Ancient Greek physician Hippocrates described the importance of place (climate, water supply, and environment) in medicine. The earliest records of the area known as Mississippi indicate that the region indeed possessed a distinctive medical sense of place, with the state’s sultry clime and native diseases influencing its history. Before the arrival of European explorers and settlers, Mississippi’s Native Americans confronted disease and illness through healers, conjurers, and shamans. These medical practitioners held prominent positions in early Native American culture, often as part of the priestly class, and treated sickness with medicine made from native herbs and roots as well as with religious ceremony and ritual. In the eighteenth century, their skill as herbalists and the success of their treatments impressed some Europeans. Le Page du Pratz praised the cures of the Natchez “surgeons” as superior to those of the French physicians. Although they called the Choctaw and Yazoo medicine men “charlatans,” both Jean-Bernard Bossu and Dumont de Montigny acknowledged Native Americans’ talent in using botanical and nonbotanical medicines to treat wounds, snakebites, and other ailments.
Clear archeological evidence suggests a significant decline in the Indian populations after the earliest arrival of European immigrants. Historians argue that pandemic diseases erupted in the sixteenth century, with new European maladies such as measles, smallpox, and influenza ravaging the native populations, who had little immunity. These epidemics decimated entire nations and cultures, reshaping which Indian groups dominated the Mississippi landscape. In the aftermath of Hernando de Soto’s expedition, disease effected a massive cultural change in the Southeast. Choctaw stories suggest that the tribe migrated to central Mississippi to find a land free of disease during a period of widespread death and sickness. Europeans also brought many diseases that became endemic to the area, such as malaria, typhoid, dysentery, and smallpox.
Europeans, too, were ravaged by illness and suffered high death rates after arriving in Mississippi. In June 1542 the once-vigorous warrior de Soto, then forty-two years of age, died of a slow, wasting fever. The French suffered similar afflictions in subsequent years. In 1701 colonial French governor Sauvolle reported that at Fort Maurepas, near Biloxi, he had thirty sick men who could not “recover from a tertian fever that saps their strength.” Sauvolle himself died at the Mississippi fort that same month, the state’s first recorded death of yellow fever.
The area’s first physicians and surgeons were French and arrived as part of the earliest European settlements. Biloxi and Natchez had numerous physicians and even hospitals in the French colonial period, largely as a consequence of the French military presence, which usually provided surgeons with medical supplies. Spanish and English physicians were also present during those countries’ colonial periods. The American period, which began in 1798, brought the dominance of English and American medical traditions, with Americans in the isolated Natchez District quickly realizing the dangers of disease and the importance of public health.
The Legislative Assembly of the Mississippi Territory passed the first law focused on disease prevention on 18 March 1799. The “Law Concerning Aliens and Contagious Diseases” sought to prevent the spread of epidemic disease—specifically, the plague, yellow fever, and smallpox—and authorized the governor, with the advice of a physician, to take measures to prevent the spread of disease and to aid the sick. The first public health emergency of the American period was a smallpox epidemic in New Orleans in the spring of 1802. Territorial governor William C. C. Claiborne utilized the law to establish a smallpox “hospital camp” to separate those with the illness from the rest of the population. Virginia-born physician brothers William and David Lattimore oversaw the camp and led a mass vaccination of more than two-thirds of the population of the Natchez District. At Claiborne’s urging, the Territorial Legislature passed a 13 May 1802 act that provided fines and imprisonment for anyone found guilty of the “importation and spread” of smallpox. These efforts prevented a serious outbreak of the disease and were the most significant early uses of public health measures in Mississippi.
Natchez’s early physicians registered a number of impressive medical accomplishments, creating the area’s earliest public hospital and its first board of health. Natchez Hospital, the territory’s first charity hospital and one of the first in the United States, was incorporated in January 1805 to care for poor city residents as well as indigent boatmen who became sick while there. Soon after statehood, in February 1818, an extensive public health act created a board of health for Natchez with five appointed commissioners as well as a physician to serve as health officer. These commissioners of health and police oversaw cleanliness and hygiene from the city’s sewers to its burial ground and worked to protect of the city from communicable diseases.
The Lattimore brothers, who had arrived in Natchez in 1801 and advised Claiborne during the smallpox epidemic, became prominent medical and political leaders in Mississippi’s territorial and early statehood era. William, who moved to Amite County, served as Mississippi’s first territorial congressman from 1803 to 1817. In that capacity he selected the line of division of the Mississippi Territory and led the admission of the territory as a state. He also was one of the three men who in 1822 selected the site for the state capital, which became Jackson.
While Lattimore’s political accomplishments are significant, his medical accomplishments, especially in advancing the state on the path of medical licensure, were also critical. He helped create and served alongside his brother on the state’s first board of medical licensure, the Board of Medical Censors. On 12 February 1819 the General Assembly passed the state’s first law to regulate physicians and surgeons. Gov. David Holmes made the first appointments to the seven-member Board of Censors, which was “to license those who practice Physic and Surgery.” The legislature created additional boards in 1821 and 1827, and the license laws further strengthened the board until 1836, when the state Supreme Court required that the boards have limitations on tenure to comply with the Mississippi Constitution of 1832. The Jacksonian-era decision resulted when a Wilkinson County man appealed his conviction for practicing medicine without a license. He not only won his case but invalidated the state’s entire licensing process. The ruling effectively removed any state control over the practice of medicine for the next forty-six years, although in 1844 the well-organized physicians of Natchez persuaded the legislature to pass a state law creating a board of medical censors for Adams County.
The process of creating a statewide organization of physicians began in January 1829, when the legislature incorporated the Medical Society of the State of Mississippi. A decade later Jackson physicians led an effort to organize the Grand K. A. Society of Hippocrates of the State of Mississippi. An attempt to organize the various local medical societies into a statewide organization resulted in the creation of the Mississippi State Medical Society in Jackson on 14 January 1846, with physician Samuel A. Cartwright of Natchez elected as its first president. This group was officially recognized by the American Medical Association, but it, too, dissolved several years later, after Cartwright moved to New Orleans. In December 1856 the Mississippi State Medical Association (MSMA) was established in Jackson. William Young Gadberry of Benton led the effort and became the association’s first president, with M. S. Craft as secretary. The association planned to meet in November 1857 but did not reconvene until 20 April 1869, when many of the same physicians gathered in Vicksburg to reestablish the association, which became a potent medical and political force.
Other health professionals also established state associations. Led by Matthew F. Ash, John F. Buck, and William P. Creecy, pharmacists established the Mississippi State Pharmaceutical Association in 1871. In April 1875 at Vicksburg, state dentists established the Mississippi Dental Association, with J. D. Miles serving as the group’s first president. The Mississippi Nurses Association was founded in 1911 by a small group of nurses at the Natchez Hospital in Natchez, with Jennie Quinn serving as its first president.
Many of the state’s earliest and most talented writers and scholars were physicians, including George Elliott Pendergrast, George Pfeiffer, Henry Tooley, C. H. Stone, John Wesley Monette, Samuel A. Cartwright, William H. Holcombe, and Henry Clay Lewis of Yazoo County. Holcombe was a national leader in the homeopathic medical movement and wrote prolifically in areas of medicine and poetry. Lewis achieved national fame by writing frontier humor under the pseudonym of the Louisiana Swamp Doctor, Madison Tensas. Many other Mississippi physicians published extensively in the nation’s antebellum medical journals, and after the Civil War the reestablished state medical association began publishing the annual Transactions of the Mississippi State Medical Association. John Monette published an extensive treatise on yellow fever in the Washington Lyceum’s South-Western Journal in 1837–38, but the state lacked a medical journal until 1891, when the Mississippi Medical Monthly, edited by Drs. N. L. Clarke and Hugh H. Haralson of Meridian, appeared. It morphed into the Medical Record of Mississippi (printed in Biloxi by Haralson) and subsequently into the Journal of the Mississippi State Medical Association after the MSMA assumed its management and moved it to Vicksburg. It then ceased publication, and by 1929 the Mississippi Doctor, published by W. H. Anderson in Booneville, had become the MSMA’s official organ. In January 1960 the MSMA began publishing the Journal of the Mississippi State Medical Association, which remains an influential scientific publication and one of the last remaining monthly medical journals in the South.
Prior to the early 1800s, Mississippi’s physicians generally studied not in medical school but rather under other physicians. Subsequently, however, most Mississippi physicians received their training from medical schools in New York; Philadelphia; New Orleans; Augusta, Georgia; and Louisville and Lexington, Kentucky. Mississippi’s first medical school was the short-lived Kirk’s Clinical Institute of Medicine and Surgery, chartered in 1882 in Meridian. The University of Mississippi considered establishing a medical school as early as 1871, but because of poor resources the school did not open in Oxford until June 1903, when it was a two-year institution that did not offer clinical training. From 1908 to 1910 the university offered a four-year medical course in Vicksburg, but the University Board chose to discontinue that program and return to the two-year curriculum. In 1906 the Mississippi Medical College, a full four-year school, was organized in Meridian. This ambitious institution, which admitted two women in its first class, graduated hundreds of physicians who received their clinical training at the Matty Hersee Hospital. The school closed by 1913, leaving Mississippi with no four-year school of medicine for almost a half century.
In 1871 Dr. J. P. Moore of Yazoo City listed the diseases that embraced the “great aggregate of the death-rate of the state, the most fatal in the order as mentioned”: pneumonia; malarial fever; inflammation of the brain and membranes, mostly affecting children; typhoid fever; dysentery; diarrhea; consumption; cholera infantum; influenza; scarlet fever; diphtheria; and irritative fever. Mortality schedules recorded for the state from 1850 to 1880 substantiate Moore’s assertions, with a wide range of diseases noted as causes of death alongside childbirth, hives, suicide, and teething. Medical practitioners soon progressed beyond the long-established therapeutics of bloodletting, purgatives, mercury, digitalis, opiates, and “counter-irritation.”
The most dreaded of all diseases in the state in the nineteenth century was yellow fever. Epidemics occurred almost annually from the 1820s to 1905. The Union blockade of southern ports during the American Civil War significantly restricted the Caribbean shipping trade, instituting an unintentional yellow fever quarantine that freed Mississippi of yellow fever for the war’s duration. After trade was reestablished, yellow fever returned in 1867 and became the primary public health threat for Mississippians until eradication measures were discovered in 1905.
Race and poverty have played roles in both the complexity of illness and the delivery of health care in the state. Antebellum physicians recognized the role of genetics in illness, such as improved yellow fever and hookworm resistance in those of West African descent. In 1854 Drs. Luke Pryor Blackburn and A. H. Brenham opened Natchez’s Infirmary for the Cure of All Diseases of Colored Persons, a for-profit hospital to care for slaves and Natchez’s large population of free persons of color. Cartwright became the state’s most prominent antebellum specialist on slave physiology and health, although his research and writings were poisoned by his political and racial views.
Vicksburg gained its first black physician in 1865, and a handful of others followed. In 1890 only thirty-four black physicians and surgeons practiced in the state. A decade later, thirteen of the state’s black physicians formed the Mississippi Medical and Surgical Association, which remains a vital professional association focused on the needs of the black physician. The MSMA began to allow black physicians to participate in scientific and society meetings in 1955 and by end of the decade granted full member status to its first black doctor. Early hospitals operated by black physicians included Alcorn A&M College Hospital (Lorman), Afro-Americans Sons and Daughters Hospital (Yazoo City), and the Taborian Hospital (Mound Bayou). Prior to 1962, when the University of Mississippi School of Medicine began admitting African Americans, most of the state’s black physicians were trained elsewhere—usually at Meharry Medical College or Howard University Medical School—often assisted by the Mississippi Medical Education Program, which was created in 1946 to provide black Mississippians with scholarships to out-of-state medical schools in an attempt to prevent admitting them to in-state schools. In 1947 Meharry established one of the earliest rural training programs in the United States, sending residents and interns to Mound Bayou’s Taborian Hospital until 1974. The Tufts-Delta Health Center, also in Mound Bayou, opened its doors in November 1967 as one of the nation’s first comprehensive community health centers.
Well before these twentieth-century developments, the Civil War advanced the surgical skills of the average Mississippi physician, as the conflict retarded most public health and organized medicine initiatives in the state. The return of yellow fever in the postwar period resulted in the creation of boards of health in coastal counties by 1876 to quarantine ports and prevent the spread of disease. By 1877 a multiyear effort of the revived MSMA produced legislation to create the Mississippi State Board of Health. Originally unfunded and granted few powers, the board’s creation was the most important medical event in Mississippi’s history. Over the next decade physicians further refined its purpose and activities, including the registration of marriages, births, and deaths; sanitary regulations; quarantine powers; county health officer nominations; physician licensure; and legislative funding. The board played a major role in Mississippi’s three epidemic outbreaks: yellow fever in 1878, smallpox in 1900–1901, and influenza in 1918–19. Smaller epidemics included smallpox in 1878 and yellow fever in 1897, 1898, and 1905.
Waller Leathers, a Virginia-born academic physician educated at Johns Hopkins and Harvard, organized the University of Mississippi Medical School in 1903 and served as its dean until 1924. In addition, Leathers served as the executive director of the State Board of Health from 1910 to 1924. His leadership helped create a full-time Department of Health, and he was a nationally recognized authority on public health and medical education. Leathers embraced research and encouraged aggressive attacks on hookworm infestation, influenza, pellagra, and malaria, working closely with Joseph Goldberger and the Rockefeller Foundation. His successor as state health officer, Felix Underwood, served until 1958 and created a nationally respected health agency. Assisting Underwood was registered nurse Mary D. Osborne, who served as the department’s supervisor of public health nursing from 1922 to 1946. Also prominent during this period was Henry Boswell, Mississippi’s “Conqueror of the White Death,” who served for decades as superintendent of the Mississippi State Tuberculosis Sanatorium at Magee.
In the early 1940s Underwood and other physician-leaders began the drive to create a four-year school of medicine as a means of addressing the state’s physician shortages. The idea’s legislative champion was Hinds County senator Hayden Campbell, who authored the 1950 measure that established a four-year school and teaching hospital in Jackson on the site of Mississippi’s first insane asylum on North State Street. The institution was dedicated on 24 October 1955 and awarded its first medical degrees in 1957. Among its most prominent physician-professors were David Pankratz, Robert Q. Marston, J. Robert Snavely, James D. Hardy, Herbert Langford, Thomas Brooks, Blair Batson, and Arthur C. Guyton. By the mid-1970s schools of dentistry, nursing, and health-related professions joined the School of Medicine and University Hospital to create the University of Mississippi Medical Center.
The Mississippi Regional Medical Program, created in 1965 and led by Guy Campbell and T. D. Lampton, had a monumental impact on the state’s health delivery system. Some of the program’s major accomplishments included the first stroke intensive care unit, the state’s blood bank system, a statewide cardiopulmonary resuscitation program, the first renal transplant program, the first regional newborn care system, the first regional renal program, the first radiation therapy program, the first coronary care units, and the first ongoing effort to provide continuing health education for all types of health care providers. But the program did not transition into a functional health planning agency and was phased out in 1977.
The State Department of Health, under the leadership of Alton Cobb, reasserted itself as a national leader in public health from 1973 to 1993. Cobb had previously served as the first director of Mississippi’s Medicaid program. As state health officer, Cobb introduced the district system and the certificate of need program, resulting in declines in infant mortality. He also oversaw the development of home health programs and the Special Supplemental Nutrition Program for Women, Infants, and Children.
Cobb was succeeded by longtime state epidemiologist Ed Thompson, who served as state health officer from 1993 to 2002. During this period the department achieved the highest immunization rates in the country and lowered tuberculosis and syphilis case rates below the national average. Thompson returned as state health officer in 2007 after a crisis in leadership at the State Department of Health that also resulted in the reconstitution of the Board of Health with a higher percentage of physician members and the requirement that the board chair be a physician. After Thompson’s December 2009 death, state epidemiologist Mary Currier became state health officer. Under her leadership Mississippi’s Department of Health has garnered national praise for its public health work and has opened a new state-of-the-art public health laboratory, which bears Thompson’s name.
At the beginning of the twenty-first century the medical community faced a tort liability crisis, physician shortages, and a poorly coordinated trauma system. After “white coat” rallies by physicians at the State Capitol and significant grassroots public pressure, comprehensive tort reform legislation was passed in special sessions in 2002 and 2004. The 2007 creation of the Mississippi Rural Physician Scholarship Program also represented a major step toward improving the number of physicians in the state’s rural and underserved areas. And the 2008 opening of the William Carey University College of Osteopathic Medicine in Hattiesburg gave the state its second medical school. Legislation passed the same year created a funded mandatory “pay or play” trauma system network that became a model for rural states across the country.
- Lucie Robertson Bridgforth, Medical Education in Mississippi (1984)
- John Duffy, The Rudolph Matas History of Medicine in Louisiana, 2 vols. (1958)
- T. D. Lampton, Twelve Years of Challenge and Change . . . 1965–1977, Mississippi Regional Medical Program (1977)
- Felix Underwood and R. N. Whitfield, Public Health and Medical Licensure in the State of Mississippi, 1798–1937 (1938)
- Tom Ward, Black Physicians in the Jim Crow South (2003)