Monday, February 6, 2012

How They Paid the Doctor in New Riegel, ca 1860

(Probably the oldest surviving phograph of New Riegel shows the Nuns' Covent in about 1857, contemporary to Doctor Hermann)

We all groan inwardly when faced with medical bills and the complications of insurance. Some procedures are covered; some are not. Some are paid in full, some in varying percentages. And if you are covered by more than one insurer, the paperwork becomes mountainous. Don’t get me wrong, the only thing trickier than insurance is no insurance, so perhaps we should be happy with our lot.

In 1857, my great great grandfather, Johann Baptist Ilgert, fractured a bone. He lived near the hamlet of New Riegel in Seneca County, Ohio. The people in and around New Riegel were mostly German-speaking immigrants and mostly farmers. Luckily, New Riegel had its own doctor, who was able to treat the fracture. Grandfather Ilgert paid Dr. Franz Hermann two dollars, who carefully recorded it in his account book (although, curiously, he failed to record which bone was fractured!). Dr. Hermann accepted cash, but as we shall see, took his payment in many forms.

In rural communities, long before insurance or Medicare, doctors were often paid with either farm produce or labor. Dr. Hermann’s account books and ledgers are preserved in the Rutherford B. Hayes Presidential Library in Fremont (a copy is in the Center for Archival Collections, Bowling Green State University) and show what the doctor traded his medical expertise for in the 1850s and 60s.

Franz Hermann was born in 1821 in Kaiserslauten, Germany. He left Germany for the United States in 1850, allegedly to escape prosecution for being involved in a “student revolt.” Settling in New Riegel in 1857, he saw patients there until 1866 when he relocated to Bluffton in Allen County. He married Christina Hemley in 1855 and the couple had at least five children. Dr. Hermann died in 1882 and is buried in Pandora in Putnam County, his wife’s hometown.

There were two doctors in New Riegel in the early 1860s. In the 1860 census, they lived practically next door to each other, separated by one empty house. The other doctor, Jacob Boep, had been born in France and was slightly older than Hermann. It may be that New Riegel’s mostly German-speaking citizens preferred Dr. Hermann. Dr. Hermann’s net worth, as shown in the Census of 1860, was slightly higher than Dr Boep’s, too.

But in looking over Hermann’s list of patients, their medical needs, and how they paid, one wonders if he had any cash money at all. Take the case of Peter Theis. Theis, a 47 year old farmer from Luxembourg, paid his bill with one load of pumpkins and sixteen pounds of pork! John Stuhl, a 58 year old farmer born in Belgium, only needed “advice” from Hermann, and his bill was less, accordingly. He paid with three dozen eggs and two bushels of barley.

There were telltale signs of changing medical practices. Peter Hubertssprung underwent “cupping” from the doctor. Cupping was a treatment involving pressing a heated cup to the skin; as the cup cooled, it was believed to “draw out” the disease. Although cupping has long since been discredited, the farmer paid with a ham, four chickens, and a bushel each of corn and potatoes. There is a clear distinction between doctors and dentists in our day, but Dr. Hermann was willing to work on teeth as well. A certain N. Plews paid fifty cents for “drawing 2 teeth.” For another patient, he received forty five cents for drawing one tooth, but only a nickel for the second.

Not all the patients paid with farm produce. Karl Hauser paid with a half-day of wood chopping. Barbara Hiesbun paid by doing laundry. In 1860, John Pieri (sp?) paid him with a 'bookstand" valued at two dollars and "wool....45 cents." Conrad Sacher gave the doctor both “hay” and “work.” Baptist Heitzman was credited fifty cents for "3/4 day work w/o board.” A Mr. Hasenbihler apparently traded his son’s work; he was credited fifty cents for "one day chopping wood (by boy)." When one considers that “work” at that time was hard, slow, and mostly done with the hands, these payments were not casual.

We don’t know how Dr. Hermann valued the produce and the labor he received. From one patient he received a "load" of corn fodder, which he valued at one dollar. How big a load was it and what did he do with the fodder? The doctor may have had cows; horses cannot eat corn fodder. But he also may have resold the fodder. Like much of history, the evidence does not answer all our questions.

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