MEDICAL SECTS

12 May

The first wave of medical sectarianism in nineteenth-century America included Hydropaths, Thomsonians, Eclectics, Physio-Medicalists, Eclectics, and Homeopaths. Despite differences in their medical theories and therapeutic systems, members of these sects agreed that the allo- paths, or so-called regular doctors, were the most dangerous quacks of all. Unorthodox practitioners saw themselves as reformers, healers, revolutionaries, professionals, and members of new philosophical schools, not as members of cults or sects. The true test of any medical system, they argued, should be patient satisfaction, especially in the case of chronic illnesses where allopaths had already failed. Critics of ortho- dox medicine argued that medical licensing laws infringed the rights of American to make their own decisions about health and healing. Samuel Thomson (1769–1843), a New Hampshire farmer, created a system of medicine based on herbal remedies as substitutes for the harsh drugs prescribed by orthodox doctors, especially those that con- tained mercury, arsenic, antimony, and other toxic chemicals. Rejecting the therapeutics and the authority of regular physicians, Thomson became one of the most influential healers in America during the 1820s to the 1830s.

Adopting what he called a wholly empirical approach, Thomson advertised his system as the product of the ‘‘study of patients, not books—experience, not reading.’’ According to Thomson, he became an authority on herbal remedies by studying the methods of an old woman who practiced herbal medicine in rural New Hampshire, free of competition by any so-called real doc- tors. After losing loved ones to a combination of disease and the damage done by orthodox physicians, Thomson decided to abandon farming and became an itinerant botanical doctor. In his autobiography, Thomson noted that orthodox doctors called him a quack, but he asked: ‘‘which is the greatest quack, the one who relieves them from their sickness by the most simple and safe means .. . or the one who, instead of curing the disease, increases it by poisonous medicines which only tend to prolong the distresses of the patient, till .. . death relieves him?’’ Unlike regular doctors who insisted on bleeding and purging with calomel and other dangerous drugs, Thomson offered a system that was cheap, safe, and easy to use. Following his system helped in avoiding the expense of consulting a doctor and the embarrassment of having male physician examine female patients. While Thomson’s remedies were not revolu- tionary, his marketing strategy was innovative and quite lucrative. By the early 1830s, millions of rural Americans were using his system and reading his books. Basically, Thomson prescribed botanical substances and steam baths. Despite his empirical orientation, Thomson did express a simple theory of healing, which involved increasing internal and external bodily heat in order to eliminate disease. His botanical remedies included lob- elia, a botanical emetic that cleansed the stomach and induced perspi- ration; cayenne pepper and steam baths, to restore bodily heat; teas made from various roots, barks, and berries to improve the digestion; and botanical tonics made with wine or brandy to strengthen the patient. Followers of Thomsonism were taught to use a kit containing six numbered remedies that were given in a predetermined sequence.

Thomson also gave practical advice about healthy living, and the harm caused by tainted meats and excessive alcohol consumption. The first of many editions of Thomson’s New Guide to Health; or, Botanic Family Physician, Containing a Complete System of Practice, including A Narrative of the Life and Medical Discoveries of Samuel Thomson was published in 1822. Some editions included the phrase Learned Quackery Exposed in the title. Before buying the book, subscribers had to purchase the ‘‘right’’ to a copy of the book and membership in a local Friendly Botanic Society. Members of Friendly Botanic Societies pledged to use the Thomsonian system and help other members ‘‘in times of need.’’ Calling attention to the clear, simple language used in his book, Thomson warned readers against the deadly poisons prescribed in a dead language by regular doctors who deliberately used obscure Latin terminology in an attempt to confuse and intimidate simple people. In many states, Thomsonism competed very successfully with regular medicine, but success led to the proliferation of agents marketing the authentic system, as well as the appearance of imitators and com- petitors. Some regular physicians surreptitiously adopted the Thomsonian system and unauthorized agents marketed drugs that were not approved by Thomson. Thomson fought to retain his vision of lay practice as a self- help movement, but the original system was subverted by ‘‘expert’’ prac- titioners who established their own drug regimens, established private clinics, trained students and apprentices, and warned patients against treating disease on their own.

Thomsonism split into warring factions and no national conventions were held after 1838. By the 1840s, the Thomsonian movement had been fragmented and overshadowed by vig- orous new competitors. New sects known as physio-medicalists and eclectics adopted Thomson’s botanic medicines and his condemnation of orthodox drugs, but in contrast to Samuel Thomson, members of these sects considered themselves professional physicians by virtue of their doctrines, edu- cation, schools, and professional journals. Alva Curtis (1797–1881), founder of physio-medicalism, was a botanical practitioner who attempted to compete with both Thomsonians and regular doctors by establishing a new professional identity. The first physio-medical school was founded in Columbus, Ohio, in 1836. Additional physio-medical colleges were established in Alabama, Georgia, Massachusetts, New York, Tennessee, and Virginia, but all of these schools disappeared by 1911. The fundamental philosophy that united this otherwise conten- tious sect was the ancient belief in the body’s inherent ‘‘vital force’’ or ‘‘internal physician.’’ Physio-medicalists claimed that their botanical remedies enhanced the body’s own healing force. Allopathic mineral drugs, those used by regular physicians, were condemned as dangerous and unnatural poisons.

These fundamental principles were adopted by the Reformed Medical Association of the United States and the American Association of Physio-Medical Physicians and Surgeons. In addition to his lectures on medical science and botanical drugs, Curtis explained the advantages of physio-medicalism over other systems in his book A Fair Examination and Criticism of All the Medical Systems in Vogue. He also published responses to ‘‘provocation’’ from regular practitioners. Although the physio-medicalists constituted only a small fraction of American medical practitioners, and their medical schools were academically inferior, physio-medicalists demanded the right to compete for positions with the army and navy, as well as representation on state licensing and regulatory boards. Wooster Beach (1794–1868), the founder of eclectic medicine, had no direct ties to Thomsonism, but he had studied with a botanical healer and published a book on domestic medicine. Beach considered himself a professional botanical physician, because he attended a medical school in New York and held a license issued by the county medical society. In The American Practice of Medicine (1833), Beach contended that the practice of orthodox medicine was ‘‘pernicious and dangerous to the extreme.’’ The whole materia medica of orthodox medicine consisted of a few poisonous minerals that did more damage to the human body than the diseases for which they were prescribed. Eclectism, in contrast, was a philosophical school of thought that called for the reform of medicine.

The new botanical medicine, according to Beach, was based on ‘‘immutable and eternal principles of truth.’’ The principles of eclec- tic medicine had been proved by experiments, observation, and facts deduced from clinical practice. Texts published by eclectics included pathology, symptomatology, diagnosis, prognosis, and comparisons of the remedies used by allopathists, homoeopathists, hydropathists, and eclectics. In 1830, Beach and several colleagues organized a medical college in Worthington, Ohio, that claimed to be the first chartered, degree- granting botanical medical school in the United States. Although Beach believed that the new school would establish a scientific foundation for botanical medicine, he called his therapeutic system ‘‘eclectic,’’ because it lacked a unique medical philosophy. By the time the school closed in 1839, because of a dissection riot, it had graduated almost 100 eclectic physicians. The Eclectic Medical Institute in Cincinnati, Ohio, which was chartered in 1845, was the most important and successful eclectic school. By 1892 there were 10 eclectic medical schools. The curriculum of the eclectic schools was basically the same as that of orthodox medi- cal schools. Courses included anatomy, pathology, materia medica, sur- gery, and obstetrics. Despite some resistance, eclectic schools were more willing to admit female students than regular medical schools. As suggested by their name, eclectics adopted a flexible approach to therapeutics, although they emphasized remedies derived from native plants and new forms of so-called concentrated medicines, and cate- gorically rejected bloodletting. Eclectics were fairly successful in com- petition with physio-medicalists and Thomsonians, but the sect remained small compared to regular medicine and homeopathy. Never- theless, at the beginning of the twentieth century, the National Eclectic Medical Association had chapters in 32 states. John M. Scudder (1829– 1894), a professor at the Eclectic Medical Institute, John Uri Lloyd (1849–1936), and others, attempted to elevate the status of Eclecticism by publishing textbooks and professional journals, developing new rem- edies, and improving the standardization of eclectic drugs. Their efforts failed and the Eclectic Medical Institute, the last eclectic school, closed in 1939. The Lloyd Library founded by John Uri Lloyd and his brothers, however, retains a valuable collection of books in phytopharmacy and its history. Despite the demise of eclecticism, Lloyd became a very successful pharmacologist and manufacturer of pharmaceuticals. Lloyd served as president of the American Pharmaceutical Association and was credited with helping to secure passage of the National Pure Food and Drug Act of 1906. A prolific author of works of fiction and nonfic- tion, Lloyd’s books included A Systematic Treatise on Materia Medica and Therapeutics, Dynamical Therapeutics, and a study of the herb Echi- nacea angustifolia (which still is popular for colds and flu). Homeopathy, one of the most successful of the nineteenth-century medical sects, was founded by the German physician Christian Frie- drich Samuel Hahnemann (1755–1843). Although Hahnemann was a respected doctor and chemist, he withdrew from medical practice because of his conviction that conventional therapies were dangerous and ineffective. It was only in 1796 when he discovered his new system of healing, based on the principle similia similibus curantur—‘‘like cures like’’—that he felt capable of resuming his vocation. In 1810, Hahne- mann published the first edition of his Organon of Medicine, which described the fundamental principles of homeopathy. In response to attacks on his system, Hahnemann published a Defense of the Organon of Rational Medicine. ‘‘The physician’s high and only mission,’’ Hahnemann said in the Organon, ‘‘is to restore the sick to health.’’ A true science of medicine must be built upon experience and advanced by ‘‘due attention to nature by means of our senses, by careful honest observations and by experi- ments.’’ It was through his own experiments, using drugs of the highest degree of purity possible, that he discovered the principles of homeo- pathy. According to Hahnemann, when drugs are given to healthy people in large doses, they produce certain effects that are like the symptoms of disease in sick people.

Hahnemann called his experimental program of testing drugs and determining what symptoms or effects they caused in healthy subjects ‘‘proving’’ the drug. The symptoms exhibited by patients were carefully noted, so that they could be given small doses of drugs known to produce the same symptoms. In essence, Hahnemann’s system of medical treatment was based upon the assumption that disease is not wrong but right action, that nature was doing its best, and that medicine should be given to help the body by increasing the existing symptoms instead of changing them. Hahnemann also believed that the less he helped or interfered with nature the better. Therefore, as soon as medicine had increased the existing symptoms, he stopped giving medicine. Hahnemann argued that members of the old school were simply members of a dangerous sect that practiced allopathic medicine, that is, treatment by opposites. In other words, allopaths belonged to a sect that believed in treating dis- eases with remedies that produce effects different from those caused by the disease itself. If true quacks existed, Hahnemann argued, they were practitioners who championed allopathic medical theories and methods. In a scathing attack on the ‘‘old school,’’ Hahnemann denounced allopathic medicine as ‘‘a pure nullity, a pitiable self-deception, eminently fitted to imperil human life by its methods of treatment.’’ Allopathic doc- tors attacked the body with large and frequent doses of powerful medicines given as complex mixtures, including dangerous emetics, purgatives, siala- gogues, diuretics, caustics, and then compounded the damages by massive bloodlettings that further weakened their unfortunate patients.

As a result, in addition to the original disease, the body developed ‘‘new and often ineradicable medicinal diseases.’’ Allopaths had constructed ‘‘so-called systems’’ out of empty spec- ulations about the unknowable nature of vital processes and the origin of diseases within the living organism. But, Hahnemann insisted that the physician could not expect to see the vital force or spiritual being that produced disease. For the homeopathic physician, the signs and symp- toms presented to the senses constituted the ‘‘true and only conceivable portrait of the disease.’’ By removing all the symptoms, the homeopath destroyed the internal, hidden cause of the disease. Ignoring the symp- toms, allopaths engaged in a futile search for the hidden primary cause of disease. The goal of homeopathy, in contrast, was the complete annihilation of the disease by means of a cure that was rapid, gentle, reliable, and harmless. In order to determine the proper drugs and dos- age, the homeopathic physician had to carefully assess the ‘‘physical constitution of the patient, his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function,’’ and so forth. The first law of homeopathy was the law of similars. The second fundamental principle was the law of infinitesimals. Because the sick were extremely sensitive to drugs, the homeopathic physician never used crude, undiluted drugs. To eliminate the possibility that even a small dose of the drug would aggravate the patient’s symptoms, Hahnemann carried out a series of dilutions. In order to maintain the potency of the drug after dilutions that ordinary chemists thought would eliminate any trace of the original substance, Hahnemann diluted his preparations by a series of steps that he claimed reduced toxicity and increased the heal- ing properties of his ‘‘high potency’’ dilutions. Each time he diluted his preparation he submitted it to a powerful series of shakes or succus- sions. According to Hahnemann, this process liberated the ‘‘essence’’ or ‘‘idea’’ of the drug from its inert material base or ‘‘substance.’’ Drugs were diluted or attenuated by mixture with water, alcohol, or milk sugar, which according to painstaking provings were neutral substances. Advocates of Natural Hygiene, naturopathy, and other drugless sects, preferred homeopathy to allopathy, but said that Hahnemann’s theoretical basis was flawed because he assumed that medicines could help nature and cure disease. Naturopathy is the treatment of illness by ‘‘properly arranging the intake of foods,’’ in order to eliminate toxins from the body and ‘‘build normal cells, blood, tissues, and secretions.’’ Naturopaths do not use drugs for either healing or preventing disease.

They attempt to establish a ‘‘health environment’’ through diet and proper mental attitude. In practice, homeopaths used such infinitesimal doses of drugs that they were unlikely to pose any danger to the patient. Allopaths and chemists ridiculed the claims made for the efficacy of extreme dilutions. Cynics proposed a homeopathic chicken soup recipe for particularly sensitive invalids, which was made by allowing the shadow of a chicken to fall into a pot of water. Exploiting dissatisfaction with the harsh remedies of regular doctors, homeopaths enjoyed a tremendous wave of popularity in the United States. Epidemic diseases provided numerous opportunities for homeopaths to emphasize the safety and efficacy of their therapeutic system and the dangers of allopathic methods. According to homeopathic physicians Dr. William Holcombe and Dr. F. A. W. Davis, during a yellow fever epi- demic in Natchez in 1835, only 33 of their patients died, while 430 died under the care of orthodox doctors. When homeopaths were put in charge of the Mississippi State Hospital in Natchez in 1854, they increased survival among their patients by forbidding the use of bloodletting, purgatives, calomel, blisters, and other allopathic methods. Constantine Hering (1800–1880), one of the first homeopaths in America, established a successful practice and converted some allopaths to the new therapeutic system. Hering introduced an American edition of Samuel Hahnemann’s Organon of Homoeopathic Medicine, which was issued under the auspices of the North American Academy of the Homoeopathic Healing Art, Allentown, PA. He also published A Con- cise View of the Rise and Progress of Homoeopathic Medicine, Condensed Materia Medica, and other works on the materia medica of homeo- pathic medicine. When the Homeopathic Medical College of Pennsylvania was founded in 1848 most of the faculty members were graduates of regular medical schools who had adopted homeopathy. Disagreements within the faculty led to the creation of the rival Hahnemann Medical College, but the two schools merged in 1869. At the beginning of the twentieth century, there were about 40 homeopathic medical colleges in America, as well as homeopathic hospitals, dispensaries, medical societies, medi- cal journals, and physicians, including many female practitioners. By the 1920s, however, only two homeopathic medical schools were still in existence.

The successful development of bacteriology, pathology, physiology, and pharmacology tended to erode support for homeo- pathic theory. Hahnemann Medical College survived by modernizing its curriculum, abandoning the teaching of homeopathy, and eventually merging with the Medical College of Pennsylvania; the new entity was renamed the Allegheny University of the Health Sciences. Women—as patients, advocates, and practitioners—played an important role in the growth and dissemination of homeopathic medi- cine among middle and upper class families. Popular female writers, such as Elizabeth Stuart Phelps (1844–1911), incorporated homeopathy into their work. Phelps, who said her personal causes were ‘‘Heaven, homeopathy, and women’s rights,’’ explored the affinity between women and homeopathy in her novel Doctor Zay. The protagonist of the novel was a female homeopathic doctor, Dr. Zaidee Atalanta Lloyd, a Vassar graduate with three years of medical school and one year of study abroad. Clearly, Dr. Lloyd was more highly educated and more sensitive to her patients than her allopathic rivals and detractors. Never- theless, homeopathy did not always welcome female practitioners. In 1867, the American Institute of Homeopathy (AIH) rejected a woman’s application for membership, but two years later the AIH voted to accept all candidates, male or female, who wanted to learn and practice homeopathy. Members of the AMA, which did not admit women until 1915, argued that the strong bonds between women and sectarian medi- cine provided further proof that women were unsuited to become phy- sicians. Some physicians were unsure where quackery pure and simple ended and eccentricity and innovation began, but Oliver Wendell Holmes (1809–1894) was sure he could tell the difference between true medicine and the ‘‘delusions’’ of homeopathy and other deadly errors that appealed to the fatal credulity of the public. While insisting on the superiority of orthodox medicine, Holmes admitted that probably 90 percent of the patients a physician might see would recover, sooner or later, if nature were not thwarted in effecting a cure. Therefore, he concluded, nature healed and the doctor claimed the credit and the fee.

Holmes also famously declared that if all medicines, with a few important exceptions, were thrown into the sea, it would be better for humankind and worse for the fishes. Although William Alcott, John Harvey Kellogg, Wooster Beach, Andrew Taylor Still, and Samuel Hahnemann had credible medical credentials, despite their ‘‘delusions,’’ Holmes charged the leaders of competing medical sects with misrepre- senting themselves and their systems, claiming inventions and ideas that others had made, lying about their education and training, and other high crimes and misdemeanors. Despite the disappearance of homeopathic medical schools, homeopathy remained popular in some populations and interest surged by the end of the twentieth century with the rising popularity of holistic and alternative medicine. Some states passed laws that gave certain alternative practitioners—homeopaths, acupuncturists, chiropractors, naturopaths, and so forth—equal status with traditional medicine for purposes of insurance reimbursement. A new homeopathy emerged which emphasized spiritual and holistic doctrines rather than Hahne- mann’s principles of similars and infinitesimals. Hahnemann’s doctrine that the innermost workings of the body can never be known and his rejection of the so-called reductionist doctrine of specific diseases resonated with the belief that holistic homeopaths treat the whole patient, while reductionists treat diseases. Purists object to the use of homeopathy as a slogan applied to various preparations sold in drug stores and health food stores. Nevertheless, like their nineteenth-century predecessors, advocates of homeopathy and holistic medicine seem to be calling for the breakdown of boundaries between regular, reductionist medicine, and alternative practices.

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