Robert Usher

[84] ANNA CONE, dau. of Jonah Cone [22] and Elizabeth Gates, b. East Haddam May 29, 1755, m. as second wife Robert Usher, son of Hezekiah Usher and Abigail Cleveland, Jan. 25, 1779. He was b. Jan. 3, 1743. He became a noted physician, and served his country in War of Revolution as Surgeon in Col. James Wads-worth's regiment. He d. Mar. 27, 1820, at Winchester, Conn. She d. May 20, 1849, aged 93 years.

Ch.

181.JAMES, b. Feb. 27, 1780; d. Aug. 12, 1780.

182.JAMES, b. July 18, 1781; d. unm. 1817.

183.* REviit.o, b. July 19, 1783, m. Mandana Robbins; d. Dec. 7. 1868.

184.ANNA, b. Oct. 25, 1784; d. Sept. 21, 1801.

185.STATIRA, b. July 22, 1786, m. Stephen Palmer; no ch.; d. June 8, 1848. 186." ABIGAIL, b. May 30, 1788, m. Jonathan Cone; d. Aug. 30, 1873.

187.DIODATE, b. April 6, 1790; d. unm. March 24, 1871.

188.SOYHRONIA, b. Jan. 29, 1792, in. Abigail Lord; d. Dec. 8, 1873.

189.HARRIET, b. Dec. 16, 1793; d. unm. 1868.

190.ELIZABETH, b. Jan. 19, 1796; d. unm. Feb. 16, 1838. 191. JOSIAH, b. Aug. 24, 1802, m. Ruth Frisbie; d. 1895.

The colonial physicians who formed the American Army's Medical Department in 1775 were all civilian practitioners, many without any military experience. A small percentage had earned M.D. degrees, but most were either apprentice or self-trained, and few made any attempt to specialize in the manner customary in Europe, where a choice was usually made among medicine, surgery, and pharmacy. During the Second half of the eighteenth century, however, American doctors were growing in stature at home and abroad. Although more of them were receiving a formal medical education, usually in Europe, they were still limited by the general lack of scientific data and by their profession's predilection for reasoning rather than research as a way of discovering better forms of treatment for their patients. The traditional humoral explanation for disease was by this time losing ground to several new and conflicting systems, where fact took second place to theory, in an all-out attempt to reveal one or two basic causes for all disease. Disagreements over therapy gave added intensity to the feuds and controversies which characterized eighteenth century practice, in general, and American medicine, which was not restrained by European guild traditions, in particular. Furthermore, the effort to develop a fundamental theory deemphasized the importance of the diagnosis of specific diseases. Treatment continued to consist largely of bleeding, purging, and blistering, regardless of the symptoms, since surgery alone was based to any significant degree upon experience as a guide in preference to theory.1

MEDICINE

The system prevailing in the colonies in the years immediately preceding the American Revolution, that of the great Dutch physician and teacher Hermann Boerhaave, explained disease in terms of chemical and physical qualities, such as acidity and alkalinity, or tension and relaxation, instead of the blood, phlegm, yellow bile, and black bile of the traditional humors, and urged that nature be permitted to aid in any cure. The Boerhaavian system was increasingly challenged in the second half of the century by that of William Cullen, the Scottish physician and teacher so much admired by

Hermann Boerhaave. (Courtesy of National Library of Medicine.)

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William Cullen. (Courtesy of National Library of Medicine.)

Americans studying under him at the University of Edinburgh, many of whom would later be leaders in the Continental Army's Hospital Department. Cullen believed that either an excess or an insufficiency of nervous tension underlaid all disease. Too much tension was often characterized by a fever, to be treated by a depleting regimen including bleeding, a restricted diet, purging, and rest and sedation. A cold or chill, on the other hand, indicated too much relaxation and called for restorative measures. In time, Cullen became so influential that Benjamin Rush, just gaining prominence in American medicine during the Revolution, was able to write his former teacher that the American edition of his work "was read with peculiar attention by the physicians and surgeons of our army, and in a few years regulated in many things the practice in our hospitals."2

Despite his doctrine that disordered nervous tension was the cause of all disease, Cullen encouraged the study and classification of specific diseases. Rush, however, eventually modified Cullen's doctrines, which he had originally so much admired, and discouraged the study of separate disease entities by blaming all disease on excessive tension which caused disturbance in the blood vessels. By 1793, he was openly contending that there was but one single disease in existence. The method of treatment upon which Rush insisted with increasing inflexibility called for a low diet, vigorous purges with calomel and jalap, and bleeding until the patient fainted. Rush apparently did not hesitate to remove a quart of blood at a time, or, should unfavorable symptoms continue, to repeat such a bleeding two or three times within a two- to three-day period, it being permissible in his opinion to drain as much as four-fifths of the body's total blood supply. In time, Rush's system and treatment became, in the words of a noted medical historian and physician, "the most popular and also the most dangerous 'system' in America."3

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Theorists of the eighteenth century did not generally include in their systems an explanation for the outbreak of certain forms of disease among many people in one area within a short period of time. According to his background, training, and experience, therefore, a physician might blame mass outbreaks of disease on climate and season, unhealthy elements in the air, contagion, possibly caused by "animalcules," or God's determination to punish sinful man. There were many discussions of possible sources of disease carried by the air. Rush strongly believed in the danger of bad odors, or miasmas, and Sir John Pringle, a noted British Army surgeon and a Physician General in the British Army from 1745 to 1758, much respected by the many Americans who knew him in their student days, wrote that putrefaction was the greatest cause of fatal illness in armies. He listed corrupted marsh water, human excrement remaining exposed in the hot weather, crowded military hospitals, and straw used for bedding rotting in tents as the four principal sources for putrid air. Although he recognized cold as a predisposing factor in disease, Pringle noted that heat, too, was often a cause of sickness, especially when wet clothes and beds or a very humid atmosphere tended to interfere with normal perspiration, "relaxing the fibers and disposing . . . to putrefaction." He found it "not surprizing [sic] that the dysentery and bilious fever, both putrid diseases, should ensue." The theory of the atmosphere as a cause of many types of fevers was still maintained as late as 1812. David Hosack, a respected American physician, pointed out at that time, however, that disease might also be spread by direct physical contact, as in syphilis and scabies, or through the purest air, as with smallpox. Many authorities at that time also blamed sudden changes in the weather for causing outbreaks of disease.4

The average eighteenth century physician had little in the way of either equipment or understanding to aid him in distinguishing one specific disease from another. The concept of a standard body temperature had only been suggested, the body's heat-regulating mechanism was not understood, and Fahrenheit's recently developed mercury thermometer was not commonly used by physicians. The stethoscope was not invented until 1814, and although a "pulse watch" had been developed in 1707, it also was largely ignored by physicians, who preferred describing the pulse to counting it. The use of percussion to aid in diagnosis, however, was beginning to become more widely understood because of the work of the Viennese physician Leopold Auenbrugger. The reasoning underlying some eighteenth century diagnoses, however, may seem strange to us today. When a fever described as yellow fever responded to quinine, for example, rather than concluding that the fever was in reality malaria, the eighteenth century physician assumed that quinine must be effective against yellow fever. Since all fevers were regarded as stemming from the same physical unbalance, such a conclusion was logical. Rashes were not regarded as particularly significant in diagnosis, and differing symptoms appearing in patients believed to have the same disease might be brushed off as indicative merely of the conditions under which the illness was contracted.5

In the eighteenth century and, as far as the U.S. Army was concerned, until World War I, disease invariably caused more deaths than wounds. It has been estimated that, during the American Revolution, 90 percent of the deaths occurring among the inexperienced, poorly clothed, poorly fed soldiers of the Continental Army, most of them country boys without previous exposure to communicable diseases, and 84 percent of those among the seasoned, disciplined British regulars were from disease. Under the circumstances, however, it is difficult today to determine from the diag-

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noses and descriptions of eighteenth century physicians what specific diseases were most common in the army of that period. Respiratory illnesses were most often seen in cold weather and dysenterylike conditions in hot weather, while fevers were always a threat. Venereal disease was common, and smallpox could wreak havoc in the ranks of American armies. Scurvy was a danger on land as on sea, and scabies, otherwise known as the Itch, was a more than ordinary nuisance for military forces. Other diseases, such as diphtheria and scarlet fever, were less common in eighteenth century armies despite their occasionally devastating effects upon the civilian population.6

Whatever the eighteenth century diagnoses were, eighteenth century fevers were often in fact malaria, widespread in the colonies and endemic from New England southward. Yellow fever, despite its fearful reputation, was endemic only in the deep South, although rare outbreaks occurred during the summer in a few ports north of Charleston, South Carolina. The incidence of malaria was rising during the Revolution, especially in the South with its long hot summers and undrained swamps, affecting with particular severity, for example, not only Cornwallis's men but also New Englanders participating in the fighting around Yorktown. Although mosquitoes were rarely suspected as carriers of disease, eighteenth century physicians were aware of the relationship of fevers to swamps and undrained areas.7

While "intermittent" and "remittent" fevers were probably malaria, those called putrid, malignant, jail, or hospital may have been either typhus or typhoid. Authorities do not agree on the extent to which late eighteenth century physicians could differentiate between these two diseases.8

An examination of the writings of the period shows, however, that when British military physician and author Richard Brocklesby made his diagnoses, he did not take into consideration the petechiae which modern physicians believe to be the key to a definite differentiation between the two diseases in the absence of laboratory tests. British surgeon Donald Monro, furthermore, believed that the symptoms manifested by a malignant fever depended upon the conditions prevailing at the time the disease was contracted, and the prominent Austrian military surgeon Gerhard van Swieten considered the appearance of a rash to be an indication of a favorable outcome rather than one of the nature of the disease. A modem authority on the epidemic diseases of pre-Revolutionary America also points out that "Not only was typhus rarely found in the colonial period but even after the Revolution the United States remained relatively free of the infection." He ranks typhus in importance after malaria, dysentery, and typhoid.9

Eighteenth century soldiers "often exposed to the putrid Steams of dead Horses, of the Privies, and of other corrupted

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Gerhard van Swieten. (Courtesy of National Library of Medicine.)

Animal or Vegetable substances, after their juices had been highly exalted by the Heat of Summer"10 sometimes found themselves afflicted with "A flux of the belly, attended with violent gripings, of very painful strainings for stool."11 This was blamed on "obstructed Perspiration,"12 or on "bile grown acrid by the great heats and the fatigue of war" when "the soldier, when hot, suddenly exposes himself to cold air, or sleeps in his cloaths [sic], soaked with rain" as well as on stagnant water and tainted food. Van Swieten, whose work was influential in America, believed that dysentery could be spread through an entire army by the breath of those afflicted with the disease and that ordinary diarrhea could degenerate into dysentery if not promptly treated with a mild purge followed by a dose of opium. In the eighteenth century, however, even dysentery itself often remained untreated. The soldier unlucky enough to be so afflicted might, indeed, prefer neglect to the very generous doses of purgatives and emetics required by eighteenth century doctrine, or to the blister which would adorn his abdomen should the physician determine that this portion of his anatomy was too tense. It was only after he had survived these remedies that the patient could hope for a dose of opium, which might at least temporarily relieve his agony even if his disease had been misdiagnosed, a distinct possibility, and was actually typhoid or typhus.13

Venereal disease was another ever-present threat to the eighteenth century army but one not always reported because of the punishment often administered to its victims. Some modern historians believe that eighteenth century physicians could distinguish between gonorrhea and syphilis, but examination of a number of publications of the time suggests that the distinction was partial at best. The British John Hunter, one of the century's finest surgeons and anatomists, stated that the two were but "different forms of the same disease," gonorrhea

John Hunter. (Courtesy of National Library of Medicine.)

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being the form in which the urethra alone was affected and chancre a nonsecreting version of the same disease. Hunter could state this confidently even while he noted with surprise that mercury, which cured chancre, only made gonorrhea worse.14 Brocklesby, too, considered gonorrhea but one symptom of "lues venera," as did van Swieten and at least one physician as late as 1815.15

Although it may not have been fatal, scabies brought more patients to British Army hospitals during the Seven Years' War than any other condition, according to British Army surgeon Donald Monro. Its cause was known to be "Little Insects Lodged in the Skin, which Many Authors Affirm They Have Seen in the Pustules by the Help of a Microscope."16 The Itch was very common in colonial America, Benjamin Franklin's mother-in-law having advertised a remedy for it in 1731. The condition usually appeared first between the fingers in the form of a "pustule, or two, full of a sort of clear water, which itch extremely: where these pustules are broke by scratching, the water that issues out communicates the disorder to the neighboring parts . . . in its progress the pustules augment both in number and size, and when opened by scratching a disgusting crust is formed." The favorite remedy for the Itch seems to have been sulfur, a remedy still in use today, applied in either an ointment or a soft soap.17

Among the respiratory ailments often afflicting armies in the eighteenth century were pneumonia, often called peripneumonia, and pleurisy. Van Swieten suggested treating the former, as soon as diagnosed, by a "large bleeding in the arm" but also urged that the air be kept moist and the patient encouraged to bring up the secretions from his lungs. If the progress of the disease weakened the patient, however, this authority recommended that bleeding, purging, and sweating be avoided. The soldier unfortunate enough to be afflicted with so severe a pleurisy that the pain interfered with his breathing would be treated not only to bleeding but also to blistering, clystering, and, to encourage the pus to drain outward and thus avoid the formation of an abscess, plastering. If the patient could not sleep, he might be dosed with a syrup of white poppies. To soothe his cough, his medicine would be administered while lukewarm, and wine, salt, and acid foods would be denied him.18

Specific types of therapy for specific diseases were understandably not too common in the eighteenth century and certain remedies were used for almost all diseased conditions. Bleeding was popular, the amount and frequency varying with the individual physician and the system he followed. A moderate bleeding was considered to be one taking 8 to 12 ounces at a time, a heavy one 16 to 20 ounces. Cleansing the digestive tract was another generalized remedy followed with or without much caution, using such purgatives as rhubarb, manna with tincture of serma, or Rush's favorites, jalap and calomel, emetics such as ipecac and antimony, and enemas of varying formulation.19

The following order for medicines and hospital stores for Fort Meigs placed by Brig. Gen. William Henry Harrison during the War of 1812 suggests that the same kinds of medicines remained popular for many decades.

Peruvian bark (in powder)

50 lb.

Opium

10 lb.

Camphor

10 lb.

Calomel

5 lb.

Corrosive sublimate

2 lb.

Tartar emetic

2 1b.

Gambage

2 lb.

Jalap

10 lb.

Ipecuanto

17 lb.

Rhubarb (in powder)

10 lb.

Kino

15 lb.

Colombo (in powder)

20 lb.

Nitre crude

20 lb.

Nitre sweet spirits

40 lb.

Glaubers salts

50 lb.

Prepared chalk

20 lb.

Castor oil

12 gal.

Olive oil

5 gal.

Gum arabic

20 lb.

Allume

5 lb.

Acquous

20 lb.

Adhesive plaster

20 lb.

Barley

2 bbl.

Chocolate

300 lb.

Tapioca

50 lb.

Blistering ointment

20 lb.

Beeswax

20 lb.

Muriated acid

4 lb.

Sulphuric acid

4 lb.

Nitric acid

4 lb.

Vials

5 gross

Instruments

Amputation

3 sets

Trepanning

3 sets

Pocket

3 sets

Cases scalpels (No. 6)

Lancets

3 doz.

Splints

12 sets

Sponge

7 lb.

Muslin

1,000 yd.

Wine

200 gal.

Brandy or rum

100 gal.

Vinegar

200 gal.

Molasses

200 gal.

Coffee

300 lb.

Hyson tea

50 lb.

Rice

5 bbl.

Sugar

5 bbl.

Sago

50 lb.

Dr. Robert Usher was married x2, 1st to Susannah Gates (1748 - 1777). and 2nd to Anna Cone (1755 - 1849) on 25 Jan 1779.

Children of Robert & Susannah (Gates) Usher: (Note: yes, there are 2 Jonathan's, with the first one dying at age 14 months, and the 2nd Jonathan being born approximately 14 months later).

• Jonathan Usher (1768 - 1769)
• James Usher (____ - 1817)
• Jonathan Usher (1770 - 1839)

Children of Robert Usher &I Anna (Cone) Usher:

• Josiah Cleveland Usher (1802 - 1893)

Headstone Inscription: "AE 77, Sgt. Col. Wadsworth's Regt. Rev. War, continued the Practice of Physics 19yrs, 10 months.. Dr." Find A Grave Memorial# 7119754