Medical Care in the Early 20th Century

Ann Robinson, PhD Candidate, UMass History

Over the summer, I worked on a project with Kathie Gow of the Hatfield Historical Museum and our own Emily Redman.  The project, Understanding Medical Care in Early 20th Century Hatfield, was funded by a grant we applied for from Mass Humanities. The grant gave us the opportunity to interpret and analyze the medical collection at the Hatfield Historical Museum.  This collection is comprised of over 100 items, many of which are connected with Dr. Charles A. Byrne, who practiced medicine in Hatfield from 1895 to 1933.  Included in the collection are a wide variety of items, from medical tools and equipment to scrapbooks, to nursing exams and Dr. Byrne’s patient records. Throughout my work, I learned a lot about medicine and medical care in the first decades of the 20th century and I want to use this post to share a sampling of these.

One of the largest parts of the collection is made up of (mostly glass) containers which once held – and some of them still do! – drugs and patent medicines (concoctions of alcohol and herbs, and often cocaine or heroin, which claimed to cure just about everything). Dr. Byrne was a practicing pharmacist in Brooklyn for several years before earning his medical degree at Long Island College Hospital. Unlike today, when you begin training in a specialization early into your medical education, this was not an unusual path to take. He continued to make some of his own medications after settling in Hatfield, so some of the containers are bulk-size and contain substances that serve as ingredients for many different medications. The Museum also has Dr. Byrne’s mortar and pestle, as well as a cast iron double-boiler pot, both of which could be used to mix ingredients and prepare medicines. While researching these medicine containers and their contents, I discovered some really interesting things. For one, I encountered veterinarian at the turn of the 20th century who produced a line of patent medicines specifically for dogs. I also learned that the bottles themselves told a story: medicine bottles were colored to prevent light from affecting the contents but, more specifically, cobalt blue bottles indicated the presence of poison, as did raised bumps near the top of the bottle. I also learned that bottle collecting is a very serious business, as this incredibly detailed site on the identification of bottles shows.

Dr. Byrne’s patient records include all of his appointment books from 1897 through 1933, along with the small paper envelopes that contain slips detailing each visit with a patient – and often those appointments with members of the patient’s household. There is a treasure trove of information in these documents, however it can at times seem nearly buried – Dr. Byrne’s handwriting is very small and occasionally eccentric. He also used medical shorthand a great deal, which can be difficult to decipher. The documents were also stored in boxes in an attic for many years, so some of them are fragile.

The medical collection also contains some of Dr. Byrne’s more public writings. He was active in local medical societies and the Museum has the notes for several of his talks. They are mostly discussions of specific cases in which he describes the patient, their symptoms, and his diagnosis and treatment. Such discussions at local medical societies provided opportunities for early 20th century doctors to talk about unusual or perplexing cases and solicit information about new treatments, new diseases, etc. Dr. Byrne gave an interesting lecture in 1917 about the therapeutic use of alcohol. He was very much a temperance man (he pasted a copy of the 18th amendment into his appointment book for 1920) and he exhorted his fellow doctors to consider the example they set by abstaining from alcohol, and to use alcohol as a treatment only when it had been proven useful.

Dr. Byrne also gave lectures to non-medical groups, such as the women’s group of the Hatfield Congregational Church and the Hatfield Book Club. One of these lectures, given in 1908, was on what he described as an “appalling” topic – educating children about sex. Dr. Byrne, like many doctors in the early 20th century, viewed masturbation as self abuse. But perhaps surprisingly, he advocated for telling children the truth when they asked questions about sex. The truth needed to be tailored to age, of course – and yes, there was actually talk of birds and bees! If parents lied to their children about this, he argued, when children discovered the lies, they would be less inclined to believe anything their parents told them.

The state of medicine and medical care in the early 20th century was obviously much different than it is today. Although the germ theory of disease, which postulated that diseases were caused by specific microorganisms, had largely been accepted, there was still very little known about which microorganism caused which disease. There were also very few vaccines available, although Massachusetts did require children to be vaccinated beginning in 1810. Most medical treatment was palliative, treating the symptoms rather than the causes. The Hatfield Town Reports from 1883 through 1914 listed cause of death and the number of residents who died from each. The top eleven (there was a tie for 10th place) were pneumonia, heart disease, phthisis (consumption of the lungs), stillbirth, nephritis (kidney disease), apoplexy, cancer, premature birth, paralysis, cholera infantum, and old age. I found this list really interesting for a couple of reasons. I hadn’t considered heart disease and cancer to be leading causes of death a hundred years ago; they seem like very modern afflictions, and are often presented as such in popular reports. I was also surprised by how few deaths were attributable to infectious diseases, especially given the lack of vaccines and only a basic understanding of public health.

As a former librarian (if one can be such a thing) and as a historian of science, I’m very interested in how things are classified. For many years the town reports broke causes of death down into several categories “according to the nomenclature adopted by the State Board of Registration.” I never did find this nomenclature, however I did come across a brief history of the classification of disease that indicated that Massachusetts most likely used a nomenclature based on that of the Royal College of Physicians. Diseases were generally broken into three main categories. Constitutional diseases were ones affecting an entire bodily system, the entire body, or were inherited. Local diseases affected only a specific area of the body. Zymotic diseases were understood to be caused by a specific virus or zyme (a ferment caused by a chemical change). Today, the International Classification of Diseases is much more complex but interestingly enough still breaks diseases down into which parts, or systems, of the body they affect.

There are a lot of other things I learned while working with the medical collection at the Hatfield Historical Museum, but I should probably stop here. Check out Kathie Gow’s blog post for images and other interesting facts. Plans are afoot for exhibits in the future so keep an eye on the Museum’s web site!

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3 comments
  1. Out of curiosity, because of my own research, did Dr. Byrne use any herbs or preparations sourced from the Shakers?

    • Ann E. Robinson said:

      Hi Brian – I didn’t find any evidence of that. All of the containers that the Museum has are either from drug companies or have labels which indicate chemical/drug composition. From what I could read of the patient slips, his prescriptions were for standard (for the time) preparations.

      • Thanks for the response; the “no” is as informative as a “yes.”

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