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HEALTH OFFICER
ON A RAINY September evening in 1879, newly inaugurated Governor Luke Pryor Blackburn greeted constituents and visiting dignitaries who crowded into Frankfortâs glittering Capitol Hotel ballroom to congratulate him. As he received their good wishes, the corpulent, white-haired governor must have reflected on the strange road that had brought him to this honor and responsibility. A native of Kentucky, he had spent most of his adult life in the Deep South, where he won acclaim as a health officer and humanitarian. What could a physician with little political experience contribute as the commonwealthâs first citizen? Blackburn earlier had announced that he hoped to make improvements at the stateâs penitentiary, but most Kentuckians expected very little from the philanthropist. They saw his election as nothing more than a reward for the âGood Samaritanâsâ long devotion to victims of epidemic yellow fever and Asiatic cholera.
The Blackburns were among Kentuckyâs pioneer families. George and Prudence Blackburn, Lukeâs grandparents, came to Kentucky from Virginia about 1784 and built a log home and fort in the northern part of what became Woodford County. It was rumored that the Blackburns kept a pet bear at the fort, but whether the animal frightened away Indians or entertained the Blackburnsâ offspring is unknown. If the latter, the bruin had plenty of playmates, for the pioneer Blackburns raised at least twelve children to maturity. Lukeâs father, Edward M. (âNedâ), read law with George Nicholas and practiced his profession for many years, but he was best known as one of the stateâs leading breeders of fine horses. In 1809 Ned married fifteen-year-old Lavinia Bell and built for his rapidly increasing family a brick home, âEquira,â at Spring Station. Luke, the fourth of their thirteen children, was born at sunrise on June 16, 1816.
Blackburn grew to maturity on the familyâs large Woodford County farm. Nothing is known about his formal schooling, but he undoubtedly derived much of his practical education from listening to the conversations of the men in his family. His maternal grandfather belonged to Kentuckyâs 1799 constitutional convention, his Blackburn grandfather hosted the famed Marquis de Lafayette during the generalâs Kentucky visit in 1825, and both grandfathers had known George Rogers Clark and other early explorers and settlers. Henry Clay was a distant cousin and an occasional visitor to the Blackburn home; Lukeâs Uncle William had served in the state legislature since 1808 and would be lieutenant governor during the administration of James T. Morehead; and a great-uncle, Gideon Blackburn, was the Westâs best-known Presbyterian minister, a former missionary to the Cherokee Indians, and a president of Centre College. Churchill Blackburn, another uncle, was an unusually well educated and highly esteemed physician in Paris, Kentucky. Medicine was the least prestigious of the professions in which the older Blackburns excelled, but it was the one that held the greatest attraction for young Luke. Shortly after his sixteenth birthday, he began a two-year apprenticeship with Churchill Blackburn and was engaged in this training when Asiatic cholera made its initial visit to Kentucky.
No Kentuckian, indeed no American, knew much about cholera in 1832. Medical books described it as an epidemic scourge of India and the Far East. Yet in 1828 it swept across Russia; the following year it decimated the German states and by autumn of 1831 was ravaging the British Isles. In the spring of 1832 the pestilence crossed the Atlantic with immigrants, and throughout the summer it plagued North American port cities; 2,500 died in Montreal, 3,500 in New York City, 1,400 in Norfolk, 5,000 in New Orleans. On July 12 the Lexington Observer and Reporter predicted that the pestilence would reach every part of the United States.
Although most of her physicians had denied that the scourge would visit the commonwealth, cholera cases were reported in several Kentucky towns in the late fall of 1832. An early frost, however, ended the threat before the disease reached epidemic proportions. The death toll in Louisville was unofficially listed as 122. Maysville and Lexington each reported a few cases. A resident of the latter town wrote that the disease âkilled five intemperates, frightened our citizens into strict temperance, drove away some of the faint hearted pupils [at Transylvania], and then took wing itself and troubled us no more.â1 Residents of the Bluegrass state breathed a premature sigh of relief.
Blackburn followed with concern the news of choleraâs westward journey. He read in his uncleâs medical books and in the various reports carried in the newspapers that cholera was believed to be a miasmatic disease, caused by poisonous gases produced by rotting vegetation and standing water. The malady, according to contemporary literature, was âexcitedâ by the ingestion of green fruits and vegetables, by intemperance, and by strong emotion. Recommended treatments included bleeding, cupping, purging, and an infinite variety of medical concoctions.
In the summer of 1833 Blackburn gained firsthand knowledge of the disease when cholera hit the Bluegrass portion of Kentucky with vicious force. Maysville reported her first cholera deaths on May 29, and within thirty-six hours most of her white inhabitants had fled inland, carrying in their intestines the highly toxic Vibrio comma, the cholera-causing bacillus that is spread by careless disposal of sewage and subsequent contamination of the water supply. Most Kentuckians obtained water from poorly located wells that received frequent washings from shallow privies; in many parts of the state the springs that fed these wells ran through underground limestone caverns into which raw sewage was discharged. Thus, the disease hit areas with sudden, explosive force, affecting large portions of the population within a brief period.
The true cause of the scourge was unknown to Blackburn and other antebellum physicians, but they observed that cholera made a precipitous onset characterized by copious and purging diarrhea (and, eventually, ârice-waterâ stools), vomiting, subnormal temperatures, severe muscle cramps, and general prostration. Death generally occurred within thirty-six hours. For the small percentage who survived, recuperation was slow; immunity to future attacks would be temporary.
Cholera plagued most of the towns in central Kentucky in the summer of 1833, and residents experienced fright and hardships similar to those recorded in Lexington, where the malady raged unchecked throughout June and early July. Lexington, like most major towns, had a board of health whose contribution to the townâs well-being was nebulous; during the epidemic the board members and other city officials fled and made no pretense of aiding the sick. Of Lexingtonâs 6,000 residents, less than two-thirds remained in town; 500 of these died. A contemporary description of Lexington, previously labeled the stateâs healthiest town, sounds much like one of Europe during outbreaks of the bubonic plague.
The houses of business were all closed and scarcely anything was to be seen or heard in the streets except the hearse bearing its victims to the grave or some terrified messenger rushing or galloping for assistance. It was extremely difficult to have coffins and graves prepared in proper time for the dead. . . . If the pestilence here had any choice in its victims, it seemed to prefer the temperate and those who according to human reason were adjudged to be beyond its reach. The intemperate were generally sparedâon the other hand some of our best citizens perished.2
Another Lexingtonian lamented that since âall the markets were suspended and the bakersâ shops shut,â there was ânot a pound of beef to be gotâand very little else. Not even a cracker for sale.â3
Of the Lexington physicians in town throughout the entire epidemic, only Benjamin Dudley, a professor at Transylvaniaâs medical department, survived without a sign of illness. At least seven of the townâs practitioners died. Dr. Joseph Boswell, the father of Blackburnâs future wife, became ill while making a house call in the country. Experiencing the sudden onset of abdominal cramps, he stopped at a farmhouse about six miles from Lexington and received permission to lie down on the porch. The lady of the house covered him with a blanket and went to fetch her husband; when she returned a few minutes later, Boswell was dead.
Late in June cholera struck Paris âwith almost unparalleled malignity.â4 For three weeks Luke and his uncle aided the townâs cholera victims, but despite their efforts and those of other doctors and volunteers, 10 percent of the townâs population died. Nothing is known of Lukeâs specific deeds, but his thoughts were probably similar to those of a Danville apprentice who attended cholera patients and later wrote that he felt âterror and trembled like an inexperienced soldier who hears the report of the first gun that brings on the engagement,â but âbecame courageous and met the destroyer [cholera] without faltering . . . [and] for the first time acted as a physician, giving medicine to those who requested my aid.â5 Certainly young Blackburn learned much about the psychological problems of a town under siegeâof people waiting to be stricken by a mysterious malady and die, of the desperately ill who had no one to nurse them, of small children trying to care for their sick parents, of orphans who became public charity cases, or uncoffined bodies, shallow, mass graves, lack of food, lack of everything. It was a lesson he would never forget.
Upon completion of his two-year apprenticeship, a nineteenth-century form of premedical training, seventeen-year-old Blackburn entered the medical department of Transylvania University, one of the nationâs oldest and most prestigious schools. As at other medical institutions of the antebellum period, Transylvaniaâs academic year extended from November 1 to February 28. Graduation requirements included attendance at two of the annual sessions, satisfactory passage of a comprehensive oral examination, and the completion of a thesis.
Blackburnâs eighteen-page thesis, entitled âCholera Maligna,â reiterated most of the accepted theories of the day. He noted that the disease was fickle in its selection of sites and victims, but that it had an affinity for watercourses, and it struck âlike a thunderstorm or whirlwind.â Cholera was more likely to be fatal to those whose constitutions were weakened by intemperance or impoverished diets than to the healthy, Blackburn wrote, and it was caused by eating crude vegetables or unripe fruits and drinking acid beverages, beer, porter, and âbad water,â an inclusion he did not explain. Blackburn had learned that during the Lexington epidemic all residents of the town, even those not stricken by cholera, suffered from disorders of the gastrointestinal system; âthe epidemic principle bears a specific relation to the alimentary mucous surface . . . impairing its function.â The young man concluded that the effect of cholera on the body was that of a âuniversal sedation of organic life, manifested in the capillary tissue, then in the larger vessels and heart,â thus causing bodily functions to cease.6
Blackburn received his medical degree in March 1835, three months before his nineteenth birthday, and opened an office on Lexingtonâs Main Street, where he and an associate âgratuitously prescribe for the poor every day at 7 A.M.â7 The partnership was brief. Cholera struck Versailles in August, and the local physicians either fled from the disease or became victims of it. Hearing of the townâs plight, Blackburn went to Versailles, and he and at least one other doctor worked day and night to care for the sick. A resident of the town later labeled Blackburn the âkindest and most gentle yet bravest manâ he ever met, for he âentered homes of the sick and dying, and many did he bring back from the jaws of death by his skill and intrepid nerve.â8 Nineteenth-century accounts indicate that Blackburn remained in Versailles at the cessation of the epidemic because of pleas from local residents that he do so, but his family ties with the area undoubtedly influenced his decision also.
In November of 1835 Luke married his distant cousin, Ella Gist Boswell, one of the many orphans of the 1833 Lexington epidemic. Ellaâs ancestors were also early explorers and settlers from Virginia. Her father, a former army surgeon, had practiced medicine in Lexington for nearly three decades and had been part-owner of several of that townâs mercantile establishments. An older brother was known for his fine racehorses.
Little is known of the Blackburnsâ life in Versailles. The practice of medicine, especially in rural areas, was generally not lucrative, and Blackburnâs income may have been insufficient for his growing family. Shortly before the 1837 birth of his only son, Cary Bell, the doctor invested his savings in a company that manufactured hemp products. Unfortunately the enterprise failed, and Blackburn suffered a considerable loss. In 1843 he campaigned as the Whig candidate from Woodford County and was elected to the Kentucky House of Representatives, but he served without distinction and apparently was not interested in a second term. A year later the Blackburns moved to Frankfort where Luke and a younger brother shared an office on Saint Claire Street. Their advertisement promised that a servant would always be present to aid ladies in and out of carriages and to return home those patients who were too ill to travel alone.
Flush times in Mississippi during the 1840s attracted many Kentuckians, including the Blackburns. In the early months of 1846 the doctor and his family moved to Natchez, a town famous for its wealthy elegance, brawling river-front, and fine racetrack. The Boswells and Blackburns were well known to Natchez residents. Ellaâs brother frequently raced his prize-winning horses there, and some of the areaâs best horses and cattle had been born on Ned Blackburnâs Woodford County farm. The Blackburns purchased a home on Canewood Place, next door to the Presbyterian parsonage, and Ella was delighted with the interest the doctor exhibited in its furnishings and yard plantings. Cary briefly attended the Natchez Institute, one of the Southâs early public schools, but in the fall of 1848 he returned to Kentucky to stay with his grandparents and study with Mr. B. B. Sayre at the Frankfort Academy. Ella sorely missed the absent child, who was ânever out of my mind.â Moreover, she wrote, âI had no idea that Doctor would take being separated from him so hard, still he says he knows it is best for the childâs own good.â9
In Natchez Blackburn quickly became active in community affairs. The doctor served as his fatherâs agent for residents who wished to purchase Kentucky cattle; he helped found a temperance society and was elected honorary captain of the Natchez Fencibles, an elite militia group. When the town honored Jefferson Davis and the First Regiment of Mississippi Volunteers returning from the war with Mexico, Blackburn served on the planning committee and as toastmaster at the âheart inspiringâ reception for the âlaureled volunteers.â The troops, conducted from the wharf to the promenade grounds by various city militia groups, were presented with bouquets from students at the Natchez Institute and enjoyed a âsumptuously loaded boardâ prepared by the women of Natchez. Toasts led by Blackburn âsped merrily around the boardâ as hosts and guests saluted the nation, the president, Major Generals Zachary Taylor and Winfield Scott, âOld Kentucky,â the First Mississippi Regiment, and the ladies, the âfirst to cheer the soldiers onâthe first to welcome them back.â10
Blackburnâs circle of friends in Natchez included Davis and other social and political figures of the area, but William Johnson, the famed âbarber of Natchez,â was his most interesting acquaintance. A free Negro and a slave owner, Johnson kept a diary which he filled with business transactions, family news, and local gossip. Included in it were notations of Blackburnâs visits to ailing members of Johnsonâs family, services the barber rendered for Blackburn, and the death notice of one of the doctorâs brothers, killed during a street brawl in Frankfort. The diary also contained Blackburnâs annual bill for professional servicesâone dollar for each office call and two dollars for each house call, regardless of the malady treated. In 1851 Johnson died from a gunshot wound inflicted by a neighbor with whom he had quarreled over a boundary question. In his dying breath the barber named his assassin to Blackburn and heard the doctor promise to care for his friendâs family. Blackburn served as one of the executors for Johnsonâs estate and for many years, even after he moved from Mississippi, acted as an advisor to Johnsonâs widow and many children.
During his Natchez years Luke enjoyed a lucrative career. In November 1853 he informed his father that he had netted $10,000 that year from the practice of medicine, a handsome income even for an area where the cost of living was...