Most immigrants to Missouri suffered at one point from fever, termed “bilious fever” because victims appeared yellow. The most common cause was likely malaria, endemic to the Mississippi Valley. Flint further observed that those failing to contract the fever for some time after arrival often had the most severe symptoms. At the time of statehood, no major epidemics occurred in Missouri, but smallpox, cholera, typhoid fever, and many of the so-called childhood diseases could occur periodically.
Medicine was only beginning to adopt scientific methodology in 1821. The effectiveness of many medications was untested, and medical treatment might involve herbal remedies only. There were no such things as anesthesia, antibiotics, or requirements for formal medical training. Many doctors apprenticed with an older physician, then began their practice at the conclusion of their apprenticeship. There was almost no understanding of the cause of major ailments, and the role of bacteria, viruses, and other infectious agents was nearly unknown. Accordingly, the importance of sterile instruments and treatment facilities was underappreciated and infections were rampant.
One common school of medicine was heroic medicine. Underlying this was the belief that the body had four humors: black bile, yellow bile, phlegm, and blood. These were in a delicate balance, and disruption necessitated readjustment. Methods for adjusting the humors included bloodletting, purging, and sweating. Draining up to 80% of the blood, administering emetics such as senna and tarter emetic, and intestinal cleansing with calomel, a mercury-based material, were common treatments. Sweating used blisters based on different materials.
If the patient survived the so-called “cures,” they might regain their health. Palliative care practiced by some physicians might have been the best treatment.