“Patients’ Voices in Early 19th Century Virginia”:
an online exhibit from the University of Virginia

“Patients’ Voices” exhibit

Joan Echtenkamp Klein

Patients’ Voices in Early 19th Century Virginia: Letters to Doct. James Carmichael & Son, a collection of letters written to a Fredericksburg, Virginia, father-and-son team of physicians in the early 1800s, documents how ill individuals in central Virginia felt about their and their families’ disease, affliction, pain, and suffering.  The long-lost carmichael-portrait-5-copyvoices and perspectives of laypersons dealing with illness are captured in the collection.  The 700 letters, dated 1819 through 1830, are often scrawled missives of urgency, describing a complaint, requesting medicine, or appealing for a visit from the doctor.  The authors’ worry and concern about an ill loved one transcend time.  A modern parent can easily identify with a father’s anguish when he writes about his violently ill daughter:  “pray send out Dr. Carmichael to me immediately — as I consider her to be in great danger.  Delay not a moment for her life and my happiness depend on it.”

Some 21st-century physicians, too, can identify with the home visits that were central to the Doctors Carmichaels’ 19th-century medical practice. The first issue of Hospital Drive included a poem by Daniel Becker, Home Visit, which—save for the blue Ford tractor, electricity, and the TV—could easily have described a visit to a patient’s home by Dr. James Carmichael in the early 1800s.

The Papers of James Carmichael and Son provide a captivating look into the lives of the early 19th-document imagecentury inhabitants of Fredericksburg, Virginia, and its surrounding rural areas. Because the authors wrote so candidly, the letters provide interesting details describing 19thth-century medical treatments and drugs and patients’ reactions to them. The Carmichaels’ patients discussed bloodletting, cathartics, and purgatives—all popular methods employed to cure affliction.  As the Carmichaels also acted as their own pharmacists, the patients and their families did not hesitate to request that certain pills, teas, powders, and tinctures be delivered to them.  The correspondence also explores the health and medical care of slaves.  Over 100 families in the antebellum community wrote to the Carmichaels.  Many of these families owned slaves and, concerned about their workforce, they employed the Carmichaels to tend to their ill or injured slaves.

Laura Shepherd, M.D., while a third-year resident, wrote “The Carmichael Papers:  A Collection of the University of Virginia Library,” a paper analyzing the letters for the Twentieth Annual Department of Internal Medicine Research Day, University of Virginia Health System, April 2001. The papers presented for the forum are the culmination of research projects conducted during the previous year—Dr. Shepherd’s paper and research were unique that year in that they were more humanities-based than data driven.

We encourage you to spend some time with the Drs. Carmichael’s patients, whose voices can be heard over the centuries and articulate the same concerns as patients today.

About the Carmichael Collection. The online “Patients’ Voices” exhibit includes the 700 letters themselves, the centerpiece of the Carmichael Collection, which Historical Collections digitized, transcribed, and made searchable.  The digitized image of the original manuscript and its transcription are shown side by side in the “Collection” section of the exhibit site. The Collection permits searching in numerous ways, including by date or subject.  Subjects include complaints and diseases or treatments, all the individuals mentioned in all the letters, medical education, and slavery, to name a few.  The “Story” portion of the exhibit provides the context for the letters.

The “About” section of the online exhibit contains present-day photographs of the landscape of the Carmichael letters, taken by Historical Collections staff members.

The original Carmichael letters are physically maintained in the Albert & Shirley Small Special Collections Library at the University of Virginia. Historical Collections undertook the digitization of the letters (including the transcription and mark-up to make them searchable) thinking we would do a small sample.  We were so struck by the richness, drama, and immediacy of the patients’ voices in their notes and letters that we realized we could not possibly pick only a few to make available online. The decision to make all 700 documents accessible online was easy to make but the process took much longer than a small sample would have taken.

Joan Echtenkamp Klein is the Alvin V. & Nancy Baird Curator for Historical Collections, Claude Moore Health Sciences Library, at the University of Virginia.

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