Just what the doctor ordered!

The Parish Hall at Church of the Holy Spirit on Daniel Island looked a bit like 18th-century Charles Town on the evening of Jan. 20, or more specifically, a Colonial-era physician’s office. 

Before an audience of close to 100 people, Andrew Shuler stood at the front of the room. Dressed in a mustard yellow waistcoat, breeches, and ruffled linen shirt, he looked every bit the part. Laid out on a table before him were various medical tinctures, teas, poultices, and other tools of the trade.  

“I always open my conversation with ‘18th-century surgeon at your service,’” quipped Shuler as he kicked off the Daniel Island Historical Society program. “'If I can't cure what's wrong with you, I can remove it.’ And that's kind of the crux of it. That's everybody's perception.” 

A marine biologist with a passion for history, Shuler specializes in exploring science and medical care during the American Revolution. For his Daniel Island presentation, he spotlighted medicinal practices used more than 250 years ago, not only in Charleston but on the Cainhoy Peninsula, where the former Cainhoy Meeting House off Clements Ferry Road once served as a Revolutionary War field hospital. 

“A field hospital isn't like a true hospital like we think of today,” Shuler told the attentive audience. “These are mobile trauma centers. These are places that are moving to where skirmishes are taking place. During when this location was used as a field hospital, there were a lot of active skirmishes and battles, and there's a multitude of reports of engagements with fairly large casualties on some occasions.” 

According to Shuler, the Cainhoy site and other field hospitals operating at the time were different from those providing medical care at a military encampment. 

“A field hospital was strictly a place where soldiers went,” he explained. “It was neutral ground. You were going there solely to receive immediate care. You were going there to have surgery performed on you and then to stabilize your condition. Once you were stable, you were moved out of these places and onto somewhere else.” 

Typically, a field hospital would have a director, a surgeon, a surgeon’s mate, and a nurse, noted Shuler. And since patients were coming straight from the battlefield, the most common injuries treated were lacerations, head wounds, gunshot wounds, and broken or shattered bones.  

“They were all things that had to be treated at a place like Cainhoy Meeting House,” Shuler said. 

To stop bleeding, a variety of materials were used to pack wounds, including flax, animal fur, and even spider webs.  

“By and large, we are packing these wounds and trying to stop any excessive blood loss,” he said. “Now, is that happening first in a field hospital? No. Often that's something that may be happening in the field to get somebody to that field hospital. Blood loss is something that's pretty important, and it happens pretty immediately. But those are the chosen ways to treat that. We don't have Band-Aids, we don't have butterfly bandages, but this is what we have. We have a clotting agent to help bring that wound to a close.” 

Head traumas were common at the time, Shuler added. The method for treating swelling of the brain elicited gasps from the audience when Shuler held up the tool most often used. 

“That is where trepanation comes in,” he said, displaying a trephine, a small cylindrical saw with a central retractable pin for drilling into the skull. “This goes through your skull.… And you assess that contusion, that bruising on the brain…. Hopefully just opening that up gives it room, and it can expand…These individuals not only survived but often went on to live long lives after having this procedure done.” 

There were other cringe-worthy tools on display: a saw for amputations (also common), a trocar (another tool for relieving pressure on the brain), a bullet extractor, and more. 

Shuler also spoke of the medicines administered and how they were delivered. Most were herbs that were mixed into tinctures, teas, salves, poultices, ointments, and pills. Typical ailments of the day included fever, cough, gastrointestinal issues, and pox. Bloodletting was used for a variety of conditions, explained Shuler, under the theory that getting rid of the “excess” would help overall health. 

“Most of the medicine you see in this era is still purgative in nature,” he said. “They were missing some critical pieces of information, but they were doing the best thing they knew at the time.  

Shuler calls this period in medical history the “revolution” that no one talks about. 

“At this time, they really don't have a good understanding of what we know today, but they're starting to get a lot right.” 

They began focusing on hygiene, inoculation, and containing contagions, Shuler said, and much of that started in military encampments. 

“The medical staff of an encampment was really driving this part of it,” he added. “This is disease prevention.”