Rural Medicine

Rural Medicine Gets New Tools

Penicillin AdThe mythical figure of a country doctor is a staple of American popular culture – think of Doc Hough in the recent movie “Doc Hollywood.” Well, there are actual country doctors, like Dr. Charles Ashby from Geneva, Nebraska. In the 1940s, Ashby saw a revolution in medicine with the introduction of penicillin and other antibiotics.

Before antibiotics, people around the world often died from diseases like small pox, tuberculosis, polio, whooping cough, tetanus, and malaria. American soldiers fighting in the South Pacific, North Africa and other areas faced diseases they did not have at home. People around the world were dying of common infections.

The world can thank agriculture for moving penicillin from the laboratory into the field. Alexander Fleming, a Scottish bacteriologist, discovered penicillin in 1928 when he noticed a certain kind of mold killed bacteria. But after his discovery, scientists couldn’t grow enough mold to make it into a medicine. In 1941, two British scientists came to a U.S. Department of Agriculture laboratory in Illinois and brought with them a powder made from a mold. These scientists began growing penicillium mold. They found that the mold grew faster when “fed” a mix of corn liquor and milk sugar. Yet even a year later, scientists had only grown enough penicillin to treat one person. Then they discovered a stronger strain of penicillium on a moldy cantaloupe! When the agricultural scientists gave the new cantaloupe-based strain to the drug companies, the production of penicillin took off.

Dr. Charles AshbyCommercial production of penicillin went from zero in 1941 to 21 billion units in 1943. Through the efforts of many people, there was enough penicillin to treat Allied soldiers who were wounded during D-Day in 1944 and following battles.

Dr. Charles Ashby started his medical career in the Navy before becoming a country doctor in Nebraska. He remembers treating sailors with the new drug. The first formulations didn’t have any painkiller as part of it, so the area around the shot would get very sore. When the sailors would complain, “I’d just give them a little sympathy and didn’t think too much about it,” Ashby says. Then he got sick, “and they started doing that to me! And I had a lot more sympathy after that.”

Penicillin saved lives in World War II and afterward. Later, the animal form of the drug helped farmers protect livestock from infection and disease.

After the war, research into new “wonder drugs” exploded and health care got better. A host of new antibiotics were introduced. Medicine took on ancient diseases. For example, poliomyelitis is a contagious disease that strikes children and young adults and can result in permanent paralysis. President Franklin Roosevelt was a victim. In 1947 and ’48, a polio epidemic killed more than 1,000 people and crippled many more. By 1949, scientists were making progress on a polio vaccine that could protect children from being infected. The promise of that vaccine came true in the 1960 when millions of children were inoculated and polio almost became extinct.

Yet, for all the advances, there were some things that remained the same in the practice of rural medicine. After the Navy, Dr. Ashby spent his entire career in Geneva, Nebraska. “If you notice the front door [to the office],” he says. “That door is never locked… I haven’t had any trouble, except one day Fast Eddie stole the television set, ran off with that. He’s one of the local boys.”

Written by Claudia Reinhardt and Bill Ganzel, the Ganzel Group. A partial bibliography of sources is here.

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