John W. Cowart

              A snake bit Caroline Singleton in a tender place.

              Miss Singleton wrote about her experience with Jacksonville's medical community in 1877:

               "I was bitten on the breast by a snake about two months ago and was attended by Dr. King, who failed to do me any good. I then called on the Indian Doctress and Fortune-teller at 37 Newnan St. and was cured by her in four weeks!"

              Similar testimonials for physicians, healers, and medical paraphernalia  abound in the pages of early Jacksonville newspapers.

              "To all who are suffering from the errors and indiscretions of youth, nervous weakness, early decay and loss of manhood, I will send a receipt that will cure you... This great remedy was discovered by a missionary in South America. Send a self-addressed envelope to ..."

              Such advertisements, though strange to modern eyes, reveal that Jacksonville's concern for health care has been evident from the city's earliest days.

              Immediately after the American Revolution, a party of loyal English refugees escaped from the democracy to settle under the Spanish monarchy in St. Johns Town, a village on St. John's Bluff.

              "Hugh Rose, Esq., Practitioner of Physick" arrived from Charleston in December, 1782, and by his practice in his new location "cleared about 200 guineas," said Dr. Webster Merritt, a medical historian.

              According to old records, Dr. Rose hired two "Carpenters 2 Months at a Dollar & a half per Day for Each... he enclosed  an Acre with a post & rail fence & built a framed dwelling House 20 feet by 16 Shingled Roof boarded in the Inside two stories high & 3 rooms on Each floor."

              St. Johns Town was abandoned by 1785 and another physician did not come into the area until Dr. James Hall moved to East Florida in 1798. For nearly 40 years, Hall was the only physician in Florida. He practiced under both Spanish and American rule till his death in 1837.

              In 1835, the Jacksonville Courier newspaper said, "This place bids fair to become the most important town in Florida, not only on account of its pleasant and healthy situation, but also its situation with respect to trade; there are at this time more exports and imports from this section than any other in East Florida."

              Charles Dickens Jr., son of the famous English author, observed this love for health and commerce in Jacksonville when he visited in 1885. Dickens  met "one of Jacksonville's most eminent physicians" on the street.

              "He was a little dark man with spectacles on his nose, and a quick nervous step indicative of the enquiring and active mind within him... (the city) brings him as many patients at five dollars a visit as he cares to have.

              "For by a merciful dispensation of Providence, there comes a time annually to almost every resident in Florida when the conviction comes that he has a liver, and that that liver is out of order...," Dickens wrote.

              Dickens observed that posters advertising cures for liver complaint were posted on nearly every pine tree or cypress tree within sight of the St. Johns to catch the eye of riverboat passengers.

              "A family provided with a comprehensive household specific like HOSTETTER'S STOMACH BITTERS is possessed of a medicinal resource adequate to most emergencies..." said one catchy Nineteenth Century ad.

              Also advertised was the HEALTH JOLTING CHAIR, a seat mounted on powerful springs which were tightened by cranks, levers and pulleys. The patient would wind it up, sit down, then release the spring -- this device was touted as a sure cure for everything from bad complexion to constipation.

              During the Nineteenth Century many people lived on farms in outlying areas and it was common for Jacksonville physicians to travel by canoe or horseback to reach their patients.

              William F. Hawley, who survived the great yellow fever epidemic of 1888, said, "I well remember old Dr. Beatty who drove over the countryside in a little two wheel cart drawn by a little black mare: they all seemed part of each other.

              "Every drug store had a leech jar from which a worm could be secured to suck the blood from bruises, black eyes and for the reduction of blood pressure. The blood sucking worm when full of blood could be stripped of his internal load and put back to work again," Hawley said.

              Most doctors in those days compounded their own prescriptions and one of the most popular was a draught called Blue Mass. "The nastier the taste, the better the effect" was the slogan of the day.

              When Hawley was a boy, he fell into the river and caught a cold which put him to bed for months. His family told Dr. Beatty of his decline.

              "He punched me in the ribs and I let out a yell, whereupon the old doctor said, 'Decline nothing. Give the little devil some blue mass,'" Hawley said.

              But Jacksonville doctors were not limited to leeches and blue mass, they were effective surgeons too as an August 13, 1874 baseball game proved. The Tri-Weekly Union newspaper reported:

              "Two of the (team) members began quarreling with each other. Finally (Mannie) Franklyn, after saying something to (Archie) Terry took his position as catcher behind the bat. Terry followed him up and calling him a d-n s-n of a b---h, struck him a horrible blow across the temple with a bat, crushing his skull and knocking him senseless. He was then taken home in a dying condition...

              "When the physicians, Drs. J.D. and F.A. Mitchell, were called, he was in strong convulsions, moaning and gasping, and from all appearances about to die. It was thought best to trephine the skull, which was immediately done, several pieces of bone being removed, and the clotted blood which had collected to a considerable extent was cleansed away. Then, by raising a large piece of the skull that had been forced down upon the brain, the patient was given almost immediate relief..."

               Two of Jacksonville's pioneer physicians, Dr. Abel Seymore Baldwin and Dr. Francis W. Welford, founded the Duval County Medical Society, the state's first medical society.

              Baldwin was the only physician in a 20 mile radius of the city when he came to Jacksonville in 1838. He was a founder of the DCMS and was later first president of the Florida Medical Society in 1874. He helped bring railroads to Jacksonville and his scientific studies of tides led to the construction of the jetties at the mouth of the St. Johns which made it possible for Jacksonville to develop as a major port.

              Dr. Wellford earned distinction as Jacksonville's first medical martyr during an epidemic of yellow fever which struck North Florida in 1877.

              Wellford volunteered to serve inside a quarantine area.

              A letter to his friend, DCMS president Dr. Richard D. Daniel, describes Wellford's attitude:

              "I am tired after more than 50 visits today, yet I am hearty and well and on the principal of naught being in danger, I am brighter and brisker than half the people here. Don't think I am either reckless or boastful, I appreciate life as most, but thank God I appreciate something higher still than mere physical existence. When you kneel down at night to offer thanks for present favors and future good, ask for me that God will bless that immortal soul that will survive the grave. And if your prayers be granted, I care not how soon the summons may come."

              Yellow fever killed Dr. Wellford less than a week after he wrote this letter.

              Yellow fever decimated Jacksonville periodically all during the Nineteenth Century.

              The Civil War divided Jacksonville's loyalties, as it did the nation's, and local physicians served both factions with distinction.

              Although invaders had swept over Jacksonville several timed during the war, refugees from burned out farms all over the south poured into the city. On March 11, 1865, a Society of the Daughters of Charity was formed here to "provide relief for the sufferings of the destitute refugees in Jacksonville".

              On April 28, the worst refugees the city was to see arrived. "A ghastly army descended on the town."

              They were not Southerners.

              They were 3,328 Yankee prisoners of war released from Sumter Prison, Andersonville, Ga.

              "In tatters and covered with the dust of Georgia clay and Florida sand, stumbled into Jacksonville looking more like ghosts and candidates for the grave than human beings... Many were emaciated, crippled and in need of medical care for maladies ranging from fever and malnutrition to diarrhea and scurvy. Some were without shoes or hats, all were begrimed with dirt and black smoke from their campfires and they looked pitiable in the extreme as they staggered into town," said historian Richard A Martin in his 1973 history of St. Luke's Hospital.

              Jacksonville citizens of all political persuasions cared for the POWs taking them into homes, cleaning, feeding, dressing and nursing them.

              The city's kindness paid unexpected dividends. Less than six months after the Civil War ended, Yankee tourists and invalids began coming to Jacksonville as a vacation spot and health resort.

              Jacksonville's reputation as a healthy haven drew many who suffered from consumption -- as tuberculosis was called then.

              Poet Sidney Lanier, a consumptive, came in January, 1874. Here's what he found:

              "The visitor strolling down (Bay) street soon discovers that not an inconsiderable item in the commerce of Jacksonville is the trade in Florida curiosities ... sea-beans, alligators' teeth, plumes of herons’ and curlews' feathers, cranes'-wings, angel-fish, mangrove and orange walking canes, coral branches, coquina-figures and many others...

              "Jacksonville is as it were a city built to order, and many provisions have been made for employing the leisure of its winter visitors..."

              Lanier discussed some of the treatments tuberculosis patients might find here:

              "The milk cure, the beef-blood cure, the grape cure, the raw-beef cure, the whisky cure, the health-lift cure, the cure by change of climate, and many more have been devised..."

              He described the whisky cure at length:

              "First to ascertain the proper dose (which varies indefinitely with different individuals) by experimenting until you have found such a quantity as neither quickens the pulse nor produces any sensation in the eyes, this quantity being usually very small; and then to take this ascertained dose at intervals of not less than one hour and a half, with the greatest regularity; the theory being, that as the stimulus of the first dose decreases, its reaction will be met by the new stimulus of the second does, the reaction of that by the action of the third, and so on...

              "In most cases, pure whisky ... has been found to be the best possible form of stimulant...

              "This treatment -- by regular doses of whisky administered at intervals of from an hour to an hour and a half through each entire day from sleep to sleep -- has been known to effect marvels, unaided by any other remedies save generous food and proper exercise...

              "No person entertaining the least doubt as to the possibility of the stimulate habit so fastening upon him or her as to become itself a controlling disease should meddle with it. As between dying a drunkard and dying a consumptive no one in his senses could hesitate a moment in favor of the latter alternative."

              Between 1865 and 1872 the population of Jacksonville increased from 2,000 to 7,000 people and over 30,000 guests annually registered at Jacksonville hotels during the winter months.

              "The chief attraction for Northern people to go to Jacksonville... is so great that if the whole population of the town should turn out, their houses would not furnish room for the army of consumptives who have found their way there," said a pamphlet, GOING SOUTH FOR THE WINTER WITH HINTS FOR CONSUMPTIVES by Dr. Robert Speir in 1873.

              In those days, haunting music floated over the city.

              People thought that playing the flute exercised the lungs of consumptives beneficially and flute therapy was popular in Jacksonville. Hundreds of flute-playing invalids practiced while rocking in chairs on the verandahs of the city's finest hotels.

              Neither whisky nor music cured tuberculosis.

              An 1885 pamphlet titled PETALS PLUCKED FROM SUNNY CLIMES by Silvia Sunshine said:

              "Too many invalids, before coming to Florida, wait until they have already felt the downy flappings from the wings of the unrelenting destroyer, and heard the voices from a spirit-land calling them, but come too late to be benefited and take a new lease on life. The climate should not be blamed because the sick will stay away until death claims them..."

              Many who came to Jacksonville for their health died here. Some had spent all their money to get here and died in hotel outhouses or in the streets.

              A group of women, whose husbands were all either physicians or attorneys, decided to open a hospital to care for indigent patients.

              St Luke's Hospital opened with four beds on March 11, 1873.

              Before that, sick or injured people were treated in their own homes, in a doctor's office, or often, when surgery was necessary, at a drug store.

              Before St. Luke's was founded there had been a few specialized hospitals in Jacksonville such as a "pest house" and a facility for soldiers wounded by Indians during the Seminole Wars of the 1830-40s. But St. Luke's was the first hospital for the general population.

              The hospital was needed and prospered to the extent that expansion was called for in 1876. A new 12-room hospital was built but a few days before it was to open, an arsonist burned it to the ground.

              "The new St Luke's Hospital built by the ladies of this city and completed after years of self-sacrificing toil and unceasing effort, was on Saturday morning offered up a holocaust on the altar of charity," said the July 24, 1876, Daily Florida Union newspaper.

              The next day's paper said, "The ladies (of St. Luke's) express their determination to rebuild the hospital at once..."

              The women began fund raising all over again and on February 24, 1878, the new hospital, at Palmetto and Monroe streets, was dedicated. Its construction had cost $6,350. It was one of Jacksonville's first buildings to have indoor bathrooms.

              Speaking at the dedication, Judge Thomas Settle said, "When a woman voluntarily enters the precincts of a room of sorrow, of sickness and death, she rises to a higher plain and forms a near relationship with the angels."

              In 1882, Dr. Malvina Reichard, a pioneer woman physician, became St. Luke's first resident physician at an annual salary of $523.50.

              By 1885, 60,000 tourists were arriving each year in Jacksonville.

              Rabid dogs foraged in Jacksonville and the city hired men to patrol streets shooting any strays. But in 1885, Louis Pasteur discovered a rabies vaccine. Other medical advances and discoveries of the era included smallpox vaccination, the X-Ray, radium and the use of disinfectants in sickrooms.

              The mosquito still had not been identified as the vector in Yellow Fever and an epidemic in 1888 decimated Jacksonville and spelled the end of that early tourist era.

              When the first cases of Yellow Fever were reported, the city's population dropped from 130,000 to 14,000 in just a few weeks as everyone who could fled.

              The 14,000 people who did not escape quick enough were quarantined inside Jacksonville. Leading citizens formed the Jacksonville Auxiliary Sanitary Association to fight the epidemic. Yellow fever killed 67 members of the association including five of Jacksonville's 11 physicians.

                  (See the July 1986 issue of JACKSONVILLE MAGAZINE for a more detailed account of the 1888 epidemic.)

              According to Marian J. Rust's excellent book THE HEALERS: A History of Health Care in Jacksonville, Florida, 1791-1986, in the 1890s a physician at Duval County Hospital received a salary of 35 to 50 cents per day. The per capita cost for a patient's total maintenance for a month was $3.73!

              A great typhoid epidemic hit Jacksonville in 1898.

              The battleship Maine exploded in Havana Harbor on February 15th and the Spanish-American War began. Jacksonville's Camp Cuba Libre, in present day Springfield, was the staging area for 32,000 troops. Typhoid killed at least 362 of the men stationed in Jacksonville; only 385 US soldiers were killed in battle during the entire war.

              Legislation requiring the screening of outdoor toilets from flys did not come until 1910; that year Jacksonville's typhoid cases dropped from 110 to five within six months.

              Jacksonville burned in 1901. Several local physicians treated black burn victims in a shelter called Faith Cottage. This endeavor later became Brewster Hospital and Nurse Training School, forerunner of Methodist Hospital.

              In 1910, Rodgers Hospital, forerunner of Riverside Hospital, opened. In 1916, the American Daughters of Charity opened St. Vincent's Hospital.

              In 1965, Baptist Medical Center was founded, and Memorial Medical Center of Jacksonville opened in 1969.

              University Hospital, which has ancestors in various institutions where the poor could find care as far back as the city's founding, assumed private, non-profit status in 1982. Mayo Clinic Jacksonville opened in 1986.

              If a snake were to bit Miss. Singleton's breast today, she could readily fine help; all Jacksonville hospital emergency rooms now keep the specific pharmaceutical kits of anti-venom serum needed for snake bite treatment.

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              Paisley "Pete" Boney III is co-chairman of the Health Care Council of the Jacksonville Chamber of Commerce, a group formed in 1987.

              "Our primary purpose, the bottom line, is recruiting. To attract industry to Jacksonville  -- medically related or non-medical -- who might come to Jacksonville because of our health industry," he said.

              The mission statement of the Council encourages it to establish Jacksonville as a regional health care center of national significance by attracting companies involved in medical research, bio-medical research, manufacturing pharmaceuticals, surgical developments, and all other aspects of the health care industry, he said.

              Based on his knowledge of the local medical picture, he agreed to talk about some current medical issues and to speculate on the future of healthcare in Jacksonville:

              "The changes in hospitals over the next few years will be staggering," Boney said.

              "Hospital emphasis is already changing from inpatient to outpatient. The result is small hospitals will go out of business.

              "They are also changing from acute care to psychiatric -- which is a sad commentary on our society.

              " We'll see more wellness centers, the use of facilities to keep people well before they need curing. And we'll see more and more hospital advertising in print, and on tv.

              "We'll see more cooperation between hospitals to buy expensive equipment such as the magnetic imager or the lithotripter -- the kidney stone smasher. Four million dollars is a lot for one hospital to spend on one machine, and we'll see more cooperation is the purchase and sharing of such equipment," he said.

              The future holds three especially difficult challenges for Jacksonville's healthcare community, Boney said.

              * AIDS -- "(Isolation or quarantine) may become a reality.

              "Some of the numbers I hear indicate that AIDS patients double every ten months -- That's scary.

              "One group beginning to focus attention in the AIDS area is the hospice groups.

              "All AIDS patients are terminal patients".

              * COOPERATION -- "We're seeing great cooperation in the medical community and I think we'll see more and more.

              "There has been a reaction in the medical community to the way Mayo was handled. The objection was to the way it was done, not to Mayo per se. (Mayo doctors were exempt from taking the Florida medical examinations.)

              "The Chamber and business community welcomed Mayo with open arms as a savior, but there was no intent on anybody's part to say existing doctors and hospitals were second rate in any way.

              "The thing doctors need to know is Mayo will be an asset to recruiting industry to Jacksonville who bring employees and their families who therefore will be come patients.

              "Doctors and dentists and hospitals benefit directly from population growth. The new employees will have children who need braces, and break arms on skateboards and so on".

              TORT REFORM -- Jacksonville's Preston Haskell and Lakeland's Scott Linder are on a five-member task force with the presidents of Florida State University, University of Miami, and the University of Florida.

              The Academic Task Force For Review of Insurance and Tort Systems In The State Of Florida was established by the Tort and Insurance act of 1986 to study and make recommendations to help solve malpractice problems.

              "Men of good will with conflicting opinions on both sides of the issue are at work ironing it out for the benefit of the whole community," Boney said.

                  This article appeared in the September, 1987, issue of Jacksonville Magazine.


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