Purpose of Lesson: This lesson gives students an overview of some of the common illnesses and medical treatments during the pioneer era in Indiana
Objectives: At the end of this lesson, students should be able to:
Correlation to Indiana Standards (for Fourth Grade Social Studies)
4.1.13 Distinguish fact from opinion and fact from fiction in historical documents and other information resources.
4.1.15 Using primary source and secondary source materials, generate a question, seek answers, and write brief comments about an event in Indiana history.
4.2.7 Define and provide examples of civic virtues in a democracy.
4.2.8 Use a variety of information resources to research and write brief comments about a position or course of action on a public issue relating to Indiana's past or present.
4.5.5 Give examples of the impacts of science and technology on the migration and settlement pattern of various groups.
Content from Oliver Robinson, "Medicine, Pioneer Style, 1825," IMH 35 (March 1939); Leonora Miller, "Doctors, Drugs, and Disease in Pioneer Princeton," IMH 52 (June 1956); Hugh Ayer, "Nineteenth Century Medicine," IMH 48 (September 1952); and Walter J. Daly, "'The Slows': The Torment of Milk Sickness on the Midwest Frontier," IMH 102 (March 2004)
Vocabulary words : hygiene, malnourishment, susceptible, bacteria, parasite, virus, bleeding, purging, poultice
Read the following out loud to the class, pausing to define vocabulary words and answer questions:
Illness was a problem for many pioneer families. Poor hygiene, dirty water, and harsh living conditions contributed to a short life for many people. Pioneers were often malnourished as well, which made them more susceptible to disease.
Question: Ask the class to think about what they have learned about life on the frontier, especially in log cabins. Why would poor hygiene be so common? What might cause malnutrition among the pioneers?
Four common diseases were cholera, malaria, smallpox, and typhoid fever. All four were often deadly; those who lived could be weak and sickly for months or have the disease re-occur throughout their life (malaria).
Suggestion: Put this Chart of 4 Common Pioneer Diseases up on the board or on a screen. Go over the causes and symptoms of each disease.
Seeing a doctor when you were sick was difficult during pioneer times. In most areas of Indiana, like other parts of the frontier, there were very few doctors available and many of those who were available had very little education or training, when compared to today's doctors. For example, Dr. Richard Carter, who wrote a book about cures for common diseases in 1825, studied for a few months with two Native American herbalists and then read through his father's small collection of medical books (probably no more than half a dozen). Within less than one year, he considered himself qualified to be a doctor and began practicing.
Many pioneer women were both nurse and doctor to their families. And when widespread sickness came to a town or rural area, neighbors who were well would often help out families whose members were ill.
Question: Why would help from neighbors be so important?
Pioneers knew nothing of bacteria or viruses and, compared to today, had a very primitive understanding of the workings of the human body. They could observe facts, but their conclusions were often incorrect. Pioneers noticed, for example, that malaria was most common in low-lying areas near sources of water (particularly stagnant water), but they believed that mists (sometimes called a "miasma") that rose up from the water somehow caused the disease. They did not know that the mosquitoes which bred in the water actually carried the disease.
Most doctors and patients relied on homemade remedies. Two favorite remedies for many illnesses were bleeding and purging. Sometimes these "cures" made the ill person so weak, they died. Most people also used herbs and other plants to make poultices, teas, and syrups. Here are some examples:
Question: As you read each of the remedies below, ask the class: Do you think this would cure or even help that particular disease? Why or why not?
"For curing the Ague and fever [malaria]. . . Take one third Rhubarb and two thirds best Barks [bark from a tree or bush—sassafras was widely used in Indiana], mix them with Brandy or old whisky until they are about as thin as rich cream – take a wineglass full, 4 or 5 times a day. If it gripes too severely [causes stomach cramps], dilute it with water." [Written on an 1822 storekeeper's ledger. From Jones and Stockwell's General Store, Princeton, Indiana.]
"For cancer, . . . a salve to be made from pennyroyal, camomile flowers, mullein, and one-half gallon of apple vinegar. After this mixture has been boiled twenty-four hours, we must add salt and a gill [5 fluid ounces] of honey; then we are to simmer to mixture down to a salve – which is to be applied to the cancer with a feather." [from Richard Carter's A Valuable Vegetable, Medical Prescription... (1825) ]
"For Gout, Rheumatism, Cramps, and Weak Nerves. . . Kill the fattest young dog that you can get, in the month of March or April; clean him as you would a pig; gut him; and stuff his body with a pint of red fishing worms, a pint of red pepper, a considerable portion of the bark of the root of sassafras, and water frogs; then sew up the incision, roast the dog well, and save the oil to annoint sores, gouts, weak nerves, etc." [from Richard Carter]
"For bilious, nervous, and putrid fevers [putrid fever is usually typhoid; bilious fever can be jaundice, yellow fever, or typhoid]. . . Get a double handful of the bark of the roots of dogwood, a handful of ground ivy, a handful of mullein roots, and a handful of the bark of the roots of sassafras; boil them all well together in water, strain the syrup and put it in a vessel to itself. Then get a quart of good clean cow dung and put it in a tight little linen bag and boil it well in water; then strain it with the other syrup, boil it down to a quart and bottle it." [from Richard Carter]
In Class or Take Home Assignment: Compare and Contrast
Have the students fill out a worksheet with the following categories:
Ask them to list four medical problems they'd had, who helped them cure each one (i.e., school nurse, parent, doctor), and what cured each one (cast for a broken wrist, prescription medicine for an infection, cough syrup for a cold). Ask them if they can include at least one example of a "home cure" and one example of a "doctor cure."
During the next class (or after a set period of time), write the three categories on the board and write down student answers as they give them. After you have a good sampling, go over the results with the class and see if you've found any comparisons with what the pioneers might have done for an illness. Or have you found mostly contrasts? (If there are no comparisons on the board, mention lemon and honey for a cough, chicken soup, etc.)
Purpose of Lesson: This lesson tells students a story about a specific illness in pioneer Indiana and how it affected the life of Abraham Lincoln.
Objectives and Correlation to Indiana Standards : See part one
Lesson content from: Walter J. Daly, "'The Slows': The Torment of Milk Sickness on the Midwest Frontier," IMH 102 (March 2004)
Lesson Activities: Read aloud to the class or assign as a take-home reading.
When the first pioneers moved into Ohio and Indiana, they discovered an illness they had never seen before. It seemed to be related to a sickness that their farm animals, especially cows and sheep, sometimes developed. The animals would begin to shake and tremble whenever they tried to move very far; within a few days, the sick animals died. The pioneers called the illness the “trembles” or the "slows" (because the few people who survived the illness often spent weeks or months feeling very tired and unable to work or even move around).
Doctors soon could list the symptoms of the disease: weakness, muscle pain, vomiting, bad breath, and extreme fatigue. Many patients, within a few days of falling ill, went into a coma and died.
Pioneers noticed that the animals who became sick with the "trembles" were mostly those who had grazed in oak forests or in low-lying areas with oak trees and smaller plants. For many decades, doctors and scientists tested animals with the disease and tried to find its cause. During this time, the settlers who were most affected by the disease could do little to prevent or cure it, except to move away from one area and hope that the next place they settled would be free from the disease.
In 1816, Thomas and Nancy Hanks Lincoln, along with their two children and Nancy 's young cousin Dennis Hanks, settled in a wooded area near Pigeon Creek, Indiana . They lived in a three-sided lean-to for several months until Thomas finished building a small log cabin. Soon Nancy's aunt and uncle also moved to the same area. In the fall of 1818, several people who lived near the Lincoln's cabin became seriously ill. All of the sick people, including Nancy Lincoln's aunt and uncle, had similar symptoms – the symptoms of the "slows." Soon Nancy also became ill and she, like the others who were sick, died within a few days. Thomas Lincoln was left alone to raise his wife's young cousin and his two sons, including nine-year old Abraham. In December 1819 Thomas remarried, in part to give young Abe a new mother.
In the 1850s, when Abraham Lincoln was a lawyer living in Illinois, scientists finally confirmed the cause of the "slows", or what was now known as "milk sickness." The cause was a poisonous substance in the white snakeroot plant. The snakeroot grew in oak forests and in low-lying areas. If a grazing cow or sheep ate enough snakeroot, it would become sick and its milk and meat would carry the poison to the person who drank or ate it.
It took many years for people to learn about this discovery. In 1859, in Randolph County, Indiana, three children from the same family died from milk sickness. In 1862, Mary Bell Wilson, living in Lockport, Indiana, wrote a letter to her grandparents telling them that "a disease called milk sickness carried off a good many people last fall." Milk sickness began to disappear in the years between 1850 and 1900 as farms became larger, and grazing pastures became fenced in so that animals could not stray into the woods.
For Class Discussion the Next Day:
1. Why do you think it took so long for doctors and scientists to discover the cause of milk sickness? What was lacking in early 19th-century society that might slow down research? [Examples: modern transportation so that people in rural areas receive news; communication technology so that scientists and doctors can share their findings with each other; technology that aids in research; etc.]
2. Read the following text from Dr. Daly's article aloud to the students:
"Treatments [for milk sickness] were varied . . . but none was specific and none effective. Purging the bowels with calomel, sedation with opium and/or alcohol, and bleeding were common."
Ask the students: Why do you think so many people used remedies and treatments that didn't work?
An Optional Assessment Project Worksheet is available here