Most families in Colonial America relied on their own resources or local healers and herbalists rather than professional physicians. Domestic medicine was preferred to imported drugs, which were either un- available or expensive. Those who wanted to avoid doctors, or had no access to healers, depended on traditional remedies, popular herbals, and self-help books for information on how to maintain health and deal with illness and injuries. For example, Every Man His Own Doctor: or, the Poor Planter’s Physician (1734) was written anonymously by John Tennent (ca. 1700–1760), a Virginia physician, who denounced other doctors for their exorbitant fees and for prescribing remedies that were as bad as the disease. Despite the attacks of fellow physicians, he offered advice, not for those who could afford ‘‘learned Advice,’’ but for the poor, who needed to ﬁnd the ‘‘cheapest and easiest ways of getting well again.’’ The mashes and swamps of Virginia, he warned, generated many fevers, coughs, quinsies, pleurisies, consumptions, and other plagues. In addition to descriptions of the symptoms of each disease, Tennent provided advice on diet, prevention, and medicines. Some of his suggestions for preventing sore throat and similar disorders were as simple as washing the neck and behind the ears in cold water every morning, but other conditions required bleeding, blistering, poultices, syrup of peach blossoms, or even pills made of turpentine and ‘‘Deers Dung.’’ Because the book was written for those who could not afford to ‘‘dye by the Hand of a Doctor,’’ Tennent deliberately avoided refer- ences to mercury, opium, and Peruvian bark. Many books offered advice to mothers about the health of their family and the physical and mental development of their children. Catharine Beecher (1800–1878), founder of the Hartford Female Semi- nary, advocated exercise and dress reform based on the science of physiology.
The curriculum at Hartford Female Seminary included calisthenics and physical education. In Suggestions Respecting Improve- ments in Education (1829), Beecher insisted that the health and well being of children depended on teaching women about anatomy and physiology so that they would understand how diet, air, exercise, and modes of dress affect the body and promote good health. ‘‘The resto- ration of health is the physician’s profession,’’ Beecher explained, but preserving the health of children was primarily the responsibility of women. By the end of the twentieth century, prestigious healthcare insti- tutions and professional organizations were meeting the growing demand for domestic medical guides. Such texts include The American Medical Association Family Medical Guide, Mayo Clinic Family Health Book, Johns Hopkins Family Health Book, Harvard Medical School Family Health Guide, American College of Physicians Complete Home Medical Guide, and The Merck Manual of Medical Information: Home Edition. In contrast to Tennent’s 70-page pamphlet, modern guides to domestic medicine may approach 2,000 pages of advice on acute and chronic diseases, drugs, alternative medicine, medicinal herbs and nutraceuticals, diseases of unknown origin, death and dying, nutrition, and popular weight-loss diets. Eighteenth-century Americans were actively involved in all aspects of medical practice, prevention, diagnosis, and treatment. By the onset of the Civil War, the inﬂuence of medical experts, whether orthodox or sectarian, on the management of disease was increasing. That is, prac- titioners were claiming professional privilege and expertise in the treat- ment of disease and warning potential patients and caregivers to defer to professionals. Many orthodox physicians believed that the widespread dissemination of information about diagnosing and treating disease increased the production and inﬂuence of competitors, such as Thomso- nians, health reformers, homeopaths, and hydropaths. When writing health texts for laymen, regular physicians provided general guidance, but insisted that the management of disease required a well-qualiﬁed physician. The role of the patient was reduced to calling for a doctor and carefully following his advice. As sectarian practice became more organized and professional, they too advised patients to call for the expert.