Doctors and Diseases on the Oregon Trail
On the Trail
We pitched our tents but soon found we were in a distressed crowd. Many Oregon families. One woman & two men lay dead on the grass & some more ready to die of cholra, measels & small pocks. A few men were digging graves, others tending the sick. Women & children crying, some hunting medicine & none to be found scarcely; those that had were loathe to spare. With heartfelt sorrow we looked around for some time until I felt unwell myself. Ordered the teams got up & move forward one mile so as to be out of hearing of crying & suffering.
John Clark
The idea that microscopic creatures we call "germs" cause disease did not gain scientific credibility until 1861, when the French physician Louis Pasteur published Memoire sur les corpuscles qui existent dans l'atmosphere. Before Pasteur, the idea that diseases could be contracted from the environment had gone in and out of fashion over the centuries. It was in fashion during the 1800s, and people believed that damp, foul-smelling air, often called "miasma," was the cause of disease and epidemics. The scent of mold in a dank basement, a reeking cesspool or pile of rubbish, or even the mist rising off a swamp were among the potential sources of bad, disease-causing air -- in fact, the word "malaria" literally means "bad air."
Thus, the Oregon Trail emigrants had no real understanding of the nature of disease. They did, however, appreciate its effects. Epidemics tore through the country every few years, aided in their spread by improvements in transportation -- every new road, canal, steamboat, clipper ship, and railroad line was a potential route for a local outbreak to spread into an epidemic. Children were at risk from illnesses such as scarlet fever and diptheria which are all but forgotten in the United States today. Tuberculosis, known as "consumption" for the way it slowly wore down its victims over the course of many years, was so common that a deep, hacking cough was almost a badge of old age, like wrinkles or gray hair. Malaria was such a major barrier to settlers along the upper Mississippi that some medical experts of the day declared that parts of Illinois, Iowa, and Missouri would probably never be permanently settled.
There was an old German doctor in our train. I don't know why I call him old -- he was only 34 years of age -- but he seemed old to me then. ... When Father died, Dr. Dagon volunteered to drive the wagon and help us to Oregon. After Mother's death, Dr. Dagon took care of us children and was both father and mother to us.
Elizabeth Sager Helm
Not many wagon trains had doctors traveling with them, and it was common for trains without doctors to try to stay close to a train that did have one. Although doctors generally had a low reputation in the United States of the mid-1800s, there are many stories of physicians on the Oregon and California Trails giving generously of their time, energy, and limited stocks of medicine. These men were fondly remembered by their fellow emigrants.
Unfortunately, in addition to trained doctors, quacks also came West.
A boy eight or nine years of age had had his leg crushed by falling from the tongue of the wagon and being run over by its wheels... When I reached the tent of the unfortunate family to which the boy belonged, I found him stretched out upon a bench made of plank ready for the operation which they expected I would perform. I soon learned...that the accident occasioning the fracture had occurred nine days previously. That a person professing to be a doctor, had wrapped some linen loosely about the leg and made a sort of trough, or plank box, in which it had been confined. In this condition the child remained without any dressing of his wounded limb, until last night, when he called to his mother that he could feel worms crawling in his leg!... An examination of the wound for the first time was made, and it was discovered that gangrene had taken place, and the limb of the child was swarming with maggots!... I made an examination... The limb had been badly fractured, and had never been bandaged; and from neglect gangrene had supervened, the childs leg from his foot to his knee was in a state of putrefication. ...
The [surgical] instruments to be used were a common butcher knife, a carpenters handsaw, and a shoemakers awl to take up the arteries. The man commenced sawing; but before he had completed the amputation of the bone, he concluded that the operation should be performed above the knee. During these demonstrations the boy never uttered a groan or a complaint, but I saw...that he was dying. The operator, without noticing this, proceeded to sever the leg above the knee. A cord was drawn around the limb...so tight that it cut through the skin into the flesh. The knife and saw were then applied and the limb amputated. A few drops of blood only oozed from the stump; the child was dead -- his miseries were over!
Edwin Bryant
Most of the overland emigrants took responsibility for looking after themselves; as at home, doctors on the Trail were only called upon in the event of an emergency. The Oregon Trail emigrants were mostly farm families and could take care of themselves reasonably well, as the women brought their granny medicine with them. When the women got sick, however, the men had to improvise.
Mrs Knapp, one of the members of the wagon train, died of cholera, and Mother laid her out. Mother took the cholera. Father didnt know what to do, so he had her drink a cupful of spirits of camphor. The other people thought it would kill her or cure her. It cured her.
Abigail Hathaway King
Traffic on the California Trail, on the other hand, was dominated by unattached men who tried to treat their own illnesses as best they could.
June 25 Somewhat indisposed this morning for the first time on the trip. Prompted by the advice of an Illinois friend, I had brought with me a pint of brandy and some quinine for cases of sickness. Feeling that this was such a case, I prepared a dose according to directions, but found it so excessively-bitter I could not swallow it. Not being acquainted with either of the ingredients, I attributed the bitterness to the brandy. After adding quantities of sugar and coffee with the vain hope of making it palatable I threw the whole mess away in despair and disgust.
William Smedley
The most dangerous period of the emigration was the early 1850s, when cholera broke out in the jumping-off towns along the Missouri River. The emigrants and Gold Rushers headed for Oregon and California picked up the disease while outfitting for the journey and carried it west along the Platte and North Platte Rivers. The cholera epidemic on the Trail certainly killed hundreds and may have killed as many as a few thousand overlanders, but it was rarely mentioned in the emigrants' diaries and journals once they passed Fort Laramie. No one knows if the epidemic simply ran its course and burned out at about the same time every year or if some environmental factor stopped it once the wagon trains were past a certain point on the Trail.
Dear Uncle,
I find here a station for the purpose of conveying a letter to the States and I hasten to inform you of our travels and the incidents pertaining thereto. First of all I would mention the sickness we have had and I am sorry to say the deaths. First of all Francis Freel died June 4, 1852 and Maria Freel followed the 6th, next came Polly Casner who died the 9th and LaFayette Freel soon followed, he died the 11th, and her baby died the 17th. So you see we have had a sad affliction on our short journey. You see we have lost 7 persons in a few short days, all died of cholera. Although I know it will be a sad epistle of news to send you, still, I feel it a duty to let you know how matters are progressing, but thank God we are all well and likely to do well for we have had no sickness since the baby died. Please let Sophia Parkinson read this letter when you have perused it and let all of our friends know about our sad afflictions. We have had very good luck with our teams and have prospered well except sickness and deaths.
And I would say here a word about traveling and tell it to all of your friends that think of coming on this vast prairie, it is this, do not, as you value your lives, ever drink water out of springs and sunken wells on the side of the road or any where else. Always use the Platte River water and you will have no sickness. Even if you do have to go a mile or two miles, do it rather than to drink out of those cursed pittholes of deaths. For it is nothing less than that caused all of our sickness.
We didnt know anything about it, and as the water is generally good and pleasant to drink, we thought we were using the best water. So remember this, and as I said before, advise your friends to do the same. I have not time to write more at present, for we are stopping our teams in the middle of the road for the purpose of writing this. So good bye for the present. I will write to you again the next opportunity and believe me yours as ever
Your affectionate nephew
George Kiser
Ann Kiser
While cholera was the most widely feared disease among the overlanders, tens of thousands of people emigrated to Oregon and California over the course of a generation, and they brought along virtually every disease and chronic medical condition known to science short of leprosy and the Black Death. Dysentery, smallpox, measles, mumps, and influenza were among the diseases named in diaries and journals, but cholera, mountain fever, and scurvy were probably the biggest killers.
Mountain fever was not described well enough to pin down exactly what it was. Some speculate that it was typhoid fever, while others believe that it was an insect-borne disease such as Rocky Mountain spotted fever. Camp fever was almost certainly scurvy -- which is not actually a contagious disease, but the result of a vitamin deficiency -- as bleeding gums were described as the first symptom of a fatal case.
Disease was the single biggest threat to the emigrants on the overland trails, but doctors were often called upon to deal with accidental injuries, as well. Horses and oxen sometimes bit or kicked their owners, people occasionally slipped as they were climbing on or off their wagons and were run over, and there were even a handful of people struck by lightning over the years. Among the most difficult injuries to treat were gunshot wounds, as doctors could do little beyond bandaging the wound and relieving pain. If a bullet or musket ball remained within the body, doctors used slim rods of metal or bone to probe the entry wound, poking around until they found the bullet by touch, and then tried to reach in (often with their bare fingers) and pull it out through the wound it made on the way in. Most gunshot wounds on the emigrant trails were the result of somebody's carelessness or lack of experience with firearms.
Some stir in camp this morning in consequence of a sentinel's gun going off accidentally, which killed a mule belonging to James Williams, the bullet breaking the mule's neck. This is the most serious accident which has yet occurred from carelessness in the use of firearms, though, judging from the carelessness of the men, I have anticipated more serious accidents before this time, and if they do not occur, they will be avoided by great good luck, not by precaution.
James W. Nesmith
There was no telling where illness or injury might strike, and it was common for doctors to ride miles out of their way to reach patients in distant wagon trains. Overland trails historian John Unruh, Jr., observed that, "...it is evident that physicians were among the heroes of the migrations, especially during the Gold Rush."