As an example, in 1869-70 Dakota, reported causes of death included consumption, freezing, fever, pneumonia (these were the four commonest), croup, dropsy, acute diarrhea, cancer, diphtheria, gunshot wounds, cholera, lung fever, bronchitis, fits (the 10 next commonest), suicide by drowning or poisoning, drowning in a well, dysentery, congestion of the brain, spasms, erysipelas, bilious colic, apoplexy, inflammation of the liver, and knife wounds. Ten years later the list was topped by diphtheria and consumption, besides "struck by lightning," St. Vitus' dance, teething(!), "kicked by a horse," gravel, worms, inanition, alcoholism, "struck by a falling body," calculus (presumably not the mathematical kind), scalding, asthma, "gored," sunstroke, hanging (whether official, accidental, or suicidal is unspecified), heart disease, suicide by hanging, endocesditis, "killed by Indians," and "shot while sparking another man's wife." Often it's difficult for the modern researcher to decide what the contemporary terms actually convey: instead of appendicitis people had "inflammation of the bowels," instead of carditis "heart failure," instead of bad tonsillitis "quinsy," instead of dysentery (or bowel disorders in general) "the flux," instead of appendicitis "peritonitis" or "inflammation of the bowels," and instead of meningitis "spotted" or "brain fever," the latter being a term also used for encephalitis and almost any other illness that involved a high fever. All sorts of digestive problems were diagnosed under the sweeping name of "liver trouble," and light cases of diphtheria were often misdiagnosed as "fever."

A unique feature of the 19th-Century landscape was the "patent medicine" (generally not patented), which was the forerunner of today's over-the-counter remedy. As the Age of Science advanced, talk of "the wonders of science" was in the air, popular magazines bulged with new "discoveries," and their advertising pages carried heartening news: from now on, if promises were to be believed, healing would be by pills, and the doctor appeared all but obsolete. Already by the 1840's these proprietary cures were going strong, and accounted for a large share of newspaper advertising revenue: Sherman's Worm Lozenges, Dr. Spolen's Elixir of Health (to fend off the ill effects of overindulgence in food or drink), Sebring's Cordial for Indigestion, Hutching's Stomach Bitters (for dyspepsia), Whitwell's Opodeldoc (for rheumatism, sprains, chilblains, and cramp), Dr. Taylor's Balsam of Liverwort (for coughs and chest pains), Roussel's Amandine (for the prevention and cure of chapped hands), Dr. Wheeler's Balsam of Moscatello (for cholera morbus and the cramps caused by drinking cold water), Abernethy's Botanical Pills (for irritation of the kidneys and "diseases of a delicate nature"), Lucina Cordial, or Elixir of Love (a cure for incipient consumption, barrenness, etc.), Dr. Convers's Invigorating Cordial for Genital Debility (for sterility in men), Portuguese Female Pills, Mme. Restell's Preventive Powders (a contraceptive), and such "universal cures" as Moffat's Universal Vegetable Life Pills, Phoenix Bitters, Thorn's Compound Extract of Cobaila and Sarsaparilla, and Roake's Iodine Liniment. Quackery and false medical theories were based on the new system of drugging and the idea that everyone could be his own doctor; people commonly purchased boxes of "specifics," complete with book of instructions, and pinned their hopes to them, especially for infantile diseases. Many medicines were advertised as being purely vegetable, without clarifying the fact that opium and other dangerous ingredients (including alcohol) might legitimately be described as of vegetable origin.

By 1850 Loudon & Co. was advertising a whole family of cures--Indian Expectorant, Alterative Sarsaparilla, Carminative Balsam, Tonic Vermifuge, Indian Sanative Pills, Female Elixir, Fever & Ague Pills, Certain Cure for Piles, and All Healing Salve. Quackery became big business after the Civil War, and people swallowed patent medicines (literally and figuratively) because they wanted the solace the medical profession couldn't honestly give them--and because the new remedies were cheap and always at hand. Until the passage of the first Federal narcotics laws in 1911and the establishment of the Food, Drug & Insecticide Administration in 1927 (it became the FDA three years later), there was no restriction on the ingredients of nostrums or the claims made by advertisers and no laws preventing people from buying any drugs they wished over the counter: laudanum, opium, morphine, marijuana, cocaine and paregoric were readily available and widely used, especially in the rural districts. Alongside harmless substances like cod-liver oil, petroleum jelly, witch hazel, and arnica, every drugstore carried laudanum (15-20c. for a one-ounce bottle, 42-56c. for four-) and paregoric (18-24c. for two ounces, 27-36c. for four), and even so reputable a company as Sears, Roebuck, in its 1897 catalogue, lists several pages of "specifics" with names like Bust Cream or Food ("unrivalled for developing the bust, arms, and neck"), Dr. Chaise's Nerve & Brain Pills (60c. per box), Dr. Barker's Blood Builder (75c. for a "large bottle"), the German Liquor Cure ("guaranteed to destroy all desire for liquor," 50c. for a box of 24 doses), Dr. Rowland's System Builder & Lung Restorer ("greatest vegetable medicine of the age for the thousand ailments common to the masses," three bottles for $1.50), Dr. Rose's Obesity Powders (88c./box), Curtis' Consumption Cure (small bottle 20c., large 35c.), Pasteur's Microbe Killer (97c. per half gallon), and Dr. Rose's Kidney & Liver Cure (85c. a bottle). Late in the century naive Americans made an $80,000,000-a-year business of the type. On lonely homesteads particularly, some women deadened their anguish with these laudanum- and opium-laden specifics, which included everything from horse liniment (touted for humans as well: Pratt's Healing Ointment for Man and Beast advertised itself as a cure for "harness and saddle galls, open wounds, cuts, sores, scratches, burns," and it was given internally too, at the usual dose of "one for a man, two for a horse") through "blood purifiers" touted as beneficial for everything from scrofula and epilepsy to dropsy, croup, and even cancer, to the universal "tonics." Most patent medicines, including sarsaparillas and bitters, contained a high percentage of alcohol, up to 47% in some, yet they were often endorsed wholeheartedly by temperance leaders and famous preachers like Henry Ward Beecher, and were copiously but unsuspectingly consumed by teetotalling plainswomen and also given to infants (Grove's Tasteless Chill Tonic claimed to make "children and adults as fat as pigs," in a day when farmers thought a healthy baby should be fat). This was mixed with some combination of anise, digitalis, senna, goldenseal, oil of cloves, and water, and many contained large proportions of opium, morphine, or cocaine; infants became addicts from narcotic-based cough syrups, also used to quiet crying spells. Strychnine was used in the tonics to give a good belt to the appetite. Ointments were little more than a mixture of petroleum jelly, cheap perfume, and carbolic acid, and their curative powers amounted to nothing but a temporary disinfecting and glazing over of stubborn ulcers. One of the most famous (and an exception to the non-patented rule, since its label, at least, received that imprimatur in 1876) was Mrs. Lydia E. Pinkham's Vegetable Compound (18-20.6% alcohol), whose eponymous creator had already been concocting an herbal medicine for "woman's weakness" and related ills for more than a decade, stepping up her activity after her husband lost all his money in the Panic of '73; it sold at a dollar a bottle, six for $5, or a dollar for a box of pills or lozenges, and her Blood Purifier went for the same.

Sick people wanted to believe a medicine could help them; even more, they desired a sure cure, an absolutely effective remedy that would give them perfect health. Indeed, from one standpoint the 19th century could be called the age of the panacea: "The sure cure for all our troubles is..." The answer to all our troubles is public-school education for everyone, declared Horace Mann, crusading for school reform in the '30's. The answer to all our troubles is free public libraries, others proclaimed. The answer is for everyone to stop drinking alcohol, trumpeted the Temperance leaders. And so likewise the various splinter groups touted their own beliefs: The sure way to stay healthy is to wear flannel next to the skin...to eat graham flour...to sleep with the windows open, because otherwise there's not enough oxygen in the room.

--From A Thunder at Dawn

Theories abounded regarding the best means of maintaining good health. In 1830 Edward Hitchcock of Amherst College wrote a book he called Dyspepsy Forestalled and Resisted, in which he advocated abstemiousness, exercise, fresh air, and bathing--even in winter. During the same decade Sylvester Graham, a Connecticut lecturer on temperance, preventive medicine, and food reform, came into prominence with his teachings regarding chastity, total abstinence (from liquor), loose light clothing, daily exercise, hard mattresses, early rising, cold sponges, pure drinking water, a bath at least three times a week, and a meatless diet of milk, fresh fruit and vegetables, "graham" bread made of coarsely-ground whole-wheat flour and allowed to age for twelve hours or more before being eaten, and plenty of "roughage," thoroughly chewed, eaten in an atmosphere of relaxed cheerfulness rather than rude haste. He barely tolerated eggs and honey, considered butter a luxury and condiments (even salt) anathema, and believed that pepper, mustard, and ketchup could cause insanity. Similar were the pronouncements of Mother Ellen Harmon White, spiritual leader of the Adventist Church, who declared that health and happiness would attend all those who ate two meatless meals a day, drank only water, avoided salt and spices, and didn't smoke.

Closely related to the patent medicines but probably a good deal less harmful was the medicine-show man, a wagon-dwelling itinerant often seen in Westerns. Though at least one showman followed the Erie Canal route in the 1820's, the institution seems to have hit its stride 30 years later, and flourished most widely 1880-1900. Some had regular troupes of entertainers--musicians, comedians, comic dancers, contortionists, bar and flying-ring acrobats, vaudeville acts, comedy skits or a play, trained dogs (as many as 10 plus two "comic") and other performing animals (one advertised the "wonderful leaping cat Spot, springing 15 feet high through a hoop of fire"), Negro or blackface minstrel-comedians (very common), or a small brass band. Others leaned upon the skill of the "professor" himself--juggling, fire-eating, ventriloquism (complete with dummy), jokes or funny stories, card tricks, magic and sleight-of-hand, a puppet show, music and song, photography, fortune-telling (at an extra 50c. per person), palmistry, phrenology, or thought-reading. Somewhere in between were the small outfits of three to four persons, including some combination of a trick horse or dog, a tumbler, acrobats, rope-walker, sharpshooter (who did trickshooting and was matched at targets against locals for stake money), a female singer and dancer, a midget, and a tattooed man. There was usually a colored man dressed as a savage from some dark and mysterious continent no one had ever heard of, and another man, or a young woman, dressed in veils and possessing all the mystic healing powers of the East. From the '80's many of these shows featured Indians or Indian medicine (real or claimed), though the doctor himself was usually white. The show centered on the "medicine wagon," whose back end let down to make a platform used as a stage; kerosene flares were lit for nighttime performances. The medicine, almost always touted as an "Indian remedy"--a cure-all herbal concoction originated by some fictitious Indian medicine man who possessed mystic and divine powers--was generally in fact a simple compound made up largely of alcohol (sometimes 80 proof), spices, root herbs, and belladonna as a painkiller, plus anything from colored sugar water to crude oil; it was touted as a relief for colds, piles, rheumatism, cancer, and croup, and sold for fifty cents to a dollar and up per three-ounce bottle, depending on the show, the skill of the barker, and the gullibility of the sucker. The show, free to all, opened with music, usually guitar, banjo, and very loud drum. As soon as an audience assembled, the performers went through a few variety acts, then passed out songbooks advertising certain wonderful remedies soon to be offered for sale. In exchange for these "valuable, absolutely free" books, the spectators were expected to join in singing several well-known ballads of the day. At the proper psychological moment, the medicine man would begin his pitch. He opened with an attack on doctors, who he claimed charged too much for their services, then launched into a panegyric describing the properties and benefits of his own nostrum, which he said contained secret herbs, barks, and berries, mixed with the purest purling spring water. In many cases the recipe had been given to his grandfather by a dying old Indian medicine man, who had extracted a promise to use it only for the good of humanity and not let it fall into the hands of evil men. The recipe might be worth thousands of dollars (a figure which seemed a fortune indeed to most rural folk), but listeners were asked only to contribute $1 per bottle to enable the "doctor" or "professor" (who seldom had any legitimate claim to the title) to continue his missionary efforts to rid humanity of illness. Meanwhile, to the rhythmic beating of the drum and the merry thrumming of guitar and banjo, the medicine was passed through the audience by one or two performer-assistants. After the first flurry of sales, more entertainment followed, then more sales, and so on until the audience began to thin out. Retired farmers and their wives, who were always complaining of ill health, were steady customers of such shows, and cheerfully spent the requested dollar for nostrum and evening's entertainment rather than pay far more to a real doctor who offered no entertainment at all. Most of them were troubled chiefly with dirt calluses (which they mistook for corns), constipation (particularly common among rural folk who ate salt pork all winter), indigestion (which the "doctor" told them was the first sign of liver disease), malaria, "catarrh," and the like. Some vendors offered a variety of products--salves, ointments, tonics, and elixirs--and not a few sold a line of cheap jewelry, silverware, patent soap, and cigars on the side; most were smooth talkers of innate charm. (This is a line Ezra has almost certainly taken a turn at.)

Though frontier doctors bitterly opposed the medicine show (as early as 1854 one newspaper ran an indignant letter from a local physician condemning "Indian doctors in whom credulous females, children, and ignorant, superstitious men, have great confidence"), their diatribes had little effect. The audience's aches and pains were beyond the doctor's ability to cure, and the showman as a rule tried not to sell anything genuinely harmful, because he, unlike the patent-medicine manufacturer, had direct contact with his customers and wanted to be able to come back next year. Mostly his nostrums were laxatives, bitters, salves and liniments, invigorating tonics (with a high alcoholic content), and harmless herbs, based on vegetables or mineral salts; those which contained narcotics were more generally sold by mail-order or off store shelves. Sometimes he bought his wares from reputable drug firms whose remedies worked to the best of the pharmaceutical knowledge of the time; if he made his own, as most probably did, he usually knew how to at least achieve a laxative effect, and certain of his offerings were based upon herbs still in use today.

Still, Western people, as a whole, were probably a robust lot: an old saying has it that "The cowards never started and the weak died on the way." And for all its physical perils, the 19th century was in many ways a psychologically more healthy era to live in than our own. The statistical majority of people, right through World War I, lived on farms or in small country towns or villages, where they were in large part their own masters: they owned their own homes (or had good prospects of doing so eventually) or lived with family, they operated their own businesses or worked for small companies with no more than 50 or so employees, where the boss knew them as individuals, not merely time cards or performance reviews. Taxes were low and almost entirely local, chiefly in the form of property rates and business licenses, plus an occasional luxury levy (see my article "Little Towns on the Prairie," at this site); indeed, up until the Civil War, many people could go through their whole lives having no contact at all with the Federal government except for the distribution of the mails. Though the economy was uncertain, with bank failures and periodic nationwide "panics," there was little job-related stress. No one had ever heard of terrorism, global warming, school shootings, date rape, or many of the other concerns that now appear every day in the news; only a few people were familiar with the concept of communism (with a small C), and no one had ever imagined it engulfing whole nations or threatening the peace and security of their own. Though alcoholism and drug addiction existed, they were for the most part discreetly hidden, and the latter at least was rare. My reading suggests that some modern scourges were rare, particularly cancer: when it occurred at all, it was probably the result of the oncogene (said to cause less than a quarter of today's cases) rather than environmental factors (pollutants, the depletion of the ozone layer, chemicals in the food chain) that didn't yet exist. Work, in the home and out of it, was largely hands-on, but help was easy to find, and cheap when it had to be paid; even in homes without a hired girl, there was almost always an unmarried female relative--mother or mother-in-law, sister or grown-up daughter--to share the wife's chores, while Father was assisted by sons and young daughters. Children played outdoors more than they do now, keeping fit and healthy and getting socialized, and were rarely if ever under the supervision of adults or in organized programs that pressured them to perform rather than simply have fun; even when boys fought in the schoolyard (and rare was the lad who didn't, at some point, get into a tussle), it was with fists, not knives and guns. People weren't caught in a race to "keep up with the Joneses," or constantly bombarded by social or economic pressure to acquire great quantities of things. They seemed, for the most part, to know who they were, where they were headed for, and what they wanted out of life; if they couldn't find it where they were, they could sell out and move on in search of greater opportunities, without a lot of bureaucratic hassle. They felt that all problems--the world's as well as their own--could and would be solved, given time and thought; those that weren't could be met with a calm resignation as being "God's will." Most issues could be comprehended by the average person; most difficulties were straightforward and could be dealt with directly.

The dangers of dirt and germs were unknown, but Nature was on the side of health. The air was fresher than in a later day, there was no smog, and people had to walk long distances and do hard physical work that kept their bodies in good condition. Vegetables were grown without chemical preservatives, fertilizers, additives, insecticides, or special treatments before planting, and boiled in chlorine-free water, so they had more flavor and less doubtful ingredients. Milk in the country or small town was usually fresh and unadulterated, quite often from the user's own family cow, where in the bigger towns and cities it was likely to be mixed with chalk or plaster so a dishonest storekeeper could "stretch" it, or produced at a distillery which also kept cows, feeding them on a mash that contained alcohol and was passed on to the drinker of the milk. Even ice cream, made with unpasteurized cream, was richer and more flavorful. People walked much more than they rode, and rode horseback--a splendid means of keeping hips narrow and belly flat--when they didn't walk, and the ten-to-thirty-minute jaunt to and from the office offered fine mental and physical therapy. The country doctors weren't always able to make people well, but their patients were friends and neighbors. They delivered many of the babies in the community and watched them grow up. They really cared for those who needed their help; when there was illness, they stayed with the patient for as long as they were needed. They made house calls and took payment in chickens, eggs, meat, and produce. Their loving concern helped to make up for their lack of knowledge about medicine...

No matter how unpretentious the home, meals were eaten leisurely. Work, too, was unhurried, leaving time for talk, the favorite recreation. Village people rose early in the morning and set a pace that saw them through a long working day without exhausting their energies. Women deserted their canning, washing, and housecleaning to gossip over the back fence or rock in a neighbor's home while they circulated reports on the condition of the local sick and passed rumors of moral dereliction from house to house; housecleaning or the family wash were allowed to wait while the latest word crossed and recrossed the back fences...

...Small towns of this day were much more integrated communities than their counterparts of a hundred years hence. They were held together by a powerful social fabric in which each individual had status and from which he could draw the satisfactions he needed. People didn't move in and out very much, for there were few places to go, and no convenient ways to get there. There were few mass- communication media to penetrate their horizons, and a trip even to the next state was a major problem in travel. People tended to stay put. Likewise the number of people rising or falling within the community itself was relatively small. People knew their places in the society and generally drew satisfaction from the knowledge. It was a cozy, stable, predictable world. Since the community wasn't dominated by restless, hard-driving climbers, families felt no great pressure incumbent on them to advance economically or socially. Each was content to move slowly, if at all, for that was the speed of their neighbors.

Townsfolk knew each other well. They liked one another for qualities of basic goodness and service to society--kindness, usefulness. They had stable rules to live by; it was possible to live almost by rote--society didn't change much, and the rules that had served a young person's grandparents were equally useful to him. Most people were producers; they got their satisfactions largely from serving each other and society, from doing useful jobs for which they were rewarded materially and with community applause. The majority were old residents; many had been born and brought up there. Life was simple; there was less need for broad education, whether formal or informal. Planning and preparation for the future could be directed along a single, narrow path. Families were together: grandparents, parents, children, uncles, cousins, all living within the community. Having been near each other for so long and shared the same general experiences, they had similar tastes, values, and understandings. They spoke the same language, played the same games, helped each other with chores and crises.

The town where they lived was their town. They had deep roots there. Not being caught in a frantic battle to get ahead, they had time to give to it, time and energy to organize clubs, social events, sporting events, parades. The town, too, had time. Its growth was slow, its institutions uncrowded. Newcomers could be assimilated without strain. There was room for everybody, wherever he wanted or needed to be.

Long hours on the job didn't always mean long hours of toil even for the working man, and in many jobs there were enforced periods of idleness. Towns and relatively small cities had small industrial operations, where an employee whose child was sick might ask his boss for the day off, and receive it; in depression, such small companies might keep men on the payroll out of humanitarian and Christian attitudes of responsibility. Since there were no laws prohibiting the keeping of chickens and livestock, many a working family had half an acre or more where it grew vegetables, raised chickens for eggs and Sunday dinners, and even kept a cow. In a day before workmen's compensation and unemployment insurance, town families often stuck together and pooled their resources. The homes they lived in had room for a good-sized family, coal or wood stoves and heaters, long verandas with porch swings to sit on in the cool of summer evenings. Life was tolerable.

When a girl married, she had a pretty good idea of what she was getting into: she married the son of a farmer, who would inherit the land someday and live on it till he died, or the man who owned the hardware store on the corner, or a bank teller with a predictable future, or a carpenter whose work was in great demand in the community. She knew what sort of income her husband would probably have the rest of his life and what sort of social position they would most likely occupy within the community; in many cases she knew exactly where she would be living the rest of her days--it wasn't unusual for the young couple to move in with the groom's parents on the farm, or in a big rambling house at the edge of town, where the family group was often augmented by an older bachelor brother or an unmarried sister, and sometimes by a widowed aunt or uncle, besides being quickly augmented by a succession of babies; there were many households where the supper table had to be set for ten or a dozen. She knew exactly where she stood: her job in life was to take care of the house, bring up the children, and see that her husband was well fed. She knew that she would be doing the family wash on Mondays, the ironing on Tuesdays, the baking on Saturdays, and so on--perhaps a somewhat dull and onerous prospect, but a secure one. She knew a little more about her husband than her great-granddaughters would: for one thing, he was usually in his late twenties, when character is more apparent; for another, people in general came in a less bewildering variety--they were less complicated. The bride knew that her husband had grown up in the same neighborhood as she, had been taught by the same teachers in the same schools, had listened to the same sermons, read the same news in the same papers, and had the same memories of school picnics, ice-skating parties, and band concerts. She could count on his being very much like her brothers, and indeed very much like herself.

Almost every person in town had a place, a status, that was uniquely his own and universally recognized. And it was based on things other than income and material possessions. A woman contributed a beautiful voice to the church choir, or won prizes at the summer flower show, or--and this was enough--raised a batch of healthy youngsters. From these things she gained the self-importance every person needs. She was able to do so because her neighbors had lived near her long enough to know her accomplishments and abilities. They had had time enough to notice her. She also had a full and easygoing life. Nearby were her mother, aunts, and grandmothers, old ladies with time on their hands and a need to be useful. They helped eagerly with her new baby, gave counsel on the problems of womanhood and motherhood, took the children so she could get out of the house. She had many friends, many activities, all developed over long, slow years. She had stayed in her mother's home till she married, and hadn't seen glamorous, moneyed worlds outside her community. Homemaking wasn't a drudgery, but one of the prime reasons for her existence, and in any case help was easy to find. Hers was a satisfying life, for it was carried on in the right kind of human environment: plenty of help, plenty of companionship, a feeling of usefulness and importance.

Her husband need not commute far, nor did he wear himself out fighting to get ahead. He came home with time and energy to give his family. Nor did home maintenance demand inordinately much of him. He felt no compulsion to make his house look like a magazine advertisement. He had other ways of earning status: sports, clubs, community activities. Like his wife's, his standing in the town was based on his being known by his neighbors. He worked longer hours than his great-grandchildren would do, but when he put down his tools or his pen he tended to forget business. He wouldn't have minded earning more money, but doing so wasn't a driving obsession. His pace of life was leisurely.

Though they weren't farmers, and the husband left home each morning to work somewhere else, the small-town couple had a closeness with each other and their lifelong friends and neighbors that a more mobile family might lack. He, not caught in a desperate struggle to get ahead, shared her deep interest in the community that was their home. They knew the same people, often enjoyed the same activities together, and were likely to spend more time in each other's company, to have the habit of talking. She was also more likely to know more about his work than would her granddaughters and great-granddaughters: not only did he have more time to discuss it with her, but it was typically easy to understand. The world hadn't yet grown so technologically and economically complex that jobs had to be divided and re-divided into increasingly narrow specialties. It was possible for one man to know all there was to know about the company where he worked--or which he owned.

The commitment to accepting individual differences and providing "separate spheres" in which people might express their emotions and concerns, as well as the safety valve provided by the candid expression of ideals and frustrations in family letters and conversation, provided a means of living with family problems. The strength of family bonds, the commitment to sacrificing for the children, the intense ties of affection and emotion, and the sense of mission made the mid-century family a remarkably strong institution. Close bondings between mother and daughter, aunt and niece, sisters, female friends and cousins, paralleled the severe social restrictions on intimacy between young men and women...As nurses and confidantes ministering to each other's health--especially in the recurring cycles of confinement connected with childbirth, a bodily concern that modest women couldn't so easily share with their mates--they were in touch with other matters of head and heart as well. Frequently they had occasion to fear for one another's lives, or to commiserate over the loss of children or grandchildren. The rituals of weddings and funerals provided an opportunity to express themselves in public without restraint-- a contrast with the decorum expected in mixed company. The importance of religious work, especially Sunday schools and sewing societies, brought them together and gave them a sense of special purpose outside the home; with others of her sex a woman could enjoy the fellowship that charity duties, prayer meetings, and other activities encouraged. Common domestic tasks, even something as mundane as making hominy or picking and canning beans, could be made fun if shared with a sister, cousin, or daughter while both gossipped and shared experiences.

Middle-aged and older women weren't cast adrift. If a woman's husband died or walked out, she automatically went to live with a sister, a daughter, or some other relative in her town. When her children grew up and married, they didn't seek to be independent of her; they lived nearby, asking her counsel and help with babies, marital problems, and sickness. A resident grandmother was often of invaluable assistance in caring for her son's or daughter's children--dressing them, giving them their lessons, playing with them, nursing them when they were ill, and sitting with them at bedtime. And when she wasn't busy with them, community activities occupied--in fact demanded--her time. There were certain tasks that were the bailiwick of women in just her position: preparing the church supper, sewing costumes for the Fourth of July parade, making the rounds to help when new babies arrived. Many articles for family use were produced by hand-canned foods, clothing, confections; her help with these was always needed. Nor did financial insecurity loom large and ugly in her community. Small-town folk admitted their dependence on each other. When you fell upon hard times, relatives supported you--that was what families were for. In the same spirit, it wasn't unusual for a younger unmarried sister to come to assist a recently married one trying to cope with the burdens of a house and growing young family; when this sister in turn married, her next younger sister would perform the same service for her.

The small-town youngster was surrounded by a large family. When his father wasn't there, other men were: grandfathers, uncles, cousins. He knew them well because they were around all the time; they didn't just come to visit at Christmas. They helped teach and manage him, just as their female counterparts did his sisters. Besides this, he had society itself to guide him. He lived in an integrated town. He and his friends had common backgrounds. Most of their families were old residents. There were community traditions, founded solidly in generations of time. Young people learned these traditions from one another; newcomers were soon initiated into the rules. Year after year, older children taught younger ones how to play marbles, hold a baseball bat, build a treehouse. There was a dominant, clearly apparent pattern of male behavior, maintained and policed by the boys themselves. They didn't need their fathers to be "pals."

A father, in his turn, could wash his hands of responsibility for raising his children, without risking unfortunate consequences. Indeed, well-placed Northern fathers especially, busy with financial and commercial enterprise, had no time for the superintendence of their young. Besides, it would have been indecorous to show too much affection, which was best left to mothers and nurses to provide. A mother, for her part, had other helpers in this work than simply her husband. She was supported in her domestic and child-raising tasks by the larger family around her and by the firm rule-enforcement of the community itself. She didn't have to carry the entire burden by herself if Father refused to help her.

On the other hand, in this stable, unhurried world, a father and son might spend long hours working in the fields with each other, or fishing, or simply walking. They had more time. The habit of comfortable, companionable talk was more likely to be ingrained in them. The boy had often learned about sex simply by watching farm animals, but if he still had questions, the subject could be brought up with a minimum of hemming and hawing and in a natural atmosphere.

...Marital unfaithfulness was very rare indeed. There were social controls that worked to prevent it. People and their business were known by many other people. The moment anyone did anything that was in any way out of the ordinary, news of it spread through the community. There were eyes everywhere. Unless you were prepared to face some quite harsh music--social and even economic ostracism--you dared not conduct an affair in any but the most difficult circumstances of secrecy and fear. A casual one was almost impossible. It had to be dead serious, and hence worth all the trouble of keeping hidden, or not at all. If you did unwisely begin a casual flirtation, your own family, your spouse's, or even both--backed by the community at large--landed on you. In this closely controlled situation, it was hard for married people to betray each other...Often a widowed relative, a young cousin, or a newly arrived immigrant in need of a home came to live in the household, and the running of such a melange called for considerable ingenuity and tact.

The weak and the timid were protected by a wall of friendship. Everyone was known by many others about town. If someone started taking advantage of a woman, her husband, brothers, and neighbors were there to help. People weren't strangers to one another, and mutual help was their support. Not only did they have more protection; they needed it less. Theirs wasn't a changing world. They dealt less often with strangers than with people they knew well and had reason to trust. The non-producer in this society had a hard time of it. He could perpetrate dishonest acts only a few times before news of him spread through the community, and then he was out of business.

...Though her life was circumscribed, a wife knew her worth as well as her place: she was not only the family's housekeeper, cook, and seamstress, but also its nurse, often its doctor, frequently its religious instructor, and sometimes schoolteacher to its children. The family couldn't possibly get along without her, and everybody admitted it; her job was totally secure. Her husband was duty-bound to support her, and in the almost unheard-of event of divorce he would have to keep supporting her through alimony...

--From A Thunder at Dawn

Like all human societies, it had its easy and hard aspects, its good and bad. But, cliched though the saying is, life really was "simpler then." And the doctor, untroubled by bureaucrats, HMO's, and the threat of malpractise suits, aware that no one expected him to stave off death forever or even in every instance, did the best he knew and probably saved thousands of lives.

Major sources:

The People's Chronology, James Trager

The Gentle Tamers, Dee Brown

The Expansion of Everyday Life, 1860-1876, Daniel E. Sutherland

Reader's Digest's History of the Great American West

Growing Up With the Country, Elliot West

A Pictorial History of Medicine, Otto L. Bettman