Paracelsus (1493–1541), Benjamin Rush (1746–1813)
From about 1780 to the mid-nineteenth century, “heroic medicine” strongly influenced American medical practice. Intended to rid the body of disease-causing impurities from all possible egression sites, treatment approaches included methods to induce vomiting and profuse sweating, blistering to draw out infections, cleansing the bowel with calomel, and bloodletting with help of leeches. The treatment of George Washington’s presumed infection of the epiglottis involved the removal of more than five pints of blood over a sixteen-hour period, which likely hastened his demise in 1799.
Benjamin Rush, the most illustrious physician of the period and among the most influential and aggressive practitioners of heroic medicine, used bloodletting and calomel (mild mercurous chloride) to treat a 1793 yellow fever epidemic in Philadelphia. He also used mercury salts to promote copious salivation when treating syphilis, typhus, and tuberculosis. Rush’s influence far transcended his active medical practice. He was a professor of medicine at the University of Pennsylvania, author of the first American textbook of psychiatry, and signer of the Declaration of Independence.
The use of calomel did not originate with Rush; Paracelsus first proposed it for use as a diuretic, cathartic, and treatment of syphilis. Between the first documentation of syphilis in Europe before 1500 and the introduction of Salvarsan in 1910, mercury compounds were the primary drug treatments for the disease. Successful treatment required continuous and painful weekly injections of mercury over a two-year period and was invariably accompanied by hair loss, loosened and lost teeth, kidney damage, and other symptoms of mercury toxicity.
One response to the harsh—some would say, barbaric—treatment approaches of the “heroic period” was the introduction of homeopathic medicine at the end of the eighteenth century. Another far more powerful counterbalancing influence was the rise of scientific medicine.
SEE ALSO Homeopathic Medicine (1796), Salvarsan (1910), Merbaphen (1920), Penicillin (1928).
A “cure” with calomel was often worse than the disease, as was experienced by George Washington in his final hours in 1799. This portrait of Washington was painted by Augustus Weidenback in 1876.