Dr Church and Medical Practice in Pre-Revolution Boston

   In 1775 there were approximately twenty-one physicians in Boston servicing a population of approximately 16,000. Of these, thirteen had received formal training above the apprenticeship level. All thirteen had studied in Europe and twelve had walked the wards of one of London's great hospitals and attended one or more of the city's famous courses in anatomy, surgery and obstetrics Only three or four had obtained a medical degree; Church was not among them. There was no requirement to obtain a license to practice medicine and only two American institutions granted a Bachelor of Medical Diploma - College of Philadelphia (Penn) starting in 1768 and King's College (Columbia) starting in 1769. Unlike the other major colonial ports, Boston's medical community was noted for its homogeneity. Of the forty-seven physicians who practiced in Boston between 1760 and 1798, all but four were New England born of English stock.

   That doctors held a special place in Massachusetts society is quite apparent from the number of physicians who were active Whigs and the fact that twenty-three physicians representing various districts of the state attended the First Provincial Congress in 1774.

   In contrast to the British and Continental occupational distinctions in the hierarchy of physicians, surgeons, and apothecaries, American physicians usually performed surgery, and they also dispensed drugs. As surgeons, they performed operations generally restricted to the surface of the body and the extremities. Surgery was concerned basically with cuts,bums, bruises, sprains, boils, abscesses, fractured bones, septic conditions, dislocated joints, and gunshot wounds. More adventuresome surgeons could operate on a harelip, perform tonsillectomies, attempt paracentesis,and cut for stone in the urinary bladder. They performed only two capital operations-trepanning and amputations. Amputations of the limbs were extremely dangerous. One estimate is that 50% of capital operations in 18th century Britain were fatal. Without a means to protect his patients from infection, or a method to relieve him from painful probing, sawing, cutting,and stitching, a surgeon's chances of success were limited. He knew nothing about the nature of infection or about the danger of shock. A surgeon expected a flow of "laudable pus" as essential for healing. He could not operate safely upon the bodily cavities, for anatomical explorations of the thorax and abdomen were far off. Surgery had not yet been affected by contemporaneous discoveries in pathology and physiology. Even established knowledge about the circulation of the blood produced no significant results on the operating table in that era. (Taken from F. F. Cartwright's "The Development of Modern Surgery.")


DR CHURCH RETURNS FROM LONDON
 
    Upon his return from studying medicine in London, Dr Church was the subject of an item in Boston newspaper (Boston Post Boy ,9 July 1759) in which he announced "Just arrived from London...imported a good Assortment of Druggs and Medicine to be sold at his shop at the South-End, next to Mr Draper's Printing-Office, by large or small Quantities; where Town or Country Physicians may be supplied with the best Medicines at the most reasonable Rate." Church also noted that he had "some noted Modern Authors in Physic, Surgery and Midwifery and all kinds of Grocery."

 A DOCTOR CHURCH PRESCRIPTION

   Light mutton or chicken broth or Gruel...must be your Diet Tomorrow, in general weak Chocolate with a proper proportion of Milk will serve you: milk and water boiled together is a good Draught for you, the Hartshorn Decoction is good with brown Biskett after the operation of the Physick, rice in every form suitable, Wine and water, ripe Fruits, chamomile Teas must be used with discretion.

   a. harts' horns are the horns of the red male deer and shavings from the horns were used in several medicines. Hartshorn Decoction was used to treat diarrhoea.

   b. Chamomile tea as a medicine has been traced as far back as ancient Egypt and recent research indicates that it may have been used as far back as the Stone Age.

   c. I could do without the Hartshorn Decoction but any physician who prescribes the consumption of wine and cautions me to limit the intake of herbal tea is all right with me.

  DR CHURCH THE SURGEON

   A June 10, 1773 Boston News-Letter article gives this account of one of Dr Church's operations:

   Mrs Hodges...had been totally blind for many Years. She is now able to distinguish Colours very well, and her sight is returning daily, --From the Dexterity and Steadiness of Hand, displayed by the Doctor on this Occasion, and the many eminent Qualifications of his Profession, the Public have much to expect from his Service in this Way.

   Treatment of the eyes seems to have been a specialty for Dr Church. Writing to his wife Abigail from the Continental Congress on July 7th, 1775, Adams wrote this:

  I have really had a very disagreable Time of it. My Health and especialy my Eyes have been so very bad, that I have not been so fit for Business as I ought, and if I had been in perfect Health, I should have had in the present Condition of my Country and my Friends, no Taste for Pleasure. But Dr. Young has made a kind of Cure of my Health and Dr. Church of my Eyes.

   Adams was well acquainted with Church as a physician going back as far as April of 1764. During the great smallpox epidemic of 1764 in Boston and the neighboring area, Adams resisted inoculation until he was forced by his mother to go into Boston and become inoculated. Inoculation should not be confused with vaccination, and is a much more involved and dangerous process. Patients prepared themselves for days ahead of time and often were sick for weeks afterwards. Adams and nine other patients were confined to the hospital for three weeks, suffering headaches, backaches, knee aches, gagging fever, and eruption of pock marks. During that time, Adams was attended to by Dr Lord and Dr Church.

   But inoculation saved lives. Of those who remained in Boston and were not inoculated, one in six died. Of those who stayed or fled into Boston and were inoculated, fewer than one in a hundred died.

CRISPUS ATTUCKS AUTOPSY REPORT

I, Benjamin Church, Jun., of lawful age, testify and say, that being requested by Mr. Robert Pierpont, the Coroner, to assist in examining the body of Crispus Attucks, who was supposed to be murdered by the soldiers on Monday evening the 5th instant, I found two wounds in the region of the thorax, the one on the right side, which entered through the second true rib within an inch and a half of the sternum, dividing the rib and separating the cartilaginous extremity from the sternum, the ball passed obliquely downward through the diaphragm and entering through the large lobe of the liver and the gall-bladder, still keeping its oblique direction, divided the aorta descendens just above its division into the iliacs, from thence it made its exit on the left side of the spine. This wound I apprehended was the immediate cause of his death.The other ball entered the fourth of the false ribs, about five inches from the linea alba, and descending obliquely passed through the second false rib, at the distance of about eight inches from the linea alba; from the oblique direction of the wounds, I apprehend the gun must have been discharged from some elevation, and further the deponent saith not.

BENJ. CHURCH, Jun.