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The Salt Lake Sanitarian: Medical Adviser to the Saints
The Salt Lake Sanitarian: Medical Adviser to the Saints
BY SHERILYN COX BENNION
What avail the largest gifts of Heaven, When drooping health and spirits go amiss?
IN APRIL 1888 DR. MILFORD BARD SHIPP and two of his four wives, Drs. Maggie C. Shipp and Ellis R. Shipp, founded a monthly magazine "devoted to the prevention and cure of diseases and injuries, and the promulgation of the laws of health and life." The Salt Lake Sanitarian was subtitled "A Monthly Journal of Medicine and Surgery." It survived until January 1891, offering advice on subjects ranging from cholera to "coffeeism" and encouraging its readers to educate themselves regarding "the laws of life and sanitation."
The Sanitarian began at a time when the field of medicine was in transition. During the early part of the nineteenth century most members of the medical establishment practiced what came to be known as heroic medicine after Oliver Wendell Holmes gave it that label in derision. It included purging, bleeding, and administering large doses of drugs. Diagnosis was rudimentary, and few effective medicines were available. The practice of medicine required neither a medical degree nor a license.
Given the uncertain state of orthodox medicine, many patients lost confidence in it and turned to a proliferation of medical sects. In the words of one historian:
To the pathies—hydropathy, vitapathy, osteopathy, isopathy, homeopathy, phrenopathy, electropathy — could be added magnetic healing, physiomedicalism, sun therapy, chrono-thermalism, Thomsonism, Grahamism, eclectic medicine, and Christian Science.
Thomsonian medicine, which relied on herbs, hot baths, and dietary moderation, numbered several prominent early Mormons among its disciples. Frederick G. Williams purchased the right to practice it before he joined the church. Willard Richards and his brother Levi were other licensees close to Joseph Smith and may have influenced his advocacy of botanic medicine. The Mormon Word of Wisdom, Section 89 in the Doctrine and Covenants, advised prudent use of wholesome herbs, and Section 42 gave this prescription: "And whosoever among you are sick, and have not faith to be healed, but believe, shall be nourished with all tenderness, with herbs and mild food, and that not by the hand of an enemy. " The next verse directed elders of the church to lay their hands upon the sick and pray for them.
Joseph Smith's successor, Brigham Young, also supported faith healing backed up by Thomsonian remedies. Although his feelings for doctors mellowed and he consulted them as he grew older, apparently no longer considering them "a deadly bane to any community" as he did in 1869, only two years before his death he told the Saints that when their children were sick "Instead of calling for a doctor you should administer to them by the laying on of hands and anointing with oil, and give them mild food, and herbs, and medicines that you understand. . . ." When he encouraged Mormon women and men to obtain medical training in the late 1860s and the 1870s it probably reflected not a change of heart toward the medical profession but his desire that Mormons be treated by Mormon doctors rather than by gentiles and that obstetrical practice be restricted to women.
Health had been a prime concern of church authorities ever since the first Saints reached Utah in 1847, perhaps partly because of an alarmingly high death rate, surpassed in 1850 only by that of Louisiana. Mormon doctors formed a Council of Health in 1849, promoting botanic medicine and suggesting a search for medicinal plants native to the area. In 1852 the territorial legislature passed laws requiring labeling of any medicine containing poison and stipulating that doctors must explain "in plain, simple English" the effects of any poisonous drug they intended to administer and obtain written consent for its use. Salt Lake City began requiring physicians to be licensed in 1856. A series of physiology classes for women met in 1872 and 1873, and in 1874 Eliza R. Snow spearheaded the offering of instruction in nursing and obstetrics. In 1878 Dr. Ellis Shipp, subsequently one of the editors of the Salt Lake Sanitarian, opened a School of Obstetrics and Nursing. It affiliated with the Relief Society's Deseret Hospital, operated between 1882 and 1890 primarily for women. The nursing instruction continued until well into the twentieth century with both Ellis and her sister wife Dr. Margaret Shipp (Roberts) as teachers.
By this time conventional medical theory had undergone many changes. The work of Louis Pasteur led to recognition of a relationship between microorganisms and disease. Robert Koch's discoveries paved the way for the development of vaccines. Diagnostic methods became more sophisticated, and doctors began to specialize. Surgical innovations accompanied the use of anesthesia. Educational practices underwent reform, and hospitals began to take a central role in caring for the sick. Still, medical science in the United States lagged far behind that in Europe, and advances filtered down to everyday practice slowly. Only toward the end of the century did the average citizen begin to benefit from the new discoveries and techniques.
Part of the credit for the modernization of medical treatment must go to periodicals that spread word of innovations. As early as 1829 magazines began to be published in behalf of various theories and practices. In fact, the aims of the Journal of Health, founded that year by an association of physicians in Philadelphia, resembled those of the Salt Lake Sanitarian. It would present "plain precepts, in easy style and language, for the regulation of all the physical agents necessary to health." It advocated fresh air, good food, exercise, healthful clothing, proper correlation of mind and body, and abstinence from tobacco and liquor.
Along with the periodicals designed to aid readers in making themselves more healthy came those directed toward medical practitioners, which contained more specialized and technical information. Most states and many cities had their own journals for physicians, as did the various medical specialties.
The pathies, too, had their journals. Between 1850 and 1865 at least seventeen of them promoted homeopathy. The hydropaths had the Water-Cure Journal, the Water-Cure Monthly, and the Water-Cure World. Disenchantment with conventional medicine led both to enthusiasm for the heretical movements and their publications and to an avid concern with health that fueled interest in health magazines of all kinds. Probably about a thousand journals in medicine and related fields were published between 1885 and 1905, many of them depending on patent medicine advertising. A history of the American Medical Association refers to the middle 1890s as "the days of competitive journalism in American medicine" in which "the battle raged continuously." Health also played a prominent part in popular general magazines.
In this atmosphere the Salt Lake Sanitarian made its appearance. During the 1880s the idea of vaccination had spread through the United States, Koch had isolated the microbes of tuberculosis and Asiatic cholera, and Friedrich Loeffler had discovered the diphtheria bacillus. Researchers realized that insects might be agents of infection. Physicians began operating successfully on the abdomen. Between 1890 and 1900 the U.S. mortality rate would fall nearly 10 percent and the average age at death rise from 31 to 35.2° Salt Lake City had three hospitals and a corps of physicians freshly trained in eastern medical institutions. Brigham Young had advised that church members should be their own physicians, "know their own systems, understand the diseases of their country, understand medicine and they ought to know enough to treat themselves and their neighbors in that way that they will live as long as it is possible for them to live." It must have seemed to the Doctors Shipp that a magazine encouraging healthful living and explaining how to achieve it could make a real difference in the lives of the Saints.
In the Spring of 1888, Bard, as he was called by his friends, was 52, Ellis 41, Maggie 38. Ellis had married Bard in 1866 while she was living in the home of President Brigham Young, against the prophet's wishes. Two earlier marriages had ended unhappily for Bard, but that did not deter Ellis. He was helping his father with a hat and shoe store in Salt Lake when the marriage took place, but the couple soon moved to Fillmore to manage a new branch store there. It foundered, and they returned to Salt Lake to face financial problems and the acquisition of three more wives for Bard. The first of these was Maggie, whom he married in 1868.
A year later Brigham Young began sending Mormons East to study medicine. Heber John Richards was the earliest. Romania Bunnell Pratt (Penrose) became the first woman in 1873. In 1875 Maggie Shipp followed, leaving two children in the care of her sister wives. She became extremely homesick, however, and stayed only a month at the Woman's Medical College of Pennsylvania in Philadelphia. Ellis took her place, having decided after the deaths of two children that her life's work would be caring for the sick. She left her three surviving children in Salt Lake. By the time she received her degree in 1878 she had borne another. After Ellis returned to Salt Lake, Maggie decided to give Philadelphia another try and received her degree in 1883. Like most women doctors of the time both specialized in obstetrics.
In the meantime Bard apparently concluded that medicine was the family vocation. He had studied law while Ellis was away, but he abandoned it and obtained his medical degree from Jefferson Medical College of Philadelphia the same year Maggie got hers. One of his daughters later wrote that he never really intended to practice: "His purpose in going to a medical college was to better prepare himself to write and edit a health magazine for the people that they might better understand first aid, home nursing and sanitation." He did not open a medical office but sometimes diagnosed and prescribed for his friends and acquaintances.
Bard's magazine was the Salt Lake Sanitarian. The eight numbers of the first volume, issued monthly and dated April through December 1888, listed the "Drs. Shipp" as editors, but after that Bard's name appeared alone. Although the first number was dated April, it came out at the end of May according to a May 27 announcement in the Salt Lake Herald. An editorial in the first number of the second volume, April 1889, stated that the editors had hoped in vain to catch up by publishing extra numbers during the year.
Perhaps all three cooperated on the magazine's first editorial in which they expressed their intention to cultivate an understanding of physiological laws and discuss care of the sick and treatment of disease. They assured readers that they were "tied to no exclusive dogmas" but would "endeavor to advance only such principles as are established in the light of science and have the sanction of professional authority." They also invited friends to ask questions, which would be answered in the magazine, although nothing in the Sanitarian's content indicates that this plan was carried out. Ellis, who wrote poetry that was published in the Woman's Exponent and in a book, may have been responsible for the flight of fancy that began and ended the editorial with marine metaphors: "It is with no little apprehension that we launch the Sanitarian upon an untried sea. . . . The aspirations of the Sanitarian will be to serve as a beacon light to warn the frail barks freighted with human lives of the shoals and snags that abound in the stream of time."
The magazine was 6 " x 9" in size, and each number contained 24 pages of text. In addition, each carried up to seven unnumbered pages of advertising, including the inside front cover and both sides of the back cover. A note assured advertisers of circulation in 400 Mormon towns and settlements in Utah and surrounding territories. Others told readers that the editors would permit only reliable advertisements. Some ads had medical connections, like those for druggists, "humanized milk," Beck's hot springs ("The finest Medical Baths of the United States"), and "Essence of Life for Teething Children," the last suspiciously reminiscent of a patent medicine. But most touted miscellaneous products and services: a bank, carriage store, music store, bakery, furniture store, feather bed cleaning establishment, and confectionery. Subscribers paid two dollars a year for the Sanitarian; a single copy cost twenty cents.
The editors kept their promise to discuss prevention and treatment of disease. The vast majority of articles dealt in one way or another with these topics. Articles about specific diseases and medical problems appeared most frequently, amounting to almost one-third of the total. Articles directed toward the health of children, which also discussed specific diseases, came next, followed by those whose major theme was use of medicines and other therapies. Practices of healthful living, sanitation, and nutrition were other significant concerns. Columns by Bard and Ellis and editorials emphasized the same areas.
In addition to articles and editorials, the Sanitarian used fillers. They were likely to be humorous anecdotes, bits of miscellaneous information, or brief snippets of medical advice.
The articles were predominantly reprints. Fully two-thirds came from forty-five other publications, mostly professional medical periodicals. From a New York publication the Shipps took not only articles but also the name of their publication. A list of their sources indicates the editors' wide exposure to the medical literature and their conformity to standard journalistic practices of the day. Editors of both magazines and newspapers during the nineteenth century used scissors as an essential tool. The Sanitarian's editors ranged widely and passed on whatever seemed of value to them. They had absorbed Brigham Young's pragmatic approach and supported his reliance on common sense.
The first number set the tone for the Sanitarian and sounded many of its recurring themes. Its lead article, "Remedial Agents, By the Editors," noted the rapid advances being made in treating disease but warned against excessive use of medicine:
The editors wrote for those who depended upon themselves in times of sickness but noted that qualified, honest physicians who were "up with the times" also would not "dose with much medicines."
Articles by Ellis concerned the use of olive oil as a therapeutic agent and scarlet fever. Another original article, on disinfectants, was written by a Dr. Brown. Typical of many Sanitarian articles on sanitation, it advised readers to clean outbuildings, move kitchen waste far from the house, get rid of stagnant water and anything decaying, ventilate cellars, disinfect sickrooms and clothing worn by the sick and their visitors, and get fresh air: "You cannot have too much pure, fresh air, enlivened by a sufficiency of sunshine, in your house, and the sicker you are the greater is the necessity for a liberal supply."
Reprints followed the same lines, focusing on medical problems and treatments and also previewing the Sanitarian's concern with children's health: "Do Not Forget to Give the Baby a Drink," "New Mode of Treating Boils," "The Conditions of Longevity," "Precocious Children," "Simple Constipation," and "Warts."
The remaining content of this first number consisted of an editorial and fillers. Only rarely did the humor of the fillers spill over into the articles. Here is the beginning of a parody of "The Old Oaken Bucket" included in an article about typhoid fever:
Perhaps because two of the Sanitarian's editors were women and mothers, the health of women and children came in for considerable attention. The Sanitarian also joined the battle against unhealthy clothing. It reprinted "A Scientific Attack on the Corset," which provided the following list of symptoms from which corset wearers could expect to suffer: "Local inflammation of the liver, gallstones and bilary colic, wandering liver, protuberant abdomen and enteroptosis, prolapse and flexions [sic] of the womb, lateral curvatures of the spine, anaemia and chlorosis, dyspepsia, diminished lung capacity and oxygen starvation, intercostal neuralgia, weak eyes and Bright's Disease."
The infant science of psychology began attracting attention during the latter part of the nineteenth century, and Sanitarian articles recognized the importance of the mind in the health of the body. A long address by the president of the American Surgical Association, reprinted from the Medical Record, was titled, "The Relation of Social Life to Surgical Disease, " and, after his stay in the Utah penitentiary as a result of unlawful cohabitation. Bard wrote about "The Effects of Incarceration upon the Body and Mind."
The modern reader could not argue with much of the information communicated by the Sanitarian, although a number of exotic maladies like "brewery stomachs" and brain exhaustion also merited attention, and the author of "The Deadly Cold Bed" stated that it was "astonishing and appalling how many die or become permanently diseased from sleeping in damp or cold beds."
The themes of the magazine stayed the same over its twenty-one numbers, but the publishing arrangements changed. Because the dates on the magazine did not necessarily coincide with its actual appearance, it is difficult to judge the impact on it of Bard's ten-week prison sentence. He was in the penitentiary from September 18 to December 1, 1888, when he paid a $65 fine and was released. He began the second volume as sole editor in April 1889, after nine numbers of volume one, blaming his "incarceration in the pen" for the failure of the Sanitarian to catch up with its numbering. It seems unlikely that Maggie and Ellis continued to produce the magazine in his absence. He promised a fifty-cent refund to readers who requested one, or they might apply it to the next year's subscription.
The same editorial that referred to Bard's stay in the penitentiary examined "the labors of the first year" and took encouragement from success beyond expectations. It also recognized the difficulty of terminology in one article and accepted criticism to the effect "that some of the pieces that have appeared in the Sanitarian carried such a scientific diction that they were better suited to the professional than to the general reader." However, the editorial continued, the first object of the magazine was "to advance only such doctrines or ideas as have the sanction of professional and standard authority." To do so it was best to let them speak for themselves, even though medical terms would be used to convey their thoughts. Readers could solve the problem with the help of "a little 'dictionary light,' " which would "bring astonishing relief," and the rewards would be well worth the effort.
The editor recognized that long reprints and difficult vocabulary might discourage readers, but more and more long articles appeared as time went on with even less original material. Maggie's final article came out in May 1889. Ellis wrote one the following month and then nothing else until the final number in January 1891. Bard explained in October 1890 that "During the winter months of last year's volume we published the lectures of Drs. Shipp, instead of the regular issues of the Sanitarian proper. The past summer we have been engaged traveling through the settlements and cities of this and adjacent territories, lecturing on the subject of sanitation, and in consequence did not commence the third volume until now, October. " The first volume had included nine numbers, the second eight, ending with November 1889. Bard went on to say that he did not see anything that would hinder publication for the coming year.
Yet by February 1891 the Sanitarian was dead. Readers received no explanation in the pages of the magazine, and Salt Lake City newspapers published no obituaries. An article about Ellis suggests that "Feuds between Maggie and Milford, who were eventually divorced, may have been the cause of its demise." However, Maggie had contributed only a half-dozen articles to the magazine, and it seems unlikely that her work was vital to its survival. Marital difficulties aside, a more likely explanation for the Sanitarian's demise was its reliance on long, often technical reprints. Readers might not have shared Bard's enthusiasm for scientific phraseology even if they agreed with his contention that he was bringing them "some of the best products found in our medical literature upon topics that are of common interest and can be utilized in domestic practice." This promised reward probably was not worth the effort of approaching the Sanitarian with dictionary in hand.
Circulation probably never exceeded 500. A contemporary directory places it in the 250 to 500 range in 1891, the only year in which the Sanitarian was listed. Potential readership was limited, with Salt Lake City having a population in 1890 of only 44,800 and Utah 210,779.
In attempting to assess influence, one must look beyond circulation figures. Unfortunately, no subscription lists survive, but it seems safe to assume that Sanitarian subscribers were among the prominent members of the community, who generally had more exposure to the mass media then as now. Certainly the city's medical professionals must have been familiar with it, perhaps using it as a digest of current medical opinion and trying out some of its recommendations. The editors naturally would have selected articles that supported the opinions they already held, but simply examining the forty medical periodicals from which they used reprints must have broadened their outlook and exposed them to the most up-to-date information available. Their influence was wide, as they went beyond their private practices to teaching obstetrics and nursing and to lecturing throughout the region and crusading for better sanitation. The impact on the Doctors Shipp of their experience with the Sanitarian must have been substantial. This is largely speculation, of course. The medical and cultural climates of the time influenced the magazine, and it no doubt had some influence in turn, but exactly where it fit into that circle of cause and effect is impossible to determine. What can be concluded is that it reflected the transitional state of medicine during its brief lifetime, as well as the pragmatic position of the Mormon church regarding medical questions, and that it worked along with other influences to reinforce certain lines of medical thought and experience.
The Sanitarian supported the new approach of the medical schools as they struggled to adopt scientific methods and determine the implications of new discoveries. However, its content included vestiges of folklore and the pathies, as did the medicine practiced on most of the country's population. The emphasis on prevention and sanitation was scientific and in line with the best opinion of the day.
The antiphysician attitudes of the Mormon hierarchy had relaxed considerably by 1890, and the Sanitarian signaled the entrance of the church into the mainstream of medical thought and practice, although the magazine still recognized the power of faith to heal and avoided advocating the services of physicians as a substitute for administration to the sick. It also followed church leaders in stressing the responsibility of the people for their own good health and in warning against the "dosers and druggers," but these were themes of the medical establishment as well.
The editors wrote that "no other age is so noted as the present for the development and production of those things that conduce so greatly to human happiness" and that "in no direction is this more perceptible than in the rapid strides that are being made in the selection and uses of remedial agents in disease." The Sanitarian helped publicize those rapid strides and perhaps added a small portion to the human happiness of the Saints.
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