A HISTORY OF KRMC

 

An Introduction & Prelude:

Medicine in Mohave County and Kingman

 

The following can be considered more a series of snapshots rather than a complete story. A fair portion of this picture-puzzle, as it were, is presented so that the overall themes can be understood. We are aware that there are many gaps still remaining to be filled. And while some of the medical events listed below are major advances, most were really just starting points. Improvements and developments which extend to the present day -- and into the future -- often dramatically altered or replaced the practices and policies of these original events. The art and science of medicine in its various appearances, modalities, and understanding of human health is a continually evolving process.

 

This is an ongoing project. If you are a former employee of the hospital or otherwise have information, photographs, newspaper clippings, anecdotes, etc. which could be used in further developing or clarifying this history, please contact the Education Department at (928) 692-4640 or e-mail krmced@azkrmc.com. Thank you very much for your support.

This Page Last Updated: June 14, 2005

 
[1857 - October 8: Lt. Edward Fitzgerald Beale was commissioned by the government to lay out a wagon road along the 35th Parallel across what are today Arizona and New Mexico during this year and the next. He used camels in addition to pack mules and horses. Less than 40 miles inland east of the Colorado River, Beale camped on this day at the unnamed springs located by his road building crews. The springs were on the southeast side of the twenty-five mile long Cerbat Mountains, which are to the southwest of the Grand Canyon. Well described, the watering hole is called to this day Beale's Springs.]
 

[1858 - February: Seven companies of the 6th Infantry and artillery detachment reached the Beale's crossing on the Colorado River. The Mojave Indians there found themselves outnumbered and no match with their arrows for the guns of the Army. The Mojaves agreed to live in peace with the white men.]

[April: At month's end, a site was selected, not on the California side of the river as per instructions from their superiors, but on the high bluff on the Arizona side, within 500 feet of the river. Free of swamps and some 198 miles north of Ft. Yuma, the new post was named Camp Colorado. (It would soon be renamed Fort Mojave. Some skirmishes would occur with the Indians that summer.)]

[August: Anatomy Descriptive and Surgical was received with much acclaim when it was published in London, the result of eighteen months of dissection by surgeon Dr. Henry Gray and artist Dr. Henry Vandyke Carter. Their purpose was to supply an affordable, accurate teaching aid for students like their own, who might soon be required to operate on soldiers injured on some battlefield. The book they planned together was a practical one, designed to encourage youngsters to study anatomy, help them pass exams, and assist them as budding surgeons. Unlike its small print and smaller illustration competitors, this book held well in the hand, felt substantial, was small enough to be portable yet large enough for decent-sized illustrations which had diagrammatic clarity, atypical for the time. (A U.S. edition would be published the following year, a second London edition the next, and Gray himself would die of smallpox in 1861.) (See also 1887, 1938)]

 

[1860 - The hundred or so soldiers who lived at Ft. Mojave were accompanied by nineteen civilians, according to census records. Most of these latter were soldiers' wives and children, but also a stonemason, hunter, laborer, a druggist (William Hamilton), and a post physician (James C. Herdon).]

[During the period just before the Civil War, a physician received minimal surgical training. Nearly all the older doctors served as apprentices in lieu of formal education. Even those who had attended one of the few medical schools were poorly trained. There were no standard curricula. (In Europe, four-year medical schools were common, laboratory training was widespread, and a greater understanding of disease and infection existed.) The average medical student in the U.S., on the other hand, trained for two years or less, received practically no clinical experience, and was given virtually no laboratory instruction. Harvard University, for instance, did not own a single stethoscope or microscope until after the war. A majority of physicians followed a standard pattern, heavily influenced by the "heroic medicine" of Benjamin Rush, who said that "there is but one disease in the world," and that it was treatable by "depletion," which translated as blood-letting, blistering, and purging. (The fledgling American Medical Association had itself only been founded some thirteen years earlier. And anesthesia had only been reported the year before that, in 1846.) (See also 1874)]

[Florence Nightingale's Notes on Nursing was published in 1860, the first textbook for nursing. (Nightingale (1820-1910) had trained as a nurse in France, Germany and Egypt as there were no nursing schools in England at the time. Back in England, she volunteered to care for English soldiers wounded in the Crimean war (1853-1856). Against incredible odds --including the stupidity of officers who couldn't fathom a woman as medical professional -- Florence and her band of 38 volunteers became the de factor saviors of over 12,000 wounded men in Turkey and the Crimea (part of the Ukraine). As in many 19th century wars, far more men died of disease than of battlefield wounds. She returned to London in 1856 and soon opened The Nightingale Home for Nurses in St. Thomas's Hospital. The opening of this school marked the beginning of professional education in nursing. Her written works (which also included Notes on Hospitals in 1859 and Notes on Nursing for the Labouring Classes in 1861) helped change nursing from untrained, menial labor to a full-fledged profession. Her 1858 Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army, in addition to improving the care of the English military, is said to have influenced management of American hospitals during the Civil War.]

 

[1861 - May 28: Fort Mojave was abandoned and the garrison was transferred to California due to the Civil War (April 1861 - April 1865).]

[When the war began, the Federal army had a total of about 98 medical officers, the Confederacy just 24 surgeons -- who, in fact, resigned from the U.S. Medical Department so they could serve with the Confederacy. (By 1865, some 13,000 Union doctors would have served in the field and in the hospitals; in the Confederacy, about 4,000 medical officers and an unknown number of volunteers treated war casualties. In both the North and South, these men would be assisted by thousands of women who donated their time and energy to help the wounded.)]

[The Corps had about 20 clinical thermometers, and didn't have a "modern" microscope until 1863.  No one in the U.S. really had any idea what a laryngoscope, stethoscope, or ophthalmoscope was.  No surgeon used hypodermic syringes to administer medicine. Instead, morphine, the leading pain-killing drug of the time, was rubbed or dusted into the wound.  Sometimes it was also given in the form of opium pills.  Medical personnel had little or no idea what addiction was, and so many soldiers came home from the war addicted to opium.  Fortunately for these poor soldiers, opium was available at every self-respecting local druggist.]

[The Civil War doctor, Surgeons as they were called, ranged from the brave and brilliant to drunks and quacks. The uneven quality was the result of political influence in the appointment of some medical officers and wildly varying state-to-state standards in some cases. There were no licensing boards. One state required no medical degrees from prospective surgeons on grounds that "scholarship" was no "measure of practical ability," which may explain the former barbers and similarly qualified men occasionally commissioned as surgeons. The quacks deceived the public by their irresponsibility. The qualified doctors deprived the public by their excessive responsibility. They were so obsessed by quackery that they distrusted new innovations, even when they were based on scientific theory.]

[In addition to the Army Surgeons, there was the contract surgeon, who many times was not sufficiently trained to be accepted by Army standards to be an officer. During the War, 5,500 were engaged for periods of 3 to 6 months with only about 1,500 serving at any one time. Many of the doctors still practiced saddle bag medicine. The greatest share of the doctors at the beginning of the war had never seen or treated a gunshot wound in their life.]

[During the struggle and the months immediately following it, more than 12,000 medical officers -- regulars, volunteers, and contract -- examined over 250,000 wounds and treated more than 7 million cases of disease. In the course of their duties, more than 300 Army surgeons died from wounds, disease, or accidents. Although Civil War doctors were commonly referred to as "butchers" by their patients and the press, they managed to treat more than 10 million cases of injury and illness in just 48 months and most did it with as much compassion and competency as possible. Approximately 620,000 men (360,000 Northerners and 260,000 Southerners) died in the four-year conflict, a figure that tops the total fatalities of all other wars in which America has fought. Of these numbers, approximately 110,000 Union and 94,000 Confederate men died of wounds received in battle. Every effort was made to treat wounded men within 48 hours; most primary care was administered at field hospitals located far behind the front lines. Those who survived were then transported by unreliable and overcrowded ambulances -- two-wheeled carts or four-wheeled wagons -- to army hospitals located in nearby cities and towns.]

[Almost 6,000 regimental medical officers, whose qualifications were initially ascertained at the state level, served at one time or another in the Union Army. An equivalent number of civilian doctors unwilling or unable to join the Army worked as contract surgeons, either for short periods when necessity dictated or in general hospitals in the cities where they lived.]

[Everything about the operation was septic. The surgeon operated in a blood- and often pus-stained coat. He might hold his lancet in his mouth. If he dropped an instrument or sponge, he picked it up, rinsed it in cold water, and continued to work. When loose pieces of bone and tissue had been removed, the wound would be packed with moist lint or raw cotton, unsterilized, and bandaged with wet, unsterilized bandages. The bandages were to be kept wet, the patient was to be kept as quiet as possible, and he was to be given small but frequent doses of whiskey and possibly quinine.]

[Three out of four operations were amputations. Usually, when a soldier was struck in an appendage by the dreadful minnie ball, if it hit the bone, the bone would splinter. It would usually carry skin and dirt into the wound. Generally, the surgeon's only option was amputation. The survival rate for amputations done in the first 24 hours after an injury was very good, with only 25% mortality. When amputations were done after the first 24 hours, the mortality rate doubled to 50%. Naturally, surgeons tried to ship patients through as quickly as possible. The surgeon usually had an operating table of a couple of boards between barrels.  He usually had a rag soaked with chloroform, which was liberally doused.  Today it is recognized as a dangerous procedure.  Somehow, surgeons back then knew enough to periodically remove the rag or sponge.  Thus, few deaths resulted from chloroform poisoning. First the surgeon would cut off the blood flow with a tourniquet.  After that he would take a scalpel and slice through the outlying tissue and flesh.  Then he would use a hacksaw-like tool called a capital saw to saw through the bone.  The tool had replaceable blades.  After the bone and flesh was all sliced off, the surgeon would take silk sutures in the North, and cotton sutures in the South, and sew the major arteries and veins together. The limb would be dropped on a pile that got thrown out after the day. Time was of the essence, so after an amputation the soldier would be carried off of the platform and another soldier would be placed on the platform. This would take about fifteen minutes. Amputation saved many more lives than it killed.  It was remarkably effective considering the medical knowledge of the time.]

[Those who survived their wounds and surgeries still had another hurdle, however: the high risk of infection. While most surgeons were aware of a relationship between cleanliness and low infection rates, they did not know how to sterilize their equipment. Due to a frequent shortage of water, surgeons often went days without washing their hands or instruments, thereby passing germs from one patient to another as he treated them. Of the Federal dead, roughly three out of five died of disease, and of the Confederate, perhaps two out of three. One of the reasons for the high rates of disease was the slipshod recruiting process that allowed under- or over-age men and those in noticeably poor health to join the armies on both sides, especially in the first year of the war. About half of the deaths from disease during the Civil War were caused by intestinal disorders, mainly the devastating typhoid fever, diarrhea, and dysentery. The remainder died from pneumonia and tuberculosis. Camps populated by young soldiers who had never before been exposed to a large variety of common contagious diseases were plagued by outbreaks of measles, chickenpox, mumps, and whooping cough.]

[With the coming of the big battles of 1862, both armies more or less simultaneously evolved larger and better field hospitals. First, regimental hospitals clustered together as brigade hospitals with some differentiation of duty for the various medical officers and with the chief surgeon of the brigade in charge. Soon brigade hospitals clustered into division hospitals.]

[During the Civil War, more than five thousand women served as nurses. Their service saved lives and carved out a place for women in post-war professional medicine.]

[Agents were sent by the Confederacy at once to Europe, most of whom were in London, and where they established a weekly newspaper, with local correspondents in nearly every Southern town from Virginia to Texas. Instructions were given that, as there were only two sources of supply, capture and blockade running, importance was to be given to securing first, arms and ammunition; second, clothing, including boots, shoes, and hats; third, drugs and chemicals, such as were most pressingly needed, as quinine, chloroform, ether, opium, morphine, rhubarb, etc. For this latter concern, the druggists of the South had either to manufacture what they could from native barks and leaves and herbs and roots, or purchase at the Southern ports such supplies as the blockade runners brought in that were not intended for the government. While the army frequently captured the wagon trains of the enemy, thus obtaining some supplies of medicines and surgical appliances, these were barely sufficient to supply the most distressing needs in the army; so, it may be seen that home manufacture and blockade running were the only source of supply during nearly four years for between six and seven millions of people.]

[The diets of both armies did not help and were deplorably high in calories and low in vitamins. Fruits and fresh vegetables were notable by their absence, and especially so when the army was in the field. The food part of the ration was fresh or preserved beef, salt pork, navy beans, coffee, and hardtack -- large, thick crackers, usually stale and often inhabited by weevils. When troops were not fighting, many created funds to buy fruits and vegetables in the open market. More often they foraged in the countryside, with fresh food a valuable part of the booty.]

 

[1863 - May 19: Ft. Mojave was reopened with two infantry companies from California. The fort consisted of only a few miserable shanties made of wood and mud with thatched roofs. There was no stockade around the grounds. One of the first reports listed a hospital with 25 square feet for sick room and dispensary with storeroom of 12 x 16 feet each; two buildings for the enlisted men; four officers' quarters and a guardhouse.]

[Mohave City was adjacent to Ft. Mojave, "a scragle of wind-weathered tents and makeshift brush shelters," and there the traders, saloonkeepers and other white settlers lived.]

 

[1864 - Mohave was established as one of the four original counties in the Arizona Territory, which was carved out of the New Mexico Territory. (The county was named for the Mojave Indians living along the Colorado River. Mohave County and Mohave City have an "h" because such spelling was written into the law creating the county. Mojave Indians and Ft. Mojave have a "j" because such original spelling was retained in the early documents.")

[March: Congress published the act (Public 22) to create an Ambulance Corps for all the Union Armies.]

[By this time in most field armies there were corps hospitals. There the best surgeons would operate; one surgeon would be in charge of records, another of drugs, another of supplies, and yet another would direct and treat the sick and lightly wounded.]

[Throughout the war, both the South and the North struggled to improve the level of medical care given to their men. In many ways, their efforts assisted in the birth of modern medicine in the United States. More complete records on medical and surgical activities were kept during the war than ever before, doctors became more adept at surgery and at the use of anesthesia, and perhaps most importantly, a greater understanding of the relationship between cleanliness, diet, and disease was gained not only by the medical establishment but by the public at large. Another important advance took place in the field of nursing, where respect for the role of women in medicine rose considerably among both doctors and patients.]

[April: Mohave City, the first county seat, was now described as "a real nice little city, permanent frame and adobe buildings, law offices, and a good merchantile establishment. There were even a few homes with new tree and gardens started."]

[When the boundaries of the county would finally be settled on in 1871 with some of the original land going to Nevada, there would be 13,479 square miles of mostly high desert land here, approximately 9% of the eventual state of Arizona. The county is larger than the states of Maryland, Massachusetts, New Hampshire, New Jersey, Rhode Island, or Vermont.]

[The incorporation of the Fort Mohave [sic] - Prescott Toll Road in south central Mohave County was approved by the Legislative Assembly. The road, about 165 miles long, started at Ft. Mojave on the Colorado River and passed through valleys, mountain ranges and open desert spaces before reaching the teritorial capital of Prescott. Following a prehistoric Indian route developed over the centuries, the route was a series of trails rather than distinct roads as we are familiar with today. The toll road established a station located at Beale's Springs.]

 

[1865 - British surgeon Joseph Lister (1827-1912) began to clean wounds and dress them using a solution of carbolic acid (aka phenol). (In August 1861, he had been appointed surgeon at the Glasgow Royal Infirmary and put in charge of its new surgical building. The hope was that the new building would decrease the number of deaths caused by what was then called hospital disease (now known as operative sepsis). This proved a vain hope when Lister reported that between 45 and 50 percent of his amputation cases died from sepsis between 1861 and 1865 in his Male Accident Ward. By the middle of the nineteenth century world-wide, post-operative sepsis infection accounted for the death of almost half of the patients undergoing major surgery. A common report by surgeons was: operation successful but the patient died. It was in this ward that Lister began his experimental work with antisepsis. Having tried methods to encourage clean healing, with little, or no success, Lister began to form theories to account for the prevalence of sepsis. He discarded the popular concept of direct infection by bad air ("mal-aria") and postulated that sepsis might be caused by a "pollen-like dust." Although, there is no evidence to suggest he believed this dust to be living matter he was close to the truth. When, In 1865, Louis Pasteur suggested that decay was caused by living organisms in the air, which on entering matter caused it to ferment, Lister made the connection with wound sepsis. A meticulous researcher and surgeon, Lister recognized the relationship between Pasteur's research and his own. He considered that microbes in the air were likely causing the putrefaction and had to be destroyed before they entered the wound.) In the previous year Lister had heard that "carbolic acid" was being used to treat sewage in Carlise, and that fields treated with the affluent were freed of a parasite causing disease in cattle. (Lister would be able to announce at a British Medical Association meeting, in 1867, that his wards at the Glasgow Royal Infirmary had remained clear of sepsis for nine months. Although his methods were initially met with indifference and hostility -- how could patients be contaminated by their own doctors who operated ungloved with unsterile instruments, used textile mill floor sweepings as surgical dressings, and wore a blood-spattered frock like a badge of honor?! -- doctors gradually would begin to support his antiseptic techniques. In 1870 Lister's antiseptic methods would be used, by Germany, during the Franco-Prussian war saving many Prussian soldier's lives.) (See also 1877, 1887)]

[Hungarian Obstetrician Ignaz Philippe Semmelweiss showed that the increased rate of mortality in women after childbirth was attributed to infectious agents transmitted by unwashed hands. This was rejected by the medical community at the time.]

 
[1866 - A military encampment was set up at Beale's Springs to protect the mails carried on the Toll Road.]
 

[1867 - August 23: A second military post was established in Mohave County, Camp Willow Grove. This was about 76 miles northeast of Ft. Mojave. Camp Willow Grove was located in a mountain terrain with the growth of juniper and pine, more or less halfway from Ft. Mojave to Prescott on the wagon road. During its two year's of existence, skirmishes were recorded between the post's soldiers and the Apache and Hualapai Indians in the area. The first post surgeon is listed as E. Wood.]

[An open tube was first used to examine the genitourinary tract, combining alcohol and turpentine with a flame in order to generate a brighter, more condensable beam of light than had been first used fourteen years earlier by another French surgeon. (See also 1901, 1911)]

 

[1868 - A total of eighty-one to ninety-three officers and men were stationed at Camp Willow Grove during the first half of the year, seven being assigned to the Camp Beale's Springs outpost and another ten out escorting wagon trains. The men at Camp Willow Grove were quartered in nine pyramidal tents elevated on wooden stockades. Two such tents and one wall tent were used as hospital and dispensary. Two log buildings with paulin covering served as quartermaster and commissary storehouse. One tent was for guardhouse, but a permanent building was under construction. Two buildings and one tent housed officers. One building contained the hospital kitchen. In addition there were two laundresses quarters and one cook house. The camp's buildings were constructed out of timber in contrast to the permanent adobe structures of Ft. Mojave. Thomas E. Snow was the post surgeon and medical officer at Camp Willow Grove.]

[July: In Paris, nitrous oxide was successfully liquified for storage and portability in metal cylinders.]

[August: In England, an apparatus employing a cylinder of gas, a reservoir bag and a Clover face mask was introduced for the induction of anesthesia.]

 

[1869 - February: Camp Willow Grove had 156 offiers and men.]

[September 30: The troops were engaged in the removal of stores to their new camp closer to Prescott at Tollgate, where fees for the use of the road were collected. The new post was named Camp Hualapai in Yavapai County. And thus Camp WIllow Grove, sometimes called Camp WIllow Springs, came to its end.]

[A modified cystoscope was used to cauterize a hemorrhagic uterine growth, the first diagnostic and therapeutic hysteroscopy. (See also 1934)]

 

[1870 - Mohave County pop.: 179]

[Ft. Mojave's two dozen buildings were partially renewed by this year. "The present hospital is warmed by fireplaces, and lighted by windows. The ventilation is deficient. The ward, 28 by 25 by 10 feet, generally contains six beds. There are no bath or wash rooms; a bathing tub is used in the ward."]

 

[1871 - March 27: Camp Beale's Springs was established to provide continued protection along the Toll Road and to act as a feeding and supply station for the Hualapai Indians. "The Hospital... is composed of three Hospital field tents [each 14 x 14-1/2 ft.and built of canvass with lumber sides and floors] and is well located; one tent is used for a ward, and has capacity for five beds, four of which are up. The ventilation and light good, and it is heated by stoves. There is no kitchen attached, and cooking is done in Company kitchen. Water supplied from Spring. The Hospital is well supplied with furniture, bedding, and medicines. Instruments in good order. No vaccine matter on hand, and no vaccination has been done at the post... The general Sanitary [sic] of the Post excellent." (In the hyperlinked picture -- the left half of which is looking eastward -- the ward tent is the stark white broadside structure left of center and towards the rear.)]

[Three contracted "acting assistant surgeons" would serve during the Camp's existence, all previously having had Civil War experience: William B. Dodds (Dec. 1871-March 1872), William O.G. Springer (May 1872-Feb. 1873), and Dr. James Reagles (Apr. 1873-Apr. 1874). In addition, there were three hospital stewards: William A.R. Sherpich (March 1871-Jan. 1873), James G. Guthrie (Jan. 1873-July 1873) and Joseph Blattler (Oct. 1873-Apr. 1874). A fourth soldier served a stint as an acting steward and four others put in extra duty as nurses. The troop compliment was briefly up to about eighty, but Congressionally-mandated cutbacks in the nation's army dropped that number to around sixty. No less than about fifty soldiers were at the post at any time.]

[The rest of the camp included a corral, granary, blacksmith shop, quartermaster and commissary store house, laundry, company kitchen, three sets of officer quarters, and company barracks.]

 
[1872 - Addinell Hewson, M.D. described 93 patients whose wounds from ulcers, burns, gun shots, and various surgical procedures healed within 15 days after being packed with earth. Coming just after the discovery of antiseptic wound treatment and surgery by Lister (see 1865), Dr. Hewson's otherwise now forgotten "dirt dressings," though grounded on the action of antibacterial microbes, were the antithesis of the push for cleanliness. This was an era when 20% of patients got gangrene, and 20% died from infections. When wounds were healing by secondary intention over weeks and months, Dr. Hewson's patients would heal in 15 days even after a mastectomy and major other operations.]
 

[1873 - January: The Beale's Springs Indian Agency was established at the Camp as a temporary one square mile reservation for the 650 Hualapai Indians. (Mining claims had been worked as early as 1865 in the northern part of the Hualapai Mountains, but at first there were no permanent residents. Miners came, worked for a few months and left, usually chased by the Hualapai Indians. From January 1865 through 1869 there had been sporadic but constant fighting between settlers in the area with troops and the Hualapai. Both sides suffered losses. The military posts in Mohave County were established for the protection of travelers, wagon trains, prospectors, miners and ranchers from the various Indians.) At Camp Beale's Springs, the Indians "are peaceable in their habits and subsist entirely on rations furnished by the Government."]

(For a list which includes medicinal plants used by these tribes, please go to the University of Michigan-Dearborn Native American Ethnobotany site, http://herb.umd.umich.edu/ and enter "Hualapai," "Walapai," Mojave," and "Mohave" as different search string objects. See also "Health and Healthcare of American Indian and Alaska Native Elders")

[Ft. Mojave was much improved and had a very fine hospital finished this year. "It was built of adobes with floor and ceiling, shingled roof and ventilator at the ridge of the whole length of the building. A porch of 10 feet wide surrounded the entire building. One ward had capacity for ten beds, and next to it was a half, five feet wide running across the building used as an isolation ward. Storeroom and dispensary were located in separate rooms. In the rear of the hospital building were the kitchen and mess hall. It had floors but no ceiling. The building was shingled, well lighted and ventilated, and well furnished with fixtures and furniture. The dead house was 160 feet from the hospital building, constructed of adobes with a shingled roof. Water was piped to the dead house, which also was used as a bathroom. (Shade trees would be set out the following year on the east and south sides of the hospital, adding greatly to the appearance of the hospital grounds.)"]

[An estimated 1,800 travelers were passing through Mohave County annually. It is not known how few or how many of them may have had the need to be treated at the hospital at Ft. Mojave or Camp Beale's Springs.]

 

[1874 - April: At least 560 Hualapai were forced to leave Camp Beale's Springs for the Colorado River Indian Tribes reservation at La Paz (near modern day Parker, Arizona). Dr. Reagles left Camp Beale's Springs when it was abandoned then and became the surgeon at La Paz. (He would serve there until November, and leave the Arizona Territory in 1878.)]

[August: Conditions on the reservation were thus described in an end of month official report: "They have been on the reservation four months, and their condition is deplorable; being mountain Indians, the heat of the place with a want of proper diet has produced an eruptive disease, which seems to have become almost epidemic. Many of their children are nearly blind, the result of glare of the sun and drifting sand."]

[Following the abandonment of Camp Beale's Springs by the military after eighteen months, its twelve adobe buildings were turned to be again a stage coach stop with hotel, restaurant and other facilities. (A five stamp mill and ranch would also eventually be put into operation at the Springs.)]

[Heroin was synthesized from opium this year. (It would find its way to the side of morphine -- a natural constituent of opium which was used as a painkiller during the Civil War painkiller --- and codeine as a patent remedy medicine.) (See also 1914)]

[For most U.S. medical students during and before the 19th century, apprenticeships with local physicians, supplemented by occasional clinical lectures with demonstrations, formed the basis of clinical education. After the Civil War, several U.S. medical schools had begun imitating European practice by extending the number of required terms for graduation and adding bedside and ambulatory teaching in the dispensaries and hospitals of large cities. But most U.S. medical schools, which were often proprietary enterprises started by a few local physicians, did not. In the 1870s, state legislatures took over the granting of medical licenses from county medical societies and substituted medical school graduation for the earlier requirement of apprenticeship. Consequently, by this time, "the apprenticeship deteriorated into a meaningless formality and the student often finished his formal education without ever having been alone with, much less having touched, a patient."(See also 1897, 1913)]

 

[1876 - Thirty ranches were listed on the tax records in Mohave County.]

[July: The nitrous oxide-ether sequence was introduced in the British Medical Journal along with an apparatus for its administration for anesthesia.]

[The telephone was invented. (Its rapid network integration would mark a radical change in patient access to individual physicians. Patients immediately used the telephone to contact physicians in emergencies. Indeed, the first telephone exchange would connect several Connecticut physicians to a central drugstore. Such pharmacy-based telephone services would proliferate, encouraging patients to rely on the pharmacies to store and relay messages for individual physicians. And from its inception, the telephone would engender concerns about privacy and security.)]

 

[1877 - October 26: Joseph Lister, for the first time under antiseptic conditions, carried out an operation which often resulted in generalised infection and death. (Opposition to Lister's work (see 1865) was great in England and the United States mainly against Lister's germ theory rather than against his "carbolic treatment." Edinburgh was regarded as a provincial centre, despite the ancient fame of its medical school. Surgeons were prepared to await for clear proof that antisepsis constituted a major advance. Lister knew that before the usefulness of his work would be generally accepted he must convince London.) When, in 1877, he was offered the chair of Clinical Surgery at Kings College, Lister's chance came: a simple operation of wiring a fractured kneecap, entailing deliberate convertion of a simple fracture into a compound fracture. News of the operation was widely publicized arousing much opposition. Its success was instrumental in forcing surgical opinion throughout the world to accept that his method's greatly added to the safety of operative surgery. Many honours now came to him. (See also 1865, 1887)]

 

[1878 - Dr. Joseph Lesene was practicing in the county seat of Mineral Park this year, along with Dr. E.S. Reese and Dr. W.A. Tompkins. This was about six miles south of the silver mining town of Chloride, also on the west side of the Cerbat Mountains, and about twenty miles northwest of Beale's Springs.]

[British physiologists recorded the heart's electrical current with a capillary electrometer and showed it consists of two phases (later called QRS and T). The device had been invented six years earlier. (See also 1895)]

[In Germany, by this time, Robert Koch was demonstrating the usefulness of steam for sterilizing surgical instruments and dressings based on Lister's work. (Two years earlier Koch's monumental work on the anthrax bacterium was published.) (See also 1881)]

[A New York surgeon, Stephen Smith, advised abolition of operating amphitheaters as dangerous to the patient and useless for the purpose of instruction. Surgical procedures at the time were performed and demonstrated while a simultaneous lecture was given to an enthusiastic surrounding audience, with no regard for contamination, sepsis or eventual pain. (The primary change to occur first would be separation of the operating room from the visitors' gallery by way of glass partitions. Movements of patients and personnel, air flow in the operating room, as well as other essential rituals would be defined and controlled so as to keep the environment free from contamination.)]

[From this year through 1887, A.T. Simonds owned the Beale's Springs property. It was described in tax records as "160 acres of land, water rights and known as Beale's Springs Ranch... consisting of adobe houses, frame house, garden and fencing." Simonds operated a stage coach stop, hotel, restaurant and bar. Another man had a general store there.]

 

[1880 - Mohave County pop.: 1,190.]

[Dr. James B. Lawrence was a contract surgeon for a mine at Mineral Park and also served briefly as Mohave County Treasurer this year]

[August: A "furious tornado visited [Ft. Mojave] post destroying company quarters and killing [four] and wounding two seriously... A heavy thunderstorm, rain, and hail of a fearful size fell in torrents, breaking windows, rearing up roofs, flooding floors and entirely demolishing the company's quarters in which there were thirty men. For a long distance to the north the ground was strewn with broken timbers, shingles, clothing, boxes, chairs, harness, etc. The post physician, while rushing over to the hospital, was knocked down by flying timbers and terribly bruised."]

 

[1881 - Dr. Edwin L. Burdick was the first doctor to comply with the territorial law requiring the registration of his diploma. He had graduated from Kansas City Medical College. This year he was elected the Mohave County Treasurer.]

[May 21: Clara Barton and a circle of acquaintances founded the American Red Cross in Washington, D.C. (A Civil War nurse, Barton (1821-1912) first heard of the Swiss-inspired International Red Cross Movement while visiting Europe following the War Between the States. She had followed her doctor's orders and traveled to Europe to rest and regain her health. It was during this trip that Barton learned about the Treaty of Geneva, which provided relief for sick and wounded soldiers. Twelve nations had signed the treaty, but the United States had refused. Barton vowed to look into the matter. During this time, Barton also learned about the Red Cross. She observed the organization in action while traveling with several volunteers to the front of the Franco-Prussian War. Returning home, she campaigned for an American Red Cross society and for ratification of the Geneva Convention protecting the war-injured, which the United States ratified in 1882. Barton would remain Red Cross president until 1904. During her tenure, she would head up relief work for disasters such as famines, floods, pestilence, and earthquakes in the United States and throughout the world. And while trained nurses had proven their value in the contained environment of the hospital, most people still initially believed that women lacked the strngth and the stamina necessary for disaster relief work. In every case the nurses proved the doubters wrong. The last operation Barton would personally direct was relief for victims of the Galveston, Texas flood in 1900. In addition, she would serve as an emissary of the Red Cross and addressed several International Conferences.)]

[Robert Koch (1843-1910) discovered the tuberculosis organism this year, launching a new awareness of the role of germs in disease, which strongly influenced the practice of medicine. (He would publish his classical work on the tubercle bacillus in 1882, discover the cause of cholera the year after that, and be awarded the Nobel Prize in 1905 for the tuberculosis discovery. His work in Africa and India resulted in at least partial success against malaria, typhus, human trypanosomiasis, and other tropical diseases.)]

[Samuel Siegfried Karl Ritter von Basch invented the sphygmomanometer to externally measure blood pressure. His device consisted of a water-filled bag connected to a manometer. The manometer was used to determine the pressure required to obliterate the arterial pulse. Direct measurement of blood pressure by catheterisation confirmed that von Basch's design would allow a non-invasive method to measure blood pressure. Feeling for the pulse on the skin above the artery, was used to determine when the arterial pulse disappeared. However von Bacsh's design never won a keen following, many physicians of the time being sceptical of new technology, claiming that it sought to replace traditional ideas of diagnosis. In addition, many questioned the medical usefulness of information about the blood pressure. (See also 1896, 1901, 1905)]

 

[1882 - The town of Kingman was established at an elevation of 3300 feet. It was northwest of the fifty mile long Hualapai Mountains and just to the southeast of the Cerbat Mountains, east of Beale's Springs. Kingman's origin was as a simple railroad siding in the Middleton Section along the newly constructed route of the Atlantic and Pacific Railroad. The numerous mines -- principally silver, gold, lead, and copper -- in the area were the reason for the siding. The Springs were one of the first sources of the town's water. (Six more counties had been established in the Arizona Territory by this time.)]

[November 5: The Mohave County Miner was established as the official newspaper of Mohave County in the county seat of Mineral Park.]

 

[1883 - February: The 'Steen House' near the Keystone Mine in Mineral Park was purchased for $111.11 in warrants on the General Fund so the structure could be used for County Hospital purposes.]

[March: A post office was established in Kingman and the first train pulled into town by month's end. The first depot was a boxcar. Railroad engineers laid out wide streets in the area to allow passage of buckboards and the long line (8 to 16) mule teams hauling heavy ore wagons back from the outerlying mines. The freight teams would also haul supplies and machinery out to the different mines.]

[The Hualapai Indian Reservation was established with almost a million acres of land. At the time, most of the Hualapai Indians were scattered throughout the area and not living on the newly established reservation.]

 
[1884 - Topical local anesthesia of the eye with cocaine was used for the first time for surgery in Germany.]
 
[1885 - Dr. H.E. Gale registered his diploma and set up practice in the new settlement of Kingman. He may have been the first "permanent" doctor in the new town.]
 
[1886 - Dr. David S. Livingston came to Kingman this year. Within three years he was living in the old Perry home "on top of the hill." He was paralyzed from the waist down, but his wife would harness his horse, help him into the buggy, and off he would go to see his patients.]
 

[1887 - Kingman became the fifth and final county seat. The Mohave County Miner trailed the move from Mineral Park to Kingman by mid-January. Dr. E.L. Burdick posted a bond of $1000 on April 5 as County Physician, but on May 14 that contract was transferred from Burdick to a Dr. Livingstone. No reason was given. (It is not known if this Doctor was actually the same one as mentioned above in 1886, but without the final "e" in his name.) Dr. W.N. Sherman also was in Kingman in 1887.]

[Due to the presence of a significant addiction problem in the country, Congress passed a bill prohibiting the importation of opium. (A huge black market would quickly develop for crude opium.)]

[Amphetamines, the first major synthetic drug, was discovered and its use as a stimulant quickly became widespread.]

[Colour printing was introduced in the 11th edition of Gray and Carter's Anatomy Descriptive and Surgical. New techniques of photolithography and half-tone were not as yet perfected, and their results during the next few decades resulted in inferior illustrations. (For the 1905 16th edition, these attempts would be jettisoned and the illustrations replaced with newly commissioned wood engravings or line drawings intended to harmonize with Carter's original figures. Carter had died eight years earlier.) (See also 1858, 1938)]

[The Johnson & Johnson Company was incorporated. (Eleven years earlier Robert Wood Johnson had heard Joseph Lister speak on his theory of antisepsis. For years afterward, Johnson nurtured the idea of a practical application of Lister's teachings. Lister's methods required complex and cumbersome equipment suited only to the largest hospitals, of which there were few. A solution or a spray of carbolic acid bathed the operating room and the patient in a foggy mist. Johnson concluded there ought to be a better way, so he joined a partnership with his two brothers in 1885 and opened a company with 14 employees the following year.) The first products were improved medicinal plasters containing medical compounds mixed in an adhesive. Next came a soft, absorbent cotton and gauze dressing that could be mass produced and shipped in quantity to hospitals and every crossroads physician and druggist. (In 1888 the Company would publish "Modern Methods of Antiseptic Wound Treatment," which for many years would remain the standard text on antiseptic practices.) (See also 1865, 1877, 1890, 1892, 1897, 1920, 1951, 2002)]

[Herbert Burrell, a surgeon at Boston City Hospital, made several seminal observations on clinical biomechanics and spinal cord injury. The prevailing attitude of Burrell's contemporaries toward spinal cord injury was one of extreme pessimism, a view not entirely unjustified given a mortality rate >70% at that time. Burrell, however, noted that there were patients presenting with spinal fractures and neurological deficits who recovered if immediate intervention was taken. Therefore, he strongly argued for the biomechanical principle of immobilization, admonishing the police, hospital attendants, medical students, and even house officers to keep their "hands off" patients with spinal cord injuries. Even the surgeon was told to examine the patient only by turning the body as a whole. He then broke further from conventional thought by emphasizing the urgent need for spinal reduction and external immobilization. Writing this year on his experiences with 16 patients using this therapeutic philosophy, he remarked: "First: That, in the immediate correction of the deformity and fixation with plaster-of-Paris jacket or other means, we have a rational method of treating a large number of cases of fracture of the spine. My own belief regarding the status which the procedure should occupy in surgery is, that it will occasionally be a life-saving measure and that apart from the chance of recovery offered to the patient by this means, it will almost invariably make the patient more comfortable, in that he can be handled more easily" (italics are Burrell's). His results reflected the soundness of his thinking. Ten of the sixteen patients treated in this manner were greatly improved. (The need for immediate reduction would become so important in Burrell's mind that by 1905 he would be advocating open reduction if closed reduction failed. His conclusions were sound and for the most part would be followed in the modern management of patients with spinal cord injuries. The major shortcoming of Burrell was his inability to divide spinal fractures into different categories based on the mechanism of injury and the pathological abnormality produced.)]

 

[1889 - Richard Taggart became owner of the Beale's Springs property, and had an adobe dwelling, fences and five acres of land known as Grape Vine Spring. (He would own the property for the next few years. During this time, the County tax records would show that a poor farm and hospital were in operation at Beale's Springs, and new buildings were erected for that purpose.)]

[Andrew Taylor Still (1828-1917) was an American frontier doctor who was convinced that 19th century patient care was severely inadequate. This resulted in an intense desire on his part to improve surgery, obstetrics, and the general treatment of diseases, placing them on a more rational and scientific basis. This was in no small part especially because of the loss of his three children to cerebrospinal meningitis in 1864 shortly before he returned home from Civil War service as a hospital steward and military surgeon. While Still practiced the orthodox medicine of his day from 1853 to 1879, including the use of oral medications such as purgatives, diuretics, stimulants, sedatives, and analgesics, and externally applied salves and plasters, once he began using his new philosophical system he virtually ceased using drugs. This occurred after several years where he experimented with combinations of drugs and manipulative treatment. In addition, he compared his results with those of patients who received no treatment at all. After several years' experience, he became convinced that his mechanical corrections consistently achieved the same or better results without using medications. He dissected numerous cadavers to understand the construction of the human body. In his view, it was the job of the physician to correct structural disturbances so that the body works normally, just as a mechanic adjusts his machine. "Bones can be used as levers to relieve pressure on nerves, veins and arteries."

As his perspectives and clinical understanding evolved, Still created an innovative system of diagnosis and treatment with two major emphases. The first highlights treatment of physical and mental ailments while emphasizing the normalization of body structures and functions. Its hallmark was a detailed knowledge of anatomy that became the basis for much of his diagnostic and clinical work. The second emphasizes the importance of health and well-being in its broadest sense, including mental, emotional and spiritual health, and the avoidance of alcohol and drugs, and other negative health habits. The system, officially named osteopathy in 1889, "...is the law of mind, matter and motion." (See also 1892, 1896, 1900, 1911)]

 

[1890 - Mohave County pop.: 1,444 ; Kingman pop.: 322]

[William Stewart Halsted (1852-1922) was the first surgeon-in-chief of the new Johns Hopkins Hospital, established in 1889. (Its School of Medicine would open in another four years.) Halsted pioneered many surgical operations, including radical mastectomy and safer inguinal hernia surgery. In the winter of 1889/90, the nurse in charge of his operating room complained that the solutions of mercuric chloride produced a dermatitis of her arms and hands. As she was an unusually efficient woman, Halsted gave the matter his consideration and one day in New York requested the Goodyear Rubber Company to make as an experiment two pair of thin rubber gloves with gauntlets. On trial these proved to be so satisfactory that additional gloves were ordered. In the autumn, on his return to town, an assistant who passed the instruments and threaded the needles was also provided with rubber gloves to wear at the operations. At first the operator wore them only when exploratory incisions into joints were made. After a time the assistants became so accustomed to working in gloves that they also wore them as operators and would remark that they seemed to be less expert with bare hands than with the gloved hands. It was a coincidental observation that the incidence of asepsis decreased for gloved procedures.]

[Hopkins ushered in a new era marked by rigid entrance requirements for medical students, a vastly upgraded medical school curriculum with emphasis on the scientific method, the incorporation of bedside teaching and laboratory research as part of the instruction and integration of the School of Medicine with the Hospital through joint appointments. The new model also created standardized advanced training in specialized fields of medicine with the creation of the first house staff fellowships and post graduate internships. The basic scientists and later the clinicians were free to do research by having a full-time salary, a departure from the tradition of employing part-time local practitioners to teach classes. Another innovation assured higher quality applicants: rigid entrance examinations after prerequisite college education, heavy on basic science - chemistry, physics, biology - and rigid entrance examinations, were expected of all students who ventured into a Hopkins medical school classroom. Classes were small and involved hands-on training with patients, a departure from the old lecture format. From the start, talented women were permitted to enroll, breaking a prohibition that many older schools held for decades. Medical research by both faculty and students was fostered as part of the educational process and as integral to patient care. The "clinician-scientist" became a Hopkins hallmark. Study was rigorous and lasted four years, including unprecedented hours of bedside learning at the side of experts, original research projects guided by respected clinicians, and extensive laboratory training. Then came postgraduate education in the Hospital for interns and residents, an innovation that became the model for the postgraduate clinical education of the 20th century. Hopkins' "products" soon were in demand across the country.]

[The first case report of continuous oxygen therapy was published in 1890. Oxygen, discovered in 1774 by Joseph Priestley, was employed for medical purposes shortly afterward. For almost the entire nineteenth century, oxygen was prescribed only for intermittent use. (Nevertheless, it would not be until well into the twentieth century that oxygen therapy was placed on a rational, scientific basis.)]

[In response to a doctor's complaints of patient skin irritation caused by the Company's plasters, Johnson & Johson sent a container of Italian talc to soothe the skin. The talc began to be packaged with the plasters, and soon customers were asking for more of the powder. (The scented talc would soon be sold as Johnson's® Baby Powder, which would remain one of the most recognized and trusted products in the world.) (See also 1887, 1897, 1920)]

[About 60,000 head of cattle and 5,000 goats ranged the mountains and mesas of Mohave County. Some 2,000 acres (alfalfa, barley and vegetables) were under cultivation in the valley of the Big Sandy Wash, some seventy miles away from town.]

[Also this year Dr. Herman Hardwick, a contract surgeon for the Atlantic & Pacific Railroad, registered his diploma to practice in Kingman. (Coming from New Mexico, he would practice here until his retirement in 1908.)]

[July 1: Ft. Mojave was abandoned and the buildings were placed in the hands of the Indian school superintendent. An industrial school was to be opened up for the Mojave, Hualapai and Chemehuevi Indian children, as soon as the soldiers were removed. (See also 1863, 1873, 1934)]

 

[1891 - Dr. J.S. Dean set up practice in Kingman.]

[British surgeon Joseph Lister saw the cumulation of his emphasis on the principle of preventative medicine with the opening of the Lister Institute of Preventative Medicine this year. (See also 1865, 1877)]

 

[1892 - Dr. J.G. Bryant set up practice in Kingman and registered his diploma.]

[Dr. Joshua Miller, then president of the Maricopa County Medical Society, along with four other physicians, sent a letter to all of the physicians of Arizona, calling a meeting to organize a Territorial Medical Society. A few days later, Dr. Miller was elected the first president of the newly-formed nine-member Arizona Medical Association.]

[May: The 22 unknown and 38 known sets of remains from the Ft. Mojave Cemetery were carefully removed, boxed, labelled, shipped to and reinterred in the San Francisco National Cemetery. One of the known sets belonged to hospital steward John Houghton.]

[By early this year, Johson & Johnson's year-old bacteriological laboratory successfully met the requirements for making true sterile products through a continuous method of handling dressings under asceptic conditions while employing first dry heat and then steam and pressure. (See also 1887, 1920)]

[The first successful school where osteopathy was taught, the American School of Osteopahty, was chartered in May and opened that fall with a class of about 21 men and women. The faculty consisted of Andrew Still and Dr. William Smith, a physician trained in Edinburgh, Scotland, who taught anatomy in exchange for learning osteopathy. (See also 1889, 1900, 1901, 1911)]

 
[1893 - Dr. Alexander M.Cowie began practicing in Kingman and Dr. H.B. Bessac listed White Hills as his residence.]
 
[1894 - November: Two doctors at Massachusetts General Hospital introduced the anesthetic record.]
 

[1895 - Dr. R.M. Taylor claimed Cedar as his home, south of the present Boriana Mine.]

[Different from both osteopathy and allopathic medicine is chiropractic, founded by one Daniel David ("D.D.") Palmer this year in Davenport, Iowa. The term chiropractic comes from the Greek "to work by hand." D.D. developed spinal manipulation as the way to cure ills, since most sickness, he believed, arises from vertebral mis-alignment that affects nerves. A mis-aligned vertebra, called "vertebral subluxation," puts pressure on the nerves and lowers the body's resistance to disease. Originally chiropractic and osteopathy were considered similar, since both eschewed drugs and surgery. (See also 1889, 1987)]

[A Dutch researcher, Einthoven, using an improved electrometer and a correction formula, distinguished five deflections in the electric current of the heart's action which he named P,Q,R,S,and T. (See also 1878, 1901, 1938)]

[German physicist Wilhelm Conrad Rõntgen announced his discovery late in the year of a "new kind of ray." (The description of the ability to see through the body with these X-rays was greeted by many with considerable incredulity and early descriptions made pains to reassure the public that this was indeed a serious discovery by a respected scientist. The clinical use of the readily available apparatus was appreciated immediately. The apparatus would gradually be improved and hospitals started to acquire the equipment. Within a few months many who worked with the machines developed signs of radiation injury due to the absence of protection.) (Rõntgen would be awarded the Nobel Prize in 1901.)]

 

[1896 - Cloth masks were first used in surgery this year.]

[Scipione Riva-Rocci developed the mercury sphygmomanometer. This design was the prototype of the modern mercury sphygmomanometer. An inflatable cuff was placed over the upper arm to constrict the brachial artery. This cuff was connected to a glass manometer filled with mercury to measure the pressure exerted onto the arm. (See also 1881, 1901, 1905)]

[The first legislative recognition of osteopathic practice came from Vermont in 1896, where graduates of the American School of Osteopathy, Kirksville, MO were accorded the right to practice in that state. (A student organization would begin there the following year under the name of American Association for the Advancement of Osteopathy. It would be renamed the American Osteopathic Association in 1901, a regulatory group no longer under student control.) (See also 1889, 1892]

 

[1897- Johnson & Johnson developed an improved sterilizing technique for catgut sutures. (Two years later the Company would introduce the zinc oxide type of adhesive plaster. With greater strength and quick-sticking quality, this type of plaster avoided skin irritation and would become an important adjunct to surgery.) (See also 1887)]

[A German physician successfully used a primitive bronchoscope to remove a small piece of bone from the right main-stem bronchus of a 63-year old timber sawyer with dyspnea and hemoptysis. An electric headlight provided illumination for the rigid scope. (See also 1964)]

[An editorial in the Journal of the American Medical Association made a plea for the relevance of internship, expounding on the benefits of hospital-based internship. Postgraduate hospital training provided unmatched experience with patients, diseases, and physical diagnosis. Many graduating students, however, felt financial pressure to start practice immediately. And not all medical schools had the funding of hospitals and affiliations with endowed universities to be able to provide professors with both clinical practices and salaries. Without good faculty supervision, interns' errors went uncorrected, to the detriment of patient, hospital, and clinical education. As a result, as late as 1900, internships remained unpopular with both hospitals and students. For those graduate students who could afford the trip, European hospitals and clinics in Berlin, Vienna, or Paris provided many opportunities. (See also 1874, 1913, 1924 )]

 

[1898 - By this year, a plant in Kingman made ice which "was available to those who were lucky enough to have an ice box and could afford to buy the ice." An ice box consisted of an insulated compartment for the ice and another for the food.]

[Also this year, Dr. J.W. Flinn started practicing medicine in Kingman, coming to Arizona to recuperate from tuberculosis. (In 1902 he would move on to Prescott to set up a tuberculosis sanitorium there. He would live there until his death in late November 1944.)]

[Dr. Ancil Martin brought the first x-ray apparatus to Arizona this year. Practicing in Arizona from 1892 to 1926, he was president of the Arizona Medical Association in 1894.]

[May 2: The founding meeting of the Association of Medical Librarians was held in Philadelphia, PA.]

[August 16: The first operation with spinal anesthesia was performed at the Royal Surgical Hospital of the University of Kiel, Germany. The patient had suffered severe adverse effects from previous general anesthesia, so the surgeon suggested giving "cocainization of the spinal cord." Intraoperatively the patient felt no pain at all. Some vomiting and headache were present after surgery, but the adverse effects were minimal compared with the patient's previous experience. (Dr. August Bier would introduce the intravenous regional anesthia, the so-called Bier block. In addition to his many scientific and clinical papers and lectures, he would also develop new concepts for forestry as well as the famous "steel-helmet" for the German soldiers of World War I.) (See also 1928)]

[The induction of nitrous oxide anesthesia with face mask and maintenance of anesthesia with nasopharyngeal insufflation was described.]

[The second x-ray machine west of the Mississippi was installed at the American School of Osteopathy in Kirksville, MO this year. (See also 1892, 1910)]

[By this year, surgical amphitheaters had disappeared and either became small appendages of surgical wards, or were rebuilt to incorporate separation of the performers from the observers.]

 

[1899 - Spring: The Mohave County Medical Society was founded by Drs. R.B. Knight (president), J.W. Flinn (vice president), and A.M. Cowie (secretary).]

[Dr. Ealy was another one of the pioneer doctors in Kingman. If someone was seriously ill elsewhere in the county, the doctor would be summoned and arrive at bedside in a day or two. The patient either got better or didn't. The doctor would then stay for several days and treat any others in the area who were ill at the time. On occasion the doctor might advise the patient, if he or she would be able to survive the trip, to be taken at once to Los Angeles to undergo treatment under the care of a specialist.]

[Dr. Cowie recorded this year his knowledge of a private surgical facility that was located in the rear of the northeast corner of Third and East Beale Street. It was known then as the Locust Inn or Locust Rooming House.]

[Also this year, Kingman's first telephone directory with 23 listings was published in the local paper.]

[Dr. Rudolph Matas from New Orleans reported this year the use of endotracheal intubation using an apparatus he developed for endotracheal intubation and anesthesia. (The field of thoracic surgery would be able to be created because of this procedure.]

 

[1900 - Mohave County pop.: 3,426 ; Kingman pop.: approx. 550. There were 122,931 people in the Arizona Territory, and about 76 million in the United States.]

[The estimated life expectancy for persons born this year in America was 47.3 years (46.3 for males of all races, 48.3 for females of all races). The ratio of physicians to the population in the United States was up to 173 per 100,000. At this time there was an oversupply of poorly trained physicians that had been produced by an unregulated, largely proprietary system of medical education.]

[Poliomyelitis, the infectious viral disease that attacks the nerve cells and sometimes the central nervous system, often causing muscle wasting and paralysis and even death, has been around since ancient times. Especially since 1900 there would be cycles of epidemics, each seeming to get stronger and more disastrous. The disease, whose early symptoms are like the flu, struck mostly children, although adults caught it too. Vaccine developments for polio would begin in the early 1900's. However, early attempts would fail, partly because researchers did not know there was more than one virus. Ironically, before the 1900's, immunity was acquired primarily during infancy because sanitation conditions were poor and efforts at sewage and water treatment were primitive. Babies were frequently exposed to polioviruses. These infants did not contract the disease because their mothers¹ antibodies were passed on to them through breast feeding. The babies then developed their own antibodies to the virus. Paradoxically, when sanitation improved, infants were no longer exposed at an age when they were protected, so they did not develop antibodies to the viruses. Consequently, when they were exposed to the virus in later childhood and adulthood, they were at risk to contract polio. Ten percent of infected people developed symptoms and one percent developed the paralytic form of polio. (See also 1938, 1955, 1963)]

[By this time there were over 700 students at the American School of Osteopathy with a faculty of 18. In addition, there were more than a dozen "daughter" schools founded by graduates of the original school. (See also 1889, 1892, 1898)]

[About this time, with the growth of an educated nursing profession and a new sense of sanitation, hospitals began to be -- at the very least -- safe. Many small institutions were privately owned by surgeons who furnished hotel services and nursing for their own patients. New general hospitals began to appeal to patients other than the poor, and patient fees began to help with facility development.]

[December: A newspaper article notes that Dr. Cowie advised a young boy be taken at once to Los Angeles under the care of a specialist to undergo treatment for appendicitis.]

 

[1901 - Walter E. Sauls (Schott?) was a dentist operating out of room 14 of the Hotel Beale in downtown Kingman by this year. His work was guaranteed and the locals could save a trip to Los Angeles. Like other businessmen at the time, he would have some involvement with mining claims in the area and hire a few men to work the site.]

[Dr. John R. Whiteside was the druggist in Chloride.]

[Riva-Rocci's sphygmomanometer was spotted by the American neurosurgeon Harvey Cushing while he was travelling through Italy. Seeing the potential benefit he returned to the US with the design this year. After the design was modified for more clinical use, the sphygmomanometer became commonplace. (See also 1881, 1896, 1905)]

[Dutch researcher Einthoven invented a new galvanometer for producing electrocardiograms (ECGs) using a fine quartz string coated in silver. This "string galvanometer" weighs 600 pounds. (Four years later he would start transmitting ECGs from the hospital to his laboratory 1.5 km away via telephone cable. And in 1924 he would be awarded the Nobel Prize for inventing the electrocardiograph.) (See also 1895, 1928)]

[A surgeon wore head mirrors to reflect light and augment visualization and used access technique in which a speculum was introduced through an incision in the prior vaginal fornix. Also this year, the first experimental laparoscopy was performed in Berlin by a surgeon who used a cystoscope to peer into the abdomen of a dog after first insufflating it with air. (See also 1867, 1938, 1961)]

[Dr William Smith returned to the UK by this year after teaching anatomy at the American School of Osteopathy in Kirksville, MO and commenced practising in Dundee. (See also 1892, 1911)]

 

[1902 - Arizona Medical Association Founding President Dr. J.A. Miller died. Membership in AzMA was over 100 for the first time. Eighty-five percent of Arizona physicians were members.]

[May: H.H. Watkins installed a soda water fountain at the Pioneer Drugstore in Kingman to supply the thirsty with all kinds of temperance drinks.]

[Dermatologist William Pussey was the first to use radiation therapy to treat Hodgkin's disease, a malignant condition of lymph tissue.]

 

[1903 - The Arizona Territorial Board of Health was created. Dr. Whiteside represented Mohave County to the Territorial Legislature and introduced, and secured, passage of Arizona's first Public Health Law. (When Arizona became a state nine years later this law was rewritten but little changed.) The two year old Board of Medical examiners was revised.]

[A Dr. Dundon and his wife were living in Cerbat at year's end.]

 

[1904 - June: A fire started in the County hospital and destroyed two other buildings as well. "Yesterday [June 3] morning about 3:30 o’clock the hospital at the Harrington House was discovered to be on fire and the alarm was give, which brought nearly the entire population of the town. Efforts were made to stay the flames, but there was little water and practically no means to fight the fire, and in a few minutes the main building was in flames. Practically everything in the Harrington House was saved: however, from the Harrington House the flames spread to the Quinones building on the west, and in a few minutes both buildings were consumed: and the Brawn residence on the east was burned through in many places. The fire is supposed to have been the work of one of the patients." (County records dated Jan. 4 show payment for the County hospital and poor farm building in amount of $5,612.95. This was probably the same building which burned down five months later.)]

[There was a serious drought in the area at this time.]

 

[1905 - February: The newspaper's edition on the 25th stated that "Dr. J.P. Wallace returned from Burro Creek Tuesday last.  He was compelled to stay at the mines some time longer than he anticipated by the great floods in Burro Creek." A month later the paper noted that two other gentlemen "and Dr. J. P. Wallace, returned from the Big Sandy Tuesday last, being unable to reach the mines of Burro Creek, owing to the high water." (No other reference to this doctor has yet been found in our researchers.)

[April: The County Board of Supervisors appointed Dr. A.E. Ealy as county health inspector.]

[May: An issue of the Journal of the American Medical Association saw fit to include the following: "The automobile is becoming an important element in our civilization. The record of accidents from its use is becoming appalling. Since January 1 there are said to have occurred in New York City and vicinity no less than seven hundred and nonety-three automobile casualties... If this can happen in one city it is not pleasant to think of the possibilities for the whole country. We do not vouch for the figures--which would seem to justify a popular uprising--but, even if exaggerated many fold, seem to demand action. Much of this record, if not all of it, may be credited to high-speed automobiling... One New York millionaire is reported to have thirteen accidents to his credit, two of them fatal and nine causing permanent injuriy. As physicians are beginning to use automobiles very largely, we hope and trust that our profession will keep its record clean in this matter.]

[Cocaine had been widely used as a local anesthetic after its effectiveness was demonstrated in 1884. By the end of the 1800s, however, the addictive properties of cocaine had been recognized. Doctors, realizing they needed to develop substitutes for cocaine's active anesthetic ingredient, carefully studied the exact chemical structure of cocaine. Many of the first synthetic cocaine products that were developed were too irritating to be of any practical use. In 1905, procaine was discovered by a German researcher and given the trade name Novocaine, from the Latin novus ("new") plus cocaine. Novocaine soon showed that it had all the positive effects of cocaine with none of that drug's drawbacks. Injected by needle, the substance immediately became popular in Europe and America as a local anesthetic for both medical and dental purposes. (See also 1948)]

[The sphygmomanometer could only be used to determine the systolic blood pressure. Observing the pulse disappearance via palpitation would only allow the measuring physician to observe the point when the artery was fully constricted. Nikolai Korotkoff was the first to observe the sounds made by the constriction of the artery this year. Korotkoff found that there were characteristic sounds at certain points in the inflation and deflation of the cuff. These Korotkoff sounds were caused by the abnormal passage of blood through the artery, corresponding to the systolic and diastolic blood pressures. A crucial difference in Korotkoff's technique was the use of a stethoscope to listen for the sounds of blood flowing through the artery. (This auscultatory method proved to be more reliable than the previous palpitation techniques and would thus became the standard practice. In the meantime, however, many physicians chose to use the cuff in a manner that preserved their exclusive use of the new tool and maintained a high level of skill for their individual practices. An early proposal to introduce the new blood pressure cuff as a simple tool for nursing met with resistence.)(See also 1881, 1896, 1901)]

 

[1906 - An increased rate of pregnant women were going to hospitals to have pain-free childbirth. "Twilight Sleep" was introduced by this year to women as a method to reduce discomfort in childbirth. Morphine was given first, then followed by scopolamine (derived from either the herbs belladonna, jimsonweed, or mandrake). Ether or Chloroform would follow on the delivery of the baby's head, and amnesia for the new mother was a side effect. Maternal and neonatal respiratory depression and maternal delirium often occurred. (This chemical technique would be used up to the 1920s with variation up to the 1950s).]

[George Crile reported that blood transfusion in 14 patients was done by direct vascular anastomosis between donor and recipient. This avoided contact with foreign materials and, thus, clotting. This was accomplished before effective, safe methods of anticoagulation had been developed. (See also 1937)]

 

[1907 - January: The Food and Drug Act of 1906 went into nationwide effect "For preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein, and for other purposes." (See also 1938, 1962)]

[The first organization devoted to osteopathic research began, though the first recorded osteopathic research was done almost a decade earlier.]

[Clarence E. Yount Sr., MD, of Prescott, along with Dr. H.D. Thomason of Fort Whipple, gave the first spinal anesthesia to a patient in Arizona.]

 

[1908 - May: For $2,000 the County purchased the Beale's Springs ranch which had recently had its mortgage foreclosed. The property was to be used "for care of the indigents of the County, sick and well admitted to the County hospital and poor farm including medicine, attendance, food, lodging and other supplies necessary for their maintenance in a manner satisfactory to said Board of Supervisors."]

[September: "…the board of supervisors let the contract for hospital buildings to J.N. Cohenour for the sum of $3,579, being the lowest bid received. Mr. Cohenour will commence work on [repairing] the buildings at once."]

[Continuous chlorination of drinking water began in the early years of this century in Great Britain, where its application sharply reduced typhoid deaths. Shortly after this dramatic success, chlorination was begun in Jersey City, N.J., in 1908. (Adoption by other cities and towns across the US would soon follow and result in the virtual elimination of waterborne diseases such as cholera, typhoid, dysentery, and hepatitis A. Before the advent of chlorination for drinking water treatment, typhoid fever killed about 25 out of 100,000 people in the US annually, a death rate approximating that now associated with automobile accidents. The filtration and disinfection of drinking water would be responsible for a large part of the 50 percent increase in U.S. life expectancy in this century. By the beginning of the 21st century, some 98 percent of systems that treat water would employ chlorine-based disinfectants, with more than 200 million Americans and Canadians receiving chlorine-disinfected drinking water every day.)

Chlorine's most important attributes are its broad-spectrum germicidal potency and persistence in water distribution systems, providing residual protection against microbial regrowth. It also would be used to control taste and odor problems by oxidizing many naturally occurring substances such as foul-smelling algae secretions, odors from decaying vegetation, hydrogen sulfide and ammonia.]

 

[1909 - The Desert Power & Water Company's powerhouse in Kingman became operational, supplying inexpensive electrical power to area mines, homes and businesses.]

[The caudal (at the base of spine or tail) epidural administration of anesthesia for a woman about to deliver was first used this year. (Other methods/positions would be tried over the years and the lumbar (lower back) technique would be described in 1921.)]

 

[1910 - Mohave County pop.: 3,773 ; Kingman pop.: 900 (voting precinct).]

[About 75% of all males at age 65 were still in the work force.]

[March: "Quite a number of patients are now in the county hospital. Last week there was thirteen in all and more are being added daily. The place is under the management of George Atmore and is kept in the best possible shape. Trees are being set out around the hospital ground and garden truck has been planted in the lower part of the ground. Before summer is over the place will present a most pleasing picture. Supervisor Potts is taking a great interest in the beautifying of the county farm and it will not be long until he has it one of the model farms of the southwest."]

[April and May: The world during the day talked about and at night watched as Halley's Comet made its closest fly-by to our planet, possibly brushing us with its tail. (Halley, as photographed over Flagstaff, AZ, 120 miles east of Kingman)]

[Most people in town dug or drilled their own wells and, due to all the breezes in the area, had windmills for pumping the water. Kingman was called the "City of Windmills" for many years around this time. And between 1881 and this year, some twenty doctors recorded their diplomas in the county. Children died of communicable diseases like diptheria and whooping cough. Dysentery was a great killer. Death also led to many second marriages. Men were killed in accidents; wives died in childbirth. Tuberculosis and pneumonia were also rampant.]

[In photography's earliest era, most middle- and working-class families could not afford to have a photograph taken. The expense could not be justified during one's lifetime, but at death it was the only way to preserve the visual memory. Taking a photograph of a deceased loved one, and even posing with one, became a normal part of Amercian culture until the second decade of the 20th century. Childhood mortality, especially, ranged from 30 to 50 percent and children died quickly from a wide variety of infections, some looking quite healthy in their posthumous photos.]

[August: "It is being reported that the big stone building now being erected on Pine street by James Pendegast will be opened as a sanitarium when completed."]

[Also, early this month, Amy Cornwall Neal boarded the train in Kingman for the 350-mile journey to Los Angeles to give birth to her first son, John Leonard, six weeks later. She had travelled for two days by pack mule from Burro Creek Ranch north to the Big Sandy Wash (near present day Wikieup), and then three days in wagon northwest to Kingman. As this town did not have adequate hospital facilities at the time, she and husband John elected to have their baby born at the Queen of Angels Hospital, attended by a doctor, a practically unheard of innovation in that age of home-births and midwives. (Four years later the couple's second son would be born at the small hospital in Prescott. Otherwise, most of the accidents and illnesses around the various ranches were handled with a mixture of basic first aid, common sense and a reliance on the body's own ability to heal itself. "You got better or you didn't get better." See also 1933)]

[Especially during the past two decades, as Kingman grew and the roads to it were improved, the town's demand for fresh fruits and vegetables increased. The gardens in the Big Sandy Valley were made larger and more and more farm produce was freighted to the county seat about seventy miles away, usually in the bed of the farmer's wagon, protected by loose hay and cooling damp sacks. The trips were many months apart. The farmer would return home after a few days with store-bought or traded-for whole-bean coffee, sugar, flour, baking soda, kerosene oil, wicks and chimneys for the lamps, a bolt each of calico and denim, a few yards of lace, hats and shoes -- whatever was on his wife's list.]

["Medical Education in the United States and Canada," quite possibly the most important written document in the history of American and Canadian medical education, was published this year. It is known today as the Flexner report, after its author who researched the paper for the Carnegie Foundation. The Flexner Report triggered much-needed reforms in the standards, organization, and curriculum of North American medical schools. At the time of the Report, many of the 150 medical schools were proprietary trade schools operated more for profit than for education. In their stead Flexner proposed medical schools in the German tradition of strong biomedical sciences together with hands-on clinical training. Flexner found only five that he thought were adequate, and he held up Johns Hopkins as the model. The Flexner Report caused many medical schools to close down and most of the remaining schools were reformed to conform to the Flexnerian model. Eight osteopathic schools remained when the dust settled. Kirksville was the largest osteopathic hospital at the time with 54 beds. (Six of those schools would survive into the new millennium.) (See also 1890, 1892, 1900, 1913]

[Cornell University Medical College in New York first published an American review of electrocardiography. The recordings were sent from the wards to the electrocardiogram room by a system of cables.]

 

[1911 - The first laparoscopic surgery was performed in the U.S. by a Johns Hopkins Hospital physician who used a proctoscope of a half inch diameter and ordinary light for illumination. And in Stockholm this year, a surgeon used the three-faced laparoscopic instrument on the thorax and abdomen without inflating the abdomen. (See also 1867, 1901, 1929, 1934, 1938)]

[An organisation called the British Society of Osteopaths changed its title to the British Osteopathic Association (BOA). It was the formal wing of the American Osteopathic Association (AOA) for American trained osteopaths ‘to uphold the professional ethical standards and to provide the public with a list of trained and qualified osteopaths, to advance osteopathy and to maintain a professional spirit’. Members were also eligible for membership of the AOA. As in the case of other associations, membership was purely optional and there were “doubtless osteopaths with equal qualifications outside its ranks.” (See also 1896, 1901)]

 

[1912 - February 14: "At precisely the hour of ten o'clock Wednesday morning, President Taft affixed his signature to the proclamation making Arizona the forty-eight [sic] state of the Union. The news was received in Kingman by the firing of forty-eight heavy charges of dynamite and demonstrations of joy throughout the town."]

["At that time, three main trails made their ways south from the Mohave County seat at Kingman in the northwestern corner of the state. There was the Old Fort Mohave-Prescott Road through Willows and Fort Rock then through Prescott to Phoenix. As well, a westerly route crossed the Colorado into California at Needles, then came back into Arizona on the railroad crossing at Parker and on through Wickenburg to Phoenix. The most direct path, however, was the central trail down the Big Sandy River valley, through the Aquarius Mountains, across Burro Creek and on to Phoenix, via Hillside and Wickenburg. This one was about half the distance, but passable only on foot or by horseback, for at times the track was little more than a burro trail."]

[From 1881 through 1910 some twenty doctors had recorded their diplomas in Mohave County. There were several more doctors here and similarly in the other counties during that time, however, as indicated by the results of a change in the law because of Statehood this year. All doctors practicing in the State were now required to have a license issued by a Board of Medical Examiners and that license had to be recorded in the County of Practice. The following year would see a recording of licenses of several doctors who had previously neglected to record their diplomas.]

[Soon after 1910, a Kingman house south of the railroad tracks was used to house "county" patients. Then Mrs. Catherine Nichols, a trained nurse, opened a small nursing home which was largely a maternity facility. A Mrs. Pruitt was a registered nurse who went to individual homes to practice her profession.]

 

[1913 - The 1912 fourth quarter report for the Mohave County Farm and Hospital listed total expenditures of $1,043.78. W.P. Carr, the Superintendent, stated to the County Board of Supervisors that "25 Inmates were supported 824 days, making an average cost per day for each Inmate [about] $1.20."]

[The Arizona State Board of Health and the Arizona State Board of Pharmacy were created this year and the Board of Medical Examiners was recreated.]

[The mortality rate for the three different types of community-acquired bacterial meningitis in the U.S. during the first decade of the 20th century had been 75-100%. This year intrathecal equine meningococcal antiserum was first used and the mortality for meningococcal meningitis was reduced from 75% to 31%. (See also 1945)]

[The first refrigerator, as opposed to the simple ice box, designed for home use was the Domelre, manufactured in Chicago this year. (The following year would see the first household mechanical refrigerator and the next the first self-container refrigerator for household use. The two dozen models available by 1916 would blossom to over 200 by the decade's end. Steel and porcelain cabinets would be offered by the mid-20s.)]

[The American College of Surgeons was formed this year. (The American College of Physicians would be established two years later as the emergence of medical specialties began to take place. (See also 1950)]

[Partly due to the Flexner Report and partly due to substantial philanthropy by Johns Hopkins, John D. Rockefeller, and others, several influential U.S. medical schools were established along European lines. This provided the catalyst for several state governments to consolidate the better medical schools and establish university hospitals. Thus, while the number of medical schools had shrunk by 25% or more in the early 1900s compared with the 1890s, graduates were better trained. By 1913, 70% of new medical graduates were electing internship. As the graduates became more desirable, hospital demand for interns increased. (See also 1874, 1897, 1910, 1924)]

 

[1914 - The National Old Trails Highway wound its way through Kingman bringing an ever-increasing amount of automobile traffic. Also, the old lumber courthouse was replaced by a larger one made of stone. (This is the domed Superior Court building of today at 401 E. Spring Street.)]

[Practicing in both Chloride and Kingman, Dr. John R. Whiteside died of virulent tuberculosis this year.]

[Originally discovered in 1874 by an English chemist, a morphine derivative and substitute was launched by the former German dye factory Bayer in 1898 under the trademark name of Heroin (the supposed "hero" of medicines). Claims were made that it "was 10 times more effective as a cough medicine than codeine, but had only a tenth of its toxic effects. Heroin was also more effective than morphine as a painkiller. It was safe and it wasn't habit-forming." In short, it was a wonder drug - the Viagra of its day, so to speak. This met what was then a desperate need - not for a painkiller, but for a cough remedy. Tuberculosis and pneumonia were then the leading causes of death, and even routine coughs and colds could be severely incapacitating. Heroin, which both depresses respiration and, as a sedative, gives a restorative night's sleep, seemed a godsend. By 1899, Bayer was producing about a ton of heroin a year, and exporting the drug to 23 countries. The country in which it really took off was the U.S., where there was already a large population of morphine addicts, a craze for patent medicines, and a relatively lax regulatory framework. Manufacturers of cough syrup were soon lacing their products with Bayer heroin. In 1906, the American Medical Association had approved heroin for medical use, though with strong reservations about a "habit" that was "readily formed". Reports of its addictive properties were present from the beginning, but it took years before the negative aspects of the pharmaceutical were finally faced. In 1913 Bayer decided to stop making heroin.]

[At the end of the next year, the use of heroin without a prescription was outlawed in the U.S. by way of the Harrison Narcotic Act. On its face this was merely a law for the orderly marketing of opium, morphine, heroin, end other drugs-in small quantities over the counter, and in larger quantities on a physician's prescription. Indeed, the right of a physician to prescribe was spelled out in apparently unambiguous terms: "Nothing contained in this section shall apply . . . to the dispensing or distribution of any of the aforesaid drugs to a patient by a physician, dentist, or veterinary surgeon registered under this Act in the course of his professional practice only." Registered physicians were required only to keep records of drugs dispensed or prescribed. Interpretation by law-enforcement officers, however, meant that a doctor could not prescribe opiates to an addict to maintain his addiction. Since addiction was not a disease, the argument went, an addict was not a patient, and opiates dispensed to or prescribed for him by a physician were therefore not being supplied "in the course of his professional practice." Thus a law apparently intended to ensure the orderly marketing of narcotics was converted into a law prohibiting the supplying of narcotics to addicts, even on a physician's prescription. Many physicians were arrested under this interpretation during the next several years, and some 3,000 were convicted and imprisoned. Even those who escaped conviction had their careers ruined by the publicity. The medical profession quickly learned that to supply opiates to addicts was to court disaster. Furthermore, "...the immediate effects of the Harrison antinarcotic law were seen in the flocking of drug habitues to hospitals and sanatoriums. Sporadic crimes of violence were reported too, due usually to desperate efforts by addicts to obtain drugs, but occasionally to a delirious state induced by sudden withdrawal...."]

 

[1915 - A gold mining boom in the area of the towns of Oatman/Goldroad early this year created a bustling economy in Kingman thirty-two miles to the northeast. Oatman's population would reach almost 10,000 during the next year. (Through the 1940s, the area around that town would be Arizona's largest producer of gold. It is said that there were three small hospitals there. Details are being researched.)]

[Dr. Harvey Cushing, chief of surgery at Harvard Medical School's first teaching hospital (1912-1932), published an article addressing the main obstacle to neurosurgery's viability as a specialty: the lack of a universal classification system. This prevented physicians from drawing accurate conclusions about the type, source, and frequency of brain tumors. As a result, data on specific recoveries were misleading and useless as prognostic tools. Physicians did not recognize which tumors were more favorable surgical candidates than others, and many misdiagnosed patients' symptoms. Before Cushing, an internist or practitioner alone diagnosed a patient -- the surgeon was merely a technician who briefly treated patients.Cushing provided explanations of the associated mortality rate with each class of tumor. More surprising was his own reported fatality rate of only 7.3% for a toal of 149 operations, many of these fatalities not caused by the operation itself. By describing the cause of each death, Cushing attacked the assumption that the surgeon was always at fault for mortal outcomes -- death as much as 50% of the time or with severe postoperative deficits. He cited several reasons for the large difference between his operative results and those of his European peers, including such principles as perfection of anesthesia, scrupulous surgical technique, ample expenditure of time, and painstaking closure of wounds without drainage. Having established the modes by which surgeons could reduce their mortality rates, Cushing revolutionized the surgeon's role in patient care. And Cushing specifically revolutionized neurosurgery with improved diagnostic skills, rigorous surgical discipline, and refined oerative techniques.]

 

[1916 - January: The Kingman Hospital opened in the Pendergast Building for admission of medical, surgical and obstetric cases. Only cases of pulmonary tuberculosis and contagious disease would be excluded. Private rooms were priced at $25 and $28 per week; ward admissions, $18 and $20 per week. Drs. Bucher and Tilton had rented the building by early October 1914 and then equipped it for hospital purposes. Miss Katherine M. Teale, R.N. was listed as the Superintendent.](There is conflicting information at this point regarding this facility. According to Terry Organ's article "Caring," "A Mohave County Miner advertisement from Jan. 23, 1915 announced the opening of Kingman Hospital in the Pendergast Building. That building at Third and Spring [sic], later became the Greystone Inn, where St. Mary's Roman Catholic Church is located today." Per the caption for the Geystone Inn photo in that article, "This private hospital served patients from 1910 to 1915, according to the Mohave Museum of History and Arts." Dr. Brazie, on pg. 6 of his 1963 Medical History, also noted that "the Greystone Inn was attempted on a little more elaborate scale and patients were cared for by Registered Nurses.")

[Dr. W.H. Bucher, a prominent local physician and surgeon, had been working for the establishment of a hospital for some time. He continued to do so after Pendergast opened and interested the Catholic Sisters of Phoenix to come to Kingman to study the situation with a view to establishing a hospital that will meet the needs of the entire county. The Sisters' proficiency in caring for the sick had been demonstrated in all parts of the world. It was strongly felt that the need for an up-to-date hospital building equipped comparably to that of hospitals in larger cities should be filled, no matter under whose supervision it was conducted. While all the people of Mohave County would benefit, the officials of the innumerable mining companies operating in the various sections of the county would be most supportive for a central place where injured workmen could be given proper and immediate medical attention and care. (Several mining companies did maintain small "hospitals" for the care of injured or sick employees. These were basically no more than emergency buildings near the mines. At the time, as there were no compensation or insurance benefits of any kind and law suits were prohibitively expensive to undertake for the average person, a worker injured at a mine could become a non-productive member of his family.) The Miner's publisher, Anson H. Smith, announced that he would give a large site, as well as building rock, gravel, and sand for the erection of the hospital.]

 

Minnie Gulley© Mohave Museum of History and Arts. Reprinted by permission.

[Also this year (1916), August 19: what is more commonly known as the first hospital in Kingman was opened by Minnie E. Gulley in the O.E. Walker House (906 Madison Street). Gulley had received her Certificate of Nursing that February from the Chautauqua School of Nursing in New York. At the corner of Mohave Avenue two blocks south of the railroad, the structure had been built the previous year and was being leased to Mrs. Gulley as a private hospital. Walker was on the Mohave County Board of Supervisors. Surgeries took place in the small kitchen of the 2-bedroom tufa stone and adobe bungalow. It is said that medical procedures here were often learned as needed. One surgery for an "Ischio rectal abscess right side" was performed on September 10 by Dr. Tilton as the Physician and a Dr. White as the "Anisthest" [sic]. The patient had been admitted on the 6th and was discharged on the 27th after a similar abscess on the left side was also removed on September 20th. (Dr. Albert L. Tilton was one of the M.D.s who signed Minnie's Nursing Certificate. Was this the same Tilton as in Kingman?) (See also May 1986.)]

 

[1917 - March: Dr. Alexander M. Cowie, practicing in Kingman since 1893, died from a ruptured appendix a few days after his 53rd birthday.]

[April: The U.S. declared war on Germany and entered the "War to End all Wars" (which had begun in August 1914).]

[Prior to what would years later be called the First World War, the American Red Cross introduced its first aid, water safety, and public health nursing programs. With the outbreak of war, the organization experienced phenomenal growth. The number of local chapters jumped from 107 in 1914 to 3,864 in 1918 and membership grew from 17,000 to more than 20 million adult and 11 million Junior Red Cross members. The public contributed $400 million in funds and material to support Red Cross programs, including those for American and Allied forces and civilian refugees. The Red Cross staffed hospitals and ambulance companies and recruited 20,000 registered nurses to serve the military. (Additional Red Cross nurses would come forward to combat the worldwide influenza epidemic during the next two years.)]

 

[1918 - A levy was suggested "for the purpose of raising $17,500 for the building of an addition to the county hospital. The matter was looked into and found to be inexpedient and it did not go into the adopted budget."]

[November 11: Armistice Day: fighting in the Great War ended.]

 

[1919 - The board of supervisors wanted to issue bonds for a hospital building, but the attorney general refused to sanction it without a vote of the people and the bond buyers would not take the bonds without approval of the attorney general. (Prior to this, "the people of the county voted favorably on the building of a hospital, but failed to make provision for the funds wherewith to erect the buildings. This action was carried to the people at two elections and the people voted almost unanimously for it. The legislature also agreed to an issue of $30,000 for the hospital, but like the other issues this did not provide the coin.")]

[During the global Influenza Pandemic (which began the previous year and which was named the "Spanish Flu" or "Spanish Lady"), the two-year-old Mohave County Union High School in Kingman was turned into a hospital for the seriously ill. Volunteers manned the facility until they, too, succumbed to the dread disease. According to residents, very few families were not touched by the pandemic which took a large death toll as well as temporarily incapacitating many.]

[Estimates put the worldwide death toll at between 20 and 40 million. Some one billion people were affected by the disease -- half of the total human population. From August 1918, when cases of the flu (and its companion pneumonia) started looking abnormally high, until the following July when they returned to about normal, 20 million Americans became sick and 675,000 died. In October, 1918, the flu reached its peak, killing about 195,000 Americans. Young to middle-aged adults had the highest death rates. About 57,000 American soldiers died from influenza while the U.S. was in the Great War (1915-1919); about 53,500 died from battle injuries. Nurses played a critical role in preventing the further spread of influenza and reducing the pandemic's severity. They taught individuals, families, and communities about respiratory hygiene, handwashing, the disinfection of household utensils, and the critical importance of wearing gauze masks in public. And, of course, they cared for those stricken. Many also found themselves enforcing a legally binding quarantine or period of isolation on often unwilling patients. Student nurses provided almost all of the nursing care delivered in U.S. hospitals. Most stayed by their patients' bedsides, despite pleas from family and friends that they see to their own safety. Hundreds of them died. One of the hallmarks of this influenza was hemorrhage in the lungs. Early attempts to discover the source of the influenza centered on the Bacillus influenzae bacteria, incorrectly believed to be cause of flu epidemics during the previous three decades. Scientists at the time were still conceptually behind in defining a virus; they distinguished it only by size from a bacteria and not as a parasite with a distinct life cycle dependent on infecting a host cell. Other major killers at the time were smallpox and typhoid fever. (See also 1933.)]

[One of the lesser terms of the June 28, 1919 Treaty of Versailles was that the Bayer company of Germany had to give up its Aspirin® trademark. Numerous companies worldwide could now manufacture and distribute the mild, nonnarcotic analgesic, acetylsalicylic acid. (It had been first created in 1853 but not marketed. The rediscovered formula was patented in 1899 as a powder. Useful in the relief of headache and muscle and joint aches, this "miracle drug" was available after 1915 in tablet form.)]

[Arterial blood gas analysis was first used as a diagnostic procedure in 1919. Employing the radial artery puncture technique first performed seven years earlier, W.C. Stadie measured oxygen saturation in patients with pneumonia. Stadie was able to show that cyanosis seen in his critically ill patients resulted from incomplete oxygenation of hemoglobin.]

 

[1920 - Mohave County pop.: 5,259 ; Kingman pop.: 1,276 (voting precinct)]

[January: One of the personal habits and customs of most Americans suddenly came to a halt as the Eighteenth Amendment to the Constitution of the United States was put into effect. All importing, exporting, transporting, selling, and manufacturing of intoxicating liquor was put to an end by Prohibition. Shortly thereafter, the companion Volstead Act determined that intoxicating liquor was anything having an alcoholic content of anything more than 0.5%, omitting that used for medicinal or sacramental purposes. The so-called "Noble Experiment," the culmination of several decades of the temperance movement's efforts, was undertaken to reduce crime and corruption, solve social problems, reduce the tax burden created by prisons and poorhouses, and improve health and hygiene in America. (See also 1925, 1929, 1933)]

[BAND-AID® Brand Adhesive Bandages made their first appearance on the market. They were originally developed by a cotton buyer for Johnson & Johnson for kitchen burns or cuts. Produced by the company, the bandages were 3"W x 18"L, made by hand from adhesive tape and cotton gauze covered with crinoline, custom cut to size by the end-user, and were not a big hit. Four years later they would be upgraded to the first machine-made adhesive bandages, completely sterilized. (See also 1951, 2002)]

[Per the "Report of Committee on County Hospital" from this time, the hospital site would be on an unused portion of the Mohave County Poor Farm's site. The Poor Farm consisted of a Superintendent's Resident (three rooms and a bath), Main Hall ("consisting of one large recreation room, with which are connected three small one-bed chambers, one of which chambers is used as an operating room when necessity requires. In connection with the latter room, there is a small laboratory or dispensary."), thirteen small 10x12' cabins separated about five or six feet, Laundry building (containing electric washer, range, hot water boiler and other laundry equipment), Coal shed, and Kitchen and Dining Room. "No part of the County Farm is connected with the County Sewer. Sewage from the kitchen and laundry is carried through an iron pipe into the gulch immediately east of the kitchen building, that is to say, between the High School and the Poor Farm. Sewage from the main building and all other buildings is carried through an iron pipe into the gulch west of the Poor Farm. Neither cess pools nor septic tanks are provided. All sewage is emptied upon the surface without any protection whatever." Also, "[t]he present Poor Farm grounds offer many favorable points, the only objectionable feature being the close proximity to the power plant. It is stated that the noise from the power plant might be annoying to nervous patients, but that trouble might be greatly lessened by setting the Hospital building back from the street and also having wards for nervous patients in some remote part of the building."][The Report went on to say that "[t]he question as to whether or not the County Farm and the proposed Hospital should be consolidated under one management should also receive careful consideration."]

[June 8: The site, cost and other details were apparently worked out because on this date county voters went to the polls and approved by a 4 to 1 margin an $80,000 bond issue to build and equip a county hospital. (The county had an estimated taxable property base of $24 million.)]

[November: Between now and the following January, architects of the Atchison, Topeka and Santa Fe Railway Company would draw up the plans for the new hospital.]

 

[1921 - April: Construction of the new hospital began on the west side of town barely a couple of blocks northwest of the Powerhouse. Local plumbers, painters and carpenters did the work.]

[The celebration of National Hospital Week began this year when a magazine editor suggested that more information about hospitals might alleviate public fears about the "shrouded" institutions of the day. (From that beginning, Hospital Week would expand to facilities across the nation. Eighty years later, through promotion and participation, National Hospital Week would have grown into the nation's largest health care event.)]

[The Arizona Board of Chiropractic Examiners was established this year to be responsible for regulating chiropractors in Arizona. The Board’s mission is to protect the health, welfare and safety of Arizona citizens who seek and use chiropractic care.]

[June: House Bill 32, which mandated registration of all professional nurses in Arizona, became law and five registered nurses from a list prepared by the State Nurse's Association were appointed by Governor Campbell as members of the Arizona State Board of Nursing. (See also 1952)]

 
Neighborhood of the new hospital from a c.1921 map, courtesy of Mohave Museum of History and Arts
 

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