Jeremiah Barker practiced medicine in rural Maine up until his retirement in 1818. Throughout his practice of fifty years, he documented his constant efforts to keep up with and contribute to the medical literature in a changing medical landscape, as practice and authority shifted from historical to scientific methods. He performed experiments and autopsies, became interested in the new chemistry of Lavoisier, risked scorn in his use of alkaline remedies, studied epidemic fever and approaches to bloodletting, and struggled to understand epidemic fever, childbed fever, cancer, public health, consumption, mental illness, and the "dangers of spirituous liquors." Dr. Barker intended to publish his Diseases in the District of Maine 1772-1820 by subscription - advance pledges to purchase the published volume - but for reasons that remain uncertain, that never happened. For the first time, Barker's never before published work has been transcribed and presented in its entirety with extensive annotations, a five-chapter introduction to contextualize the work, and a glossary to make it accessible to 21st century general readers, genealogists, students, and historians. This engaging and insightful new publication allows modern readers to reimagine medicine as practiced by a rural physician in New England. We know much about how elite physicians practiced 200 years ago, but very little about the daily practice of an ordinary rural doctor, attending the ordinary rural patient. Barker's manuscript is written in a clear and engaging style, easily enjoyed by general readers as well as historians, with extensive footnotes and a glossary of terms. Barker himself intended his book to be "understood by those destitute of medical science."

Richard J. Kahn, M.D., M.A.C.P. Assistant Clinical Professor, Department of Medicine, Tufts University School of Medicine

Foreword by John Harley Warner Introduction: Chapter 1. Jeremiah Barker: Background, Education, and Writings Who was Jeremiah Barker? Provenance of the Barker Manuscript Description of the Barker Manuscript The Medical Geography of the District of Maine, 1760-1830 Barker's Contribution to the Medical Literature of Northern New England Articles Published by Jeremiah Barker Yellow Fever in the District of Maine? Conclusion Chapter 2. Obtaining and Sharing Medical Literature, 1780-1820 Medical Information by Mail The First United States Medical Journals & Medical Nationalism Problems Encountered by Early Medical Journals Newspapers as a Source of Medical Information And Last but Not Least, Books Conclusion Chapter 3. The Old Medicine and the New: why Barker wrote this manuscript, for whom was it written, and why was it not published? The Importance of Observation and Recording Basics of Greek Medicine and Fever Bloodletting: The Blood Was "Sizy and Buffy" "Scientific Doctors" and the "Empirics" More Competition: Domestic and Sectarian Medicine Science, Institutions, Education, Framing Disease, and Cultural Authority Case Reports and the Clinical Exam circa 1800 Recording Cases, Observations, and the Numerical Method "Thus Sayeth Galen" Meets Cullen, Rush, and Brown "Intelligible to Those Who Are Destitute of Medical Science" Why Was Barker's Manuscript Never Published? Rapidly Changing Medical Theory and Philosophy: Noah Webster Conclusion Chapter 4. "Alkaline Doctor" and "A Dangerous Innovator" Lavoisier and the New Chemistry The Acid/Alkali Debates of the Seventeenth and Eighteenth Centuries Barker, Mitchill, Septon, and the Medical Repository Barker's Use of Alkaline Therapy Chemistry, Yellow Fever, and the Contagionist/Anticontagionist Battle Barker the "Dangerous Innovator" Conclusion Chapter 5. Thoughts to Consider While Reading Barker's Manuscript Presentism, Whiggish History, the Post Hoc Fallacy, Confirmation Bias Holistic and Biomedical Models Numerical Methods and Retrospective Diagnosis Barker's Treatments, Therapeutic Efficacy, Bacon, and Confirmation Bias Nature vs. Art in Medicine-Best Available Evidence and the Burden of Disease Conclusion The Jeremiah Barker Manuscript Volume One MS V. 1, Chapter 1. Insanity and Temperance Mental illness and problems associated with the use of ardent spirits MS V. 1, Chapter 2. Early Maine Medical History Beginning in 1735 1780 Barker moves from Barnstable, Massachusetts to Gorham, District of Maine Introduces his new community and physicians practicing in southern Maine Introduces Rev. Thos. Smith's diary documenting diseases and epidemics, 1735-1780 1735 N.E. epidemic of cynache maligna, putrid sore throat, as described by Smith Excerpt of Dr. John Warren's 1813 article on cynache maligna or throat distemper Barker discusses illnesses of the 1740s including quinsy MS V. 1, Chapter 3. Deaths Following Trivial Wounds and Childbed Fever Barker's initial years in the District of Maine beginning 1780 1784-1785 unusual epidemic of serious wounds and death in men 1784-1785 unusual epidemic of childbed fever and deaths of women Discussion focusing on women with childbed fever, deaths, autopsies, searching the literature and contacting medical peers for suggestions Excerpt remarks on puerperal fever By Dr. Channing, 1817 Excerpt Dr. William DeWees on puerperal fever 1807 MS V. 1, Chapter 4. Throat distemper, Ulcerous Sore Throat, Scarlatina Angiosa, Cynache Maligna 1784: experience with throat distemper, other New England physicians and the literature Excerpt on putrid sore throat by Hall Jackson (Portsmouth, New Hampshire), 1786 Joshua Fisher on throat distemper or scarlatina angiosa MS V. 1, Chapter 5. Scarlatina Angiosa, Inflammatory Fevers, Hooping [Whooping] Cough, and Croup in Maine, 1797-1806 1796-1798 Scarlatina angiosa and the use of bloodletting and blistering 1802-1807 Scarlatina angiosa with many comments by other physicians 1805 example: 17 yo woman with Scarlatina angiosa bled, blistered, treated with alkalis 1774-1780 Barker's experience in Barnstable with quincy of croup, "a kindred disease" 1795-1806 "hooping cough" MS V. 1, Chapter 6. Bloodletting for Palsy, Hemiplegia, and Other Neurological Events Pneumonia in a minister who used his lancet on his parishioners prophylactically Use of bloodletting in disease, prophylactically, and by native Americans Excerpt on bloodletting among native Americans in "Travels in Canada and the Indian territories, between the years of 1760 and 1776." Alexander Henry, 1809 Hemiplegia and apoplexy Excerpt of "Observations on paraplegia in adults" by Matthew Baillie, 1820 Excerpt of "Cases of Apoplexy with Dissection," by John C. Warren, 1812 MS V. 1, Chapter 7. Hydrophobia Hydrophobia, cases and review of literature Value of volatile alkalis to treat three people bitten by mad dogs MS V. 1, Chapter 8. Anasarca, Ascites, Dropsy, and Foxglove 1786 move from Gorham to Stroudwater section of Portland Cancer Anasarca, ascites, hydrocephalus MS V. 1, Chapter 9. Epidemic of Influenza, Cancer, and Tainted Veal Influenza or Epidemic Catarrh Reference to Noah Webster's History of Epidemic and Pestilential Diseases, 1799 Regarding Thomas Smith's and Barker's cases Use of alkali after Barker's experiments Barker communicated his ideas on the nature of fever, together with some practical observations on the use of alkalis in fever in 1795, to Mr. William Payne, Secretary of the Humane Society in New York, who gave the letter to Dr. Samuel Mitchill at Columbia College. MS V. 1, Chapter 10. Letter to Samuel L. Mitchill in New York, May 30th 1798 The first page of a letter to Dr. Samuel Mitchill, subsequently published in the Medical Repository 1799, Vol. II No. II, pp. 147-152: "On the febrifuge Virtues of Lime, Magnesia and Alkaline Salts in Dysentery, Yellow-fever and Scarlatina Anginosa. In a Letter from Dr. Jeremiah Barker, of Portland, (Maine) dated May 30, 1798." The Jeremiah Barker Manuscript Volume Two MS V. 2, Introduction Chapter opens with a l…