Site  by Lynne Landwehr © 2004   






Features and Information

[Note: The following piece was written as background text for the San Luis Obispo County Medical Society and San Luis Obispo County Health Foundation's video presentation entitled "Champions in Health: San Luis Obispo County 1900-1929."  The video is available through the SLO County Medical Society, tel. 805/544-3020.] 

Health Services in San Luis Obispo County 1900-1929  

"My father was a general practitioner, so he treated patients with a wide spectrum of medical problems.  In his medical bag, he kept a variety of drugs, including four colors of ‘sugar pills’ which he used as placebos.  In his practice, no effort was too great to achieve the result he wanted, but he didn’t like patients asking questions about what he was giving them.  ‘I’m the doctor, and this is what you need, so just take it,’ he would reply to an inquiry.”  

This is the way that Dr. Fred Mugler, Jr., recalls his father’s manner of advising the patients he saw in his early medical practice in San Luis Obispo.  It was a different age, one in which people took for granted the role of the doctor whose knowledge was not to be questioned, and who made house calls in all kinds of weather.  San Luis Obispo resident Edna Root, born near the start of the 20th century, recalled in the late 1980s, “Doctors were different, so different, from now.  Every morning, with his little black bag in hand, our doctor made his rounds to the homes of the sick.  He was an essential part of our way of life.  For any misfortune or illness, we called the doctor--for a feverish cold, for chilblains, for a sore throat or a bean stuck in the nose, a foxtail in the throat.” 

These were the memories of a “city girl,” born and bred in San Luis Obispo.  On the isolated ranches throughout the rural parts of the county, the old ways lingered on even more strongly than in town.  Cattleman Henry Twisselman was born and grew up in the North County in the years when the closest doctor was located in Paso Robles, 45 miles away.  “This was a long day’s journey [at the time].  Some women were specifically responsible for delivering babies into the world. Amelia Packwood …did this job for my mother when I was born.  I didn’t breathe at first, so she gave me a teaspoonful of whiskey and nearly strangled me.  Next she put me in a tub of water that was sitting on the stove, but the water was too hot and she nearly scalded me.   However, by this time, I had started to breathe….”   

Henry Twisselman: "I didn't breathe at first
so she gave me a teaspoonful of whiskey
and nearly strangled me...."

The whisky used by midwives like the one who delivered Henry Twisselman couldn’t work against the two biggest killers—tuberculosis and pneumonia.  Dr. Alvin Wilmar, an early practitioner in the North County, estimated that 80% of the population had tuberculosis at some time, but many of the cases were so mild that people didn’t realize what they had.  “But pneumonia,” he explained, “you knew when you got that.  It would come on with a chill, very suddenly….If you got over it in five days, you would be fine, but if it lingered, you would be too weak to recover.” 

Measles, diphtheria, scarlet fever, and other contagious diseases killed many children, such as the three brothers who died within weeks of one another and who were buried together in the Estrella churchyard.  Edna Root remembered particularly the quarantine imposed by scarlet fever:  “Sometimes when the doctor finished a house call at a neighbor’s, a businesslike man would come by soon after with hammer and nails.  When we heard his hammer pounding, we knew a large red warning card was there for all to see, on the front of the house:  Scarlet Fever -- Keep Out.  We children knew it was something terrible and catching.  At first, we would circle a whole block to avoid a marked house, but after a few days, that seemed useless, so we would sneak by across the street and then, as a final climax, we would cross the street, half close our eyes, and run like fury.”

Against this background of the age-old scourge of disease, big changes were coming:  electricity revolutionized the world, particularly the woman’s world, and “water-under-pressure” came into the kitchen and bathroom, bringing with it the inside toilet. 

Another big change was the horseless carriage.  The doctors were quick to make use of it:  in good weather, it helped them arrive much faster at the home of an ailing patient.  In bad weather, the roads were so rough that some doctors reverted to horse-and-buggy travel because it was more dependable.   Dr. Wilmar used an early-model Ford when he could, but if it was storming and a patient needed him, he rented a team of horses and a wagon from the Paso Robles Livery Stable.

Dr. Paul Jackson was another local physician who seized the future by gripping the steering wheel of the new horseless carriage.  Auto dealer Charles Maino reminisced: “Dr. Jackson called me to go with him at two o’clock in the morning to see a patient in Avila….We started out in Paul’s open roadster in the rain.  There were no paved roads, and the mud was quite deep.  As we passed the Sulphur Springs, a man with a lantern flagged us down.  When we stopped, the man said, “I walked …three miles to meet you and take you to the house.”  We had him get in the seat on the outside, and as we approached a bad mud hole, the doctor swerved to dodge it, and as he did so, the man that met us fell out.  I said to Doctor, “Stop! stop!”  He was having such a hard time keeping the car on the road that he didn’t want to take a chance by stopping except as a dire emergency.”

"As we passed the Sulphur Springs,
a man with a lantern flagged us down...."
(Click on postcard to enlarge it.)

Just as residents adopted new ways in their kitchens and on the highways, medical and dental practitioners were finding new ways to help their patients. The causes of yellow fever and typhus were identified, the four blood groups were isolated, and hormones were discovered.  Aspirin, the non-addictive painkiller developed from coal by two German researchers, was becoming the analgesic of choice.  The international Christmas Seal program became an important source of funding for the battle against tuberculosis. Licensing laws were passed, public nursing schools were established, and the Red Cross expanded its range of services to include the Rural Nursing Service. 

For the first time, progress in the science of medicine meant that advances would benefit all people, not just the patients who had money enough to pay for treatment.  The causes of disease were being identified, and standards and accreditation were increasingly stressed as a way to create a uniform level of health care throughout the community.  Locally, the signs of this progress included the meetings of the County Medical Society, usually held in the home of one of the members.  Dr. Wilmar remembered the first meeting he attended, at the combined home and office of Dr. Sigrid Helgesen, the first female physician in the County.  Those present elected him a member, and then, almost immediately, he was made Secretary, so there would be someone to record the minutes. 

1910 – 1919

In the second decade of the century, the nation would confront two major crises—the Great War, followed by the worldwide epidemic of Spanish influenza.  The County of San Luis Obispo was not immune to these events.  Troops for General Pershing’s American Expeditionary Force trained at Atascadero’s Camp Lewis, and local boys went “Over There” to “make the world safe for democracy.”

"Troops trained....at Atascadero's Camp Lewis...."

On the home front, influenza became the enemy.  The county’s first influenza fatality was William Gibson, who died September 26, 1918.  Outbreaks of flu continued through October and November, and word of the November 11 Armistice shared the front pages of the local papers with reports on the flu’s progress—how many new cases, which schools were closed, names of the stricken, names of the dead.

One resident remembered that time as follows:  “Etched deeply in my memory is the winter of 1917-1918 and the months that followed, when so many died, unbelievably fast. No one in the whole world knew what to do for the ‘grippe,’ or the ‘Spanish influenza,’ a new word no one had heard before.  There was literally no treatment except bed rest and warm saltwater gargle.  In San Luis Obispo, as well as everywhere else, everyone wore flu masks at all times.  All gathering places were closed.   Neighbors died around us….The young died.  The middle-aged died in the largest numbers.  Death took the old quickly, but not without pain and raging fever… Flag-draped caskets accompanied by soldiers were unloaded at the depot frequently, met by awe-stricken friends and bereaved relatives.  These caskets contained the bodies of sons who had left for the service hale and hardy such a short time earlier.   In a year and a half, flu killed more than half a million in the U.S, and more than 21 million worldwide.” 


In the County, life slowly returned to normal—the influenza epidemic subsided, the rest of the troops came home, and their parents wondered “How You Gonna Keep ‘Em Down On the Farm, After They’ve Seen ‘Paree’?”  Prosperity had come to many in the area as a result of the U.S. government’s subsidy of bean prices during the war—many a bean farmer had become wealthy almost overnight.   After Prohibition became the law of the land at the stroke of midnight on January 17, 1920, others in the county would seek their riches not in beans, but in booze, as isolated spots along the county’s coast proved excellent places for Canadian smugglers to drop off shipments of whisky that would be distributed by local bootleggers. 

"...isolated spots along the county's coast...
for Canadian smugglers to drop off shipments of whisky...."

 Although Prohibition helped to create the “Roaring ’20s,” everyday life in the County was far less glamorous.  The down-to-earth County Health program headed by Dr. K.H. Sutherland included a full-time health officer, a public health nurse, a sanitary inspector, a lab technician, and two school nurses.  The program was responsible for well-baby clinics, control of contagious diseases, diphtheria and smallpox immunizations, regular monitoring of water supplies, inspections of meat markets and slaughterhouses, and methods of sewage and garbage disposal.  County Health Department employees regularly inspected restaurants and groceries, as well as the auto camps that sprang up to compete with the brand new Motel Inn, the nation’s very first motel.

By 1925, the County had seen a number of hospitals spring up to provide care for those who were reluctant to join the mostly indigent patients at the County General Hospital and Farm.  The first public hospital in the North County was the hospital at the Atascadero colony, built in 1921.  E.G. Lewis, the creator of Atascadero, ruled like a benevolent dictator.  It was he who decreed that one dollar a month was to be deducted from each employee’s pay, and that this deduction would be used to provide for health benefits, which included complete hospital care, regardless of the size of an employee’s salary or the importance of his or her job--an advanced idea for its time, and one that was rejected by doctors elsewhere who feared the spread of what they thought of as “socialized medicine.”

AtascaderoHospital.jpg (124451 bytes)
"...the hospital at the Atascadero colony, built in 1921."
(Click on photo to enlarge it.)

Private hospitals included the Hedgepeth Sanitarium in Paso Robles, the Hageman Sanitarium on Osos Street in San Luis Obispo, and the Pacific Hospital at 735 (now 743) Buchon Street.  The latter had operating room equipment, an X-ray apparatus, and private rooms for patients, including specially equipped maternity rooms.  Nurses boarded in private homes nearby, and one old-time Buchon Street resident recalled that as a young girl she spent many hours ironing the sheets for the nurses boarded by her family.   

The former Hageman Sanitarium
at 1716 Osos Street, City of San Luis Obispo.

Probably the most advanced of these private hospitals was the San Luis Sanitarium, formerly known as the Stover Sanitarium after Dr. William Stover, its originator and builder.  To make this hospital function smoothly, physically sturdy men and women were needed—the hospital had no elevators, and patients had to be pushed up and down the ramps between the three floors.  Facilities at the Sanitarium included a tiled operating room with one window an immense sheet of plate glass, and a birthing room with a special bed and a gas machine for the administration of nitrous oxide and oxygen, at the time the best anesthetic for confinement cases.  On mild days, an awning spread over an upper veranda permitted convalescing patients to enjoy the mild days out of doors.  

In the early 1920s, the Sanitarium was taken over by Drs. Howard Gallup and Fred Mugler and was known as the San Luis Sanitarium.  Dr. Fred Mugler, Jr., recalls that “My father brought with him from San Francisco not just new surgical techniques, but improved methods of sterilizing instruments and equipment for the operating room.  Laboratory tests became better in the 1920s, and an X-ray machine was installed in the hospital basement.  This made surgery so much more precise—it was like giving a map to the surgeon, a map of where the incision needed to be made.”   

1160 Marsh Street, originally the Stover Sanitarium,
then the San Luis Sanitarium, then (old) French Hospital, 
and now private offices.

Drs. Mugler and Gallup started an accredited training school for nurses, with ten nurses in training at all times. Two of the graduates, Surgical Nurse Lena Padlina and Office Nurse Hazel Dailey, stayed on to work as permanent employees for Dr. Mugler and later for Dr. Edison French when he took over the Sanitarium.

Throughout the 1920s, improved roads and transportation allowed patients to come to the doctors, and to the hospitals, rather than the doctors having to go to them.  Still, there were a few exceptions.  Dr. Mugler recalled his father’s experience: “My father was called rather often to take care of employees and guests at the Hearst Castle.  Once when my father went up there to see Marion Davies, she asked him if he liked her negligee, which was pink.  ‘It’s very nice,’ he responded, ‘but yellow is my favorite color.’  Every time after that when he went to visit Miss Davies at the Castle, she wore yellow.”

"Every time after that...Miss Davies...wore yellow."

The Roaring Twenties saw the Band-Aid introduced, insulin first used to treat diabetes, and the electroencephalogram making the first “tracings” of the human brain.  Locally, progress included the first direct blood transfusion.  Dr. Alvin Wilmar had made a trip to France and purchased the necessary apparatus. There was no clinical lab in the county, so he personally did the blood typing and cross-matching.  Then, with donor and recipient side by side, he used his apparatus to aspirate 10 cc’s of blood from the donor, adjust the pet-cock valve, and then inject the 10 cc’s into the recipient.  This procedure was repeated as needed, with a nurse keeping track of the total volume of blood transfused. 

The Twenties ended with the disastrous collapse of the American stock markets on Black Thursday—October 24, 1929.  Medically, the decade ended on a more positive note:  penicillin was discovered, although it would not be readily available for another 15 years, and the “iron lung” was first used to “breathe” for polio patients.  These and other advances were summed up by Dr. Elsa Horstmann Van Soest, who grew up in Templeton, went to medical school at the University of Southern California, and began her practice in 1908.  In 1973, she looked back at the early years and explained, “Oh, there were many anxieties and frustrations in the equipment, remedies, and facilities we did not have.  We had only opiates for pain relief and feared to use those as they were so habit-forming.  But then, a great day dawned, the blessed Bayer Company gave us aspirin…I am glad I had to experience these lacks.  How, otherwise, could I have appreciated the tremendous satisfactions in later years of a portable X-ray bought to the bedside, oxygen tank, and diagnostic laboratories available?….Tuberculosis [was a] killer of multitudes.  We knew only to give patients milk and fresh air.  Now we have this dreaded disease almost eradicated….We began to get the great blessing of antibiotics and we had help against that great killer, pneumonia.  Most elderly people died of pneumonia, though it was often labeled heart failure.  There was the advent of hormones, vitamins, and safe anesthesia…we had only chloroform….And thank god for insulin!  We didn’t know what to do for diabetes.  We took away their candy but we didn’t know how to offset that terrible demand on their bodies.  The list of miracles is now endless and I have lived to witness them.”   

Dr. Elsa Horstmann Van Soest
(photo courtesy of Templeton Historical Society)

Lynne Landwehr © 2001.  All rights reserved.

Click here to continue to Part III of the Medical History


The following resources were used
in the preparation of the above report:

Atascadero Historical Society and Museum: Mike Lindsay, Curator.

Hubbard, Jean. Historian, Paulding History House/South County Historical Society.

Krieger, Dan, Ph.D. Columns in "Times Past," San Luis Obispo Telegram-Tribune and Tribune.

Lewis, William H.  Atascadero's Colony Days. Atascadero Historical Society, 1974.

Maino, Charles A.  Old Times in San Luis Obispo, California. San Luis Obispo: Maino family publication, 1990.

Members of the San Luis Obispo County Medical Society's Medical History sub-committee for the "Champions in Health" series: Rick Cohen, Lynne Landwehr, Kathy Laster, Kaye Mickelson, Billy Mounts, M.D., Mary Parker, R.N., Ed. D., and Nancy Rosen.

Mounts, Billy, M.D. Research; liaison with Dr. Fred Mugler, Jr. and with Lois Wilmar.

Mugler, Fred R., Jr., M.D. Personal reminiscences and clippings as sent to Dr. Billy Mounts, July 2001.

Ohles, Wally. Friends of the Adobes (Rios-Caledonia and Estrella Adobes).

Rawson, Lura. Columns in the North County Tribune.

Root, Edna. Unpublished reminiscences.

Templeton Historical Society and Museum: Carla Willhoit, Curator.

The Illustrated Review, 1918 editions, published by the E.G. Lewis Printing Company, Atascadero.

Travis, Marguerite A. The Birth of Atascadero. Atascadero Historical Society, 1960.

Twisselman, Henry.  Don't Get Me Started! Los Olivos: Olive Press Publications, 1995.

Various historical articles from San Luis Obispo County newspapers past and present: The Breeze, The Semi-Weekly Breeze, The Tribune, The Daily Telegram, The Telegram-Tribune.

Wilmar, Alvin, M.D. Personal reminiscences of Dr. Wilmar, as written by him and/or as reported by Kathleen Nemetz in the San Luis Obispo Telegram-Tribune, February 17, 1981.

Winslow, Carleton, Jr., and his students at California State Polytechnic College [now California Polytechnic State University]. Discovering San Luis Obispo County. San Luis Obispo: no publisher name shown, 1972.

Young, Naomi B. "The History and Development of San Luis Obispo County Hospital System, 1874-1970." Private typescript, San Luis Obispo, 1971.


Click here to read postcard-length
dramatizations of medical milestones
from this period.

Click here to return to
Features & Information section.



Copyright © 2004 Lynne Landwehr.  
All rights reserved.