Democratic Ideology, the Frontier Ethos, Medical Practice and Hospital Culture: Pacific Northwest Health-Seekers, Community Health and the Sisters of Providence, Vancouver, WA 1856 - 1879

Most historians readily acknowledge the economic incentive that prompted many pioneers to migrate westward across the overland trail. Health motivations remain generally unexplored. Many Americans had settled the interior regions most suited to farming, especially the acreage around river valleys in the Mississippi drainage system. Unfortunately, health conditions were not favorable to human existence. The dilemma of economic well-being versus health disaster motivated a number of Americans to seek better living conditions. Some chose overland migration to the Pacific Northwest. The situation in contemporary medical practice was a kaleidoscope of competing sects and contradictory convictions. The mainline profession of medicine, failed to meet the needs of patients, was viewed as extreme in nature, and provided justification for the competition that opposed it. Paced with a number of medical options, all of which broke down in the face of epidemic disease, Americans searched for better solutions to medical problems. Assessing the success of health-seekers is a difficult undertaking. One must address both the population as a demographic group, and its individual beliefs about its new environment. The former depends upon generalized statistics from an inherently biased source, since the ability to correctly identify specific diseases was beyond contemporary technology. On the other hand, observations of settlers were often self-fulfilling prophesies that justified their migration; they reflected only romanticized notions of the promised land. Thus, the story is not easily found in either "hard facts" or anecdotal remembrances. The community in the Pacific Northwest possessed certain characteristics, both demographically and philosophically, that influenced its development. The population in the 1860s and 1870s was mostly male and largely youthful. Oregon's mortality rates in the 1860s and 1870s compared favorably with the national averages. With the exception of females of childbearing ages, age group mortality rates were generally below that of the nation. Many aspects of the new environment, including settlement patterns and the age structure of the population, accounted for the lower-than-average death rates. However, the settlers were still left with basic conditions that often worked against them. Many perceived they had found through relocation, health conditions that were vastly superior to those they had abandoned. On the other hand, as communities developed, they were faced with the same problem other more densely populated regions confronted; namely the outbreak of epidemic disease. The Sisters of Charity of Providence came to the Pacific Northwest in 1856 and immediately established institutions that answered the needs

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