As the state with the oldest permanent European settlement, Florida also boasts the first hospital in North America, founded in St. Augustine before the start of the 17th century. Since European and American immigrants first began arriving in Florida, health and illness have been primary concerns. The warm and humid state—with beaches, swamps, and deep forests—was once shrouded in mystery and allure, symbolizing at different times both the ability of environment and climate to heal and nurture and their potential to do harm.

This exhibit includes documents, photographs, and publications from the collections of the State Library and Archives highlighting the role of health and wellness in the lives of Florida’s citizens and in the development of the state. Documents included in the exhibit range from descriptions of the health effects of travel in the new territory from some of Tallahassee’s first citizens, to recollections of midwives who worked during the 1930s. Personal letters from early settlers, official correspondence from the first State Health Officer, and papers from the Midwife Certification Program give glimpses of how people experienced health concerns and needs each day, and how the state responded both in times of crisis and through long-range efforts to improve the health of the state overall.

Healthy Climes and Killer Swamps

Since its earliest years as a colony and U.S. territory, Florida has represented a place for new beginnings. With abundant farm land, a long growing season, and plenty of sunshine and rain, Florida soon attracted farmers and land owners from the American colonies, and later, states to the north searching for new economic opportunities.

For those early settlers, Florida’s climate, swaths of rich soil, thick forests, and abundant water offered the promise of health and prosperity, even while the wildness of the land, months of heat, seeming susceptibility to tropical disease, and potential for catastrophic weather proved daunting challenges to be overcome.

Surgeons and Physicians, Healers and Grannies

During the 19th century, American medicine underwent a gradual process of greater organization and increasing professionalization. This long evolution contributed over time to the ascendency of trained doctors over the folk medicine, homeopathy, and eventually, such other traditions as herbal medicine and midwifery, that had been a significant part of how Americans approached wellness, sickness, and day to day health needs. The separation between patients and the unique “experiences” of a region and professional doctors consequently became more distinct over time. Rural and pioneer physicians represented a transitional period when professional physicians still incorporated multiple sources of knowledge, employed local wisdom and plant and food-based remedies, and often served as their own pharmacists. The success of professionally trained medical doctors over other medical practitioners was largely an ideological victory, as the trained physicians, medical schools, and professional medical organizations began to exert philosophical and cultural control over how medical care was understood in the United States.

Florida has employed healers of many sorts—physicians, pharmacists, shamans, and makers of home remedies—from the colonial and territorial years, through the development of the modern state. Doctors were some of the most prominent immigrants to Florida, and access to medical care was essential, if often hard to come by, in the more remote regions of the young state.

Pioneer physicians often found that medical practices alone did not provide enough dependable income, and most pursued other professional ventures such as establishing plantations or serving in public office. In 1843, Dr. John M. W. Davidson of Gadsden County began recording medical recipes and treatments in a small, leather-bound notebook. Davidson was a family practitioner and farmer who lived and worked in Gadsden County for more than 50 years. The 126-page journal reveals a glimpse of the knowledge and concerns of a pioneer physician in early Florida, including recipes for medicines, diet supplements, tinctures, salves, and treatments for illnesses as varied as colic and typhoid fever.

As African-Americans sought greater political and economic freedom in the decades after the Civil War, the medical profession offered opportunities for success, and physicians and pharmacists were often leaders in black communities. Black physicians served important professional, political, and social roles as African-American communities negotiated years of segregation and injustice. Dr. William Spencer Stevens was born November 21, 1882, in Tallahassee.  He graduated from Florida State Normal and Industrial College and in 1904 received a medical degree from Meharry Medical College in Nashville, Tennessee. Stevens returned to Florida and became the first African-American to open a medical practice in Quincy. In 1906, he opened Stevens' Drug Store in downtown Quincy. In the 1930s, he then built a two-story building that served as a community hospital for the black population of the city.

Seminole and Miccosukee Indian healers continued to care for the health of their people through traditional methods well into the 20th century, and the use of folk medicine is still present in modern Florida. The number of physicians steadily grew during the 19th century in Florida, and physicians became more qualified and professionally organized. However, people in many areas of Florida relied on traditional or self-trained healers.

Before Modern Medicine

How physicians worked, and how patients interacted with the people they relied on during times of illness or when they were injured, changed dramatically between the founding of the United States and the advent of the nation's modern medical systems in the 20th century. Before the establishment of scientific rigor and methodology in everyday medical practice, the case narrative was an essential method of documentation and self assessment practiced by physicians, and it resulted in large portions of published medical literature throughout the 19th century. Published narratives were used as reference and guidance by physicians throughout the country and the world including John M. W. Davidson of Gadsden County, Florida, and his colleagues in north Florida, southeast Alabama, and southwest Alabama. Davidson and his contemporaries shared their personal experiences, successes, and failures, and passed along valuable ideas they had encountered through surveying other published works. The decline of the prominence of the case narrative represented the beginning of a separation between the role of the doctor and the lives of the patient, between the trained, scientific observation and recommendations of an impersonal practitioner and personal, sensitive, experience based advice.¹

The careers of John M. W. Davidson of Gadsden County and other medical pioneers in Florida illustrate the necessity of economic opportunism and the need for professionals in a given field to diversify their sources of income and social standing. Physicians engaged in what was essentially part-time work, and often found it difficult to make an adequate living in the cash-poor South. Some sold the drugs they made; practiced veterinary medicine, farming, or mercantile trades; or found some other means of supplementing their income and achieving a higher standard of living.²

Adequate financial compensation was particularly difficult for rural physicians whose patients more often than not experienced months at a time with no cash at all. If physicians received half of the cash owed they thought they had done very well and often took trade in goods or labor in lieu of cash. In terms of real income, physicians made no more than any skilled artisan, or most other professionals such as clergy or lawyers.³

Evolving Medical Training and Professionalism in 19th-Century America

In examining the state of medicine in the early 19th century, one essential aspect to keep in mind was the lack of any discernible institutionalized structure, either of university training or professional organization beyond the local or regional levels.⁴ Although there were many medical schools in the U.S., there were few that were very good, training was inconsistent and often lacked the rigor of practical application, and techniques and schools of thought varied widely. Even for well-established schools of medicine, academic training was usually seen by professional physicians and their future colleagues as more of a supplement to apprenticeship, which was by far the more dominant method of producing new practitioners.⁵

Civil War Veterans Pension Claims Examinations by Dr. Thomas H. Hammond

The medical journal kept by Dr. Thomas H. Hammond of Oxford, Florida, between 1896 and 1903 details medical examinations of Civil War veterans required for approval of pension applications or for an increase in an existing pension allowance.  The examinations were conducted for veterans of the Civil War and a smaller number of veterans who served later as required by the United States Department of the Interior, Bureau of Pensions.

For each individual examined, the reports include such information as type of pension claim (original, increase, or restoration); pension claim number; claimant's name, rank, company, and regiment; post office address of examining surgeon and claimant; cause of disability; current pension amount; claimant's statement as to reason for claim; and the physician's examination report, including pulse rate, respiration, temperature, height, weight, age, and a detailed narrative description of wounds, conditions, and disabilities.  In some later cases, Dr. Hammond also recommends a pension amount.

The journal shows both the daily activities of a physician performing essential work, in this example on behalf of the federal government, and the ailments and physical needs of men in rural Florida in the last decade of the 19th century.

“Ode to Health”

In a small notebook of writings about health and medicine, beginning with the lyrical devotion, “Ode to Health,” a medical student described many common medicines of the late 19th century as poison and debated various contrasting philosophies.  Although the notebook was included in a collection along with the veterans pension journal of Dr. Thomas H. Hammond of Oxford, Florida, the notebook does not appear to be in the same hand as that of Dr. Hammond's medical examinations. It may have been written by Dr. George Washington Wood, who received his medical degree from Birmingham Medical College and later settled in Oxford, Florida, where he came into possession of the Hammond medical journal.

As a result of the non-standardized education and the even greater lack of official scrutiny or regulation, many pioneer physicians were only marginally more trained than their patients. Medical quackery was common, with many local doctors possessing little more qualification than the title they gave themselves, and trained physicians were rare throughout the antebellum South. Physicians beginning their professional careers, even with extensive formal medical training and apprenticeships, often found gaping holes in their knowledge and were forced to consult whatever expert advice was available to them, most often from literary sources—for instance Eberle’s Therapeutics, the widely used, multi-volume compendium of treatments assembled by University of Pennsylvania-trained physician and writer John Eberle—and determine through trial and error and educated guessing what treatments were most effective and which were not effective at all.⁶

Southern cities such as Lexington, Nashville, and New Orleans did possess decent medical schools and Southern physicians also received training in Philadelphia and Europe.⁷ Despite the nascent state of the medical profession looking backwards, physicians made up a very large portion of the professionals in the South. By 1860, on the eve of the Civil War, there was one doctor for every 554 people in the South, comprising 49 percent of all Southern professionals.⁸

As the medical profession expanded and became more officially monitored by professional organizations and the government, the career still required a personal devotion to health and helping patients. And the work of physicians was still a personal expression of diligent work, commitment, and quest for professional growth.