I Feel Sick! Call the Doctor, Quick!
Sickness and Medicine in Pioneer Indiana
A Two-Part Lesson Plan
Fourth Grade
Purpose of Lesson: This lesson gives students an overview of some of the
common illnesses and medical treatments during the pioneer era in Indiana.
Objectives:
At the end of both lessons the student will:
 gain an understanding of common illnesses and medical treatments
among the pioneers
 give reasons why commitment to the common good, courage, and
compassion were traits pioneers used during times of sickness in the
wilderness
 cite examples of pioneer settlements and towns that were prone to certain
illnesses because of their proximity to certain landforms
 separate fact from opinion about the illness called “the slows” or milk
sickness
 gain an understanding of the search for the cause of milk sickness
Correlation to Indiana Standards
Social Studies
4.1.13 Distinguish fact from opinion and fact from fiction in historical documents
and other information resources.
4.1.15 Using primary source and secondary source materials, generate a
question, seek answers, and write brief comments about an event in
Indiana history.
4.2.7
Define and provide examples of civic virtues in a democracy.
4.2.8
Use a variety of information resources to research and write brief
comments about a position or course of action on a public issue relating
to Indiana’s past or present.
4.5.5 Give examples of the impacts of science and technology on the migration
and settlement pattern of various groups.
Sources:
Content from Oliver Robinson, "Medicine, Pioneer Style, 1825," IMH 35 (March
1939); Leonora Miller, "Doctors, Drugs, and Disease in Pioneer Princeton," IMH
52 (June 1956); Hugh Ayer, "Nineteenth Century Medicine," IMH 48 (September
1952); and Walter J. Daly, "'The Slows': The Torment of Milk Sickness on the
Midwest Frontier," IMH 102 (March 2004)
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Lesson Activities:
Vocabulary words: hygiene, malnourishment, susceptible, bacteria, parasite,
virus, bleeding, purging, poultice
Read the following out loud to the class, pausing to define vocabulary
words and answer questions:
Illness was a problem for many pioneer families. Poor hygiene, dirty water, and
harsh living conditions contributed to a short life for many people. Pioneers were
often malnourished as well, which made them more susceptible to disease.
Question: Ask the class to think about what they have learned about life
on the frontier, especially in log cabins. Why would poor hygiene be so
common? What might cause malnutrition among the pioneers?
Four common diseases were cholera, malaria, smallpox, and typhoid fever. All
four were often deadly; those who lived could be weak and sickly for months or
have the disease re-occur throughout their life (malaria).
Suggestion: Put the attached table up on the board or on a screen. Go
over the causes and symptoms of each disease.
Seeing a doctor when you were sick was difficult during pioneer times. In most
areas of Indiana, like other parts of the frontier, there were very few doctors
available and many of those who were available had very little education or
training, when compared to today's doctors. For example, Dr. Richard Carter,
who wrote a book about cures for common diseases in 1825, studied for a few
months with two Native American herbalists and then read through his father's
small collection of medical books (probably no more than half a dozen). Within
less than one year, he considered himself qualified to be a doctor and began
practicing.
Many pioneer women were both nurse and doctor to their families. And when
widespread sickness came to a town or rural area, neighbors who were well
would often help out families whose members were ill.
Question: Why would help from neighbors be so important?
Pioneers knew nothing of bacteria or viruses and, compared to today, had a very
primitive understanding of the workings of the human body. They could observe
facts, but their conclusions were often incorrect. Pioneers noticed, for example,
that malaria was most common in low-lying areas near sources of water
(particularly stagnant water), but they believed that mists (sometimes called a
"miasma") that rose up from the water somehow caused the disease. They did
not know that the mosquitoes which bred in the water actually carried the
disease.
Most doctors and patients relied on homemade remedies. Two favorite remedies
for many illnesses were bleeding and purging. Sometimes these "cures" made
the ill person so weak, they died. Most people also used herbs and other plants
to make poultices, teas, and syrups. Here are some examples:
Question: As you read each of the remedies below, ask the class: Do
you think this would cure or even help that particular disease? Why or why not?
"For curing the Ague and fever [malaria]. . . Take one third Rhubarb and two
thirds best Barks [bark from a tree or bush—sassafras was widely used in
Indiana], mix them with Brandy or old whisky until they are about as thin as rich
cream – take a wineglass full, 4 or 5 times a day. If it gripes too severely [causes
stomach cramps], dilute it with water." [Written on an 1822 storekeeper's ledger.
From Jones and Stockwell's General Store, Princeton, Indiana.]
"For cancer, . . . a salve to be made from pennyroyal, camomile flowers, mullein,
and one-half gallon of apple vinegar. After this mixture has been boiled twentyfour hours, we must add salt and a gill [5 fluid ounces] of honey; then we are to
simmer to mixture down to a salve – which is to be applied to the cancer with a
feather." [from Richard Carter's A Valuable Vegetable, Medical Prescription...
(1825) ]
"For Gout, Rheumatism, Cramps, and Weak Nerves. . . Kill the fattest young dog
that you can get, in the month of March or April; clean him as you would a pig;
gut him; and stuff his body with a pint of red fishing worms, a pint of red pepper,
a considerable portion of the bark of the root of sassafras, and water frogs; then
sew up the incision, roast the dog well, and save the oil to annoint sores, gouts,
weak nerves, etc." [from Richard Carter]
"For bilious, nervous, and putrid fevers [putrid fever is usually typhoid; bilious
fever can be jaundice, yellow fever, or typhoid]. . . Get a double handful of the
bark of the roots of dogwood, a handful of ground ivy, a handful of mullein roots,
and a handful of the bark of the roots of sassafras; boil them all well together in
water, strain the syrup and put it in a vessel to itself. Then get a quart of good
clean cow dung and put it in a tight little linen bag and boil it well in water; then
strain it with the other syrup, boil it down to a quart and bottle it." [from Richard
Carter]
FOUR COMMON PIONEER DISEASES
DISEASE
TRANSMITTED BY CAUSE
SYMPTOMS
Cholera
Dirty Water Bacteria
Diarrhea and
severe fluid loss
Malaria
Mosquito bites Parasite
High fever, chills,
and extreme fatigue
Smallpox
Air or physical contact Virus
High fever and
disfiguring skin rash
Typhiod
Contaminated milk, Bacteria
water, or food
High fever, chills,
severe muscle and
stomach pain
Assessment:
In Class or Take Home Assignment: Compare and Contrast
Have the students fill out a worksheet with the following categories:
Medical Problem
Who Cured It?
How Was It Cured?
Ask them to list four medical problems they'd had, who helped them cure
each one (i.e., school nurse, parent, doctor), and what cured each one (cast for a
broken wrist, prescription medicine for an infection, cough syrup for a cold). Ask
them if they can include at least one example of a "home cure" and one example
of a "doctor cure."
During the next class (or after a set period of time), write the three
categories on the board and write down student answers as they give them.
After you have a good sampling, go over the results with the class and see if
you've found any comparisons with what the pioneers might have done for an
illness. Or have you found mostly contrasts? (If there are no comparisons on
the board, mention lemon and honey for a cough, chicken soup, etc.)
Why Did Abraham Lincoln's Mother Die?
Sickness and Medicine in Pioneer Indiana
Part two of a two-part Grade 4 Lesson
Purpose of Lesson: This lesson tells students a story about a specific illness in
pioneer Indiana and how it affected the life of Abraham Lincoln.
Objectives and Correlation to Indiana Standards: See part one
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Lesson content from: Walter J. Daly, "'The Slows': The Torment of Milk
Sickness on the Midwest Frontier," IMH 102 (March 2004)
Lesson Activities: Read aloud to the class or assign as a take-home reading.
When the first pioneers moved into Ohio and Indiana, they discovered an illness
they had never seen before. It seemed to be related to a sickness that their farm
animals, especially cows and sheep, sometimes developed. The animals would
begin to shake and tremble whenever they tried to move very far; within a few
days, the sick animals died. The pioneers called the illness the “trembles” or the
"slows" (because the few people who survived the illness often spent weeks or
months feeling very tired and unable to work or even move around).
Doctors soon could list the symptoms of the disease: weakness, muscle pain,
vomiting, bad breath, and extreme fatigue. Many patients, within a few days of
falling ill, went into a coma and died.
Pioneers noticed that the animals who became sick with the "trembles" were
mostly those who had grazed in oak forests or in low-lying areas with oak trees
and smaller plants. For many decades, doctors and scientists tested animals
with the disease and tried to find its cause. During this time, the settlers who
were most affected by the disease could do little to prevent or cure it, except to
move away from one area and hope that the next place they settled would be
free from the disease.
In 1816, Thomas and Nancy Hanks Lincoln, along with their two children and
Nancy's young cousin Dennis Hanks, settled in a wooded area near Pigeon
Creek, Indiana. They lived in a three-sided lean-to for several months until
Thomas finished building a small log cabin. Soon Nancy's aunt and uncle also
moved to the same area. In the fall of 1818, several people who lived near the
Lincoln's cabin became seriously ill. All of the sick people, including Nancy
Lincoln's aunt and uncle, had similar symptoms – the symptoms of the "slows."
Soon Nancy also became ill and she, like the others who were sick, died within a
few days. Thomas Lincoln was left alone to raise his wife's young cousin and his
two sons, including nine-year old Abraham. In December 1819 Thomas
remarried, in part to give young Abe a new mother.
In the 1850s, when Abraham Lincoln was a lawyer living in Illinois, scientists
finally confirmed the cause of the "slows", or what was now known as "milk
sickness." The cause was a poisonous substance in the white snakeroot plant.
The snakeroot grew in oak forests and in low-lying areas. If a grazing cow or
sheep ate enough snakeroot, it would become sick and its milk and meat would
carry the poison to the person who drank or ate it.
It took many years for people to learn about this discovery. In 1859, in Randolph
County, Indiana, three children from the same family died from milk sickness. In
1862, Mary Bell Wilson, living in Lockport, Indiana, wrote a letter to her
grandparents telling them that "a disease called milk sickness carried off a good
many people last fall." Milk sickness began to disappear in the years between
1850 and 1900 as farms became larger, and grazing pastures became fenced in
so that animals could not stray into the woods.
For Class Discussion the Next Day:
1. Why do you think it took so long for doctors and scientists to discover the
cause of milk sickness? What was lacking in early 19th-century society that
might slow down research? [Examples: modern transportation so that people in
rural areas receive news; communication technology so that scientists and
doctors can share their findings with each other; technology that aids in research;
etc.]
2. Read the following text from Dr. Daly's article aloud to the students:
"Treatments [for milk sickness] were varied . . . but none was specific and none
effective. Purging the bowels with calomel, sedation with opium and/or alcohol,
and bleeding were common."
Ask the students: Why do you think so many people used remedies and
treatments that didn't work?
An Optional Assessment Project [Worksheet] follows
Fact or Folklore: You be the Doctor
Read each statement and decide if the information in the statement is
based on scientific fact or popular folklore.
Write "fact" on the line if the statement is a fact and "lore" if the statement
is folklore.
_______ 1. When the mists rise up from creeks and rivers, that's when
people get the Ague.
_______ 2. The "slows" is caused by the white snakeroot plant that grows
in Indiana oak forests.
_______ 3. When a person has a high fever, you should bleed them until
the fever goes down.
_______ 4. One way to reduce malaria is to control the mosquito
population.
_______ 5. Feed a cold, starve a fever.
_______ 6. The best cure for the "slows" is to purge with patient with
calomel.