These early immigrants survived the harsh times and difficult American climate as well as the wilderness on primitive basic instincts. The early settlements were often ravaged by starvation and disease.
During the colonial era, doctors' education was informal. Most were literate, but some who were raised outside of New England were not. A man who wanted to practice medicine did not need any type of certification. Most did have a period of apprenticeship with an established physician, but even this was not a requirement. Up until the late 19th century, very few doctors had a college education.
Medical facilities were unofficial. Most patients were treated in their homes. However, even the smallest towns had poorhouses, where needy people could live and receive limited medical care.
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