100 year ago in Primary Care, it was 1915 going on 1916 and the Primary Care world looked very different from today. The average man had a life expectancy of only 47 years, antibiotics wouldn’t be invented for another 13 years and the leading causes of death were pneumonia, influenza, tuberculosis and diarrhea and doctors had shockingly little education, including no college education.
How long we live
Given that the average life expectancy in the US for 2015 is nearly 79 years old for men (slightly longer for women), it is hard to imagine a time when men only lived to 47 years old. Records from the UK indicate that the average life span for men has been between 38-40 from the late 1500’s until the late 1800’s when it climbed to around 47 (see Our World in Data for a cool chart).
Causes of Death
In the early 1900’s, infections finished off most of us. Specifically influenza, pneumonia, tuberculosis and diarrheal illnesses. With the discovery of Penicillin in 1928 and it increasing use over the next couple of decades, infections had be eliminated as a “Top 5” cause of death by 1950. An interesting fact to observe in the infographic to the left is that heart disease was killing a huge portion of the population but by 2010, it had begun to decrease dramatically. Doctors feel this is mostly due to management of high blood pressure and high cholesterol in the primary care setting as well as life saving procedures such as heart bypass and angioplasty.
Another interesting development was COPD/emphysema moving up to the 3rd leading cause of death in 2010. As we all now know, we having smoking to thank for this cause of death (as well as a lot of heart disease, stroke and cancers). If you are considering quitting this year, Evolve Medical would love to help you! (Schedule a visit now: www.emc4me.com)
Doctors without education?!
Doctors were educated by a college degree was not a requirement for admission to “medical school”. In fact, there were hundreds of “medical schools”–more than in any other country. Most of these were for-profit institutions that churned out terrible doctors. “Low educational standards made American medical practice decidedly inferior to medical practice almost anywhere else in the civilized world,” according to Robert McCarty.
In 1915 American medical schools were closing as a result of a 1910 scathing report (The Flexner Report) and serious reform was underway. In fact, the teenaged Johns Hopkins School of Medicine which had opened in 1893 was the model for the nations other medical schools. And of course there was no such thing as primary care.
Over-the-counter medicine: Marijuana, nicotine, cocaine, heroin and morphine
It’s amazing to be transported back to the pharmacies of 1915. Drug companies like Parke, Davis promote their codeine and cannabis-laced drops by declaring simply, “We suggest Cosadein to Relieve Coughs.”
Pabst Extract alcohol tonic proclaims, “The joys of motherhood are increased tenfold when both mother and babe enjoy perfect health.”
Dr. Batty’s–brand Asthma Cigarettes (left) advertised,“Effectively Treats: Asthma, Hay Fever, Foul Breath, and All Diseases of the Throat.” Dr. Batty’s-brand was responsible enough to place the first ever cigarette’s warning, “Not recommended for children under 6.”
But within a decade or so from 1915, so many adults and children were dying from non-listed ingredients, such as the morphine in Mrs. Winslow’s Soothing Syrup that the United States began to take action.
Even Sigmund Freud was convinced of the usefulness of OTC cocaine when he wrote this, “I take very small doses of it regularly against depression and against indigestion and with the most brilliant of success.” In fact, Freud would tout cocaine as the cure for morphine dependency. But within 2 years he had to treat himself for his own addiction.
100 years ago and primary care
It is hard to imagine our country seeing so much change over 100 years but exciting to imagine the amazing innovations we may see from 2015 to 2115. Primary care wasn’t even invented–and if it had been, there wasn’t much that could be recommended to alter how long someone would live. In fact, some of the recommendations, such as good old Dr. Batty’s cigarettes for breathing problems, probably would not have helped. Today we have amazing opportunities to extend our lives through better, healthier living. At Evolve Direct Primary Care, we work every day to help our patients filter through all of the recommendations that are out there and help them to be sure that they are keeping up with the most important ones.