21 BRUTAL Things Doctors Did to Patients in the Old West That Would Be Illegal Today

PART 2:

Mercury was the most commonly prescribed medication in frontier America.    Given for syphilis, for typhoid, for constipation, for yellow fever, for depression. For almost anything a doctor decided needed  treating. Here’s what mercury actually does to the body at the doses frontier doctors prescribed.

  It destroys the kidneys progressively and permanently. It attacks the nervous system causing tremors that worsen over years. It causes the gums to rot, the teeth to fall out, and the jawbone itself to decay. It causes psychosis, paranoia, hallucinations. The phrase mad as a hatter comes from this era. Hat makers used mercury in their process and suffered neurological damage.

The phrase was common because the symptoms were common. Frontier doctors prescribed mercury at doses five  to 10 times what hat makers were accidentally absorbing. Patients who visited doctors for minor conditions left with mercury poisoning that would kill them slowly over the next decade. They paid for this.

 They thanked  the doctor. They had no idea what was happening to them. Number three, bloodletting was still happening in the 1880s. Bloodletting as a medical practice is 2,000 years old. The theory was that illness was caused by an imbalance of bodily fluids and that removing blood restored balance. It was completely wrong.

 It had always  been completely wrong. Frontier doctors were still doing it in the 1880s. The procedure involved cutting a vein, usually in the arm, and collecting blood until the patient showed visible effects. Pallor, dizziness, weakness. Those effects were interpreted as signs the treatment was working.  They were signs the patient was going into shock.

George Washington died in 1799 after his doctors removed approximately  five pints of blood over 12 hours to treat a throat infection. Washington was bled to death by his doctors. This practice  continued for another 60 years. On the frontier, doctors were still recommending it for infections, fevers,  and pneumonia as late as 1885.

For conditions where the patient was already weakened and losing blood was a death sentence. Number four, unqualified men called themselves doctors. There was no licensing requirement for doctors in most of the American West until  the 1890s. None. Any man who wanted to practice medicine and charge patients for treatment  was legally entitled to do so.

No medical degree required, no examination, no oversight. Historians  estimate that in the 1870s, fewer than half of the men practicing medicine on the American frontier had any formal medical training. Fewer than half. The patients had no way to tell the difference.    There was no medical board to complain to, no malpractice lawsuit to file, no regulatory body that cared.

 If your doctor killed you with incompetence, that was between you and God. The doctor had another patient in the morning.    Number five, wound treatment made infection worse. Before germ theory, doctors treated wounds with whatever their training had suggested. Poultices made from bread and milk were applied to open wounds to draw out the badness.

Turpentine was poured  directly into deep wounds. It caused chemical burns and created ideal conditions for bacterial growth. Some doctors applied animal dung to wounds because folklore suggested  healing properties. Men who survived gunshot wounds    died from the treatment applied afterward.

The bullet didn’t kill them. The doctor’s  response to the bullet killed them. James Garfield, the 20th president of the United States, was shot in 1881. The bullet lodged in his back  and missed every vital organ. Over the following 11 weeks, doctors probed the wound with unwashed fingers and unsterilized instruments repeatedly introducing bacteria.

Garfield died of the resulting infection. The assassin’s bullet had been survivable. The doctors who tried to save him were not. Number six, opium was prescribed to children.  Laudanum was liquid opium mixed with alcohol. Available without prescription, sold in every general store, advertised as a cure for pain, anxiety, sleeplessness, and general discomfort.

Doctors prescribed it to infants. Mrs. Winslow’s soothing syrup, one of the most popular frontier products, contained 65 mg of morphine per fluid ounce. Parents gave this to their teething  babies. The infants quieted down because they were sedated with morphine. Some did not wake up. The children who survived regular opium administration  in infancy were physiologically dependent on the drug before they could walk.

This was legal. This was mainstream. This was medicine. Mrs. Winslow’s soothing syrup remained on the market until 1930. Number seven, hospitals were where you went to die. If a frontier doctor told you that you needed to go to the hospital, your family began making funeral arrangements. Hospital wards housed patients with every condition in the same room.

A patient recovering  from a broken leg shared air and nursing care with a patient dying of cholera.    With a patient in advanced tuberculosis. With a patient whose surgical wound was actively  infected. Studies conducted in European hospitals in the 1860s found that patients who had surgery in hospital were four times more likely to die than patients who had the same surgery at home.

Four times. Frontier hospitals were worse than European ones. The doctor who admitted you had  just statistically reduced your chances of survival. He did not know this. That was perhaps the worst part. Number eight, they spread disease between patients. In 1847, Ignaz Semmelweis proved that doctors were killing maternity patients by going directly from autopsies to deliveries without washing their hands.

His colleagues rejected his findings. He was committed to an asylum where he died two weeks later,    probably from the same bacterial infection he had spent his career trying to prevent. Hand washing did not become standard practice until the 1880s.  On the frontier, a single doctor serving hundreds of patients across wide territory could introduce cholera,  typhoid, and surgical infection to a dozen households in a single day.

Not through negligence by modern standards, through standard practice. He was doing exactly what his training had taught him. The training was killing people. And the people who proved this were ignored    until they died. Number nine. Patent medicines contained cocaine and heroin. The pharmaceutical industry of the Old West operated on one principle.

 Make the customer feel better immediately,    regardless of what that required. Cocaine was a legal, unregulated ingredient in dozens of products. It produced  immediate feelings of energy and reduced pain. Customers came back because cocaine  is highly addictive. Heroin was synthesized in 1898 and marketed by Bayer, the aspirin  company, as a non-addictive substitute for morphine.

Read that again. Heroin  was sold as the safe option. It was used to treat children’s coughs. The medicine wasn’t curing anything.    It was creating a need for itself. And the doctors who should have warned patients against  these products were frequently receiving commissions from the companies selling them.

Number 10. Childbirth was more dangerous with a doctor. In the 1870s, childbirth in a hospital attended by a physician was statistically more dangerous than childbirth at home with a midwife. Studies documented maternal mortality rates of 10 to 35%  in physician-attended hospital births. Midwife-attended home births had mortality rates of  1 to 2%.

The difference was explained entirely by the fact that midwives washed their hands and didn’t come directly from autopsies. Women who refused physician attendance at births were criticized by their communities for being backward and distrustful of modern medicine. They were making the statistically correct  decision.

 The medicine was the danger. Number 11. They operated on women without consent. The history of gynecological medicine  in 19th century America contains some of the most disturbing abuse of medical authority in American history. J. Marion Sims, considered the father of modern gynecology, developed his surgical techniques by performing repeated surgeries on enslaved black women without anesthesia.

He argued  that black women felt less pain. He was wrong. He operated on the same women  up to 30 times to perfect techniques he would later use with anesthesia on white patients. On the frontier, hysterectomies and the removal of ovaries were used as treatments for depression, anxiety, epilepsy, and what doctors termed hysteria.

 Hysteria was a diagnosis applied almost exclusively to women. Its symptoms included disagreeing with the doctor and failing to recover from grief on a schedule the physician considered appropriate. The treatment was surgical removal of reproductive organs. Thousands of women had healthy organs removed because a male physician decided their emotional state required it.

 This was legal. This was medicine. Number 12. They diagnosed by tasting urine.    Before laboratory analysis, doctors used their senses    to diagnose disease. This included tasting the patient’s urine. Diabetes was diagnosed by the sweetness of urine, kidney disease by smell and cloudiness. Urinary infections by color, smell, and  taste.

This was standard practice taught in medical schools throughout the 19th  century. The doctor treating a patient with an infectious urinary condition was exposing himself to those pathogens through direct    oral contact. He was then seeing his next patient without washing his hands or his mouth.

A busy frontier physician who tasted multiple samples  in a morning created a direct bacterial transmission chain connecting every patient he had evaluated.    This practice was not abandoned until laboratory analysis became available in the 1890s.  Some frontier doctors continued it beyond that because they trusted their senses  more than laboratory results. Number 13.

 The operating table was never cleaned. Wood absorbs blood. Wood absorbs bacteria.  Wood cannot be sterilized. Frontier surgeries were performed on wooden tables that had hosted every previous surgery in that facility. Blood from the previous patient was wiped off,  not sterilized. Instruments were wiped with cloth between procedures.

 The cloth was not changed frequently. Every surface in a frontier operating room was a contamination  source. The surgeon’s hands, the table, the instruments, all contributing bacteria  to every open wound. The patients who survived frontier surgery did not survive because of the medical environment. They survived despite it.

Number 14. Arsenic was prescribed as medicine. Fowler’s solution, a preparation of potassium arsenite, was one of the most commonly prescribed medications in 19th century America. Given for skin conditions, for anemia, for malaria, for asthma. Arsenic causes cancer. It causes progressive nerve death.

 It causes liver and kidney  failure. Victorian women also purchased arsenic complexion wafers and powders because arsenic at low doses temporarily makes skin appear smoother. They were accumulating a carcinogen with every dose. The doctors prescribing Fowler’s solution knew it was a poison. They believed  the dose they were prescribing was below the harmful threshold. They were wrong.

 Fowler’s solution remained in the British pharmacopoeia, the official list of accepted medicines, until 1958. 100 years of prescribed  arsenic. Number 15. They charged for surgeries they invented reasons to perform. Frontier doctors  were paid per procedure. The more procedures a patient required, the more the doctor earned.

This created a financial incentive to find conditions requiring treatment. The patient had no second opinion available.    The nearest other doctor was often hundreds of miles away. Medical records from frontier towns document cases of patients bankrupted  by treatment for conditions that either didn’t exist or didn’t require surgery.

 A widow in Colorado Springs in 1879 documented in her diary that a doctor had charged her for three surgeries on her son over two months. The boy died. She later learned from a traveling physician that the original condition had been a minor infection treatable with rest. She had paid for surgeries that killed  her child.

 There was no one to complain to. There was no law that covered it. Number  16. Electroshock for almost everything. In the 1880s, electric therapy became  fashionable in frontier medicine. Electrical devices were manufactured  and sold to doctors for treating arthritis, paralysis, headaches, depression, and general weakness.

They delivered uncontrolled electrical current to whatever part  of the body the doctor applied them. Uncontrolled electrical current causes burns, cardiac arrhythmia, and in high doses, cardiac arrest.    The doses were not calibrated. The devices had no safety mechanisms. Some patients reported feeling better.

Electrical stimulation does provide temporary relief of muscular pain. Some patients did not report feeling better because they were dead. None of it was regulated. All of it was legal. Number 17. Racial medicine was taught as  science. The medical establishment formally codified racial prejudice as medical science.

 Samuel Cartwright, a prominent 19th century physician, published papers in medical journals describing enslaved people who attempted to  escape as suffering from a mental illness he named drapetomania. The cure he  prescribed was whipping. This was published in a medical journal. It was cited by other physicians.    The doctrine that black patients felt less pain than white patients persisted in American medicine    in documented form well beyond the 19th century.

 Studies conducted as recently as 2016 found that a significant percentage of medical students still held false beliefs  about racial differences in pain tolerance. The 19th century medical establishment didn’t just practice bad medicine. It practiced medicine weaponized against people who already had no power. It called itself science.

 It taught it to every doctor for a hundred years. Number 18. The lobotomy was Nobel Prize-winning medicine. This is the one I told you about at the start. The frontal lobotomy was developed in 1935. The surgeon inserted an instrument through the eye socket into the brain’s frontal lobe and moved it to sever neural connections.

Often  without general anesthesia. Used to treat schizophrenia, depression, anxiety,  and what physicians described as unmanageable behavior. In practice, used on patients whose families wanted them quieter and easier to manage. Survivors were described by families as no longer themselves. Calmer.

More compliant. Gone. Walter Freeman, the American physician who popularized the procedure, performed over 3,000 lobotomies across the United States. He performed them in psychiatric hospitals,    in his office, and in a vehicle he called the lobotomobile. He performed them on children as young as 12. The procedure won the Nobel Prize in medicine in  1949.

The last lobotomy Freeman performed in 1967 killed  his patient. His surgical privileges were finally revoked. Not in 1936. Not when the evidence of damage was overwhelming. In 1967.  Number 19. The patients who survived were called proof it worked. Every treatment on this list had survivors.

 Patients who were bled and lived. Patients who were given  mercury and didn’t die immediately. Patients who had unnecessary surgery and recovered. And those survivors became the argument for continuing. A patient who recovered after bloodletting confirmed that bloodletting worked. A patient who died after bloodletting had simply been too sick to save.

The doctors were not lying. They genuinely believed in what they were doing. These were not monsters. They were men operating within a system of knowledge that was catastrophically wrong. They were doing their best. And their  best was killing people. The patients who walked in, paid their fees, and followed instructions  were trusting a profession that had not yet earned that trust.

They had no way to know that.    They paid. They trusted. They suffered. And the doctors wrote it up as another successful  case. Number 20. The amputations that didn’t need to happen. Amputation was the default response to almost any serious limb injury.    Broken bone? Amputate.

 Severe infection? Amputate. Gunshot wound to the extremity? Amputate. The logic was that gangrene could spread  and kill. Removing the limb first was considered rational prevention. The problem was that doctors amputated long before it was necessary.    Civil War surgeons performed approximately 60,000 amputations  during the conflict.

 Historians now estimate that a significant percentage were unnecessary. Bones that could have healed were removed. Infections that could have been treated locally resulted  in permanent disability. The men who survived woke to discover they had lost a limb they might have kept. They were alive. The men living on a frontier where physical labor meant survival understood exactly what the surgeon’s decision had cost them.

For the rest of their lives. Number 21. It took a century to admit they were wrong. The most disturbing truth isn’t any single treatment. It’s how long the medical establishment defended  each one. Bloodletting had critics for decades before it was abandoned. Mercury toxicity was documented  and ignored.

 The evidence against lobotomies accumulated for 30 years before Freeman lost his privileges.  In each case, the institution protected the practice longer than the evidence  justified. Because the men who had built careers on these treatments had reputations to protect. Because admitting the treatment was wrong meant admitting that patients had died unnecessarily.

Because the system that trained doctors  to do these things was the same system that would have to condemn them. The patients who were harmed didn’t get apologies. They rarely even got acknowledgement. History recorded  the treatments as the best available at the time. Which was true. The best available treatments were killing people.

And the system that should have caught this sooner chose not to.    21 things old West doctors did that would result in criminal charges today. The mercury that destroyed kidneys for decades. The surgeries on unsterilized tables with unwashed hands. The opium given to infants. The organs removed  from women whose emotions were diagnosed as surgical problems.

The lobotomies performed on children. The  arsenic sold as medicine for a hundred years. All of it mainstream. All of it published. All of it legal. Here is what I want you to take from this. These doctors were not evil. Most went into medicine to help people. The system they operated in was wrong. The knowledge was wrong.

 The incentives were wrong. And the patients paid for all of it. Medicine today is incomparably better. But medicine is still a system built by humans with human blind spots and human incentives.    The doctors of 1875 thought they knew exactly what they were doing. They were catastrophically  wrong. A hundred years from now, someone will make a video about the things doctors did in 2025 that turned out to cause harm.

Some of what we consider standard practice  today will be on that list. That is not a reason to distrust medicine. It is a reason to ask questions. It is a reason to remember that the history of medicine    is a history of confident people being confidently wrong. And the patients who paid for their confidence.

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