Diseases in the District of Maine 1772 - 1820: The Unpublished Work of Jeremiah Barker, a Rural Physician in New England

ISBN : 9780190053253

Richard J. Kahn
547 ページ
156 x 235 mm

Jeremiah Barker practiced medicine in rural Maine up until his retirement in 1818. Throughout his practice of fifty years, he documented his constant efforts to keep up with and contribute to the medical literature in a changing medical landscape, as practice and authority shifted from historical to scientific methods. He performed experiments and autopsies, became interested in the new chemistry of Lavoisier, risked scorn in his use of alkaline remedies, studied epidemic fever and approaches to bloodletting, and struggled to understand epidemic fever, childbed fever, cancer, public health, consumption, mental illness, and the "dangers of spirituous liquors." Dr. Barker intended to publish his Diseases in the District of Maine 1772-1820 by subscription - advance pledges to purchase the published volume - but for reasons that remain uncertain, that never happened. For the first time, Barker's never before published work has been transcribed and presented in its entirety with extensive annotations, a five-chapter introduction to contextualize the work, and a glossary to make it accessible to 21st century general readers, genealogists, students, and historians. This engaging and insightful new publication allows modern readers to reimagine medicine as practiced by a rural physician in New England. We know much about how elite physicians practiced 200 years ago, but very little about the daily practice of an ordinary rural doctor, attending the ordinary rural patient. Barker's manuscript is written in a clear and engaging style, easily enjoyed by general readers as well as historians, with extensive footnotes and a glossary of terms. Barker himself intended his book to be "understood by those destitute of medical science."


Foreword by John Harley Warner
Chapter 1. Jeremiah Barker: Background, Education, and Writings
Who was Jeremiah Barker?
Provenance of the Barker Manuscript
Description of the Barker Manuscript
The Medical Geography of the District of Maine, 1760-1830
Barker's Contribution to the Medical Literature of Northern New England
Articles Published by Jeremiah Barker
Yellow Fever in the District of Maine?
Chapter 2. Obtaining and Sharing Medical Literature, 1780-1820
Medical Information by Mail
The First United States Medical Journals & Medical Nationalism
Problems Encountered by Early Medical Journals
Newspapers as a Source of Medical Information
And Last but Not Least, Books
Chapter 3. The Old Medicine and the New: why Barker wrote this manuscript, for whom was it written, and why was it not published?
The Importance of Observation and Recording
Basics of Greek Medicine and Fever
Bloodletting: The Blood Was Sizy and Buffy
Scientific Doctors and the Empirics
More Competition: Domestic and Sectarian Medicine
Science, Institutions, Education, Framing Disease, and Cultural Authority
Case Reports and the Clinical Exam circa 1800
Recording Cases, Observations, and the Numerical Method
Thus Sayeth Galen Meets Cullen, Rush, and Brown
Intelligible to Those Who Are Destitute of Medical Science
Why Was Barker's Manuscript Never Published?
Rapidly Changing Medical Theory and Philosophy: Noah Webster
Chapter 4. Alkaline Doctor and A Dangerous Innovator
Lavoisier and the New Chemistry
The Acid/Alkali Debates of the Seventeenth and Eighteenth Centuries
Barker, Mitchill, Septon, and the Medical Repository
Barker's Use of Alkaline Therapy
Chemistry, Yellow Fever, and the Contagionist/Anticontagionist Battle
Barker the Dangerous Innovator
Chapter 5. Thoughts to Consider While Reading Barker's Manuscript
Presentism, Whiggish History, the Post Hoc Fallacy, Confirmation Bias
Holistic and Biomedical Models
Numerical Methods and Retrospective Diagnosis
Barker's Treatments, Therapeutic Efficacy, Bacon, and Confirmation Bias
Nature vs. Art in Medicine-Best Available Evidence and the Burden of Disease
The Jeremiah Barker Manuscript Volume One
MS V. 1, Chapter 1. Insanity and Temperance
Mental illness and problems associated with the use of ardent spirits
MS V. 1, Chapter 2. Early Maine Medical History Beginning in 1735
1780 Barker moves from Barnstable, Massachusetts to Gorham, District of Maine
Introduces his new community and physicians practicing in southern Maine
Introduces Rev. Thos. Smith's diary documenting diseases and epidemics, 1735-1780
1735 N.E. epidemic of cynache maligna, putrid sore throat, as described by Smith
Excerpt of Dr. John Warren's 1813 article on cynache maligna or throat distemper
Barker discusses illnesses of the 1740s including quinsy
MS V. 1, Chapter 3. Deaths Following Trivial Wounds and Childbed Fever
Barker's initial years in the District of Maine beginning 1780
1784-1785 unusual epidemic of serious wounds and death in men
1784-1785 unusual epidemic of childbed fever and deaths of women
Discussion focusing on women with childbed fever, deaths, autopsies, searching the literature and contacting medical peers for suggestions
Excerpt remarks on puerperal fever By Dr. Channing, 1817
Excerpt Dr. William DeWees on puerperal fever 1807
MS V. 1, Chapter 4. Throat distemper, Ulcerous Sore Throat, Scarlatina Angiosa, Cynache Maligna
1784: experience with throat distemper, other New England physicians and the literature
Excerpt on putrid sore throat by Hall Jackson (Portsmouth, New Hampshire), 1786
Joshua Fisher on throat distemper or scarlatina angiosa
MS V. 1, Chapter 5. Scarlatina Angiosa, Inflammatory Fevers, Hooping [Whooping] Cough, and Croup in Maine, 1797-1806
1796-1798 Scarlatina angiosa and the use of bloodletting and blistering
1802-1807 Scarlatina angiosa with many comments by other physicians
1805 example: 17 yo woman with Scarlatina angiosa bled, blistered, treated with alkalis
1774-1780 Barker's experience in Barnstable with quincy of croup, a kindred disease
1795-1806 hooping cough
MS V. 1, Chapter 6. Bloodletting for Palsy, Hemiplegia, and Other Neurological Events
Pneumonia in a minister who used his lancet on his parishioners prophylactically
Use of bloodletting in disease, prophylactically, and by native Americans
Excerpt on bloodletting among native Americans in Travels in Canada and the Indian territories, between the years of 1760 and 1776. Alexander Henry, 1809
Hemiplegia and apoplexy
Excerpt of Observations on paraplegia in adults by Matthew Baillie, 1820
Excerpt of Cases of Apoplexy with Dissection, by John C. Warren, 1812
MS V. 1, Chapter 7. Hydrophobia
Hydrophobia, cases and review of literature
Value of volatile alkalis to treat three people bitten by mad dogs
MS V. 1, Chapter 8. Anasarca, Ascites, Dropsy, and Foxglove
1786 move from Gorham to Stroudwater section of Portland
Anasarca, ascites, hydrocephalus
MS V. 1, Chapter 9. Epidemic of Influenza, Cancer, and Tainted Veal
Influenza or Epidemic Catarrh
Reference to Noah Webster's History of Epidemic and Pestilential Diseases, 1799
Regarding Thomas Smith's and Barker's cases
Use of alkali after Barker's experiments
Barker communicated his ideas on the nature of fever, together with some practical observations on the use of alkalis in fever in 1795, to Mr. William Payne, Secretary of the Humane Society in New York, who gave the letter to Dr. Samuel Mitchill at Columbia College.
MS V. 1, Chapter 10. Letter to Samuel L. Mitchill in New York, May 30th 1798
The first page of a letter to Dr. Samuel Mitchill, subsequently published in the Medical Repository 1799, Vol. II No. II, pp. 147-152: On the febrifuge Virtues of Lime, Magnesia and Alkaline Salts in Dysentery, Yellow-fever and Scarlatina Anginosa. In a Letter from Dr. Jeremiah Barker, of Portland, (Maine) dated May 30, 1798.
The Jeremiah Barker Manuscript Volume Two
MS V. 2, Introduction
Chapter opens with a letter dated 20 December 1831: Dr. Samuel Emerson, Kennebunk, Maine, having reviewed Barker's manuscript, recommends that it be printed
Barker's Introduction to Consumption
MS V. 2, Chapter 1. Frequency of Consumption in Women in Recent Years in New England
General comments on consumption
anatomy of respiration
MS V. 2, Chapter 2. Tracheal Consumption
General comments on tracheal consumption
MS V. 2, Chapter 3. Phthisis Pulmonalis, or Pulmonary Consumption
General comments on phthisis pulmonale, or pulmonary consumption
MS V. 2, Chapter 4. Consumption and the Deaths of Barker's Wives
Cases of consumption beginning during Barker's pupilage
1775 Marries Abigail Gorham, age 25 with a history of chronic catarrh, hemoptysis
dies in 1790 after gradually increasing illness
1780 Lucy Garrett of Barnstable, chronic cough with blood, dies 1787
Discusses Ezekiel and Abner Hersey, their treatments and their illnesses
1790 marries Susanna Garrett, age 21 with chronic cough, dies of consumption 1793
1798 marries Miss Eunice Riggs, of Falmouth, age 25, cough with blood, dies 1799
1799 Barker claims he had been infected with the Brunonian doctrine but now embraces Rush, bleeding, and salivation
MS V. 2, Chapter 5. Various Treatments for Phthisis Pulmonalis (Consumption)
The efficacy of cooperative means such as emetics, cathartics, alkali, digitalis, epispastics, issues, diet, air, and exercise
MS V. 2, Chapter 6. The Most Extraordinary Cases of Pulmonary Affections
Cases of pulmonary afflictions cared for by Barker in Maine
Benjamin Rush and his treatments
MS V. 2, Chapter 7. Brownism to Rushism or Alcohol to Blooding
Excerpt from Dr. Young (1815). A practical and historical treatise on consumptive diseases, deduced from original observations, collected from authors of all ages.
Historical aspects of consumption
MS V. 2, Chapter 8. Cases of Phthisis Pulmonalis and Excerpts from Journals
Barker was requested to extract some of the most extraordinary cases of
consumption from various medical sources, such as the Medical Repository, the Medical Museum, the New England Journal of Medicine, the London Medical Journal, etc. not conveniently purchased or obtained by young physicians
MS V. 2, Chapter 9. Pulmonary Affections Removed by the Intervention of Some Other Diseases, also by Powerful Means, and Manual Operation [Surgery]
Pulmonary afflictions removed by surgical intervention
several more of Barker's cases


Richard Kahn (1940) is an internist and medical historian who graduated from Rutgers University and Tufts University School of Medicine, where his interest in medical history began. After internship at Maine Medical Center in Portland, he spent two years in the U.S. Public Health Service, returning to MMC for an Internal Medicine residency. Practicing in Rockport, Maine, he has had teaching appointments at Tufts, Dartmouth, and the University of Vermont medical schools. He has been active in several organizations devoted to medical history, most notably the American Association for the History of Medicine and the American Osler Society. He received the Osler Society's Lifetime Achievement Award in 2017. Assisted by his wife Patricia, a medical librarian, Kahn began work on the Jeremiah Barker papers more than 30 years ago with the rediscovery of the Barker Manuscript at the Maine Historical Society Library, culminating at last in the publication of Diseases in the District of Maine 1772-1820.