The way medicine has been approached throughout history has changed many times and is still currently changing with new advancements still being made. A ledger of medications from  1825 from of New Paltz provides an inside look at what kind of medications were used to treat illnesses, despite the fact that the ledger only contains prices of the medications prescribed as provided by a man, presumably the physician documenting the medication record, named John Bogardus. The difference between the medicines that can be assumed to be the most common for the time can be seen as being completely different than what is used today, which leads to the question: What was medicine like in the 19th century? 

Compared to Europe, medicine in the United States was not nearly as regulated as it is today. During the 1700s, most physicians dispensed their own drugs with the shop to do so attached to their office. Medicines could be bought at stores and from apothecaries, Apothecaries not only served as a place where one could purchase drugs, but they also sold regular goods and provided patient care. Once again apothecaries were not regulated and it was not a requirement for them to be educated and therefore they had the ability to call themselves whatever they want and could pick and choose which parts of the profession they wanted to practice. This lack of regulation on medical practices has been attributed to the fact that at the time the United States was still developing, but also on the prevalence that individualism and the idea of laissez-faire economies had in society at the time which made any idea of regulation be marked as unnecessary. 

Prior to the 19th century, the idea of medicine was based on the idea that illness is caused by the imbalance of “humours” within the body thus leading to medicinal treatments to revolve around the idea of restoring balance to the body. However in the 19th century, a more scientific idea of the body and illness was developed; illness/disease was caused by some type of failure of internal body parts. This idea and the development of anatomy led to a person’s symptom being attributed to a change with in the body and also allowed pharmacists and doctors to start to learn how drugs work within the body, which they learned they do so by targeting a specific system within the body rather than the body as a whole. It wasn’t until the late 19th century that actual knowledge on how the process actually occurred was developed, and therefore drugs in the mid-19th century had been classified by the reaction that they had within the body. It is because of this that drugs were given to restore the body to a normal state and didn’t get at the true root cause of whatever was causing the illness. 

During the 19th century, interest began to be put towards utilizing native herbs and plants for pharmaceutical reasons after the Revolutionary War. The introduction of herbs and plants as ways to treat illness can be clearly seen in the Ledger of Medications, one of which being Kino which was obtained from tropical trees. A lack of regulation can also be seen during this time period allowing for medical and pharmaceutical practitioners to flourish, including groups known as Thomsonians, eclectics, Reformed Practitioners, and homeopaths. Despite the introduction of these groups, most medicines were still left to be dispensed by apothecaries who still maintained their 18th century status of prescribing and dispensing medicines which created confusion and ultimately led to the of wholesale drug manufacturers. Wholesale drug manufacturers were a commercial enterprise with no medical training and had become responsible for making, mixing, and selling drugs to those who practiced medicine. 

As the 19th century progressed, wholesale drugmakers began to sell more of their drugs to the general public from a storefront, a development that led to what we know today as the drugstore which is likely how John Bogardus provided his medicines. It is with the development of the “drug store” that the responsibility to provide consumers with effective medication that actually will provide them care increased and the profit motive that came from this allowed for there to be pharmaceutical expertise shared throughout the trade. While this may seem like professionalism within the pharmaceutical industry was beginning to take place, it was not until the mid-19th century when pharmaceutical societies in schools, states, and nation wide were formed that this professionalism occurred. It is during this time when the idea of regulation became more widely accepted leading to national regulation of the pharmaceutical industry to take place later in the century. 

The majority of medicines/drugs used in the 19th century came from herbs and plants native to the area, a use that dates back to the 1500s. In the 1500s, once a medicinal use was found for an herb/plant it was documented in a pharmacopoeia leading to a more scientific approach to medicine. Pharmacists used pharmacopoeias as a reference for many centuries, and it wasn’t until the 19th century when the birth of chemistry and the Enlightenment period when these medicines began to be more understood. Chemistry allowed pharmacists and chemists to isolate and identify the active ingredient in the herbs and plants that acts as a drug which then allowed them to identify how they actually affect the body. As more drugs were discovered throughout the 19th century, the production of medicine moved from small drug stores to industrial facilities allowing for many drugs to be discovered, including strychnine, emetine, morphine, quinine, and caffeine. While the use of quinine was not explicitly stated in the Ledger of Medications, it was repeated multiple times throughout the ledger. Since the use of synthetic chemicals in drug production wasn’t common until the late 19th century, it is likely that the drugs documented on the Ledger of Medications were from herbs and plants. The distribution of drugs throughout the 1800s was in the form of powders, pills, tablets, gelatin capsules, lozenges, tinctures, and mixtures. From this is it likely that whatever drug was provided by John Bogardus held the form of one of these, however the ledger doesn’t state which was used. 

Sources:

“Drugs and Their Manufacture in the Nineteenth Century.” Omeka RSS, https://collections.countway.harvard.edu/onview/exhibits/show/apothecary-jars/nineteenth-century-drugs. 

“Ledger of Medications Dispensed and Payment Rendered.” Hudson River Valley Heritage Exhibits, https://omeka.hrvh.org/items/show/2893.