Hence a doctor who could do all his "ride" with one horse could not be very busy and the inference was he was not very capable. Such a one was called a "one-horse doctor," a term of deprecation that came to be applied to things that had nothing to do with horses, as a one-horse store, or hotel or town.
The doctor furnished the medicines to his patients. Only rarely did he write a prescription since apothecaries were rare. He bought the crude drugs, ground them with mortar and pestle, and did his own compounding. Much of his therapy was by giving the powdered crude drug itself. Sulphate of quinine was rare. Instead he gave the powdered Peruvian bark. Tinctures were little used. Instead he gave the crude drug. Few of his therapeutic agents were given in fluid form. Instead he gave powders, each dose neatly wrapped in a folded packet, and a doctor was, to some extent, judged by the neatness and uniformity of his powder packets. Bottles and vials were so expensive that they were charged separately from their contents and credit given when the empty vial was returned. To some extent the doctor used pills. These he compounded, rolled, and coated himself.
The number of drugs used was not great. Complete inventories of successful country doctors show less than fifty. A few of these were constantly used. Calomel was a stand-by. Next to this the main feature of therapy was blood letting, based on the idea that disease was due to excess of blood, and the first thing in treatment was "depletion." Contagion of certain diseases was appreciated, but no one could explain it. Vaccination against smallpox was a usual procedure.
There were no hospitals, so that all surgical operations must be done in the home, and it should be remembered that there were no anesthetics. The patient had to be forcibly held by two or more persons who could be depended upon not to quaver at the sight of blood. In an amputation of a leg or arm a tourniquet was applied and then the soft parts severed with a single encircling stroke, with a knife the length of which was proportioned to the circumference of the limb. Speed was the criterion of surgical skill. Some surgeons boasted that they could amputate an arm in three minutes and a leg in five minutes.
