Logan Munro the town doctor. Much of the way he practices is a romantic extension of my work as a town doctor. Before he came to Wolf Creek, Logan served in the Crimean War and the Indian Mutiny (as did my great grandfather) and I also drew on three months experience working in a fever hospital in Southern India back in the seventies. That gave me valuable experience in tropical medicine and I saw diseases like cholera, tetanus, malaria, typhoid, and rabies. I saw cobra bites and I did lumbar punctures by oil lamp when the hospital generators packed up, as well as assisting at operations on typhoid enteric perforations of the bowel, working in front of huge fans because of the sweltering heat. 

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4. Where did you get the idea for your latest release and tell a bit about the story?

My next western release is actually a re-release. It is a series of interlinked short stories about Doctor Marcus Quigley, a dentist, gambler, and bounty hunter. I am so pleased that the wonderful folk at Prairie Rose Publications (Cheryl Pierson and Livia Washburn) are soon to publish it.

Marcus Quigley is on the trail of someone who murdered the benefactress who put him through dental school in Baltimore. It was inspired by a series of western novels about a character called Sudden, that I read as a youngster. They were written by British author Oliver Strange and were about a young cowpuncher who was lightning fast on the draw, who was unjustly outlawed. He too was on a revenge mission. 

Once again, my medical background comes into this a great deal, for Marcus is often called upon to carry out operations including brain surgery. 

I can’t say any more than that, because the title has not been decided on and I am eager to see the cover that Livia will conjure up.

5. Are you a plotter or a pantser?

Actually, I’m both. I am a pantser when I write short stories, but when I get to novels, I feel I have to be a plotter. With the short form, including the novella, I feel that I can keep the loose threads together in my mind, but since my novels are all basically mysteries with subplots and red herrings strewn throughout, I have to be a plotter.  I envy people like the late, great Frank Roderus, and many of the human fiction factories in the Western Fictioneers who can sit down with a blank page or screen and just type a story from beginning to end.  That takes courage I don’t have. I’d worry about getting so far and then stalling.  

Let me give you an example of my transition between the two. A few years ago, I dashed off a flash fiction short story that I called The Villain’s Tale for a literary competition. Surprisingly, it won me a Fish Award and a decent pot of good Irish cash. Well, Euros actually, but in England, we still write for pounds sterling. It was a miniature historical mystery and it stimulated me to write a medieval mystery set in the 14th century, set in and around an English castle that I actually live within arrowshot of. My point is that I had to evolve from that panster into a plodding plotter. That first novel, The Pardoner’s Crime was an amalgamation of characters from the Robin Hood legends and from Geoffrey Chaucer’s Canterbury Tales. It has become a series of four novels so far, with two due out this month and next. The research involved amounts to a filing cabinet and a couple of shelves of reference books. When I am in writing such a novel my study becomes like a medieval monk’s cell with papers, scrolls all over the place, and maps of the area as it was in the 14th century pinned to my walls. 

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6. Is there a writing routine you follow, or do you write when the muse strikes?

I write when time allows if anything. I retired from general practice a few years ago, but still have a small private practice. When the pandemic started, I was deployed to Test and Trace, swapping my stethoscope for a headphone and microphone to trace contacts of positive tested Covid-19 patients. With the development and rollout of the vaccine, I am back helping to vaccinate as many people as possible. I write after I have taken care of all my other commitments, including my weekly newspaper column. 

7. Do you write in other genres?

Yes, I write crime novels set on the Scottish island of West Uist, featuring Inspector Torquil McKinnon. There are six novels in the series, and I have a seventh under contract. Torquil is a bagpipe-playing detective who heads the smallest police force in the country. I chose the setting to get away from DNA and CSI stories and get back to the ‘locked room’ style of cozy crime and good old-fashioned detection. 

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I am probably one of the worst pipers there is, but when writing these I get the bagpipes out and mess about with them. His uncle is called The Padre and he is a keen golfer, so while plotting I can be found chipping golf balls around the garden or through the house!  

As I mentioned I also write a series called the Sandal Castle Mystery Thrillers. I am the chairman of the Friends of Sandal Castle, so I know the area and the history well. It seemed inevitable that I would write mysteries about it. 

I am currently writing a mystery set in ancient Egypt during the Ptolemaic era. It is called Death of a Poet. It follows characters I used in a short story called The Man from Crocodilopolis. I intend to follow it up as another series.

Lastly, I started by writing children’s stories and I achieved one of my aims when I wrote a gothic ghost story set in Victorian London for mid-graders. The Curse of the Body Snatchers, featuring an Oliver Twist style orphan has been published by Prairie Rose Publications. 

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8.  What are your favorite areas of research and why they are important to you?

I really enjoy the research aspect of writing fiction. When you write a historical novel, it is so important to get the period right, especially if you are including actual historical characters. If you get details wrong, then there is a good chance that your reader will stop reading at that point. 

If my story has a particular theme, for example, one of my Scottish mystery novels is about whisky – no, the spelling is correct, this is Scottish malt whisky – then I’ll delve into all aspects of it. This includes the history, the science behind distilling, the sale, the bootlegging, and so forth.

Medical history is a great interest of mine and it was for this reason that a few years ago I started to write my blog The Doctor’s Bag on the Western Fictioneers blog. Troy Smith was the WF President at the time and he suggested that I should collect them and publish them as a resource for writers. 

I aimed to write articles that could be useful to anyone wanting to know how a frontier town doctor would approach a particular problem. So, the blogs are on everything appertaining to that, from gunshot wounds to arrow wounds, the infectious diseases that were prevalent, and what was known about them at the time. Also, bits and pieces like the type of stethoscope a doctor might have, whether hypertension (high blood pressure) was even known about, how to diagnose a broken bone without an x-ray, how to set it, how to reduce a dislocated shoulder or leg or pull a tooth. 

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On the subject of gunshot wounds, I think there is a problem in many genres, in that ‘safe’ wounds are plucked out of the air. The truth is that gunshot wounds can be life-changing if they are not fatal. I approach this by looking at the anatomical structures that can be damaged. Those arm and shoulder wounds that heroes in TV and film used to wrap a bandana around and then beat the heck out of a villain are just not so easy to believably shrug off. 

So too are arrow wounds. As with gunshots, I went back to the medical texts and papers of the day and then discuss the reality of the trauma they can cause, and the infections that can result and which caused many deaths. Again, it’s not just a matter of plucking an arrow out, tossing it aside, and then jumping in the saddle and riding off after the baddies. Both arrowheads and bullets needed to be extracted and, in the book, I describe the methods as used by the experts of the times, using the instruments they would have available. Infections would add a whole raft of other problems, possibly even resulting in amputation of a limb. So that is in there, too. 

I am grateful to Cheryl Pierson and Livia Washburn for taking the book The Doctor’s Bag on over at Sundown Press.

9. Is there anything else of interest about you that you would like to share?

I am a frustrated actor. I have acted as Agamemnon in Shakespeare’s Troilus and Cressida with the Touring British Shakespeare Company, in front of the Elgin Marbles in the British Museum. I have also been a supporting artiste in TV and film, usually as either a surgeon, a psychiatrist, or a peasant. 

Photo of the Interviewee on the left
provided by Keith Souter

10. What advice would you give to those who dream of writing, or what advice would you give your younger self?

First, read as much as you can. Read works by different authors, try various genres and you will find the genre that you like best and feel most comfortable in. 

Secondly, write. Don’t procrastinate and dream of being a writer. Writers write and that’s what you should do. Have a notebook with you at all times and jot down interesting conversations, character features, and ideas. If you don’t get these things down, they disappear like smoke.

For more of Dr. Souter's Medical books: Amazon

Amazon Author Page: Keith Moray

Amazon Author Page: Clay More

(c) Doris McCraw All Rights Reserved 2021

THE DOCTOR'S BAG by Keith Souter aka Clay More

Doctors in the Old West

If you ever watched Gunsmoke you would be sure to know good old Doc G. Adams. If you had bellyache, a touch of rheumatics or a bullet that needed digging out, he was your man. He seemed the sort of guy that you could trust your life with, for he was wise, well read, skilled with a scalpel and familiar with all of the latest advances in medicine.

As a character he had evolved from his CBS radio incarnation, played by Howard McNear, when he was Doc Charles Adams, to Milburn Stone’s television role as Doc Galen Adams. Of course, he was usually just known as ‘Doc.’ The radio version was apparently a lot darker, for he was a man with a past. His real name was Charles Moore, a doctor who fled from Richmond, Virginia after killing a man in a duel. Settling in Dodge City, he took on the name of Doc Adams. His radio persona was a near alcoholic, but by television days he merely had a taste for whiskey at the Long Branch Saloon.

The change of name is interesting. Milburn Stone was given free rein, and so for ten years the name above his office read Dr G. Adams. It was a good choice, since Galen was an ancient Greek physician whose teachings on medicine dominated medical thought right up until the early nineteenth century. The essence of it was the archaic Doctrine of Humors, the belief that there were four fundamental humors or vital fluids that determined the state of health or illness of a person. These were blood, phlegm, black and yellow bile. Diagnosis of the imbalance led the doctor to the right treatment, which could be to blister, bleed, purge or give an enema.

Inflammation

Although things had advanced a little by the time of the Civil War, they had not advanced very far. By then the dominant view was that inflammation caused most diseases. The four characteristic signs of inflammation – heat, pain, swelling and redness – had been known about since antiquity, when they were described by the Roma doctor, Aulus Cornelius Celsus in the first century. Yet the cause of inflammation was not known. Doctors were taught that there two types – direct and indirect inflammation. Direct inflammation was caused by a breach in the body’s integrity - from a blow, a wound, a burn or the presence of a foreign body, such as a splinter, an arrow or a bullet. Surgery was indicated for direct inflammation.

Indirect inflammation was caused by malfunction of an internal organ.This was treated medically, by bleeding, scarifying, purging with calomel, or using a diaphoretic to induce a perspiration or sweating reaction. Tartrate of Antimony, or ‘Dover’s Powders,’ containing opium and Ipecachuana, were favoured diaphoretics.

The actual causes of inflammation were not known until Dr Ignaz Semmelweiss published a treatise in Budapest in 1861, entitled‘The Cause, Concept and Prophylaxis of Puerperal Fever.’ He suggested that women who died from puerperal fever (childbearing fever) had been contaminated by doctors who had not washed their hands between attending morning autopsies and going to the labour wards. Unfortunately, it would not for another twenty years until Louis Pasteur was able to prove the Germ Theory. That would be too late for the many thousands of men who would die from contamination and gangrenous wounds in the Civil War and beyond.

The Doctor’s Bag

In this monthly blog I am going to talk about the state of medicine and surgery in the nineteenth century, and about what the western town doctor had available for his patients. I will be delving into the medical bag to look at the instruments, pills, potions and mysteries of the doctor’s bag.
But first a biographette.

I was born in St Andrews, Scotland, the home of golf and graduated in medicine from the University of Dundee in 1976. I started training in psychiatry, but for several reasons changed tack to become a General Practitioner. I have practiced as a town doctor in Wakefield in the county of Yorkshire, England since 1979. For a while I was a tutor in General Practice at Leeds University and I am also a medical journalist, having writing a weekly newspaper column for thirty years.

My interest in medical history was kindled when I joined my medical practice. I was going through the junk cupboard, a repository for all the old medical instruments that had fallen redundant over the years. There were surgical kits, post-mortem (autopsy) sets, jars with ‘sutures as used by Professor Lister,’ and even a couple of very early scarificators for the letting of blood. Our surgery, you see, had been founded in 1847, so we had a long history and I felt it needed to be on display. So I researched the history of the surgery and set up a large museum case full of old instruments, to delight the patients and make them glad that they did not live back in the nineteenth century. The picture is of the author holding a set of early nineteenth century dental instruments, back in 1983.

The picture earlier in the blog of the doctor’s bag and the medical paraphernalia on the desk are actually mine and have seen good service over the years.

The doctors of the old west

We will be looking at one or two medical personalities in later blogs, including the great Dr George Goodfellow, physician and surgeon of Tucson, who treated the victims of the OK Coral shooting in Tombstone and who interviewed Geronimo.

For now I just wanted to say something about who practiced medicine back then. Doc Adams is, of course, part of the mythic west, yet there were many doctors, both qualified and unqualified who provided care for the people of those hard and dangerous times.

Since colonial days doctors could be trained by apprenticeship. That would last anything from two to five years. Or if one had enough money, one could study at a medical school and get a proper qualification. Up to the Civil War the average length of a medical course was a mere two years of nine months each. The truth is that there wasn’t much to learn then. And if one wished to bypass the bother of actually going to a medical institution, one could always buy a diploma for five dollars from one of the diploma mills.

Anatomical dissection was illegal in many states and medical instruments were in their infancy. The stethoscope as invented by Rene Laennec, a Parisian physician in 1816, was a monaural device. That is, it was a simple stiff tube with an earpiece at one end and a collecting horn at the other. It was essentially the same as the ear trumpet used by the hard of hearing. The binaural, flexible tubed stethoscope as perfected and designed by Dr George Cammann in 1852 did not become commonly used until after the Civil War. Few Civil War doctors would have a use for one. Indeed, the esteemed Harvard medical school did not even possess one until 1868!

Many doctors allied themselves with one or other of the medical philosophies of the day. There were allopathic doctors, who gave drugs that suppressed symptoms by creating opposite effects to the symptoms that were complained of. Thus they would give a constipating drug to someone with diarrhoea. Homoeopathic doctors would follow the teachings of Dr Samuel Hahnemann and use infinitesimal doses ofsubstances that created the same symptoms as the patient suffered from, using the principle of similia similibus curentur, or ‘like cures like.’ Thomsonians would use herbal preparations and only drugs made from plants. Eclectics would use a bit of this and a bit of that; essentially using whatever they found that worked. And finally, you would get hydropaths, who would advocate using water treatments, after the teachings of Vincenz Priessnitz, a Silesian farmer.

And digging for bullets

So back we come to Doc Adams and surgery. This is something that may be very relevant in western fiction. We’ll be looking at how to dig out bullets, as well as looking at amputations, midwifery and obstetrics and some of the glorious offshoots of medicine – like phrenology - back in the old days of the west.