Saints and Sickness: Medicine in Antebellum America and the Latter-day Saints

By Joseph B. Hinckley

Joseph B. Hinckley, “Saints and Sickness: Medicine in Antebellum America and the Latter-day Saints,” Religious Educator 10, no. 3 (2009): 137–150.

Saints and Sic​kness: Medicine in Antebellum America and the Latter-day Saints

Joseph B. Hinckley

Joseph B. Hinckley (josephhinckley@gmail.com) received a BA in American Studies from BYU in 2008 and was a JD candidate at the University of Kansas School of Law when this was written.

 

Letters and journals written by early members of The Church of Jesus Christ of Latter-day Saints provide us with a unique view of their world. These documents can be used to broaden our understanding of historical events and to help narrate the story of the early Latter-day Saints. However, the numerous references to medical issues endured by the Saints have often been overlooked in these documents. Because the early Saints lacked knowledge of such things as bacteria and viruses, what would be minor medical issues to us often became life-threatening challenges to them. In our modern world, when we get a cut or scrape, we apply a sterile antiseptic ointment and cover it with a Band-Aid, and the wound heals quickly. In the early nineteenth century, however, even a minor cut could easily become so infected that the only remedy was amputation. Because even minor medical issues could be major afflictions, the early Saints’ letters and journals frequently mention their health conditions and their attempts to remedy them. Understanding this facet of the lives of early members of the Church provides us with a more complete understanding of their daily struggles.

Medicine in Antebellum America

Medical science progressed slowly from the time of the colonization of America until the early nineteenth century. It was not until after the Civil War that medicine achieved significant advances and evolved into a more scientifically based field. In the early part of the nineteenth century, there were essentially two methods of medical practice. The first was “heroic” medicine or allopathy, and the other was botanical or homeopathic medicine.

Heroic Medicine

Benjamin Rush, a signer of the Declaration of Independence, was one of the most prominent physicians of his era and contributed to the popularity of heroic medicine. Active in both politics and medicine, Rush was well known and his methods were widely respected. For example, bleeding, or bloodletting, gained increased popularity at the turn of the nineteenth century due largely to Rush’s endorsement of the practice. This practice was based on the ancient theory that all ailments could be treated by removing the toxins from the patient’s body to restore balance; this was achieved by draining blood from the patient, by using either incisions or leeches. Medical historian William Rothstein observed, “Bleeding rapidly became a panacea and was used for every conceivable illness.”[1] Every illness from fevers to fractures was treated by this procedure. Patients were often bled repeatedly, with large quantities of blood extracted at each session. Because bloodletting often produced a noticeable physiological change in the patient, physicians believed it had a profound effect. In cases when a patient indeed suffered from excessive blood volume, as in severe heart failure, reducing the blood volume towards a normal level may actually have had a temporary salutary effect. But if the basic cause of heart failure was not reversed, the benefit would have been short lived. Generally, bloodletting itself seldom accelerated the healing process. Instead, patients subjected to the procedure were often left severely weak and faint. When a patient died after bloodletting, the physician often blamed the tragedy on the patient’s not seeking treatment soon enough.

Another treatment favored by practitioners of heroic medicine was the use of castor oil, often combined with calomel (mercurous chloride). Castor oil, extracted from the castor bean, was used as a potent laxative to clear the patient’s bowels and thus clean out any toxin, infection, or disease. However, this clearing of the digestive system often left the patient’s body dehydrated and depleted of nutrients. When combined with bleeding, this treatment could make the body too weak to fight disease and infection.

Not surprisingly, these heroic treatments often caused more harm than good. The death of Alvin Smith, older brother of the Prophet Joseph Smith, is an example of a situation in which such treatments proved to be more lethal than the disease. In 1823, when Alvin was twenty-five years old, he came down with what his mother, Lucy, described as “bilious colic.”[2] The attending doctor “immediately administered a heavy dose of calomel to the patient, although he objected much against it.”[3] The calomel lodged in Alvin’s stomach, blocking nutrients from reaching his digestive system, and he died just three days later. After his death, an autopsy “found the calomel still lodged in the upper bowels.”[4] In light of this tragedy, it is easy to see why afterwards the Smith family distrusted doctors who administered calomel or used other heroic methods. In fact, Joseph Smith later spoke emphatically against heroic medicine. While greeting a group of newly arrived converts in Nauvoo in 1843, Joseph advised, “The doctors in this region don’t know much. . . . Doctors won’t tell you where to go to be well; they want to kill or cure you, to get your money. Calomel doctors will give you calomel to cure a sliver in the big toe; and they do not stop to know whether the stomach is empty or not; and calomel on an empty stomach will kill the patient.”[5]

Botanical Medicine

The other dominant form of medical practice in America at this time was herbal or botanical medicine. Samuel Thomson significantly influenced the popularity of botanical medicine at the turn of the nineteenth century. Born in New Hampshire in 1769, Thomson grew up working on the family farm and had no formal education. After a few early experiences with the healing properties of roots and herbs, he began a career as a traveling healer, rejecting the heroic methods of physicians such as Benjamin Rush. At first, Thomson’s influence was limited only to a small geographical area in New England. However, historian John S. Haller Jr. describes how Thomson “transformed his medical practice into a successful business enterprise whose agents and subagents sold several hundred thousand rights to this system of practice, along with an even greater number of books and tons of botanical medicines.”[6] By using his network of salesmen, Thomsonian medicine became popular nationwide. Before joining the Church, Willard Richards, who later served as a secretary to Joseph Smith and a counselor to Brigham Young, read Thomson’s Practice of Medicine and purchased the rights from one of Thomson’s agents.[7] Later, Richards became well known for his use of medicinal herbs and was frequently referred to as “Dr. Richards,” though he never received any formal medical training.

Thomson’s homeopathic methods were especially popular among the Latter-day Saints. References to herbal medicine in Latter-day Saint scriptures may have contributed, at least in part, to this popularity. For example, the Book of Mormon contains references to healing with “many plants and roots” (Alma 46:40). An 1831 revelation to Joseph Smith stated, “And whosoever among you are sick, and have not faith to be healed, but believe, shall be nourished with all tenderness, with herbs and mild food, and that not by the hand of an enemy” (D&C 42:43). Furthermore, the Word of Wisdom, revealed in 1833, gives council and instruction on the use of herbs—tobacco in particular (see D&C 89:8–11). In 1841, Wilford Woodruff wrote, “I read the narative of the life and medical Discoveries of Dr SAMUEL THOMSON which were truly interesting & beneficial to mankind. I have no doubt but that his invention theory & practice of administering roots barks & herbs as medicine, is a great blessing to mankind & is one of the greatest improvments of the last days & is causing a great revolution throughout America in the mode of practice. . . . I Copied Dr Thomsons instructions on preparing medicine & administering it.”[8]

Joseph Smith is reported to have said that Levi Richards, who practiced botanical medicine, was “the best physician I have ever been acquainted with.” Joseph went on to say, “People will seldom die of disease, provided we know it seasonably, and treat it mildly, patiently and perseveringly, and do not use harsh means.”[9] Bloodletting and calomel were almost certainly some of the “harsh means” that Joseph referred to. On another occasion, the Prophet gave additional instructions on the treatment of sick persons: “I preached to a large congregation at the stand, on the science and practice of medicine, desiring to persuade the Saints to trust in God when sick, and not in an arm of flesh, and live by faith and not by medicine, or poison; and when they were sick, and had called for the Elders to pray for them, and they were not healed, to use herbs and mild food.”[10] Here, the Prophet not only endorsed the use of medicinal herbs, but also established priorities: ill people were to trust in God first and call for the Elders to heal them, and then they were to employ the use of herbal medicine. Commenting on these priorities, historian Grant Underwood observed, “The Saints’ blend of priesthood blessings and basic botanical cures seems to bespeak moderation and practicality.”[11] They were not overzealous in their use of faith healing, nor were they obsessive in their use of herbal healing.

The medical profession was not well regulated in the early nineteenth century. There were no standards of proficiency even among medical schools. The quality of the education of physicians would vary greatly from one to the next. Medical historian Volney Steele writes, “Some medical schools existed only for profit and turned out nothing more than warm bodies with diplomas.”[12] Therefore, it was difficult to distinguish between those who were trained medical professionals and those who were self-appointed practitioners. Patients needed to be careful and vigilant in selecting a doctor. Like Willard Richards, many carried the title of doctor even though they never attended medical school. Because of this, people often resorted to using Thomson’s botanical and other home remedies rather than trusting a doctor.

But even though many treatments were primitive during this time, great advancements were being made that paved the way for future medical procedures. One such example is the leg operation that the Prophet Joseph Smith received as a boy. After a battle with typhoid fever when he was just “five years old or thereabouts,”[13] young Joseph was left with a severe infection in his lower leg. The pain soon became unbearably intense, and it seemed as though amputation was the only remedy. Dr. Nathan Smith, founder of Dartmouth Medical School, performed an experimental operation that saved Joseph’s leg from amputation. The procedure required the leg to be opened and the infected portions of the bone to be removed. One author has stated, “The operative removal of bone from a limb was not ordinary practice during that period. Nathan Smith had gained experience treating what was colloquially called ‘fever sore,’ or what we recognize now as osteomyelitis, the bacterial infection of bone. . . . Surgical cures for osteomyelitis were unheard of at that time.”[14] This procedure was new and unproven. In fact, besides amputation, surgery was not a common solution to any medical problem at the time because of the great risk to the life of the patient. With no anesthetics available to reduce pain, no antibiotics to prevent infection, and no specialized surgical instruments, the surgeon had to act quickly and efficiently to complete the procedure before the patient died from the loss of blood. The longer the operation took to complete, the more trauma the patient was forced to endure, which decreased the chance of survival.

Because there were no hospitals or special operating rooms in existence, Joseph’s surgery was performed in one of the bedrooms of the Smith home. Before beginning the operation, the doctor suggested that Joseph be tied to the bed or take alcohol to dull his senses and help him endure the extreme pain of surgery, since he would remain fully conscious. The use of anesthetics such as ether to render a patient unconscious during surgery would not be tested until 1846.[15] Rather than being bound to the bed or taking alcohol, Joseph insisted that he needed only to be held by his father during the operation.[16] Lucy Smith was asked to leave the house during the surgery, but upon hearing him scream, she ran back. Lucy later recalled, “I burst into the room again, and, oh, my God, what a spectacle for a mother’s eye! The wound torn open to view, my boy and the bed on which he lay covered with the blood that was still gushing from the wound. Joseph was pale as a corpse, and the big drops of sweat were rolling down his face, every feature of which depicted agony that cannot be described.”[17] Lucy explained that the surgeon then used “forceps or pincers”[18] to break off the infected portion of the bone. Although Joseph walked on crutches for the next two years, the surgery was successful and he was able to recover. As one author observed, “Joseph’s surgery has been described as ‘brutal’ and ‘gruesome,’ but when seen through the eyes of the surgeon, there was a great sophistication in the operation performed.”[19] This pioneering surgical technique would not become a generally accepted practice until the early twentieth century.[20]

Medical Conditions in Nauvoo

After being driven from Missouri in the spring of 1839, the Saints settled on a bend of the Mississippi River in a place known as Commerce, Illinois. The name of the place was later changed to Nauvoo—”the Beautiful.” Although this place may have been beautiful as a place of relief from the persecution of the Missouri mobs, the living conditions were less than ideal. Writing in 1881, Helen Mar Whitney recalled, “My first impression concerning the place was anything but pleasing; the circumstances attending my arrival there were probably the reason—the weather was excessively warm, and the bottom land being swampy, nearly everyone who had come there was sick upon the bank of the river.”[21] Unknown to the Nauvoo pioneers, the swampy, humid conditions made the riverbank an ideal breeding ground for malaria-carrying mosquitoes. One historian described Nauvoo as the “Beautiful Pesthole.”[22] Until homes were built, some families found temporary shelter in abandoned log cabins. Others lived in dugouts, tents, and wagon boxes, which provided little protection from the mosquitoes.

Due to their weakened conditions following their expulsion from Missouri, the Saints were particularly susceptible to the sicknesses of the area. Those who arrived on the banks of the Mississippi River were not only physically weary from the journey but also emotionally and spiritually drained. During the months previous to their finding refuge in Illinois, the Saints experienced the apostasy of Church leaders, a tumult of persecution, and other intense suffering. During the winter of 1838–39, the Prophet Joseph Smith was incarcerated with five other men in Liberty, Missouri, and prospects for their release were dim. The tragic massacre at Haun’s Mill, which had occurred the previous October, was still a vivid and terrifying image in the minds of the people.[23] Concerning the prevalence of malaria and the weakened state of the Saints in Nauvoo, Helen Mar Whitney wrote, “Those who were strong enough wore it out in time, but many died because they were previously worn out and had not sufficient vitality to battle with this and other diseases brought on by suffering and privation and they died martyrs to the truth.”[24]

Even in these miserable and mosquito-infested conditions, the Saints experienced a day of miraculous healings performed by the Prophet Joseph Smith. On July 22, 1839, Wilford Woodruff recorded in his journal that “Joseph [Smith] was in Montrose [across the river from Nauvoo] and it was a day of Gods power. There were many sick among the Saints on both sides of the river & Joseph went through the midst of those in Montrose taking them by the hand & in a loud voice Commanding them in the name of Jesus Christ to arise from their beds & be made whole & they leaped from their beds made whole by the power of God.”[25] However, on the same day, Joseph Smith noted that although there were many healed, “many remain sick, and new cases are occurring daily.”[26]

The Saints called malaria different names, such as the “ague” and the “shakes.” The “shakes” referred to the chills—which could be violent at times—associated with the attacks. Malaria attacked the liver and produced a severely high fever accompanied by chills that caused the victim to shiver uncontrollably. This disease posed the most serious threat to the health of Nauvoo residents. The prevalence of malaria in Nauvoo has led one historian to conclude, “In a large family, someone was almost always down with the ‘shakes.’”[27] Because infections were so widespread, death was a common occurrence in Nauvoo. One study noted that “during their sojourn in Illinois, the [Latter-day Saints] suffered from a death rate well above the national average for the mid-19th century.”[28]

As an alternative to heroic medical treatments, advertisements in Nauvoo newspapers promoted various products that promised effective relief not only from ague, but also from a variety of other afflictions. The Times and Seasons, the Church newspaper in Nauvoo, printed numerous advertisements promoting pills, powders, and ointments that would provide relief from symptoms and ailments as diverse as the ague, fever, prairie itch, scald head, bowel afflictions, dyspepsia, colic, and many others.[29] Most of these medications had no scientific basis and treated only the symptoms of diseases, not their causes. Still, people were willing to try any remedy, and even superstitious cures, to find relief. Helen Mar Whitney records a humorous incident when she resorted to a superstitious trick in order to get relief from the ague:

Every remedy that could be thought or heard of was tried; we even resorted to tricks and stratagems, some of which were ludicrous in the extreme and afforded considerable fun and amusement. . . . The following one had a striking effect upon me: when we began to feel the symptoms we were to start and run across the floor as if going onto the bed, but to go under instead, thus cheating the old gentleman, who would go as usual onto the bed. At that time my regular chill came on every other evening, and when I first felt the symptoms I started from the fireplace, but in dodging to go under the bed I gave my head a frightful blow, and felt no more chills of the fever for three weeks; but whether it was due to the blow on my head or my faith in the trick I could never quite decide.[30]

As ridiculous as it may seem to deceive an illness by hiding under the bed, this method appeared to Helen Mar Whitney to be at least temporarily effective.

Dentistry was also an emerging medical field during this era. Alexander Neibaur, an early convert to the Church, was born in Germany and had studied dentistry in England. Upon moving to Nauvoo, he presented himself as a dentist with an advertisement in the Times and Seasons offering services “in all branches connected with his profession, Teeth cleaned, plugged, filed, the Scurva effectually cured, children’s teeth regulated, natural or artificial teeth from a single tooth to a whole set inserted on the most approved principle.”[31] However, it is not likely that there was enough business in Nauvoo for him to make dentistry his primary occupation.

All the residents of Nauvoo suffered from the effects of the harsh conditions, and the Prophet’s family was no exception. Emma Smith, overworked and exhausted, gave birth to a stillborn son on February 6, 1842. In the middle of February, Joseph and Emma buried the child amidst a great deal of sorrow. Only five months earlier, their fourteen-month-old baby boy, Don Carlos, had died from the effects of malaria.

Personal letters and diaries of women in Nauvoo often spoke, without self pity, of their sorrows—many times without their spouses to assist and comfort them. As letters were the principle means of communication, they often reported the sicknesses and deaths of friends and family members. Sally Carlisle Randall wrote several letters from Nauvoo that provide the modern reader with a unique look into life in Nauvoo. After their conversion to the Church, Sally’s husband, James, traveled to Nauvoo in 1843 ahead of Sally and their children to arrange housing for the family. Sally and her three sons followed him in the fall of that year. The letters she wrote to her nonmember family in the East include detailed descriptions of the scene in Nauvoo. She writes about such things as the price of flour, the doctrine of baptisms for the dead, the events surrounding the martyrdom of Joseph and Hyrum Smith, and the health conditions in the city. Shortly after her arrival in Nauvoo, she writes, “It is very sickly here at present with fevers and fever and ague and measles, and a great many children die with them.”[32] A few weeks after writing that letter, Sally’s oldest son, George, died at the age of fourteen, presumably of malaria. Her letter to her family telling them of George’s passing shows her grief as well as her faith:

Dear Friends,

I take my pen this morning to write a few lines to you, although with a trembling hand and a heart full of grief and sorrow, to inform you of our afflictions which are very great. It seems more sometimes than we are able to bear, but it is the Lord that hath done it. . . .

George has gone to try the realities of eternity. He died the first day of this month about 3 o’clock in the morning. He was sick three weeks and three days with the ague and fever. He had it every other day about two weeks and then every day till he died. . . .

I have one request to make and that is you will not cast any reflections and say if we had not come here he might have been alive, for we don’t know. I believe it was the will of the Lord that we should come that his body might be laid with the Saints.[33]

As difficult as it may have been to live on the frontier, traveling presented its own set of challenges. The physical exertion of long journeys and exposure to the elements left travelers vulnerable to a variety of health problems. In August 1842, Wilford Woodruff traveled to St. Louis from Nauvoo, mostly via the Mississippi River, to procure printing supplies. One might think that riding on the river would be a relatively easy mode of transportation, but Wilford records in his journal all the ailments he suffered during his journey: “An exceding Cold day & night & morning. As for myself I am in almost evry kind of trouble. A severe cold has settelled throughout my body. I have the Rheumatism, teeth ake, head ake, bones ake, have got the musketoe [mosquito] fever, Bilious fever, & sick Stomack, . . . & am many more weeks getting to St Louis & if the Musketoes do not favor me more than they have done, that it will be a question whether I ever reach home or not. But I hope for the best.”[34] Obviously, this was not an enjoyable trip. Wilford’s complaints about the mosquitoes also illustrate the significant problem they presented to health conditions all along the river.

Medical Conditions in Winter Quarters

Patty Bartlett Sessions began a daybook in February 1846, just two days before leaving her home in Nauvoo to cross the river for Iowa. Having learned to be a midwife from her mother-in-law in Maine before joining the Saints in Missouri, she became an exceptionally skilled caregiver and was affectionately known as “Mother Sessions.” She wrote in her first daybook entry, “My things are now packed ready for the west, have been and put Richard’s wife to bed with a daughter [she had delivered a baby as a midwife]. In the afternoon put Sister Harriet Young to bed with a son.”[35]

It took longer than expected to cross the muddy plains of Iowa, and the Saints were forced to spend the winter on the Missouri River before they could continue on to the Rocky Mountains. During her stay in Winter Quarters from September 1846 to June 1847, Patty Sessions assisted in the delivery of fifty-five infants. Her diary from this period shows that she was constantly caring for the sick. With doctors scarce—and a good doctor even more so—women were often the primary caregivers. In addition to midwifery, Patty was also skilled in mixing herbs and natural remedies in the Thomsonian tradition. Her diary records recipes for several remedies of her own making. One of these recipes reads as follows: “For bowel complaint take tea one spoonful of rubarb one forth corbnet soda one table spoonful brandy one tea spoonful peperment essence half tea cup ful warm water take a table spoonful once an hour until it operates.”[36]

Patty assisted in the delivery of Helen Mar Whitney’s daughter in Winter Quarters. Tragically, the child did not survive. Helen later recalled, “On the morning of May 6th I was delivered of a beautiful and healthy girl baby which died at birth. Thus the only bright star, to which my doting heart had clung, was snatched away.” Weakened from this traumatic delivery, Helen was stricken with a case of scurvy and was bedridden for several weeks. “The scurvy laid hold of me,” she said, “commencing at the tips of the fingers of my left hand with black streaks running up the nails, with inflammation and the most intense pain, and which increased till it had reached my shoulder.” [37] Fortunately, Helen survived.

Just as malaria was the common killer in Nauvoo, scurvy, an extremely painful disease, was the common killer in Winter Quarters. Helen’s husband, Horace, described the terrible pain experienced by victims of scurvy: “It would commence with dark streaks and pains in the ends of the fingers or toes, which increased and spread till the limbs were inflamed and became almost black, causing such intense agony that death would be welcomed as a release from their suffering. It was caused by the want of vegetable food and living so long on salt meat without it.”[38] Horace indicates that they understood that the cause of scurvy was an inadequate diet, but with no fresh fruits or vegetables available during the winter, there was not much they could do about it.

The harsh winter conditions claimed the lives of many who were already exhausted from the hasty exodus from Nauvoo, the endlessly muddy roads in Iowa, inadequate shelter and nutrition, and other factors. The exact number of people who died during this period in Winter Quarters is difficult to determine. It is commonly thought that about six hundred Saints died at Winter Quarters, mostly from scurvy.[39] This estimate originates from Thomas L. Kane’s lecture, The Mormons, published in 1850, and most likely includes settlements in the surrounding areas.[40] Despite the efforts of sextons to keep accurate records, many burials in and around Winter Quarters went unrecorded. This difficulty in record keeping was due, at least in part, to the nearly constant stream of grieving families making their way to the cemetery.

Conclusion

The early Saints faced immense medical challenges and harsh living conditions. The frequent mention of medical challenges in the Saint’ letters and journals shows that such challenges were a major part of their daily lives. By understanding how the Saints dealt with sickness and disease we can more fully understand the early Latter-day Saint experience.

 

Notes


[1] William G. Rothstein, American Physicians in the Nineteenth Century (Baltimore: Johns Hopkins University Press, 1972), 45.

[2] Scot Facer Proctor and Maurine Jensen Proctor, eds., The Revised and Enhanced History of Joseph Smith by His Mother (Salt Lake City: Deseret Book, 1996), 115.

[3] Proctor and Proctor, History of Joseph Smith, 115.

[4] Proctor and Proctor, History of Joseph Smith, 117.

[5] Joseph Smith, History of the Church of Jesus Christ of Latter-day Saints, ed. B. H. Roberts, 2nd ed. rev. (Salt Lake City: Deseret Book, 1957), 5:357.

[6] John S. Haller Jr., The People’s Doctor: Samuel Thomson and the American Botanical Movement, 1790–1860 (Carbondale: Southern Illinois University Press, 2000), 2.

[7] Claire Noall, Intimate Disciple: A Portrait of Willard Richards (Salt Lake City: University of Utah Press, 1957), 92–94.

[8] Scott G. Kenney, ed., Wilford Woodruff’s Journal, 1833–1898 (Midvale, UT: Signature Books, 1983–85), 2:108.

[9] Smith, History of the Church, 5:366.

[10] Smith, History of the Church, 4:414; emphasis added.

[11] Grant Underwood, “Early Mormon Perceptions of Contemporary America: 1830–1846,” BYU Studies 26, no. 3 (1986): 51.

[12] Volney Steele, Bleed, Blister, and Purge: A History of Medicine on the American Frontier (Missoula: Montana Press, 2005), 151.

[13] Dean C. Jessee, ed., The Papers of Joseph Smith (Salt Lake City: Deseret Book, 1989), 1:268.

[14] LeRoy S. Wirthlin, “Joseph Smith’s Boyhood Operation: An 1813 Surgical Success,” BYU Studies 21, no. 2 (1981), 133, 135.

[15] Wirthlin, “Joseph Smith’s Boyhood Operation,” 132n2.

[16] Proctor and Proctor, History of Joseph Smith, 74–75.

[17] Proctor and Proctor, History of Joseph Smith, 75.

[18] Proctor and Proctor, History of Joseph Smith, 75.

[19] Wirthlin, “Joseph Smith’s Boyhood Operation,” 132.

[20] Wirthlin, “Joseph Smith’s Boyhood Operation,” 137.

[21] Richard Neitzel Holzapfel and Jeni Broberg Holzapfel, A Woman’s View: Helen Mar Whitney’s Reminiscences of Early Church History (Provo, UT: Religious Studies Center, Brigham Young University, 1997), 110.

[22] Robert T. Divett, Medicine and the Mormons: An Introduction to the History of Latter-day Saint Health Care (Bountiful, UT: Horizon, 1981), 60.

[23] Smith, History of the Church, 3:323–26.

[24] Holzapfel and Holzapfel, A Woman’s View, 114.

[25] Kenney, Wilford Woodruff’s Journal, 1:347–48.

[26] Smith, History of the Church, 4:3.

[27] George W. Givens, In Old Nauvoo: Everyday Life in the City of Joseph (Salt Lake City: Deseret Book, 1990), 115.

[28] M. Guy Bishop, Vincent Lacy, and Richard Wixon, “Death at Mormon Nauvoo, 1843–1845,” Western Illinois Regional Studies 9, no. 2 (1986): 70.

[29] Times and Seasons, November 1, 1840, 208.

[30] Holzapfel and Holzapfel, A Woman’s View, 111.

[31] Times and Seasons, August 2, 1841, 502.

[32] Kenneth W. Godfrey, Audrey M. Godfrey, and Jill Mulvay Derr, Women’s Voices: An Untold History of the Latter-day Saints, 1830–1900 (Salt Lake City: Deseret Book, 1982), 135.

[33] Godfrey, Godfrey, and Derr, Women’s Voices, 136–37.

[34] Kenney, Wilford Woodruff’s Journal, 2:184; spelling and punctuation in original.

[35] Richard Neitzel Holzapfel and Jeni Broberg Holzapfel, Women of Nauvoo (Salt Lake City: Bookcraft, 1992), 160–61.

[36] Mormon Midwife: The 1846–1888 Diaries of Patty Bartlett Sessions, ed. Donna T. Smart (Logan: Utah State University Press, 1997), 76.

[37] Holzapfel and Holzapfel, A Women’s View, 448.

[38] Holzapfel and Holzapfel, A Women’s View, 438.

[39] Richard E. Bennett, Mormons at the Missouri: Winter Quarters 1846–1852 (Norman, OK: University of Oklahoma Press, 2004), 136. see also Jennifer L. Lund, “‘Pleasing to the Eyes of an Exile’: The Latter-day Saint Sojourn at Winter Quarters, 1846–1848,” BYU Studies 39, no. 2 (2000): 128–30.

[40] Richard E. Bennett, Mormons at the Missouri, 136.