History of medicine in the United States

The history of medicine in the United States focuses on the work of trained professionals from colonial days to the present.

Colonial era health care was based primarily on traditional medicines and traditional cures. Professionalization was very slow before 1750, by which time there were a handful of cities of more than 20,000 population, each of which had physicians trained in England and Scotland, as well as a growing number of locally trained men. Cotton Mather of Boston was the first significant figure in American medicine.

Mortality was very high for new arrivals, and high for children in the colonial era.Malaria was deadly to many new arrivals. The disease environment was very hostile to European settlers, especially in all the Southern colonies. Malaria was endemic in the South, with very high mortality rates for new arrivals. Children born in the new world had some immunity—they suffered mild recurrent forms of malaria but survived. For an example of newly arrived able-bodied young men, over one-fourth of the Anglican missionaries died within five years of their arrival in the Carolinas. Mortality was high for infants and small children, especially from diphtheria, yellow fever, and malaria. Most sick people turn to local healers, and used folk remedies. Others relied upon the minister-physicians, barber-surgeons, apothecaries, midwives, and ministers; a few used colonial physicians trained either in Britain, or an apprenticeship in the colonies. There was little government control, regulation of medical care, or attention to public health. By the 18th century, Colonial physicians, following the models in England and Scotland, introduced modern medicine to the cities. This allowed some advances in vaccination, pathology, anatomy and pharmacology.

There was a fundamental difference in the human infectious diseases present in the indigenous peoples and that of sailors and explorers from Europe and Africa. Some viruses, like smallpox, have only human hosts and appeared to have never occurred on the North American continent before 1492. The indigenous people lacked genetic resistance to such new infections, and suffered overwhelming mortality when exposed to smallpox, measles, malaria, tuberculosis and other diseases. The depopulation occurred years before the European settlers arrived in the vicinity and resulted from contact with trappers.

The city of New Orleans, Louisiana opened two hospitals in the early 1700s. The first was the Royal Hospital, which opened in 1722 as a small military infirmary, but grew to importance when the Ursuline Sisters took over the management of it in 1727 and made it a major hospital for the public, with a new and larger building built in 1734. The other was the Charity Hospital, which was staffed by many of the same people but was established in 1736 as a supplement to the Royal Hospital so that the poorer classes (who usually could not afford treatment at the Royal Hospital) had somewhere to go.

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