On the other hand, in Virginia, the Reverend John Clayton displayed a distinct flair for the scientific method in his analysis of urine. It is safe to assume that his techniques were of a higher order than those usually associated with uroscopy. Clayton, not satisfied to practice just the art of observation, utilized the science of comparative weights hoping to find diseases distinguished by minute variations in the specific gravity of the liquid. He thought he could find manifestations of "affections in the head" by his careful weighing and study; manifestations not uncovered by visual observations alone.
In Gerard Dou's painting, it is to be remembered, the doctor not only examined the urine but also took the pulse—another common practice. This is not surprising insomuch as Galen—the great and ancient authority—had written enough to fill sixteen books on the subject of "pulse lore." Despite the facts that physicians centuries later continue to take the pulse, they would not find the theories behind the seventeenth-century practice acceptable. Galen's deductions have since been described as fantastic, and his attempt to associate a specific type of pulse rate with every disease futile. Yet the Virginia physician, when he did take his patient's pulses, certainly did not lose his or her confidence by gravely considering the mysterious palpitation.
The physician with his many techniques and remedies did not restrict himself solely to the illnesses of the sane for—contrary to popular belief today—some effort was made to treat and cure the mentally ill. America's first insane asylum was not established until 1769, but the insane had received, even before this, medical attention. If the case did not respond to treatment and took a turn toward violence, confinement under conditions that would now be considered barbarous often resulted. Before this extreme solution of an extreme problem recommended itself, however, the mentally ill might be purged. The intent was to relieve the patient of insanity-producing yellow and black bile. The belief that this type of sickness would respond to conventional treatment, however, did not completely dominate the theories on insanity; some seventeenth-century authorities considered insanity not an illness but an incurable, disgraceful condition.
One of the fullest accounts of a case of insanity in seventeenth-century Virginia describes the plight of poor John Stock of York who kept "running about the neighborhood day and night in a sad distracted condition to the great disturbance of the people." The court authorities ordered that Stock be confined but provided such "helps as may be convenient to looke after him." The court, in a sanguine mood, anticipated the day when Stock would be in a better condition to govern himself.
Housing of the Sick
If the doctor, surgeon, or nursing persons could come to the patient's home, little advantage could have been obtained in the seventeenth century by moving the patient. The need did arise, however, to care for persons outside the home. For example, an individual without family or close friends might find it more convenient to move in with those who would care for him on a professional basis, or newly arrived immigrants and transients might need housing.
Quite in harmony with the needs of the period were the men and women willing to take in a sick person in order to supplement their incomes. Illness forced one colonial Virginian to offer in 1686 to grant his plantation and his home to the person who would provide a wholesome diet, washing, and lodging for him and his two daughters. The beneficiary was also to carry the sick man to a doctor and to pay all of his debts. It is probable that the man provided these services only on this particular occasion, but by such special arrangements the century housed its sick. The number of ill persons provided for by relatives under similar arrangements or even without any compensation, must have been even greater in a period without hospitals and nursing homes.
On occasions, in the seventeenth century, the physician took the patient into his own home, but not always without some reluctance. Dr. Wyndham B. Blanton, in his search of the Virginia records for this century, found an interesting account of Dr. George Lee of Surry County, Virginia, who in 1676 had an unfortunate experience in letting accommodations to a pregnant woman. Living in a house she considered open and unavoidably cold, and having only one old sow for food, the sick and feverish woman pleaded with the doctor to take her to his home for the lying-in period. The doctor argued that the house could be made warmer, suggested that neighbors bring in food, and protested that he had only one room fit for such occupancy and that he and his wife used it. Dr. Lee said he would not give up the room for anyone in Virginia.
Offering the opinion that the room was large enough for her, Dr. Lee, and his wife, the expectant mother had her servant take her by boat to Lee's where she remained, taking great quantities of medicine, until she delivered. The doctor then had to bring suit to collect his fees.
Another example of a medical man's housing the sick, is that of a surgeon promised 2,000 pounds of tobacco and "cask" if he cured the blindness of a person he had housed—but only modest compensation if he failed. The same surgeon received 1,000 pounds of tobacco in 1681 by order of the vestry of Christ Church parish for keeping "one Mary Teston, poore impotent person."