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CHARLESTON AND SOUTH CAROLINA

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									     CLINICAL CLIMATOLOGY IN COLONIAL CAROLINA:
       1670-1776 (CHARLESTON AND SOUTH CAROLINA)
                          BY VINCE MOSELEY, M.D.

                                   CHARLESTON


   The area that is now the State of South Carolina was as a province and
colony under the rule of Spain, then France, Spain again, and finally
England.' The first Europeans to attempt settlement and exploration
were the Spanish who explored the coastline from St. Elenas to Cape
Fear in 1520 on an expedition under command of Francisco Gordillo sent
from Santo Domingo, or Hispaniola, by Lucas Vasquez de Ayllon. On
June 21, 1521, the ship of de Ayllon and that of a second Spanish captain
anchored and explored the area of Winyah Bay, now the site of George-
town, South Carolina. The confluence of the four rivers at the head
of this bay they named the River of St. John the Baptist. After exploring
the country nearby and taking Indian hostages, they returned to Santo
Domingo. This was the first Spanish landing on the North American
continent north of Ponce de Leon's land explorations near St. Augustine
in 1513. In 1525 further explorations of the coast were made, and ad-
ditional Indian hostages from the Winyah area were taken by Pedro de
Quexos to Santo Domingo.
   Although impressed with the country and delighted by the accounts
of its wealth and abundance, as told by the Indians taken as hostages
back to Santo Domingo, it was not until July, 1526, that de Ayllon was
able to outfit and sail with his settlers to this land. He, with several
of the Chicora Indian hostages from the Winyah Bay region to serve as
interpretors and guides, along with five hundred men and women, three
Dominican friars, several Negro slaves and eighty-nine horses, landed
on the banks of the Gualdape River (?Pee Dee), and proceeded to
establish the first European settlement, San Miguel de Gualdape, on the
mainland of North America north of Mexico, and the first Spanish
 Mlission.1 Although the Spanish Mission posts of California have
attained much fame in song and poetry, it is not generally appreciated
that Spanish Mission posts were established in South Carolina, and later
in Georgia, almost two hundred and fifty years before Junipero Serro's
first Imlissionl, San Diego de Alcala inl 1769, in the eventual chain of some
twenty-one foudled by himi inl California. It was niot until 1565, some
forty years later, that the first Spanish Mission post in Florida was
  From the Medical University of South Carolina, Charleston, South Carolina.
                                        12
                  CLIMATOLOGY IN COLONIAL CAROLINA                     13
started concurrent with the settlement of St. Augustine and the erection
of a fort which was done in order to discourage earlier French encroach-
ments which had taken place near there when Fort Caroline had been
built by French Huguenots under Laudonniere in 1564, who claimed
Florida for France.
   San Miguel was not a successful settlement. Indian warfare, a slave
uprising and disease caused abandonment, and only one hundred and
fifty survived to be eventually evacuated to Santo Domingo. Among
the first to die in the settlement was de Ayllon, who expired from illness
about three months after the settlement was begun. Although there were
physicians, pharmacists, and surgeons with the settlers, we have no rec-
ord of their observations or any descriptive accounts of the illnesses
experienced by the settlers.
   The next records of Spanish explorations in South Carolina that we
have are in relation to the account of De Soto's march through the State
in 1540 in his search for gold. After landing on the west coast of
Florida from Cuba, his march carried him across Florida and Georgia
into South Carolina, where he continued along the banks of the Savannah
River up into western North Carolina, then doubling back he traversed
northern Georgia, and across to the Mississippi, and into what is now
Arkansas before turning back towards the Gulf of Mexico, when he
met his death from Indian attacks in the area of Upper Alabama. It
was along this route of exploration that Juan Pardo in 1566 began to
establish Spanish missions, military garrisons, and trading posts near
the Indian villages visited by De Soto in his exploration of the westeril
border of South Carolina. These missions were a part of a chain, taking
origin from a Spanish fort and settlement San Felipe on what is now
Parris Island, South Carolina, in Port Royal Sound, and previously
named Santa Elena, or St. Helena's Sound, by the Spanish, and where
they had made settlement attempts in 1558 and 1561. The establishment
of San Felipe occurred to offset the abortive attempts made by the
French when in 1562 Charles Fort was established on Parris Island by
 Jean Ribaut at a site about two miles above the site of the later Spanish
settlement of San Felipe.
   In 1564, Fort Caroline, near present St. Augustine, Florida, was also
 established under Ribaut's direction by Rene de Laudonniere. Charles
Fort was abandoned, and Fort Caroline was captured by Menendez
 de Avilez in 1565, and who, then to guard against further encroachments
 by the French in Spanish Florida, established St. Augustine in 1565, and
 a settlement San Felipe, and a fort at Santa Elena's in 1566. This
 earlier fort was later replaced by Fort San Marcos. A chain of outposts
 and missions connected St. Augustine along the Georgia coast with San
14                              4VINCE   MOSELEY

Felipe, and those establislhed along the Savannah River in South Caro-
lina, anid these eventually extended over into upper Georgia and across
into Alabama and Mlississippi. Spanish efforts to maintain these missions
persisted until 1680 with varying degrees of success, despite many attacks
by the Indians, and eventually also by the British colonists, and as late
as 1663 extended as far up in South Carolina as Edisto Island. The last
mission post of this original group on St. Catherine's Island, on the
Georgia coast, was abandoned by the Spanish after attack by the English
colonists of South Carolina and Indians in 1680. Except for the continuedl
missionary attemipts by the Dominican friars and the military in main-
taining outposts, no further Spanish settlements were attempted north
of St. Augustine after 1586, the year in which St. Augustine was sackedl
by Sir Francis Drake, and in which year also San Felipe and Fort San
Marcos on Parris Island, South Carolina, were likewise reduced by the
English. All efforts by the Dominican friars and the military to main-
tain mission stations and military outposts were discontinued in this area
after 1680.
   Although Spain claimecd from the Atlantic to the Pacific, and to the
Arctic all of the North Aminerican continent as Florida, named by
Ponce de Leoni because of his landing near St. Augustine on Pascua
Florida, or Easter Sunday, in 1513, the limits of attempted settlemeint
or serious attempts by military or naval action to defend her claims on
the Atlantic coast, were essentially, in addition to the mission district of
Timuca, or the area of the Florida peninsula below the St. Johns
River, limited to the mission district of Quale, or the South Atlantic
coast region above the St. Johns River, extending north up to the
region of the Albemnarle Sound in North Carolina.* (See map, Fig. 1.)
Colonization attempts, however, were never made apparently above San
1\Iiguel in South Carolina, althouglh exploration of the area of the River
Jordan (Cape Fear River) had occurred in 1521 and 1526, and raids
on English settlements were made periodically until 1710 as far north
as Albemarle Sound.
   A second attempt by the Frenchi to settle on the South Carolina coast
in 1577 at Edisto Island was thwarted by Indians and Spanish who
imassacred the entire group as they hadl previously done at Fort Carolinie
near St. Augustine when it was captured in 1565.
   In 1583 English interest began in the colonization of North America.
The initial attempts were made under the direction of Sir Humphrey
Gilbert, his half-brother Sir Walter Raleigh, Sir Richard Grenville, and
John Wl'hite in 1583, and after neutralization of the Spanish forts of San
   * The Third Mission District of Florida was Appalachia, western Florida, and the
region of the northeast coast of the Gulf of Mexico.
                   CLIMATOLOGY IN COLONIAL CAROLINA                      15




                        FIG. 1. The New World, 1600.

Felipe and St. Augustine in 1586, the history of settlements in South
Carolina, as with the remainder of the Atlantic seaboard, except for
Canada and peninsular Florida, is that of the English, and to a lesser
extent Dutch and Swedish colonists. Based on earlier explorations be-
tween 1497 and 1547, by Henry Cabot and his father and brothers, for
which Cabot received support and rewards from Edward VI and Henry
VIII, Charles I decided in 1629 to further support the initially unsuccess-
ful English claims and settlemnents made by Queen Elizabeth I in 1584
and 1587 at Roanoke Island, then claimed as Virginia above Spanish
Florida, and the later successful settlements at Jamestown in 1607, and
in New England in 1620. A charter was given to Sir Robert Heath in
1629 by Charles I with instructions that Heath was to lay claiin to and
settle that part of Spanish Florida which lay between North latitudes
31 and 36 degrees, or roughly from the region of the St. Johns River
north to Albemarle Sound in North Carolina below the Colony of
Virginia. This area he named "Carolana". A group of French Huguenot
refugees were dispatched as settlers from England in 1630 by Heath, but
landed in Virginia. No further attempts at colonization were made by
Heath, and the revolution, deposition, and execution of Charles produced
16                            VINCE MOSELEY

a hiatus of further interest in the settlement of "Carolana" until after
the restoration. In 1663 Charles II issued a second charter with no
reference to Spanish claims, as had been recognized as indicated by the
use of the word Florida in setting forth the land area in Heath's charter,
granting the same area of land to several of his supporters in the restora-
tion, who were termed Lord Proprietors. Later this charter was amended,
and the southern boundary of the Province of "Carolana" was extended
to 29 degrees, or to a point about 65 miles below St. Augustine and the
northern boundary at 36 degrees and 30 minutes, or to about the present
North Carolina and Virginia line. The province was renamed "Carolina"
by the Lord Proprietors who planned to organize the province into plan-
tations from which they hoped to derive considerable revenue. The area
given in the charter embraced what are now the states of North Carolina,
South Carolina, Georgia, Alambama, and Mississippi. Peninsular Florida
was not claimed by the British until 1763, when it was ceded by Spain
and was ruled by English governors as East and West Florida from
1763-1783. The ceding of the peninsula of Florida was a move by Spain
to prevent the seizure of Cuba at that time by the British. After 1783
by treaty, Florida was returned to Spain, but Spanish administrative
authority was not fully re-established. Because of outlaw and Indian
depredations, it was occupied and annexed as United States territory in
1822 by General Andrew Jackson. During the Revolutionary War it
remained under British control and was a refuge for many Tory families
from South Carolina and other states.
   After the granting of the Second Carolina Charter, Lord Anthony
Ashley-Cooper, later the Earl of Shaftsbury, was chosen by the other
seven proprietors, the Earl of Clarendon, the Duke of Albemarle, Lord
Craven, Lord Berkeley, Sir George Carteret, Sir William Berkeley, and
Sir John Colleton, as President of the "Provincial Council of Trade and
Plantations", and began plans for colonization. English settlers in the
Barbados Islands were offered the opportunity of receiving large grants
of land upon moving to the new colony, and Captain William Hilton
was dispatched from there to explore the coast. The exploring party
sailed on the ship "Adventurer", named for the "Company of Adven-
turers" as the group of Barbadian planters, who commissioned Hilton,
named themselves in anticipation of securing land in Carolina. He
arrived in August, 1663 at Hilton Head, named for him. After exploring
this area and the area of Port Royal Sound (St. Elena), the site pre-
viously settled by the French and Spanish, he sailed further up the
coast. His advice upon return to the Barbados was to attempt a colony
farther north. In 1664 a settlement was begun at a site where a group
from New England had attempted settlement in 1660 near the Cape Fear
River. This was named Charles Town.' The area was named Clarendon
                  CLIMATOLOGY IN COLONIAL CAROLINA                    17
County, and Colonel John Yeamans, later Sir John when named Baronet,
was dispatched to become Governor of the county by the proprietors.
Both Yeamans and Robert Sandford, the Secretary for the colony, were
Barbadians.
  The proprietors then decided that a settlement farther south than
Cape Fear should be undertaken. On June 14, 1666, after various misad-
ventures with boats he had engaged, Sandford sailed to explore the coast
farther south, taking with him a physician, Dr. Henry Woodward, who
had knowledge of the Indians and their languages. It was decided that
the area about Hilton Head and Port Royal should again be considered,
and Dr. Woodward, the first English physician in South Carolina, was
put ashore to conduct explorations and negotiations with the Indians
while Sandford returned to the Barbados. Woodward was eventually
captured by Spanish patrolling in the area and taken to St. Augustine,
but was released from prison there by a British buccaneer, Searle, who
raided the town.
              Sunmma1ry 7'able of Colonial Settlemtents in Carolina
                          Spanish in South Carolina
              Explorations Poiice de Leoai's Florida 1513
              1520-1524-1540
              Sanita Elenias-Cape Fear-I)eSoto
              Settlements:
              1526 Sal} Miguiel de GCualdape
              1558-1561 Sanita Elenias
              1566 Saii Felipe Fort Sani Marcos
              156(6 Pardos Missioiis and Outp)osts
              1586 Saii Felipe destroyed by British
              1663 Last South Carolinia Mission closed-Edisto
                          French in South Carolina
              1562 llibaut at Port Itoyal-Abanidonied
              1577 Frenich Fort at Edisto l)estroyed
                    (Spatiish anid Indiainstotal massacre)
                         English Settlements-Carolina
              Albemarle Attempts 1584-1587
              St. Augtustinie anid Sain Felipe destroved-1586
              Heath's Ca rolana Charter-1630
              Cape Fear 1660 (New Eniglaniders)
              Carolinia Charter 1663
              Charles TownI 1664-1677 at Cape Fear
              Hiltont Head 1663 Explored
              Port Roval 1666- Explored (1)r. Henry Woodward)
              Albemarle Poinit-1670 (Charlestn)n)
              Stuiarts Towni 1684 Scots
              (Jamestowni 1607 Plymouith-1620)
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   Dr. WoodwardI was ev-enitually able to join another expedition to
Carolina sent from England with English anid Irish immigrants who
were to pick up others at the Barbados.3 These sailed from the Barbados
in 1669 under the command of Captain Joseph West. In this initial stage
of the voyage, none of the three ships arrivedI on the Carolina coast.
All were variously scattered anld damnage(l. Col. AW'illiam Sayle was
then commissioned Governor, and set out again from Bermuda where
the "Carolina", one of the ships, had been driven by a severe storm.
Evenitually it, the "Three Brothers", and a sloop froin the Barbados
purchased to replace the "Albemarle", wreckedl oni onie of the Bahama
Islands, inade rendezvous at Port Royal. Dr. Henry Woodward's opinion
was sustained by the Indians of the St. Helena area as to the danger of
Spanish attack if settlement should be attemptedl there, and explorations
along the coast above Port Royal were begun. Other Indians farther
north who spoke a Spanish patois as a result of their contacts with the
Spanish missions, and probably some descendanits of the settlements at
San Miguel, also dissuaded Sayle from settlinig on Bulls Bay south of the
earlier Spanish settlement at Winyah. The Kiawah chief persuaded them
to settle at his township on an easily protected land point on the Ashley
River, a short way upstream from the Charleston harbor. These colonists
who had started originally in July, 1669 from England and the Barbados,
eventually were able to begin a permanent settleiient in April, 1670.1
The earlier settlement at Charles Town on the Cape Fear was abandoned
in 1677, and that name was given to the Ashley River settlement by the
Council of the Proprietors. The settlers themselv-es had named it Albe-
marle.
   Although there were other physicians in the early colony besides Dr.
Henry Woodward, we know little about these other than their names.
Woodward, though more of an explorer and Indian linguist, did, however,
because of his knowledge of the country and its climate, contribute much
to helping make the colony a success. Of the earlier physicians associated
with the French and Spanish, we have no records.
   Another physician associated with the early history of Carolina, who
was indeed a climatologist as one of his many scientific and medical
interests, was Dr. John Locke (1632-1704), the philospher, who as per-
sonal physician to Lord Ashley-Cooper, played an important part in ad-
vising with the Lord Proprietors about their plans for the colony. The
charter of government adopted for the colony by the Council of Trade and
Plantations of the Proprietors was written by Locke. The "Fundamental
Constitutions of the Government of Carolina" it was called. It was feudal
in concept with an hereditary landed aristocracy of landgraves and
cassiques, who were empowere(d to import leetmen who were to be bouinid
                  CLIMATOLOGY IN COLONIAL CAROLINA                      19

to the land, and were to be governed by the leet courts of the landed
estates and baronies. It was also intended that these provincial nobles
were to serve, with the Governor, as members of the state or senior
council, which was to sit over to confirm the acts of the lower or elected
body or general assembly. This division of power was designed to offset
the power of a "too numerous democracy", as represented in the assembly
or parliamentary body, who were to be elected by the freemen, merchants,
mechanics, and others with property, wealth, or profession in the colony.
This "grand design" had as its intent to protect personal property, it
being a firm belief of both Shaftesbury and Locke "that it is as bad
as a state of war for meni that are in want or without prop)erty to make
laws over men that have estates".4
   There is no record of any land-boun(d leetmen entering the Charles
Town colony, although there were numerous indentured or bond servanlts,
as well as free-men. The feudal system was never in effect, except that
several were given titles, and with these received large grants of land.
The records indicate that in no instance was a title passed on to a
descenidant by inheritance. A grandsoni, Thomas Smyth II, of one of the
early governors, Landgrave Thomas Smyth, who was a physician, also
became a landgrave when he was also appointed Governor but did not
inherit the title, although some have thought he did.1
   The original colonists numbering about 148 white persons, and a few
slaves from the Barbados, and subsequent immigrants, refused to accept
many of the concepts of the "Grand -Model" of Locke. They pointed out
that in the "Fundamental Constitutions", in addition to the guarantees
of religious liberty, requiring only that each settler must subscribe to a
belief in God in order to have the rights of a citizen, the right of habeus
 corpus, incorporated as earlier written into English law by Shaftesbury,
 and trial by a jury of peers; that all laws and acts to raise revenue and
 other governing laws must originate in, or be assented to, by the elected
 assembly. On this basis they refused to recognize that the Proprietary
 Council, the Governor of the Province, or the Council of Seniors and
 Landgraves, could initiate any law that pertained to their liberties or
 gather revenue through taxation without their consent, as represented by
 the elected assembly. Likewise, they held the firm conviction that as
 English subjects they were, in fact, protected by all the "rights" of
 Englishmen that were inherent in the constitutions, customs, and laws of
 England. The Governor they believed was to act as an executive on be-
 half of the proprietors, who represented the King. The Council was
 advisory to the Governor. The Assembly was the legislative branch, and
 the courts were to counterbalance and administer justice in the customary
 manniier of the English courts.1 Thus were early laid the political prin-
20                            VINCE MOSELEY

ciples which led the colony in 1696 to abrogate the constitution of
Locke and eventually by armed force to throw off what they considered
the tyranny of the proprietors in 1719, and which was done again when
the Royal Government, which superceded the proprietary government
in 1721, was overthrown in March of 1776 for the same reasons. How-
ever, the political theories of Locke, of personal liberty as incorporated
in the original Constitution, continued as the political philosophy of
all later generations of Carolinians. These in essence were the beliefs that
"all men are under God created for liberty, and are equal under God's
natural law, that kings and parliaments have only such right to govern
as is granted by their subjects as a social contract, designed solely to
maintain order and protect property, that government should work for
the happiness and prosperity of its subjects, and that although all men
might not be born in freedom, all should be permitted to work to
freedom and full liberty under God".5
   Dr. Locke never visited Carolina or any p)art of America, and although
it was a primarily as a philosopher of government, and not primarily
as a physician that Locke influenced the province of Carolina, it does
seem more than likely insofar as he did recomnmend certain physicians to
be sent to the colony, that through his influence his interests in meteor-
ology and climatology undoubtedly were passed on to the colony by his
selection of physicians who may well have been known to him because
of their interests also in climatology. This supposition, I believe, is
supported in part by the really surprising number of the early physicians
in the colony who were men interested in climatology and its possible
relation to disease.
   Locke early in pursuit of medical and other studies in physic at Oxford,
after he had determined to enter this field instead of the ecclesiastical,
associated himself with Robert Boyle, Robert Hooke, and Richard Lower
in their studies on respiration and pulmonary physiology, and learned
to employ Wren's barometer and Hooke's hygrometer in weather obser-
v-ations. Locke became so imbued with these sorts of observations, and
with Sydenham's approach to clinical medicine, that he refused to present
himself for the formal debates and disputations then required for a
Bachelor of Physic degree at Oxford. He already had a Bachelor of Arts
and Master of Arts degree, and like Gaspar Casall, practiced for many
years without a medical degree. He was recognized as a practicing
physician of excellence for almost ten years before he would take the
formal examinations for his degree in Physic, and later his M.D. degree.
He was age 42, and had been six years a member of the Royal Society
before he completed the formal academic requirements.4 In 1666 he
entered clinical practice in association with Dr. David Thomas, and
                    CLIMATOLOGY IN COLONIAL CAROLINA                            21

soon was accepted by patients and colleagues as a physician of excellence.
In addition to his close friendship with Sydenham, it is said that
Boerhaave, who made his acquaintance after Locke was forced into
political exile in Holland at age 52, would ever afterwards when his name
was mentioned, raise his hat in recognition of his esteem for Locke.4 9*
   Although a prolific writer of letters, essays, and philosophic works,
Locke's medical publications were few during his lifetime. A fairly
lengthy treatise on the weather and its relation to disease was one which
brought some fame and interest, a case report of onychogryposis is
probably the first description of this entity, "De Arte Medica", "Anat-
omie", and "Respirations Usis; Tussis" were his only publications on
medical subjects during his lifetime. However, after his death the excel-
lence and clarity of his casebooks and clinical records caused many of
these to be posthumously published and republished.4
   The settlement of Charles Town at Albemarle Point, although appar-
ently reasonably safe from attack by both Indians and Spanish, and
saved on at least one occasion by a severe autumnal storm or hurricane
through the scattering of an attacking force of Spanish ships, was moved
in 1680 to Oyster Point on the peninsula between the Kiawah and Etiwan
Rivers, later renamed the Ashley and Cooper, which by their confluence
form Charleston Harbor, and "the point of origin of the Atlantic Ocean".
   The settlers had escaped any serious outbreaks of malaria, and the
colony had grown through the addition of a number of dissenters from
England, other emigrants from the Barbados, Ireland, and Baptist mi-
grants from New England, so that at the time of the move of Charles
Town to Oyster Point, the city population numbered some 2,000. Others
had moved farther inland, and some Scotch and Welch had settled at
Edisto Island, and others had established an independent Scotch settle-
ment, Stuarts Town, near the older sites of the French and Spanish at
Port Royal in 1682.
   Dr. Will Scrivenor, Dr. Thomas Smyth (later Landgrave), Dr. William
Clark, Dr. Peter Bordell, Dr. Joseph Clark, Dr. Charles Burnham,
Dr. John Hardy, and Dr. James Williams were in practice by 1680.6
Several of these moved to the outlying settled areas, and by 1684 the
town and district had expanded to a population of some 6,000, exclusive
of Indians and Negroes, of the latter there were then about 1,000.
Although there are no significant medical records remaining, civil and
other accounts of the colony indicate that the physicians were active in
   * Many of Boerhaave's
                         pupils became distinguished medical school teachers. The
developing Edinburgh medical school was based on that at Leyden. From Edinburgh.
and in a few instances direetlv. Boerhaave's and the Levden tradition and influence
spread to Carolina and the new worll.
22
 C
                             VINCE MOSELEY

promoting improvements in sanitation an(l in maintaining a register of
births, deaths and marriages which was begun in 1670.6 Public responsi-
bility for the health of sailors and poor emigrants was recognized, and
medical and nursing care was officially arranged for them.
   In addition to the English physicians, with the immigration of French
and other Europeans to the colony, a number of physicians accompanied
this group. We find listed in early documents mention of physicians with
the French and Huguenot names of Porcher, St. Jean D'Angelyen St.
Orange (later shortened to Jean Thomas), Cordes, Trevellian de le
Bruce, Brabaret and Bolt .6 In 1684 ten physicians were in the colony,
and by 1700 some 28 can be identified in practice.6 The population,
exclusive of Indians and slaves, then numbered some 6,000, of wlich
3,000 inhabited the town, and the others had moved into outlyiing
boroughs. Two additional towns had becn established, Willtown and
Dorchester. Stuart Town, near Port Royal, settled by Scots under Lord
Car(lross in 1682 and independent of Charleston, was destroyed by
Indians and Spanish in 1685. Importation of Negroes from the West
Indies began in 1671, at which time filariasis was introduced and re-
mained an endemic disease unitil about 1948, since when it has not been
further i(lentified as present in the W. bancrofti type, although other
types of Dirofilaria infestations are occasionally seen in humans. The
health of the colonists appears to have remained good, and no significant
or severe illness was recorded until 1699 when an epidemic of smallpox
and one also of yellow fever occurred.6"
   In addition to problems related to illness from malaria, smallpox,
and yellow fever, dengue, influenza, and pneumonia were recurring prob-
lems, and probably pleurodynia occurred in the fall of 1728.7 Snake bite,
various traumatic injuries, drownings and methods for resuscitationi of
drowned victims, and the care of gunshot and other wounds from the
intermittent warfare of the frontier areas with the Spanish and Indians,
are the chief subjects for reports in the medical records of the period
between 1680 and 1730. Records indicating the presence of typhoid do
not appear until about 1730.6 In 1734 a hospital was established. Clinics
for the poor were established, and plans to care for the indigent sick
and sailors had been provided for as early as 1684. The smallpox epidemic
of 1732 wlhich was distinguished not only by its severity amonlg the
inhabitants, but by its spread to the Indian nations, with some 50% or
higher mortality among certain of the tribes, especially the Clherokees,
served as a stimulus for the development of hospitalization for large
numbers of the sick.7 It was during this epidemic that the use of small-
pox inocuilation was introdtuced by Dr. .James Killpatrick, wlho was in-
structe(l in its use by chirugeon AMowbray of a British ship). II 1 738,
                    CLIMATOLOGY IN COLONIAL CAROLINA                             23

after a second epidemic, he published figures to show that by this means
he reduced the mortality from 17.6% among the uninoculated to 3.66/s;
among those to whom he had given the disease by inoculation; his
control group totalled 1,675, and the inoculated group 623.7 *
   In addition to Killpatrick, other European physicians who settled ill
the colony began to be recognized for their observations with pub)li-
cations appearing in the annals of distinguished societies, such as
the Royal Colleges of England and Scotland, among whom we should
name Dr. Thomas Dale, Dr. John Lining, Dr. John Moultrie, Dr.
Alexander Garden, Dr. Lioniel Chalmers, Dr. David Olyphant, Dr. John
Mlurray, Dr. William Murray, Dr. John Cleeland, and as a later and
native born member of this group, Dr. David Ramsay, to whom we are
indebted for preserving much of the early history of the colony, and
particularly the recounting of its various cultural, scientific and medical
developments. Ramsay's "History of South Carolina", published in 1808,
states that, "In the infancy of Carolina when European physicians
monopolized the practice of physic, there were more experiments made,
more observations recorded, and more medical writings ushered into
public view by the physicians of Charlestown than of any other part of
the American continent". This view is also shared by Dr. Richard H.
Shyrock in his introduction (1964) to Dr. J. I. Waring's "A History of
Medicine in South Carolina 1670-1825". Ramsay further stated in the
preface of his history that it was his hope " . . . that by his efforts South
Carolina would rise in the esteem of the citizens of other states who,
through not knowing better, then were loading it with reproaches and
denying it the credit to which it was justly entitled".7
    Among some of the reproaches then current were those related to
the still strong political feeling prevalent against the Tories or Loyalists,
of which there had been many of Revolutionary War prominence in
South Carolina, iineluding twenty physicians who were either exiled or
from whom property was taken in punishment, whereas it was overlooked
that 95 other physicians of the State had served as patriots in the
 militia and continental armies. There were more Revolutionary War bat-
 tles or skirmishes (138) fought on South Carolina soil, than in all the
 other colonies, and 103 of these were by South Carolina troops alone.1 t
   * Vaccination in South Carolina, an(d
                                             perhaps in America, was introduced as a
practice first in the winter of 1799 by Dr. John Chichester, a former pupil of Dr.
Pearson, wlho sent him sonme cow pock materials and a publication by Dr. Jenner.6
   t It is to be pointed out that fourteen battles were also fought by other colonial
troopS in which no South Carolina troops participated, and that South Carolina should
be eternally grateful for the help of the "Maryland Line" and the "Delaware Blues"
whlo came to its aid (luring its most strenuous efforts against the Britislh in 1781.
24                            VINCE MOSELEY

NMany of these battles were Whig South Carolinians against Tory South
Carolinians alone or joined with the British. This was truly a civil war
between Whig and Tory for South Carolina and persisted for 18 months
after Yorktown. Despite the wartime hatred, its great destruction of
property and the separation of families, a forgiving spirit and reaccept-
ance of many of the initially exiled Loyalists occurred within a few
years, a fact somewhat distasteful to some of the American citizelns of
other states who had indeed suffered far less during the Revolutionary
War than had most of the South Carolinians from the destruction
wrought throughout the entire State by the continuous fighting and
guerilla warfare that took place from 1776 to 1782. The most vicious
fighting and destruction in South Carolina occurred in the last years of
1779-1782 when Tory forces were reinforced by the Army of Lord
Cornwallis.
  A spirit of personal liberty and independence has been a significant
part of the temper of the people of South Carolina from its earliest
history when they refused to be bound into the feudal system of the
Lord Proprietors, and held to the ideals of the true liberty of Dr. Locke,
"not always born free, in fact, but always able to become free".5 It was
by the use of volunteer militia that the proprietary government was
overthrown in 1719. The State militia seized the British forts and State
control of the government was employed in 1765 against the Crown, and
again in 1775 when the State provincial congress made preparations
for war and seizure of the British forts and installations were carried
out. A constitution was adopted and an elected government, including
a President, John Rutledge, was established on March 24, 1776, and on
June 28, 1776, with the defeat of a squadron of the British navy and
other military forces, South Carolina made a full and irrevocable move
to pledge its forces to maintain its independence as a sovereign state,
and to aid all the other colonies then planning to do likewise.
   It is perhaps for these reasons-a fierce love of independence and
the self-reliance induced by the many wars fought by South Carolinians
during colonial times to maintain their property and rights against the
Spanish, French, Indians, and pirates, as well as against tyranny by
the mother country despite their periodic participation in all the wars of
the British during this period-that made them hesitant to joinl fully
into the concept of a federal government, to give up their full sovereignty,
and hesitant until 1788 in their ratification of the Constitution, and thus
somewhat suspect and not held in too great esteem by some of the
citizens of other states who were more enthusiastic for a strong Federal
system in the early days of the Republic.
   Although a full discussion and presentation of the biographical ma-
                   CLIMATOLOGY IN COLONIAL CAROLINA                      205i

terial available in Ramsay's "History" concerning the more prominent of
the 36 English and European physicians practicing in South Carolina by
1738 is not possible,6 8 a brief resume is believed to be worthwhile as
an indication of the scientific proclivities of several of these men, and
in particular of their considerable interest in climatological observations.
   In addition to an early interest in weather observations, soine of
the earliest data collected, classified and published by the colonial
physicians were those pertaining to the various botanical species in the
area, and their usefulness in therapy, many of which have been retained
in the pharmacopeia.6 One of the most distinguished of those who wrote
on botanical and zoological subjects was Dr. Alexander Garden, who wrote
on the virtues of "Pink Root", and published several papers in the
transactions of the Royal Society on botanical and zoological subjects,
including observations on insects, syrens, tortoises, and the mud eel. He
also corresponded with Linnaeus, who named the gardenia after him and
sent zoological specimens to Dr. John Hunter for his dissection and
study.6
   Dr. John Lining, whose house is still extant on the corner of Broad
Street and King Street in Charleston, presented observations on the
weather and other meterological observations by written reports to the
Royal Society in 1738, 1739, 1740, and 1742, which were published in its
transactions. Lining used Farenheit's thermometer and also Hauksbee's
 (0-90 graduations, with freezing at 76). Rainfall, barometric pressures,
and hygrometer readings were also part of his weather observations,
but wind force was only estimated, as he had no instrument to measure
this. Daily readings and recordings were conducted by him for some
fifteen years.
   To relate his weather observations to disease, he looked for evidence
of metabolic effects. In his metabolic studies, Lining also conducted
"statical observations" on himself which he published, weighing his
daily food intake and his excremental output, including perspirations
by periodically weighing himself during each day for over a year. A
full report and careful description of the yellow fever was sent by him to
Dr. Robert Whytt who read it, for Lining, before the Edinburgh Phil-
osophical Society in 1754. This is the first published account known of
a description of yellow fever.6 He was also interested in electricity,
corresponded with Benjamin Franklin, and repeated Franklin's kite ex-
periments.6 8
    Dr. George Milligen summarized many of Lining's observations, and
 added others of his own in "A Short Description of the Province of S.C.
With an Account of the Air, Weather, and Diseases at Charles Town
 in the Year 1763" (London, 1770).7
26                              VINCE MOSELEY

  Dr. Lionel Chalmers recorded observations on the weather from 1750
to 1760, and published an account of the weather and diseases in South
Carolina in London in 1776, but was recognized and most respected by
English and European physicians for his reports on yellow fever, and by
Cullen for the data Chalmers gathered supporting the "spasmodic
theory", as was more fully developed by Cullen7 (Fig. 2).
  These physicians were all born in Britain, and quite likely had some
of their interests in weather and disease stimnulated by Dr. John Locke
and his writings. This interest in weather observations continued well
beyond 1738 among other physicians who emigrated to the colony and
many of its native sons.
  Dr. William Bull was the first native-born South Carolinian to be




   FIG. 2. Chalmers' book was republished in German at Stendal in 1796. The London
Edition was puiblished in 1776.
                  CLIMATOLOGY IN COLONIAL CAROLINA                      27
trained as a physician in a European university. He received his degree
in Leyden in 1734, a pupil of Boerhaave.7 His interests were inore directed
towards public health, in developing laws for quarantine and other
public health measures. He practiced for only a few years before entering
the government, where he served as Lieutenant Governor and Royal
Governor, and was exiled because of his Loyalist stand after South
Carolina declared its independence from the King.' 7
   Dr. John Moultrie likewise was a native-born South Carolinian, grad-
uated from Edinburgh in 1749. His thesis was "De Febre Flora". There
are no climatological publications by Moultrie, but he was an active
member of the Charleston group who regularly made weather recordings
and met to discuss these, and the possible relationship of weather changes
to disease.7
   Ten other native sons soon followed him over the next several years,
and received medical degrees from Edinburgh. This continued for many
years to be the favorite university to which the young men of the colony
went for their medical training, all of whom to some degree upon return
developed and maintained an interest in climatologic observations.
Among these were Robert Wilson and Samuel Wilson, who, with their
father, also a graduate of Edinburgh, Dr. Robert Wilson, Sr., assisted
him in the continuous wind and weather observations he conducted at
his office for some twenty years.7 A later Dr. Robert Wilson, Sr., and
a direct descendant, was for many years a distinguished member of this
Association (1917-1946), and was a Vice President in 1939.
   As a result of these interests among its members, we find as a regular
enitry in the minutes book of the Medical Society of South Carolina,
founded in 1789, that beginning in the year 1792, as a regular part of
each meeting and extended over a period of some 20 years, a record of
the weather was entered, along with the prevalent diseases. Considerable
detail as to the temperature variations, barometric pressures, rainfall,
wind storms and lightening activity were entered in these notations.'
   Dr. David Ramsay, to whom we have inade earlier reference as an
historian and patriot, was born in Lancaster, Pennsylvania, and grad-
uatedl from that university, and was a close friend as well as pupil of
Dr. Benjamin Rush and Dr. Thomas Bone. He received his degree in
Physic in 1772. As a result of Ramsay's influence, ability, and erudition,
after the Revolutionary War, most of the students of medicine from
South Carolina attended the University of Pennsylvania. This continued
until the MIedical College of South Carolina was foundled in 1824. Dr.
Ramsay's home at 92 Broadl Street continues to stand today, about one
block east of Dr. Lining's. Among his many publications were his
gathering together of various data which he published as an appendix to
28                            VINCE MOSELEY

his "History", titled, "Sketch of the Soil, Climate, Weather and Dis-
eases of South Carolina", which contained his personal observations and
summaries of the observations of others, including those not only of
Lining, Chalmers, Dr. Robert Wilson, Sr., and Milligen of whom earlier
mention has been made, but also of the observations of certain less
well known physicians who lived and practiced in the outlying sections
of the State.7
   Dr. Ramsay wrote to physicians throughout South Carolina to obtain
information from the six Court Districts of the State, and thus we are
indebted for his curiosity to learn by this means, that in addition to those
who practiced in Charleston and nearby, that there were a number of
other physicians and some laymen who regularly made significant mete-
orologic and other scientific observations, though living in essentially
isolated districts of the State.
   Among those who rendered medical as well as statistical information
and climatologic information to Dr. Ramsay, were Dr. Isaac Auld from
Edisto Island, Dr. Edward Darrel Smith from the Pendleton District,
Dr. .Jameson and Dr. Shecut from the Orangeburgh District, Dr. Finley
from the Beaufort District, Dr. Levy Myers and Dr. Blythe from the
Georgetown District, and Dr. Davis from the upcountry area near
Spartanburgh. To Dr. Davis we are indebted for descriptions of upper
South Carolina, which, like the far West of more recent times, was once
the land where the buffalo roamed, as well as the Indians. He states
that even as late as 1750 "there were so many buffalos that three or four
men with their dogs could easily kill ten to twenty a day". In addition
to the excellence of the climate, which he documents by rainfall and
Farenheit's therinometer readings, he advises of the considerable number
of inhabitants then living in this district who were between the ages
of 80 and 100, and who continued quite alert and active. The
total white population of the area where he lived in 1808 was 17,000,
whereas he states that when he settled there in 1755, only 25 families
then were settled, thus giving some indication of the rapid growth in
this area of South Carolina, which he attributed to the salubrity of the
climate and excellence of the land.7
   Why the reports from the other Court Districts given by Ramsay
were written by clergymen or laymen, and not physicians, is not ex-
plained. Whether he did not know of physicians in those districts, or
whether there were none, which seems unlikely, is not explained. How-
ever, we know from diaries and day j ournals that there were many
patients in isolated areas who were cared for through the ministrations
of lay women and men, who resorted to Indian remedies and who by
referral to various publications, designed for home use as health and
                    CLIMATOLOGY IN COLONIAL CAROLINA                            29

therapy guides, developed by necessity even some skill in minor surgery
and amputations. Ramsay suggests that the milder remedies and Indian
and folk medicines used by the isolated farm families were more desired
than the sanguinating bloodletting practices and more violent purgatives
and emetics that began to be introduced into medicine in South Carolina
after 1765, as a result of the influence of Dr. Benjamin Rush, his very
dear friend and former teacher.
  Although Francis Packard in his "History of Medicine in the U.S."
devoted only eight paragraphs to the early medical history in South
Carolina, among some 1,200 pages of the early medical history in
America, I trust that I have not devoted too many in bringing to your
attention some brief remarks about some of the Colonial physicians who
practiced in the State, and in conjunction with these brief sketches some
of the collateral materials I believe are pertinent to an understanding of
South Carolina, its problems, and how it has attempted to meet some
of these by the self-reliant efforts of its citizens. It has in the past
enjoyed among its citizens some of distinction; it has continued to nurture
some, and as Ramsay stated in 1808, has too 'often been loaded with
reproaches it does not deserve and denied much credit to which it is
justly entitled" in the making of America.
                                  REFERENCES
1. WALLACE, DAVID DUNCAN: South Carolina, A short History-1520-1948. UTniversit
   of S. C. Press, Columbia, South Carolina, 1961.
2. LORANT, STEFAN: The new world-The first pictures of America made by John
   White and Jacques le Moyne. Duel, Sloan and Pearce, New York, 1946.
3. CHAPELL, BUFORD S.: Dr. Henry Woodward, "The Recorder", Columbia Medical
   Society, April, 1968.
4. MARTI-IBANEZ, FELIX: T'ales of Philosophy. Clarkson N. Potter, Inc., New York,
   1967.
5. MARTIN, C. F. AND ARMSTRONG, D. M.: Locke and Berkeley-A collectionl of critical
   essays. Doubleday Anchor, Garden City, New York, 1968.
6. WARING, JOSEPH I.: A history of medicine in South Carolina 1670-1825. R. L. Bryan
   Co., Columbia, South Carolina, 1964.
7. RAMSAY, DAVID: History of South Carolina from 1670-1808. reprinted from The Re-
   print Co., Spartanburg, South Carolina, 1959.
8. MENDELSOHN, EVERETT: John Lining and his contributions to earlv American Sci-
   ence. Isis 51: 278, 1960.
9. LINDEBOOM, G. A.: Herman Boerhaave: The Man and His Work. Methuen Press,
   1968.

								
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