Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century.

Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century. By Steven M. Stowe. Studies in Social Medicine. (Chapel Hill and London: University of North Carolina Press, c. 2004. Pp. xii, 373. $45.00, ISBN 0-8078-2885-8.)

In mid-nineteenth-century America the woods were full of people calling themselves "doctor," and they were a colorful gaggle--herbalists, homeopaths, Thompsonians, hydrotherapists, shamans, slaves, faith healers, and anyone who wished to augment his income by administering a bloodletting or a "laudable puke" to a patient for a nickel. Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century offers a study of regional medical practice from the perspective of doctors calling themselves "orthodox," that is, men who had earned medical degrees somewhere, somehow. Steven M. Stowe sees the profession of medicine as a cultural construct, and he examines ideas of disease and caregiving in terms of the midcentury South. His research has led him through a rich literature of letters, diaries, casebooks, and professional publications written by M.D.s. Stowe offers "country orthodoxy" as the concept that includes the "art" of medicine as well as social sanctions and expectations that are uniquely southern (p. 2).

In the first half of the nineteenth century, heroic medical therapeutics were the order of the day, procedures that produced immediate change in the patient under the skilled hand of a local doctor. Blistering, purging, and bleeding were common practices used to produce a break in fever or a sudden quiet. All this was done with the belief that drastic measures performed by an orthodox physician would restore health. Medical therapeutics at midcentury teetered on the cusp of a new empiricism that, by the decade of the Civil War, was the theory taught in reputable medical schools and that was beginning to subtly influence professional caregiving. Stowe addresses this shift in his survey, focusing on the period from 1830 to 1880. He provides a deeply informed assessment of so-called modern medicine following the Civil War, which was based on science rather than protocol.

Stowe illustrates his ideas about this cultural shift with excerpts from bedside notes and casebooks of specific country-orthodox physicians. One of these physicians was Charles Hentz, a practitioner in the Florida panhandle in 1860, who treated African Americans as well as Caucasians. Stowe notes the distinctions of race made by Hentz in choosing correct remedies for his patients (p. 182). "Two cases from Hentz's medical notebook, both concerning sick people with pneumonia---one a white woman, the other a slave man--take us into Hentz's case-time and thus further into how bedside notes made orthodox and vernacular medicine inseparable" (p. 182). The white woman, Mrs. Goodson, Stowe points out, was recorded as "'the Mother of 12 or 15 children,' which succinctly places her among a group of mature women whose constitutions had been tested before" (p. 183). Jim, the slave, was described by the doctor as a "likely boy," which refers to Jim's market value and as well as summarizing his general health (p. 189). Stowe carefully analyzes the attitudes of Hentz toward the ultimate conclusions of these two cases (Mrs. Goodson recovered; Jim did not) as an illustration of the dialectic between disease and medicine of the period in the South.

As a richly documented chronicle of medicine in the mid-nineteenth century, this book is successful and claims a high place in both social history and the history of medicine in America.

CYNTHIA D. PITCOCK

University of Arkansas Medical School