Is There A Doctor in the (Court) House?: A Doctor’s Account Book as Public Record

Robert Davidson (R.D.) Hufford was born in Wythe County in 1850. He studied medicine at the Medical College of Virginia and established a practice in Smyth County. In 1891, he moved to Tazewell County where he practiced until his death in 1898. Following Hufford’s death, all of his estate papers and account books were exhibits in a chancery cause heard in Tazewell County Circuit Court. Titled Foote and Johnson and others versus Administrator of R.D. Hufford and others (Tazewell County Chancery Cause 1903-043), the purpose of the suit was to settle Hufford’s estate. The estate papers and account books remained at the courthouse following the resolution of the suit. One of the ledgers eventually made its way to the Library of Virginia as part of a records transfer in the 1970s.

I came across Doctor Hufford’s account book while cataloguing the business records of Tazewell County. Looking through the pages, most entries contained scant information, e.g. “to visit … $4” or “to Rx … $1”. There were a few entries that provided some detail on the services Hufford provided.  They included treatment for fevers, amputation of limbs, removal of teeth, and numerous pregnancies. And there was the odd entry such as using electricity to treat the wife of a patient and setting the leg of a horse that, for a nineteenth century doctor, perhaps was not so odd. Hufford and his fellow doctors of that era had to be a “physician of all trades” … pediatrician, obstetrician, surgeon, dentist, gynecologist, and veterinarian.

The most striking entries found in the account book contained information that some of Hufford’s patients probably wished he would have left out and just written “to visit … $4” or “to Rx … $1”. Hufford treated thirty-four patients for sexually transmitted diseases, specifically syphilis and gonorrhea. Two of the thirty-four were husband and wife. Sexually transmitted diseases were very common in the late nineteenth century and early twentieth century. John Stokes, who was the chief of the Section of Dermatology and Syphilology at the Mayo Clinic wrote an essay in 1920 in which he referred to syphilis as the “third great plague” behind tuberculosis and cancer. But unlike tuberculosis and cancer, syphilis, along with gonorrhea, carried a social stigma that made treatment difficult. That stigma stemmed from the very nature of how one contracted the diseases. If it became public knowledge, a person with syphilis or gonorrhea was viewed as immoral. If the person was married, the stigma would be magnified even more because they would have been branded by society as an adulterer. Therefore, in order to avoid public disgrace, people who contracted a sexually transmitted disease chose to hide their condition. The only person who knew was their doctor and he was expected by his patient to keep quiet about it. I would imagine that many of the thirty-four were not pleased when, following Hufford’s death, his administrator came to them to collect the money they owed to Hufford’s estate for the services he rendered them.

Another set of entries I found in Doctor Hufford’s account book that his patients may not have wanted to be public knowledge related to abortion.  Doctor Hufford performed abortions for ten patients. Were the abortions performed because of complications in the pregnancies or for other reasons? It is nearly impossible to say.  Abortion was not uncommon in nineteenth century America. In the essay “Attitudes to Abortion in America, 1800-1973,” author R. Sauer cites a number of nineteenth-century sources (newspapers, physicians, the American Medical Association) expressing concerns about the increasing number of abortions. According to Sauer, abortions were concentrated among the middle and upper classes and were more common among married than unmarried women. From the small amount of information I gathered from census records, Doctor Hufford’s account book, and history books of Tazewell County, nearly all of the ten patients who had abortions were in that demographic. (I might add that the thirty-four patients who had an STD were in the same demographic.)

Doctor Hufford’s account book, along with the chancery cause Foote and Johnson and others versus Administrator of R.D. Hufford and others, have been digitally reformatted. They are available for viewing, along with the rest of the Tazewell County chancery causes (1800-1920), on the Chancery Records Index found at Virginia Memory.

-Gregory Crawford, Local Records Coordinator