Note: This is a two-part post on Health Care in New France. Part 1 will explore diseases, hygiene issues, and how to survive in New France. Part 2 will discuss health care professionals, treatments, and theories.
Last week we learned that unless you were a highly lucky individual, at some point during your 40 years of life (the average age expectancy in New France), you were bound to catch some sort of infectious disease. So what happened if you got sick? As noted before, New France’s health care was quite diverse. Who were some of the medical professionals that settlers in New France could seek out? What guided medical theory and what sort of medicines existed? If you had to get surgery done, were you screwed? Essentially, how effective were 17th and 18th century medical practitioners?
Health Care Professionals
If a settler needed medical care, what were their options? Well, they had a variety of choices:
Apothecary – If a settler felt their ailment wasn’t too bad and they just wanted some medicine, they would go to an apothecary. These professionals prepared and distributed medication to the local population and as such are the forerunners of pharmacists. Some apothecaries travelled around the colony to treat ill individuals outside the cities. They used a traveling box to store and transport their medications.
Michel Sarrazin (1659–1734), the French physician and natural scientist who immigrated to New France and became highly esteemed for his medical skills and discoveries. He became famous for helping hundreds of settlers recover from typhus and worked at both Hôtel-Dieus in Montreal and Quebec City.
Doctors – Being a trained doctor was highly esteemed because they were super rare in New France. Just how rare? Try only four throughout New France’s existence. All four of these doctors were born and trained in France because North America had no medical training institutions at the time—which is part of the reason why there were so few. (The University of Pennsylvania School of Medicine was the first North American medical school. It opened its doors in 1765). Doctors were distinguished from other medical professionals, both in New France and back in Europe, by their university education.
Surgeons – Of the medical professionals in New France, 90% were surgeons. France was like this as well. Surgeons did not need formal education, but they had to undergo a 6 year apprenticeship. In New France, unless a surgeon specialized in a particular area, “barber-surgeon” was the catch-all term for them. They did exactly as their name suggests; a two-for-one deal. Go in for some blood-letting, come out with a haircut as well. After all, the only thing you really needed for both was a sharp knife.
Nuns – If you were really ill, you could go to a hôtel-dieu (aka a hospital). In conjunction with the Crown, the Catholic Church played a huge role in providing health care for settlers. Nuns not only were in charge of caring for the sick and wounded, but they were also the ones who founded and ran the hospitals. Nuns looked after both European and Indigenous patients for short periods of time. Long-term hospital stays weren’t really a thing. This was before universal health care, so most could not afford to stay too long at a hospital. Patients’ families would take over the administration of care after their hospital stint.
A Hôtel-Dieu “sick room” reconstructed at the Canadian Museum of Civilization. Notice the altar and crucifix to the right. “Saving souls was as important as healing bodies.” Photo by Steven Darby. [Source]
Midwives – Prior to the 19th century doctors were rarely part of childbirth, midwives generally did everything. Individuals who were part of this female-only occupation, (childbirth was considered to be “indecent” for male eyes), were by and large self-trained. Midwives were a hot commodity considering the high birth rate in New France and eventually received a salary for their work from the government to prevent any shortages from happening. The only time men would be called in is if a surgeon was required to do a cesarean.
Healers – These individuals had no formal training and no regulation by the government, but were popular with settlers. Self-taught, they assisted ill patients with all sorts of issues. Some of the more popular include blood-letting, dressing wounds, and dealing with both sprains and broken bones. Often though they were called in at the very end to help with the dying process, but they would have lacked the tools and knowledge to truly assist in these cases.
Theories, Medicine, and Treatments
The medical theory about the humors from antiquity still held sway at this time. To summarize, every person contains four basic substances or “humors” and these are tied to the seasons. They are blood (spring), yellow bile (summer), black bile (fall), and phlegm (winter). They are also tied to particular organs and temperaments.
One fell ill when these humors became unbalanced and as such doctors prescribed treatments based on re-balancing them through diet, medicines, purges (via vomiting or laxative medications), enemas, and blood-letting. Re-balancing was only achievable by getting rid of excess bodily fluids, hence the types of treatments. Blood-letting, either through leeches or lancets, was extremely popular and used to treat just about everything.
With regards to medicine, plants such as flowers, leaves, herbs, barks, etc, were ground up with a mortar and pestle and in either turned into a tea or ointment. The four humors guided which plants and substances were selected for the medicine. Sometimes minerals and/or animal products were ground up and mixed in as well. These grounded up medicines were either turned into a ointment or they became a tea. Here are some examples of diseases and the plant-based medicines used to treat them:
- Syphilis – A skin ointment of guaiacum and/or mercury was used. Mercury was actually a popular treatment for various diseases and had been so since physicians used it to treat the Black Death in the 14th century. Unsurprisingly, many patients died of mercurial poisoning before their original disease killed them.
- Small Pox – Michel Sarrazin discovered sarracenia purpurea (purple pitcher plant) and it was reportedly an effective treatment for the disease. He also discovered other plant-base treatments for tumours, ulcers, seizures.
- Fevers – Chamomile tea was used to lower one’s temperature.
- Sores – Tree sap was utilized to soothe open wounds.
- Pulmonary Diseases – Lungwort leaves were turned into a tea because according to settlers, this plant resembled the lungs.
- Gout – The usage of Meadow Saffron is another example of the “signatures” theory, (if the form and colour of a plant is similar to an ailing organ, use it as a medicine). These lilies had tubers and so they were used to treat this foot-related disease.
Eighteenth-century amputation saws and tools. [Source]
Surgeries were divided into two categories:
- Minor – Blood letting, dealing with abscesses, setting broken bones, wound dressing, dental issues, stitches, and cauterization.
- Major – Amputations, tumours removal, urinary stones extraction, hernia reduction, trepanation, and cesarean sections. Only the most experienced surgeons performed these surgeries.
Unsurprisingly, you were more likely to survive if your surgery was external, like on the arms or legs. Internal operations had a high mortality rate. Without antiseptic measures (clean hands and instruments) surgery was dangerous regardless of what type it was and the risk for infection was high. Modern hemostats were not invented yet so it was difficult to stop hemorrhages. Worst of all, with no anesthesia patients went through tremendous pain. Alcohol, opium products, and a strap of leather for teeth to bite down on were used but ultimately there was little surgeons could do to numb the pain. Despite all of this though, it was very possible to survive both minor and major surgeries so long as the area operated on did not get infected.
Not-So-Fun-Fact: Alcohol did double duty. It numbed the pain and was used to prevent infection when closing up a wound. How did they do that? Surgeons either used stitches or a red-hot iron. Ouch!
At the core of this two-part look at colonial health care is the question I posed at the beginning: how effective were medical practitioners in New France? To summarize, they were moderately effective. A lot of their medications and treatments were useless (or worse), but some did as prescribed. People went into major operations and childbirth expecting to die, but that did not always happen. Armies employed surgeons to keep their men alive and they did when it was possible. By 1720, medical professionals had realized the value of quarantine and from then on it was used as a method to prevent the spread of disease. So 17th and 18th century medical practitioners weren’t completely ineffective. However as we have seen, often it was luck that kept people alive. Those living in New France would have seen it as God’s will though, not good fortune, that allowed them to live or die.
“APPENDIX A: The Organization of New France – The Medical Profession in New France,” Canadian Military Heritage. Government of Canada. March 2011. Accessed from: http://www.cmhg.gc.ca/cmh/page-161-eng.asp
Frith, John, “Syphilis – Its early history and Treatment until Penicillin and the Debate on its Origins,” Journal of Miltary and Veteran’s Health. Volume 20 No. 4. Accessed from: http://jmvh.org/article/syphilis-its-early-history-and-treatment-until-penicillin-and-the-debate-on-its-origins/
Greer, Allan, The People of New France, University of Toronto Press, 1997.
Lachance, André. Vivre, aimer et mourir en Nouvelle-France. La vie quotidienne aux 17e et 18th centurys, Montréal, Éditions Libre Expression, 2000, 222 p. / “Chronicles: Living Daily Life in New France,” Maison Saint-Gabriel, Accessed from: http://www.maisonsaint-gabriel.qc.ca/en/musee/chr-32.php
Northcott, Herbert C. and Wilson, Donna M., Dying and Death in Canada, University of Toronto Press, 2008.
Tésio, Stéphanie, “Daily Life: Health and Medicine,” Virtual Museum of New France. Canadian Museum of History. Accessed from: http://www.historymuseum.ca/virtual-museum-of-new-france/daily-life/health-and-medicine/