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Debunking American History

Quarantine: Nineteenth Century Medicine In Action
by Marilyn N.
American History Major

We all saw how Dr. Pierce handled a measles epidemic at Plumfield, and it raised some interesting questions on the forum recently. (Thanks, Margot!) I’d like to expand a little on some of the points raised in our group discussion. First, we were lucky that Dr. Pierce was relatively progressive as a physician. He didn’t recommend some treatments that we see as rather barbaric now. Second, his use of laudanum was interesting, and I’ll explore that in more depth below. And third, his choice to quarantine the school was wise, and he followed basic protocols established for infectious diseases.

The first time I saw "Quarantine," I was very relieved to see that we didn’t see any patients bled, purged, or cupped. These had been common treatments since the Greeks—fathers of medical theories that lasted until the twentieth century. I believe the procedure of bleeding is self-explanatory. The Greeks believed that the human body had four types of humours, and it was necessary to keep those in balance. An imbalance of these humours, (blood, phlegm, black bile, and yellow bile), could be achieved by getting rid of "evil humours." In addition to bleeding a patient, doctors could purge evil humours using laxatives and emetics. With modern knowledge, we know that bleeding and purging are usually dangerous for sick or injured people, but that wasn’t necessarily common thinking in 1871. Cupping meant heating round glass bowls or cups and placing them on the patient’s back. I’m not certain how this was supposed to help, but it was a common practice as well. Dr. Pierce used none of these treatments, and it would have been worse for his patients if he had.

Another practice that presents questions of effectiveness involves the prescription of laudanum for pneumonia. Laudanum was an alcoholic tincture of opium, and was probably expensive and rare. Opium came from the Middle East and Asia. With expanding Western trade with China in the nineteenth century (against China’s will, by the way), opium was more available by the 1870s but still wasn’t easy to obtain. It isn’t surprising that Dr. Pierce could run out of laudanum when new supplies had to come by train or stagecoach. According to a modern doctor’s opinion, laudanum wasn’t a good prescription for pneumonia. Of course, doctors had limited options with pneumonia until antibiotics were developed in World War II. But it is clear that while opium might help ease coughing, it could also suppress breathing. The narcotic effects could help a patient feel better, but it wouldn’t do much for the symptoms. My final analysis: it didn’t matter much what he did, because it’s very difficult to treat pneumonia empirically [treating the symptoms, not the disease]. Without antibiotics, luck played a role in who could fight off secondary infections like pneumonia.

But Dr. Pierce did have some sound medical advice in handling this measles outbreak. Epidemic protocols were firmly established by the eighteenth century, and it was standard to quarantine a population infected with dangerous illnesses. Measles is highly contagious. The worst period of contagion is just before the rash appears, before anyone has any idea of impending danger. Dr. Pierce was wise to quarantine Plumfield from the beginning. Everyone there had already been exposed, and to send "healthy" students home would have spread the illness through the entire town. And Asia opening all of the windows at the end of the episode was a good thing, too. The virus is very short-lived, and a well-aired room will be free of contagion within a few hours.

In general, "Quarantine" is accurate in its portrayal of medical procedures and practices in this episode. While it’s sad that Mrs. Jo couldn’t save Marcus, that was part of life in that era. Most families lost at least one child to illness or accident at that time. What’s astounding is that so many of the patients at Plumfield pulled through without developing further complications.

Webmaster's Note: Marilyn, thanks a million for writing for my website!!!  You have tremendous talent and it's a true honor to be able to post your work here.  I hope that the rest of you find her writing as intriguing as I do.