As spring approaches in the Middle Atlantic and Northeastern states, we welcome the chance to spend more time outdoors in the fresh air instead of cooped up in our houses – getting sick. Ailments such as colds and flu are contractible anytime, but we usually associate them with the wintertime as that’s when they seem to be more prevalent.
With modern medicine, we can easily treat and overcome these and other more serious illnesses that rise up during the colder months. People living in the eighteenth century, however, did not have the luxury of our scientific knowledge of modern medicines, and so what is easily treatable today could be, and often was, deadly during their lifetime. They had to deal with serious diseases, such as dysentery, measles, mumps, smallpox, rickets, typhus, typhoid, tuberculosis, and yellow fever, without the benefit of antibiotics.
Medical treatments for dealing with illnesses in the eighteenth century were primarily herbal remedies and traditions passed down over the centuries in medical books or as local knowledge. People like the Washington family probably relied on local healers, apothecaries, physicians, or midwives in the Fredericksburg area to prepare the medicines and treat their illnesses. It is also very likely that Mary Washington would have had the knowledge herself to oversee the formulation of cough syrups, laxatives, and other tinctures using the herbs and flowers in her own garden. Betty Washington Lewis, Mary’s daughter, owned a copy of Eliza Smith’s 1739 The Compleat Housewife: or, Accomplished Gentlewoman’s Companion, a cookbook, in which are explicit medicinal recipes for dealing with hysterics, the vapours, pain from stones, the plague, upset stomachs, a cancerous breast, consumption, and for ‘preserving the lungs,’ among other things. The chances are pretty good her mother Mary also had access to this same recipe book.
We do not have any historical information on the childhood diseases or winter ailments that were present in the Washington home, but here are two that they might have experienced.
Pneumonia, a bacterial infection of the lungs, also known as ‘Winter Fever’, was a great concern in colonial Virginia. Although it was not known as a disease in and of itself but rather a symptom of other illnesses until much later, the presence of this respiratory ailment was noted by colonists.
Pneumonia and many other such illnesses were prevalent in the winter months when conditions forced people inside with closed windows and doors. Prior to modern home climate-control technology, windows and doors were opened in good weather to create a breeze that cooled down a house but also served to air it out. Additionally, many activities we perform indoors today took place outside, such as laundry and food processing, which got people out in the open more. When the weather turned cold, however, people were stuck inside with little ventilation and essentially stewing in their own germs. As such, pneumonia spread rampantly throughout the winter, and with no antibiotics, it was often deadly especially for the young and elderly.
The commonly incorrect assumption at the time was that many illnesses resulted from bad smells or miasma. Bloodletting, laxatives, and emetics were justified treatments for almost anything wrong with you because it was essential to purge and expel the bad blood and humours from one’s body. In general, these treatments did more harm than good and, in some cases, killed the patient.
In addressing the symptoms of pneumonia (fever, cough, inflammation of the lungs), a mixture of treatments would have been proscribed for the patient. Cough syrups recipes were many and concocted from a wide variety of aromatic herbs infused in flavored waters, honey, or liquor. Opium in the form of poppy leaves was also a common ingredient. Additional treatments included bloodletting “8 to 10 ounces if strong 12 ounces” and applying ‘blisters’ on the back of their neck to promote sweating and to help with a headache. Blistering was an aggressive treatment to the skin and essentially created pain in one spot to counteract pain elsewhere. A blistering agent, such as mustard, capsicum, or Spanish Fly, was applied in a poultice to the skin, causing redness and, in extreme cases, a raised pus-filled blister. The cure might have been worse than the disease!
Scientists have since made great breakthroughs in treating pneumonia, including the invention of penicillin by Alexander Fleming in 1928. Yay science!
Bowed legs, thickened wrists and ankles, low weight, and deformities of the skull and pelvis are all signs of Rickets, a common disease of the 18th century and prevalent during the winter months. Rickets is caused by a lack of Vitamin D in a child’s diet, leading to soft, weak bones that don’t mineralize properly. The symptoms of rickets usually appear between the ages of 3 to 18 months, and if caught early, the disease is reversible by ensuring a proper diet of Vitamin D-rich foods (fatty fish, egg yolks, fish oil) and exposure to sunlight.
Eighteenth-century physicians knew about the disease and discussed the symptoms and possible remedies in their medical books, but they didn’t understand the actual cause (Vitamin D deficiency) and, therefore, how to cure it. And although Rickets is often associated with children living in poverty with limited diets or restricted to sunless living and working conditions, it affected children of all socio-economic levels.
John Freke, in his 1748 book “An Essay on the Art of Healing,” felt that the diet of the children affected by Rickets was “in general too luxuriant” and should be scaled back to a more austere diet than ordinary. “Care should be taken to send this sort of Children into a sharp Air,” and “rousing their Blood by shaking and tossing them often, giving them now-and-then a little red Wine, and dipping them every Morning in cold Water.” He was spot on to suggest letting them play outside in the sun, but restricting their diet would certainly have had a deleterious effect on the patient.
The 1710 Book of Physick was a recipe book of natural remedies using plants and minerals to cure the everyday ills and complaints of the sick. The first step incurring rickets was to administer a “purge,” which was a drink that flushes everything out of your digestive system by either vomiting or diarrhea. Purgatives were seen as a cure-all for many diseases because the prevailing thought was you had to expel whatever was making you sick out of your body.
The recommended purge was made of a long list of plants, including liverwort, speedwell, and yarrow, mixed with fruits such as figs and raisins, all slowly simmered together in water. Dosage was three spoonful’s every morning and night for 14 days.
Next on the list was bloodletting, of course! Just a prick on the ear would do the job, or leeches behind the ears! What is interesting is that this instruction was immediately followed by a reference to the page on how “to staunch bleeding.”
Not all remedies had to come from physician’s books but could be found in publications geared towards laymen. The Servants Directory, Improved; or House-Keepers Companion, published in1762, was an instruction manual on all things household, ranging from how to kill rats, clean furniture, wash silk stockings to the best way to cook parsnips. Included in a chapter on the care of small children was a cure for a Rickety child. The first suggestion was to give the child three doses of a gentle physic, or purge, similar to the 1710 Phisick book. Next, rub the child with a concoction of smashed garden snails and liquor every day for a month. Outside exercise was also recommended, thank goodness!
If the 18th century rickety child could survive multiple purges, bloodletting, a restrictive diet, vigorous body rubs with bug juice, and occasional sun exposure, who’s to say which treatment was the one that was most effective (Just kidding)! Progress in studying the causes and treatments of Rickets culminated in the early 20th century when it was clearly shown the benefits of using sources of Vitamin D, such as cod liver oil and sun exposure, in curing rickets.
If you are interested in medical history see our other blog posts on mercury, patent medications, Civil War medicines, Civil War hospitals, bad medicines, homemade medical remedies, dental care and smallpox.
Mara Kaktins, Archeologist
Ceramic & Glass Specialist
 Eliza Smith, The Compleat Housewife: or, Accomplished Gentlewoman’s Companion, J. and J. Pemberton, 1739, pgs. 240-250.
 A Book of Phisick. Made June 1710, p. 46. Wellcome Collection. Public Domain Mark
 Freke, John. An Essay on the Art of Healing, p. 247-248. 1748. https://play.google.com/books/reader?id=H_o1AQAAMAAJ&pg=GBS.PA246&hl=en
 A Book of Phisick, pg. 92-93.
 The Servants Directory, Improved; or, House-Keepers Companion. H. Glass. Fourth Edition, 1762. Reprinted 2001 by United States Historical Research Service.
 O’Riordan, Jeffrey and Olav Bijvoet. Rickets before the discovery of vitamin D. Published online 2014 Jan 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899557/