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inspection of the chest. Lond Med Gazette 1835; 17: 13–14. 3. Weiner M-F and Silver JR. Edward Harrison and the treatment of spinal deformities in the nineteenth century. J R Coll Phys Edinburgh 2008; 38: 265–271. 4. Bovine G. The portrait of Dr Edward Harrison. J Med Biogr 2010; 18: 124–126. 5. Harrison E. Remarks upon the different appearances of the back, breast, and ribs, in persons affected with spinal diseases: and on the effects of spinal distortion on the

sanguinous circulation. Lond Med Phys J 1820; 44: 365–378. 6. Williams CJB. Lectures on the physiology and diseases of the chest, including the principles of physical and general diagnosis. Philadelphia: Haswell, Barrington, and Haswell, 1839. 7. Williams CJB. A practical treatise on the diseases of the respiratory organs: including diseases of the larynx, trachea, lungs and pleura. Philadelphia: Lea and Blanchard, 1845.

Samuel Holden Parsons Lee (1772–1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut

Journal of Medical Biography 23(1) 19–27 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0967772013479275 jmb.sagepub.com

James K Mattie Jr1 and Sukumar P Desai2

Abstract Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered. In 1798 he served selflessly as the only physician in town who was willing to battle the Yellow Fever outbreak of New London, Connecticut. Because he practised at the dawn of the age of patent medicine, unfortunately his name also came to be associated with medical quackery. We argue that his contributions have been grossly underestimated. He compounded and vended medications – including bilious pills and bitters – that were gold standards of the day. Moreover, one preparation for treatment of kidney stones led to his sub-specialization in this field and was met with such success that its sale continued for nearly 100 years after his death. While a talented medical man, Lee also had a knack for business, finding success in trading, whaling and real estate. Keywords Yellow Fever, Samuel Holden Parsons Lee, Bilious Pills, German Bitters, Lithontriptic

Family background Samuel Holden Parsons Lee was born in Lyme, Connecticut, on 5 August 1772, the eldest child of Ezra Lee (1749–1821) and Deborah Mather (1752– 1826).1,2 He was named after his uncle, Samuel Holden Parsons (1737–1789), an American patriot who would become a Major General in the Continental army. His father, Ezra Lee, was selected by Ezra’s brother-in-law Samuel Holden Parsons, with the approval of General George Washington (1732–1799), to pilot David Bushnell’s (1740–1824) human-powered submarine, Turtle, when the original pilot Ezra Bushnell, the brother of the submarine’s inventor, took ill.3–5

While Ezra Lee did not succeed in destroying a British warship, his mission was far from a failure. During that eventful night, a single submarine crewed by a lone soldier forced an entire fleet of British ships to 1 Consultant Anaesthetist, Morristown Medical Center in Morristown, New Jersey, USA 2 Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, USA

Corresponding author: Sukumar P Desai, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. Email: [email protected]

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abandon New York harbour.3–5 Captain Ezra Lee made history by being the first man to pilot a submarine in battle and the first to deploy an underwater explosive in combat. His bravery was recognized personally by Generals George Washington (1732–1799) and Israel Putnam (1718–1790), the latter having witnessed the initial mission.4 He died in 1821 and his obituary in the Commercial Advisor read that it was ‘not a little remarkable, that this officer is the only man, of which it can be said, that he fought the enemy upon land – upon water – and under the water . . .’.1,6 Lee certainly had big shoes to fill. While he went on to become a devoted physician and entrepreneur, the little information readily available about him incorrectly portrays him as a mere quack and ‘snake oil salesman’. Our biographical exploration of this remarkable man is based on the published literature and his own personal documents made available by surviving members of the Lee family.

Early years (Figure 1) Lee had a privileged upbringing in Lyme, Connecticut. It was said that his ancestors once owned one-eighth of the town but his family were typical ‘waste-not-wantnot New Englanders’ who farmed and lived modestly.7 This frugality is reflected in his personal books and journals where he wrote extensively in the margins and between lines. He was afforded the opportunity to attend school until he was 15 years old and then as the eldest male child he ‘worked on the place.’8 He began medical training at the age of 17 by apprenticeship with a physician uncle in 1789. During that time, he supplemented his income by ‘keeping school’, ie teaching at a local schoolhouse. Three years later he moved to New York City to complete medical training at Columbia College under the tutelage of Samuel Bard (1742–1821), Dean of the Faculty, and Dr Richard Bayley (1745–1801), a surgeon who taught his anatomy course.8–10 He returned to Connecticut in May of 1793 to begin practising medicine. His personal life soon came to the fore and on 31 March 1794, he married Elizabeth Sullivan (1773–1847) whose father (John Sullivan) was also involved in the American Revolution.1,2,11–13 Lee opened an office and store on State Street where, like most physicians of the day, he acted not only as physician, surgeon and apothecary but also as shopkeeper, selling paints, varnishes, seeds and rum.2 The strong work ethic he developed as a young man would stand him in good stead, for he was only 26 years old when his knowledge, ability and stamina would be severely tested.

Figure 1. Doctor Samuel Holden Parsons Lee, aged 21 years, Painted on Ivory.

The Yellow Fever epidemic of New London, Connecticut Between August and October of 1798, the Yellow Fever epidemic that had swept through many of the young nation’s more populous cities settled upon New London.2 On Wednesday 22 August, Captain Elijah Bingham (1736–1798) was the first to take ill and his condition deteriorated rapidly.2 He died four days later, the first fatality of the epidemic. Within one week, 25 more persons including his family succumbed to Yellow Fever.2,14 As the disease raged through town, the panicstricken inhabitants fled the area. The streets were deserted, the shops closed, and ships stayed far from the harbour.2,15 Inhabitants stayed indoors and cared for their ill and ‘even the mourners ceased to go about the streets’.15 With the exception of Lee, few were willing to expose themselves to the dangerous effluvia, aside from the sexton and his assistants who drove the hearse and performed funeral rites in solitude.2,15 In response to a prize-winning question posed by the Connecticut State Medical Society in 1794, Lee had written a lengthy dissertation about bilious autumnal fevers.16 Thus, he was very knowledgeable on the subject and well prepared for this challenge. Of the seven practising physicians in the city, four fled early in the epidemic along with other frightened townspeople.2,14 Of the three who remained, one was ‘too indisposed to practice’ and another was ‘violently attacked by the fever’.14 This left Lee the primary physician for the city, the man ‘to whose lot it fell alone and unassisted to combat the fury of this dreadful pestilence’.14 During this period he ‘cheerfully sustained the arduous task of visiting and (treating) 30–50 patients daily, notwithstanding the great fatigue and danger of infection to which he peculiarly exposed himself’.14 This battle would be a test of stamina and will. He worked for six weeks at a stretch, without time to

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bathe or change clothes. Occasionally, when his carriage reached his patients’ homes, he needed to be woken and at times he even fell asleep in a patient’s home.2 His services were withheld only when he was briefly bedridden with the disease and for these few days Dr James Lee, a physician from the outskirts of town, worked in his place.2,14 In the late 18th century, the Germ Theory of disease had not been promulgated and both Louis Pasteur’s (1822–1895) experiments disproving spontaneous generation (1859) and Robert Koch’s (1843–1910) postulates (1890) were well in the future. American medicine was still operating on small modifications of some very ancient theories.17 The humoral theory of disease that had been developed in ancient Greece was the basis of Western medicine until the 19th century.17,18 This theory held that good health depended upon the balance of the four principal humours – blood, phlegm, yellow bile and black bile.18 Air quality was commonly believed to cause an imbalance in the humours and result in disease, including epidemics. The miasmatic theory blamed effluvia from the decay of such organic material as garbage, faeces, swamps and other strong offensive odours for the disruption of bodily humours and development of disease. Passions, eg strong emotions and intemperance, were also thought to play a role in the development of fever. Although physicians realized that diseases were contagious, nothing was known about the mechanism of transmission or the nature of the contagion.18 In a 1799 letter to Dr David Hosack (1769–1835), Professor of Botany and Materia Medica at Columbia College, Lee outlined his ideas as to the cause of this epidemic, indicating that he intended to publish his opinion. He questioned whether the disease was ‘of a specific character imported’ or ‘if it is endemic, sporadic, and of domestic origin’ though his discussion suggested an imported contagion.19 In addition, he wrote that there was nothing environmentally noteworthy in the area except a ‘few which were too evident to escape notice and which seem to be generally considered as the probable local causes’19 (Figure 2). First – ‘A large quantity of badly cured, and then stinking codfish . . . in a state of maceration’ left to dry on racks. He reports that the stench ‘impregnated the air of one half of the city’ and citizens ‘had attacks of vomiting and disagreeable sensations of the stomach’. Second – ‘A large bed of manure . . . on the long wharf . . . made up of a combination of horse, sheep, cattle, poultry and swine faeces’ adjoined by an ‘enormous accumulation of human faeces on a short wharf’. He wrote ‘in the morning the effluvia arising from this nuisance was intolerable and extended itself into a great part of Bank Street’.

Figure 2. Letter to Dr David Hosack (1799).

Third – A refuse vault belonging to Bingham’s coffee house, which was leaking and overflowing. He added ‘It was very offensive to the neighbourhood for some time before the epidemic commenced’. While these observations did not identify the actual cause of the outbreak, conditions in the city clearly provided a breeding ground for disease and were a public health hazard. In addition, Lee had expressed concern in an article in the Connecticut Gazette that the infection might remain adherent to the feathers in the bedding of the sick. He worried that, after the epidemic was over, ‘lying the bedding in sunlight . . . might excite the infection to action’.2 He wondered whether burying the bedding would even kill the infection.2 It is interesting to note that Lee’s account also identifies the geographic location of stagnant water, areas that would prove deadly during a mosquito-borne illness. Other accounts similarly note the terrible smell of rotting fish in the city at the time, as well as the weather that summer being particularly hot, humid and nearly windless and rainless. An unusual abundance of mosquitoes and large flies was noted that year although the connection between mosquitoes and Yellow Fever was not theorized until 1881.2 The late 1700s to early 1800s is known as the heroic era of medicine, a time when even Dr Benjamin Rush (1745–1813), the nation’s most distinguished physician and signer of the Declaration of Independence, advocated bleeding and purging to treat disease.20 Rush had battled Yellow Fever in the Philadelphia epidemic of

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1793 and published his views on the outbreak. His theories were mostly in keeping with the humoral and miasmatic theories discussed earlier, and the miasma he blamed for this outbreak was produced mainly by a shipload of rotting coffee.21 According to him, these effluvia led to hyperexcitability of the blood vessels and a build-up of bile that resulted in Yellow Fever.20 Treatment was aimed at relieving the pressure in the blood vessels by bleeding and controlling the build-up of excess bile through purging.21 Though some considered his methods extreme even in his time, the rationale behind the suggested treatment, along with Rush’s enormous political and medical influence, allowed these ideas to dominate American medicine for more than a generation.17,18 Lee was no exception and he applied this gold standard of treatment which consisted of inducing vomiting, cooling, bleeding and purging.2,16 For the latter he used bilious pills, a product he would later patent. Lee expressed his belief in individualized care for patients when he wrote that ‘the age, constitution and habits of the patient, the season of year, . . . the weather, the disease whether epidemic or not, the diseases most prevalent . . . are circumstances which merit peculiar attention in consulting a plan of cure’.16 In his prizewinning essay on bilious fevers, he wrote that treatment began with the patient being placed in a cool, airy chamber with few attendants. ‘Should he have stomach pains then an emetic would be administered. For fever blood would be drawn from the arm’, the amount of which varied based on the variables previously mentioned.16 After bleeding, the afflicted should have ‘cooling, diluting drinks such as lemonade or barley water’. Cathartics, emetics, bleeding and cooling all played a role in treating the disease.16 Approximately 400 cases were reported in the three months during which the epidemic raged through New London. Most cases were not spread throughout the town but rather the epidemic was confined to an area around ‘the Parade’, or public square, and the market.14,15,19 Most fatalities occurred on Bank Street between the Parade and a wharf, a section 200–300 yards long. Lee remarked ‘It is a fact worth notice that [Bank] Street has always been reputed the most healthy part of the city, on account of its high airy situation . . . constantly receiving the benefits of the sea breezes’.19 Holt remarked that of the 92 residents from this part of Bank Street who remained in town during the outbreak only two over the age of 12 escaped acquiring the disease while 33 died.14 By 28 October 1798, after less than 10 weeks, the epidemic was mostly over, having claimed 81 lives but Lee had made his mark on the town. Holt (1798) remarks that Lee’s conduct was ‘such as will call the warmest sentiment of gratitude and esteem from the

citizens of New-London as long as the remembrance of the Yellow Fever shall exist in their minds’.14 Furthermore, he commented ‘How many owe their safety to his skill and assiduity it is impossible to know; but in all probability there are many now enjoying the invaluable blessings of life and health who but for his benevolent care would have been tenants in the house of rest’.14

Bilious pills Despite his heroic work during the Yellow Fever epidemic, Lee’s name is most often found associated with his patented bilious pills which have been relegated to the realm of medical quackery. We submit that these pills were popular and widely accepted because they were the gold standard of the day, not simply a wellmarketed ineffectual and dangerous cure-all. As purging was commonly employed, many physicians used a combination of cathartics to combat biliousness where poor biliary flow was the suspected cause of symptoms. Indications included fever, jaundice, colic, dysentery, worms, headache, indigestion, dropsy (congestive heart failure) and scurvy, and also cold and sore throat.22 They could be used to ‘cure foul stomachs, where pukes are indicated’ and to ‘restore the system after a debauch of excessive eating and drinking’.22 Bilious pills were also a part of Benjamin Rush’s own medical armamentarium. Nicknamed ‘Rush’s Thunderbolts’ or ‘Thunderclappers’, they were among the medications brought along during the Lewis and Clark expedition of 1804.23,24 The composition of bilious pills varied but most preparations were based on active ingredients including calomel, jalap and gamboge. Calomel, or mercurous chloride, was used as an ‘internal medicine’ since the 1600s.24,25 While ingestion of liquid mercury was known to be poisonous, it had been used topically to treat a variety of skin lesions.24,25 The apparent success obtained using the milder and insoluble mercurous chloride in treating syphilis led to its more widespread use.24 In large doses it acted as a potent laxative but smaller doses led to cumulative effects recognized today as mercury poisoning.24 However, these symptoms were mistakenly taken to suggest that the drug was working and thus sore gums, loosening teeth, excessive salivation and discoloured stool were believed to indicate that the drug was eliminating syphilis from the body.24 Jalap or scammony was a resin or powder derived from the aptly named plant Exogonium purga.24 Its active ingredient was known as scammonin or jalapin and it was known to the medical community as ‘a safe purgative, performing its office mildly; seldom occasioning nausea or gripes’.24,26 Gamboge, with the active ingredient gambogic acid, was another potent

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German bitters

Figure 3. Bilious pills ingredients, as submitted to the Connecticut State Medical Society in 1804.

cathartic, ‘useful in dropsical conditions and to lower blood pressure, where there is cerebral congestion’.27 It was known to cause vomiting, nausea and griping, and therefore was usually combined with other purgatives to work synergistically.26,27 Interestingly, all three of these ingredients continued to be used in the USA until the mid-1900s. In 1796 an industrious man from Windham, Connecticut, named Samuel Lee Jr (1773–1814) obtained the first US patent for a medication, his bilious pills. These pills were marketed as Lee’s Windham Pills and, while the exact list of ingredients was lost in a Patent Office fire in 1836, a later dispensatory listed the ingredients as ‘gamboge, aloes, soap and nitrate of potassa’.28,29 Three years later, in 1799 Dr Samuel HP Lee secured a patent for his bilious pills composed of gamboge, aloes, soap, scammony, jalap, syrup of buckthorn (a purgative consisting of anthraquinone derivatives), calomel and gum Arabic28,30 (Figure 3). Due to the similarity in names and geographical proximity, a bitter rivalry soon ensued.2,28,29 The two Lees proceeded to attack each other through newspaper advertisements aimed at discrediting the other in the eyes of the public. Regardless of the acrimony it stirred, the advertising battle between the two Lees improved sales for each of them and their pills remained popular for many years.28,29

Another preparation developed by Lee was ‘German Bitters’ or ‘Elixir Stomacticum Germanicus’, a drug initially invented by a German, Doctor Abraham Van Vleek, but eventually passed down to Lee. The actual composition of these bitters is open to speculation but the term ‘bitters’ describes an aromatic infusion made from herbs, seeds, roots, fruit peels, spices and barks.31 The liquid component of the formula could be water, wine or spirits depending upon the type of bitters being prepared and the botanical mix through which it was passed. These bitters were prescribed for numerous indications and Lee attested to their high quality. They were used to give tone and strength to vital and natural functions and to restore the system to health after sickness, particularly when a lack of appetite and general disability prolonged recovery. ‘They may be used freely in all cases where stomach bitters are indicated; particularly in jaundices, indigestion, fevers, dropsy, chlorosis, rheumatism and gout’.32 In addition, ‘women with weak and faint stomachs accompanied with pains, cramps and windy flatulencies will find them a certain cure’.32 The bitters could also be used to prevent or treat worm infestation by destroying ‘the animacula which worms generate in the bowels of infants and adults’.32 The indications for the bitters as listed in his advertisement were in keeping with medical theory of the day. As the name ‘tonic’ suggests, they were believed to increase the tone of the various bodily systems. They were thought to exert most of the majority of their effect on the stomach and since the ‘state of the stomach commonly communicates to other parts of the system; so it is sufficiently probable that by improvement of digestion the vigour of the system may be in general improved’.31 Thus, while they were used primarily for indigestion, improving appetite and any bowel dysfunction, they were also thought useful in treating fevers, dropsy (CHF), gout, nephrolithiasis (kidney stones) and other conditions.31 In fact William Cullen (1710–1790), the famous and highly influential Scottish physician who was one of the founders of the Royal Medical Society, remarked that ‘some reports of (bitters) having been useful in even the plague itself are probably well founded’.31 The popularity of bitters waned as medical advances showed they could actually decrease the tone of the stomach, and prohibition later put the last nail in the coffin for bitters in the USA since many were prepared with alcohol. Surprisingly, some still survive to this day as alcoholbased aperitifs and digestifs, thought to improve appetite and digestion. Non-alcoholic versions include citrus and chamomile tea.

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Figure 4. Lithontriptic Label.

Lithontriptic While Lee’s Bilious pills and German Bitters were popular in their time, even greater success was to come from a drug Lee manufactured and sold with minimal advertisement. Thereafter, his interest and development of a drug known as Dr Samuel HP Lee’s Lithontriptic guided his career and would continue to be fashioned by successive generations of his family until 1953.33,34 As the name would suggest, Lithontriptic was used to dissolve stones, whether in the kidney, the urinary bladder or the gall bladder. Lee first concocted Lithontriptic around 1820 to treat a patient who he described as ‘most severely afflicted with the Gravel and Stone in the kidneys and bladder’.35 The drug ‘effectively and speedily performed a radical cure’ and Lee found this new agent to be so effective in dissolving stones and in cleansing the ‘renal organs’ that he adopted this mixture in his regular practice.34,35 Over time, patients communicated the effectiveness of the treatment to their suffering friends and neighbours who also contacted Lee to try his remedy.35,36 His success led him to specialize exclusively in the treatment of such conditions33,34 (Figure 4). Although the efficacy of the mixture is questionable, his family is in possession of hundreds of testimonials from patients and other physicians proclaiming its value. In preparation for retirement Lee taught his sons, Dr Henry S Lee of Boston and Dr Samuel HP Lee, Jr of New York, to prepare the formula ‘such that those who had benefited by it might continue to secure the Lithontriptic for years to come’.33 After the death of his sons, the recipe likewise was passed down in the family. Although the drug remained popular with customers and many prominent physicians, stricter Food and Drug Administration (FDA) regulations made its manufacture and sale too cumbersome for a small family business, forcing the closure of SHP Lee Co, Inc in 1953.37 The loyalty of its users and the ability of the company to thrive without advertising beg further exploration. First, unlike many questionable medications of

the day, there was absolutely no opiate or painkiller of any kind included in the product.38 Moreover, as explained below, the mixture was probably effective in treating most renal calculi. The active ingredients of the Littentreptic, as it was known after an FDA-imposed name change in 1931, included potassium carbonate, castile soap (usually made from ash and a fat such as olive oil) and oil of ripe juniper berries.38 The drug worked through alkalinization of the urine and promotion of diuresis, similar to the current treatment of nephrolithiasis. In Lee’s Lithontriptic, potassium carbonate and castile soap were the alkalinizing agents and juniper berry oil exerted diuretic effects. Instructions to drink at least eight glasses of water daily and the great volume of dilute urine produced through diuresis likely helped prevent and treat calculus disease.39 The label also recommended avoidance of foods high in acids, as well as meat which is a source of uric acid.39 In addition, the SHP Lee Company instructed that ‘the same rules of diet and exercise that a temperate habit would enjoin upon a healthy person should be observed’.39 During a time when the alternative to medical management was surgical lithotripsy – without the benefit of anaesthesia – it is no wonder that such a medication proved popular.

Other business exploits Lee’s financial wellbeing resulted not only from a successful medical practice but also from diversified business interests. He owned a fair amount of real estate and was said to ‘have bought and sold much property’.40 In addition to his private residence on Federal Street, he owned the building on Bank and Golden Street where his office and store were located.41,42 He was also one of the founding members of the whaling industry in New London, beginning with Dauphin in 1804, a ship built by Joseph Bauber at Pawkatuk Bridge specifically for whaling.40,43 He organized a whaling company and soon added two other ships to his employ, Leonidas and Lydia, and though their catches were sufficient and the business profitable, the enterprise had to be abandoned due to the embargo and war of 1812.40,43 Although an entrepreneur, Lee remained first and foremost a physician. Having practised in a port city and treated many sailors, he knew that sailors were ‘apt to be careless of their health, especially while at port, and expose themselves to every intemperance that can possibly produce the occasional causes of disease’.44 Thus he prepared a pamphlet with medical advice for seamen in order to ‘offer some general outlines on the appearance and management of the principal diseases which occur to seamen in different voyages’.44

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Figure 5. Lee in later life, while living in New York.

The publication offered a brief and concise method of treatment that could be practised by a ship’s crew while they were out to sea, where professional medical attention was not available. However, he warned that consultation with a physician was warranted for prolonged or serious illness. His pamphlet followed a cookbook style of medicine whereby an illness could be treated by using the contents of numbered vials in his prepared sea chests. As an example of the practicality of his pamphlet, he writes that ‘Jaundice is cured by purging with Number 3, taking a pill of castile soap two to three times a day, exercise, good diet, bitters, Number 11 bark, Number 4, brandy, wine, etc’.44 Of course he sold prepared sea chests to accompany the pamphlets but he also listed the contents of the vials such that others could replenish or make their own medicine chest and still benefit from his instruction.

Later life and conclusions (Figure 5) In 1838 when aged 66 years, Lee left Connecticut and moved to New York City to continue medical practice with his son, Samuel HP Lee Jr. For decades he continued to treat patients with urinary calculi, as well as to compound and vend his Lithontriptic until his death on 7 January 1863.2 His body was returned to Connecticut for burial in Cedar Grove Cemetery in

Figure 6. Cover Page of an Educational Pamphlet – Remarks on the Stone and Gravel.

New London where he rests beside his wife and several of their children.2 Dr Samuel Holden Parsons Lee did not reshape the field or practice of medicine. His theories will not dominate medical texts and he will never have a hospital wing named after him. However, while his exploits were not monumental, they were certainly important. To remember him in the context of medical quackery or, worse, to label him a quack would be a terrible injustice. Rather, he should rightfully be remembered for his many accomplishments which ought to be considered in the context of the period in which he practised medicine. For decades he was a valued member of the medical community who was esteemed not only by patients but also by his peers. He was an active member in the Connecticut State Medical Society and held several elected and appointed positions between 1806 and 1819.2,40,45 As an educator, he sought to further medical knowledge using several approaches. These included written dissertations on Yellow Fever and Cyanche Tonsillaris that were read at the state medical society meetings in

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1794 and 1796 respectively. In addition, he studied and sub-specialized in ‘the stone and gravel of the kidneys, liver and bladder’ and he distributed pamphlets that served to educate practitioners about the clinical entity and its treatment with his Lithontriptic (Figure 6).35,36 As a businessman, he was active in real estate in New London and pioneered the whaling industry. He was an entrepreneur who lived in the age of patent medicine and created and sold several medications; the success and practitioner loyalty associated with one medication was so great that it continued to be manufactured and sold without advertisement for almost 100 years after his death. He was also a humanitarian who took great pride in relieving the suffering of others, even when it was not profitable. He received testimonials from hundreds of physicians and patients and his altruism is evident in his pamphlets where he wrote that physicians with patients too poor to afford his cure ‘by sending me their names and place of abode . . . with a medical history of their cases (free of expense and postage) will be supplied gratis’.35 Most important, we remember the devoted physician who bravely and selflessly stood alone and risked his own life to treat townspeople during a terrible epidemic that killed one fourth of those exposed to it. From his family lineage much was expected of Samuel Holden Parsons Lee and he certainly lived up to those expectations. References 1. Hill WH. Genealogical table of the Lee family: from the first emigration to America in 1641, brought down to the year 1851. Albany, NY: Weed, Parsons & Company, 1851. 2. Labensky A. Samuel Holden Parsons Lee and yellow fever in New London. In: Thorns H (ed.) The heritage of Connecticut medicine. New Haven, CT: Whaples-Bullis Co, 1942, pp.114–120. 3. Dictionary of American Fighting Ships. www.history.navy.mil/danfs/t9/turtle-i.htm (2011, accessed 21 June 2013). Washington, DC: Navy Historical Center, Department of the Navy, 3 March 2012. 4. Lee E. Letter to General David Humphreys (original copy with Yale University), 20 February 1815. 5. Tomlinson ET. A short history of the American revolution. New York: Doubleday, Page & Co, 1901. 6. Ezra Lee’s Obituary. Commercial Advisor, 15 November 1821. Commercial Advisor. 7. Beckwith W. Early Lee family of Lyme and East Lyme Connecticut. East Lyme, CT: East Lyme Historical Society, 2010, p.iii. 8. Lee SHP. Remarks on financing Early Years, copied by SHP Lee, Jr. [1801]. 1801. 9. Columbia College Admission Ticket to Anatomy Course, fall 1792, signed by surgeon Dr Bayley, 1792. 10. Diploma from Columbia College, signed by Samuel Bard, Dean of Faculty, 1793.

11. Brown C. Vital Records, New London County, Connecticut 1646–1854. Compiled by Lucious Barbour. 1921. 12. Caulkins FM. History of New London, Connecticut: from the first survey of the coast in 1612 to 1852. Hartford, CT: Tiffany and Co, 1852, p.479. 13. Chapman FW. The Chapman Family: or the descendents of Robert Chapman, one of the first settlers of Say-Brook, Connecticut. Hartford, CT: Case, Tiffany and Company, 1854, p.273. 14. Holt C. A short account of the yellow fever, as it appeared in New London, in August, September, and October 1798, with an accurate list of those who died of the disease, the donations, & etc. New London, Connecticut: The Bee Office, 1798, p.5. 15. Hurd DH. History of New London, Connecticut: with biographical sketches of its pioneers and prominent men. Philadelphia: JW Lewis & Co., 1882, p.213. 16. Lee SHP. Autumnal bilious fevers. 17. Duffy J. From humors to medical science: a history of American medicine. Champaign, IL: University of Illinois Press, 1993, p.7. 18. Byrne JP. Encyclopedia of pestilence, pandemics, and plagues. Westport, CT: Greenwood Publishing Company, 2008, pp.295–296. 19. Lee SHP. Letter to Dr. David Hosack, 25 May 1799. 20. Rush B. Medical inquiries and observations. Philadelphia: J Conrad and Company, 1805. 21. Rush B. An account of the bilious remitting yellow fever, as it appeared in the city of Philadelphia in the year 1793. Philadelphia: Thomson Dobson, 1794, p.98. 22. Lee SHP. Interesting to all seafaring people (an advertisement). 23. Drake WW. The medical and surgical practice of the Lewis and Clark expedition. Journal of the History of Medicine 1959; 14: 280–282. 24. Higby G. Discovering Lewis and Clark–Rush’s bilious pills, http://lewis-clark.org/content/content-article.asp? ArticleID¼2564 (2006, accessed 1 February 2012). 25. Urdang G. The early chemical and pharmaceutical history of calomel. Chymia 1948; 1: 95–108. 26. Lewis W. The new dispensatory, 4th ed. Dublin: James Potts, 1778, p.155. 27. Grieve M. A modern herbal. The medicinal, culinary, cosmetic and economic properties, cultivation and folk lore of herbs, grasses, fungi, shrubs and trees with their modern scientific uses. Mineola, NY: Dover Publications, 1971, p.342. 28. Young JH. The toadstool Millionaires: a social history of patent medicines in America before federal regulation. Princeton, NJ: Princeton University Press, 1972. 29. Young JH. The medical messiahs: a social history of medical quackery in twentieth-century America. Princeton, NJ: Princeton University Press, 1992. 30. Connecticut State Medical Society. Proceedings of the president and fellows of the Connecticut State Medical Society, Annual Convention in New Haven, 17 October 1804. Hartford, CT: Case, Lockwood, and Brainard Company, 1804, p.113.

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31. Barton BS. Professor Cullen’s treatise of the Materia Medica, with large additions including many new articles wholly omitted in the original work. Philadelphia: Edward Parker, 1812, p.69. 32. Lee SHP. German bitters (an advertisement, circa 1800). 33. Lee FH. Letter to Mr. Wagner, explaining name change to Littentreptic. Mr Wagner, 28 May 1931. 34. Lee FH. Letter to Samuel Harris. Samuel Harris, 20 June 1934. 35. Lee SHP. Remarks on the stone and gravel, in the kidneys and bladder, with an account of the discovery of a solvent remedy now used with universal success, and commonly known as Dr. Lee’s Gravel Specific (a pamphlet, 1st ed, publisher unlisted), 1839. 36. Unknown. Dr. Lee’s Gravel Specific or Lithontriptic (a pamphlet, author and year of publication unknown). New York, Chas A Crittenton Company. 37. Dorias R. Letter about closure of company, and small testimonial. Lee FH, 23 March 1954.

38. Lee FH. Littentriptic Recipe, 1940. 39. Lee SHP. Littentriptic Label, with instructions for use and diet, 1940. 40. Marshall BT. A modern history of New London county, Connecticut, Vol 1. New York: Lewis Historical Publishing Company, 1922, p.391. 41. Photograph of SHP Lee’s house, with transcription on the reverse side (date unknown), 1801. 42. Manwaring D. Paperwork documenting the sale of Bank and Golden street properties by David Manwaring to SHP Lee (a legal document), 1 March 1800. 43. Holloway CM. The old whaling port. The Connecticut Quarterly 1897; 3: 215–216. 44. Lee SHP. Medical advice to Seamen. New London, Connecticut: Samuel Green, 1795, p.2. 45. Hurd HM, Drewry WF, Dewey R, et al. The institutional care of the insane in the US and Canada, Vol. 2. Baltimore: Johns Hopkins Press, 1916, p.76.

Author biographies James K Mattie Jr, MD, MS, trained in anaesthesia at Brigham and Women’s Hospital, Boston and is currently in private practice in New Jersey. Being a descendant of the subject of this article allowed him access to information and artefacts otherwise unavailable. Sukumar P Desai, MD teaches anaesthesia at Harvard Medical School and is a consultant anaesthetist at Brigham and Women’s Hospital in Boston. His interests include perioperative safety, medical instrumentation, and statistics.

The education of Ehrenfried Walther von Tschirnhaus (1651–1708)

Journal of Medical Biography 23(1) 27–35 ! The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0967772013479726 jmb.sagepub.com

Jacob Adler

Abstract Ehrenfried Walther von Tschirnhaus, mathematician, inventor, and correspondent of Spinoza, is often thought to have studied medicine at Leiden, though documentation of this fact has been lacking. Tschirnhaus’ medical education is here documented, along with the nature of his medical practice. Keywords Tschirnhaus, education, Spinoza, University of Leiden, alternative medicine

Philosophy Department, University of Arkansas, Fayetteville, Arkansas, USA Corresponding author: Jacob Adler, Philosophy Department, University of Arkansas, Fayetteville, Arkansas, USA. Email: [email protected]

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Samuel Holden Parsons Lee (1772-1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut.

Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered...
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