Diseases in the District of Maine 1772 - 1820 - The Unpublished Work of Jeremiah Barker, a Rural Physician in New

This is a rare, previously unpublished account of suffering and healing in the Early Republic, a primary source describing one medical practice. We know a lot about how elite physicians practiced 200 years ago, but very little about the daily practice of an ordinary rural doctor, attending the ordinary rural patient. Barker's manuscript is written in a clear and engaging style, easily enjoyed by general readers as well as historians, with extensive footnotes and a glossary of terms. Barker himself intended his book to be "understood by those destitute of medical science."

List of contents

• Foreword by John Harley Warner


• Introduction:


• Chapter 1. Jeremiah Barker: Background, Education, and Writings


• Who was Jeremiah Barker?


• Provenance of the Barker Manuscript


• Description of the Barker Manuscript


• The Medical Geography of the District of Maine, 1760-1830


• Barker's Contribution to the Medical Literature of Northern New England


• Articles Published by Jeremiah Barker


• Yellow Fever in the District of Maine?


• Conclusion


• Chapter 2. Obtaining and Sharing Medical Literature, 1780-1820


• Medical Information by Mail


• The First United States Medical Journals and Medical Nationalism


• Problems Encountered by Early Medical Journals


• Newspapers as a Source of Medical Information


• And Last but Not Least, Books


• Conclusion


• Chapter 3. The Old Medicine and the New: why Barker wrote this manuscript, for whom was it written, and why was it not published?


• The Importance of Observation and Recording


• Basics of Greek Medicine and Fever


• Bloodletting: The Blood Was "Sizy and Buffy"


• "Scientific Doctors" and the "Empirics"


• More Competition: Domestic and Sectarian Medicine


• Science, Institutions, Education, Framing Disease, and Cultural Authority


• Case Reports and the Clinical Exam circa 1800


• Recording Cases, Observations, and the Numerical Method


• "Thus Sayeth Galen" Meets Cullen, Rush, and Brown


• "Intelligible to Those Who Are Destitute of Medical Science"


• Why Was Barker's Manuscript Never Published?


• Rapidly Changing Medical Theory and Philosophy: Noah Webster


• Conclusion


• Chapter 4. "Alkaline Doctor" and "A Dangerous Innovator"


• Lavoisier and the New Chemistry


• The Acid/Alkali Debates of the Seventeenth and Eighteenth Centuries


• Barker, Mitchill, Septon, and the Medical Repository


• Barker's Use of Alkaline Therapy


• Chemistry, Yellow Fever, and the Contagionist/Anticontagionist Battle


• Barker the "Dangerous Innovator"


• Conclusion


• Chapter 5. Thoughts to Consider While Reading Barker's Manuscript


• Presentism, Whiggish History, the Post Hoc Fallacy, Confirmation Bias


• Holistic and Biomedical Models


• Numerical Methods and Retrospective Diagnosis


• Barker's Treatments, Therapeutic Efficacy, Bacon, and Confirmation Bias


• Nature vs. Art in Medicine-Best Available Evidence and the Burden of Disease


• Conclusion


• The Jeremiah Barker Manuscript Volume One


• MS V. 1, Chapter 1. Insanity and Temperance


• Mental illness and problems associated with the use of ardent spirits


• MS V. 1, Chapter 2. Early Maine Medical History Beginning in 1735


• 1780 Barker moves from Barnstable, Massachusetts to Gorham, District of Maine


• Introduces his new community and physicians practicing in southern Maine


• Introduces Rev. Thos. Smith's diary documenting diseases and epidemics, 1735-1780


• 1735 N.E. epidemic of cynache maligna, putrid sore throat, as described by Smith


• Excerpt of Dr. John Warren's 1813 article on cynache maligna or throat distemper


• Barker discusses illnesses of the 1740s including quinsy


• MS V. 1, Chapter 3. Deaths Following Trivial Wounds and Childbed Fever


• Barker's initial years in the District of Maine beginning 1780


• 1784-1785 unusual epidemic of serious wounds and death in men


• 1784-1785 unusual epidemic of childbed fever and deaths of women


• Discussion focusing on women with childbed fever, deaths, autopsies, searching the literature and contacting medical peers for suggestions


• Excerpt remarks on puerperal fever By Dr. Channing, 1817


• Excerpt Dr. William DeWees on puerperal fever 1807


• MS V. 1, Chapter 4. Throat distemper, Ulcerous Sore Throat, Scarlatina Angiosa, Cynache Maligna


• 1784: experience with throat distemper, other New England physicians and the literature


• Excerpt on putrid sore throat by Hall Jackson (Portsmouth, New Hampshire), 1786


• Joshua Fisher on throat distemper or scarlatina angiosa


• MS V. 1, Chapter 5. Scarlatina Angiosa, Inflammatory Fevers, Hooping [Whooping] Cough, and Croup in Maine, 1797-1806


• 1796-1798 Scarlatina angiosa and the use of bloodletting and blistering


• 1802-1807 Scarlatina angiosa with many comments by other physicians


• 1805 example: 17 yo woman with Scarlatina angiosa bled, blistered, treated with alkalis


• 1774-1780 Barker's experience in Barnstable with quincy of croup, "a kindred disease"


• 1795-1806 "hooping cough"


• MS V. 1, Chapter 6. Bloodletting for Palsy, Hemiplegia, and Other Neurological Events


• Pneumonia in a minister who used his lancet on his parishioners prophylactically


• Use of bloodletting in disease, prophylactically, and by native Americans


• Excerpt on bloodletting among native Americans in "Travels in Canada and the Indian territories, between the years of 1760 and 1776." Alexander Henry, 1809


• Hemiplegia and apoplexy


• Excerpt of "Observations on paraplegia in adults" by Matthew Baillie, 1820


• Excerpt of "Cases of Apoplexy with Dissection," by John C. Warren, 1812


• MS V. 1, Chapter 7. Hydrophobia


• Hydrophobia, cases and review of literature


• Value of volatile alkalis to treat three people bitten by mad dogs


• MS V. 1, Chapter 8. Anasarca, Ascites, Dropsy, and Foxglove


• 1786 move from Gorham to Stroudwater section of Portland


• Cancer


• Anasarca, ascites, hydrocephalus


• MS V. 1, Chapter 9. Epidemic of Influenza, Cancer, and Tainted Veal


• Influenza or Epidemic Catarrh


• Reference to Noah Webster's History of Epidemic and Pestilential Diseases, 1799


• Regarding Thomas Smith's and Barker's cases


• Use of alkali after Barker's experiments


• Barker communicated his ideas on the nature of fever, together with some practical observations on the use of alkalis in fever in 1795, to Mr. William Payne, Secretary of the Humane Society in New York, who gave the letter to Dr. Samuel Mitchill at Columbia College.


• MS V. 1, Chapter 10. Letter to Samuel L. Mitchill in New York, May 30th 1798


• The first page of a letter to Dr. Samuel Mitchill, subsequently published in the Medical Repository 1799, Vol. II No. II, pp. 147-152: "On the febrifuge Virtues of Lime, Magnesia and Alkaline Salts in Dysentery, Yellow-fever and Scarlatina Anginosa. In a Letter from Dr. Jeremiah Barker, of Portland, (Maine) dated May 30, 1798."


• The Jeremiah Barker Manuscript Volume Two


• MS V. 2, Introduction


• Chapter opens with a letter dated 20 December 1831: Dr. Samuel Emerson, Kennebunk, Maine, having reviewed Barker's manuscript, recommends that it be printed


• Barker's Introduction to Consumption


• MS V. 2, Chapter 1. Frequency of Consumption in Women in Recent Years in New England


• General comments on consumption; anatomy of respiration


• MS V. 2, Chapter 2. Tracheal Consumption


• General comments on tracheal consumption


• MS V. 2, Chapter 3. Phthisis Pulmonalis, or Pulmonary Consumption


• General comments on phthisis pulmonale, or pulmonary consumption


• MS V. 2, Chapter 4. Consumption and the Deaths of Barker's Wives; Pneumonia


• Cases of consumption beginning during Barker's pupilage


• 1775 Marries Abigail Gorham, age 25 with a history of chronic catarrh, hemoptysis; dies in 1790 after gradually increasing illness


• 1780 Lucy Garrett of Barnstable, chronic cough with blood, dies 1787


• Discusses Ezekiel and Abner Hersey, their treatments and their illnesses


• 1790 marries Susanna Garrett, age 21 with chronic cough, dies of consumption 1793


• 1798 marries Miss Eunice Riggs, of Falmouth, age 25, cough with blood, dies 1799


• 1799 Barker claims he had been "infected with the Brunonian doctrine" but now embraces Rush, bleeding, and salivation


• MS V. 2, Chapter 5. Various Treatments for Phthisis Pulmonalis (Consumption)


• The efficacy of cooperative means such as emetics, cathartics, alkali, digitalis, epispastics, issues, diet, air, and exercise


• MS V. 2, Chapter 6. The Most Extraordinary Cases of Pulmonary Affections


• Cases of pulmonary afflictions cared for by Barker in Maine


• Benjamin Rush and his treatments


• MS V. 2, Chapter 7. Brownism to Rushism or Alcohol to Blooding; Empyema


• Excerpt from Dr. Young (1815). A practical and historical treatise on consumptive diseases, deduced from original observations, collected from authors of all ages.


• Historical aspects of consumption


• MS V. 2, Chapter 8. Cases of Phthisis Pulmonalis and Excerpts from Journals


• Barker was requested to extract some of the most extraordinary cases of


• consumption from various medical sources, such as the Medical Repository, the Medical Museum, the New England Journal of Medicine, the London Medical Journal, etc. not conveniently purchased or obtained by young physicians


• MS V. 2, Chapter 9. Pulmonary Affections Removed by the Intervention of Some Other Diseases, also by Powerful Means, and Manual Operation [Surgery]


• Pulmonary afflictions removed by surgical intervention; several more of Barker's cases


• Epilogue

About the author

Richard Kahn (1940) is an internist and medical historian who graduated from Rutgers University and Tufts University School of Medicine, where his interest in medical history began. After internship at Maine Medical Center in Portland, he spent two years in the U.S. Public Health Service, returning to MMC for an Internal Medicine residency. Practicing in Rockport, Maine, he has had teaching appointments at Tufts, Dartmouth, and the University of Vermont medical schools. He has been active in several organizations devoted to medical history, most notably the American Association for the History of Medicine and the American Osler Society. He received the Osler Society's Lifetime Achievement Award in 2017. Assisted by his wife Patricia, a medical librarian, Kahn began work on the Jeremiah Barker papers more than 30 years ago with the rediscovery of the Barker Manuscript at the Maine Historical Society Library, culminating at last in the publication of Diseases in the District of Maine 1772-1820.

Summary

Jeremiah Barker practiced medicine in rural Maine up until his retirement in 1818. Throughout his practice of fifty years, he documented his constant efforts to keep up with and contribute to the medical literature in a changing medical landscape, as practice and authority shifted from historical to scientific methods. He performed experiments and autopsies, became interested in the new chemistry of Lavoisier, risked scorn in his use of alkaline remedies, studied epidemic fever and approaches to bloodletting, and struggled to understand epidemic fever, childbed fever, cancer, public health, consumption, mental illness, and the "dangers of spirituous liquors."

Dr. Barker intended to publish his Diseases in the District of Maine 1772-1820 by subscription - advance pledges to purchase the published volume - but for reasons that remain uncertain, that never happened. For the first time, Barker's never before published work has been transcribed and presented in its entirety with extensive annotations, a five-chapter introduction to contextualize the work, and a glossary to make it accessible to 21st century general readers, genealogists, students, and historians.

This engaging and insightful new publication allows modern readers to reimagine medicine as practiced by a rural physician in New England. We know much about how elite physicians practiced 200 years ago, but very little about the daily practice of an ordinary rural doctor, attending the ordinary rural patient. Barker's manuscript is written in a clear and engaging style, easily enjoyed by general readers as well as historians, with extensive footnotes and a glossary of terms. Barker himself intended his book to be "understood by those destitute of medical science."

Additional text

This is an extraordinary look at "ordinary" Maine physician Jeremiah Barker and his attempt to practice medicine at the turn of the 19th century. We see Barker practicing and writing his ultimately unpublished History of Diseases in the District of Maine amidst the rise and fall of medical theories and practices, the birth of medical journals in this country, and the attempt by orthodox medical practitioners to establish a seemingly rational therapeutics. Complementing Laurel Thatcher Ulrich's contextualization of Maine midwife Martha Ballard in A Midwife's Tale, Kahn places Barker's own evolving theories, practices, and identity, along with the full and annotated transcript of Barker's History of Diseases of the District of Maine itself, into historical context." - Scott Podolsky, MD, Professor of Global Health and Social Medicine, Harvard Medical School and Director, Center for the History of Medicine, Countway Medical Library, Boston, MA

Product details

• Authors: Richard J. Kahn, Richard J. (Assistant Clinical Professor Kahn
• Publisher: Oxford University Press
• Languages: English
• Product format: Hardback
• Released: 22.09.2020
• EAN: 9780190053253
• ISBN: 978-0-19-005325-3
• No. of pages: 568
• Subjects: Fiction > Narrative literature > Letters, diaries; BIOGRAPHY & AUTOBIOGRAPHY / General, Maine, MEDICAL / History, History of Medicine, Early 19th century c 1800 to c 1850, C 1700 To C 1800, Later 18th century c 1750 to c 1799