First Do No Harm

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The History of Medicine
1800 – 1850

Nearly all men die of their medicines, not of their diseases.” Moliere

The Revolutionary war is ended, a new century is begun, our first president has passed away and we are the freest society in the modern world. So, what are your options if you become ill?

If you lived in the cities your first choice is probably conventional medicine, which we will refer to as "regular medicine" in this article. As to physicians practicing this form of medicine, we shall call them "regulars." Regular medicine at that time was based upon the theory of the Four Humors. We’ve touched this theory in our first article on the history of medicine, The Settlers Arrive. At the turn of the century, many regulars began flirting with some of the newer theories of medicine imported from Europe, and still, none of these were based upon science. Regular medicine of this time, though deemed the best science of the age, was more a philosophy or art than a true science. One movement to which Dr Benjamin Rush  was a leader, attempted to refine all diseases into one disease, while other movements categorized diseases in hot and cold, acid and alkaline categories. Many of the papers published by physicians from this period were philosophical in nature, promulgating theories, which like most theories, easily found both proponents and evidence to back them up while ignoring all evidence to the contrary; that is, until another theory came along.

This same critique of medicine in 1800 being top heavy with theory was made by contemporaries. In a widely quoted excerpt, Thomas Jefferson criticizes basing treatment of disease on "some fanciful theory of corpuscular attraction, of chemical agency, of mechanical powers, of stimuli, of irritability accumulated or exhausted, of depletion by the lancet and repletion by mercury, or some other ingenious dream, which lets him into all nature's secrets at shorthand." He specifically scored the disciples of "Hoffman, Boerhaave, Stahl, Cullen, (and) Brown...." Historians suggest that Rush was omitted only because he was a personal friend. [Barnebeck, B, Destroying Angel: Benjamin Rush, Yellow Fever and the Birth of Modern Medicine http://www.geocities.com/bobarnebeck/ch18.html]

The number of medicines available to regular physicians of the period was just starting to grow. There were probably fewer than 100 medicines used; a firm number is hard to pin down since the first American pharmacopoeia was not published until 1820. However, Rush was of the opinion that large number of medicines was due to “nosology;” or giving names to diseases; the more diseases, the more names.

Today there are some 13,000 drugs in our pharmacopoeia, though a physician will normally administer no more than 100 different pharmaceuticals in her/his lifetime. Most physicians stick to right around 30 different drugs prescribed during their entire career.

The Pharmacopoeia of 1820 consisted mainly of herbal medicines, with few inorganic compounds, such as calomel (mercury), a favorite among regulars. Though herbs have been dropped from today’s Pharmacopoeia, approximately 40% of those drugs listed today are related to herbs in some way, whether synthetics or derivatives.

According to some historians, the regulars’ main focus was on making a living and monopolizing medicine. In the early 1800s, this plan almost worked.

Despite the push of the regulars to monopolize, you still had options during at the start of the 19th century. One option, which is egregiously overlooked in most history books, was to attend a midwife. Midwives of the time did a lot more than just help deliver babies. They practiced a form of medicine that had been handed down for centuries from mother to daughter, family to family.

Midwifery thrived during times of war because doctors were conscripted into military service. In fact, were you to take a course in women’s studies today, you’d learn how women have always progressed during times of war when the men are off fighting. World War II brought many women into the workforce; some of them even became pilots who ferried planes about the country. It was during the Vietnam War that women moved into management positions for the first time. It was during the Civil War that women were first allowed to nurse the sick and wounded. It was after the Civil War that one female physician was decorated with the Medal of Honor.

Nursing during this period, for the most part, was a male vocation. An interesting historical side note is that during the Yellow Fever epidemic in the late 1700s, black slaves were hired out as nurses, because those who had lived in Africa were immune to the disease. [http://www.geocities.com/bobarnebeck/children.html ]

One learned midwifery either from her mother or as an apprentice to a midwife. During the Revolutionary War, midwives performed every service any physician of the period could offer, and though the end of the war reined in many midwifery practices, it wouldn’t be long before England attacked the US in the War of 1812 and again their services would be required throughout the cities and countryside. However, Gail Collins, in her book America's Women: Four Hundred Years of Dolls, Drudges, Helpmates, and Heroines, points out that with the end of conflict, the influx of doctors back into society left midwives with little to do beyond delivering babies. Doctors set out to build up their practices, and offered new life saving techniques, such as delivering babies with the help of forceps that had been popularized in England. As the population of doctors grew, so did their desire to put midwives out of business and take over their practices. Collins tells us that in, “Philadelphia, twenty-one women listed their professions as midwife in the 1815 city directory; by 1824 there were only six.” [In our References and Further Reading section at the end of this article is a link to a superb paper on women in medicine.]

Ironically, if you read up on midwifery, you’ll hear that doctors and modern hospitals could guarantee a sterile environment where babies could be successfully delivered with little chance of infection to the mother. However, it was midwives of this period whose personal hygiene and habits of washing before a delivery that separated their practices from those of the physicians.

Anytime a hand or instrument was inserted into a woman’s body, she was in danger of becoming infected, with fatal results. Childbed, or puerperal, fever became epidemic at times in the nineteenth century, particularly in hospitals, where a single doctor could carry infection from one patient to the next. Hospitals were the delivery rooms of the urban poor, and in 1840 at Bellevue in New York, almost half the women giving birth during the first six months of the year contracted the fever. Eighty percent of them died. [Collins]

Another option of the period were the Indian Doctors, or as they were also known, botanical practitioners; herbalists, to be exact. Regular physicians referred to them as “irregulars." Though the name, Indian Doctor would imply that they picked up their knowledge from the natives, much of what they knew had been brought with them from the Old World. It is an interesting historical fact that herbalism in the old world and in the new world among our natives grew and flourished at approximately the same time.

Two other options of this period were hydropathy and the Thomsonians. Hydropaths believed in the curative powers of water, which, in retrospect, we realize brought a needed bit of personal hygiene into the picture, while the Thomsonian movement put medicine into the hands of the common man. The movement was founded by Samuel Thomson “after six doctors called in to help his seriously ill wife prescribed six different treatments.” [Collins] Thomsonians believed that laypeople could treat themselves better than any physician with a little help from nature’s botanicals.

To read about the State of the Art of medicine in 1800, you might want to review our final summary of medicine during the Revolutionary War.

The Early History of Medical Licensing

The Constitution of this Republic should make special provision for medical freedom. To restrict the art of healing to one class will constitute the Bastille of medical science. All such laws are un-American and despotic. . . . Unless we put medical freedom into the constitution the time will come when medicine will organize into an undercover dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers. [Dr Benjamin Rush, at the Constitutional Convention]

In 1800, all forms of medicine were practiced together. It wasn’t long before medical societies sprung up with the sole purpose of supporting one type of medicine over another.

In 1806 the first licensing laws were passed in the US, in New York, called the Medical Practices Act. This act allowed the state to license practitioners, which meant that only licensed physicians could recover their fees in courts. Unlicensed practitioners were fined $25.00 for practicing without a license. The New York Journal of Medicine candidly published the reasoning behind this new law: “the suppression of empiricism and the encouragement of regular practitioners.” 

Empiricism: the application of observation and experiment, rather than theory, in determining something. This is, supposedly, the core of modern science.

It should be noted that when the first medical licensing laws were passed, legalizing only the practice of medicine based on the philosophy of the four humors, that this particular medicine had neither cured nor had it even palliated a single illness. In fact, if you pulled all of the nutritional and herbal medicines out of their pharmacopoeia, there wasn't a single medicine left that could help an ailing patient. Pharmaceutical medicine would have to wait exactly one hundred years from this first licensing laws before it cured an illness. Yet local governments, pressured by the physicians (not the citizens), tried to force bad medicine onto the populace. 

America was still very young and many remembered the struggle for freedom and liberty. Many of these early Americans felt this kind of law to be unconscionable and far too restrictive on their rights and freedom. In 1807 the Medical Practices Act was modified to a point just short of its being repealed. The fine was dropped significantly, and the definition of an “irregular” physician was so defined as to hardly include anyone. Even a student of any of the competing practices did not fall under the parameters of this new definition.

Connecticut passed a similar law in 1832. The Thomsonians fought back and had it repealed in 1842. In 1827 the medical societies attempted to put teeth back into the New York laws, but in 1830, much of this new law was reversed, and by 1844 it was completely abolished. Even with laws on the books, the juries often took the side of the irregulars. Coulter’s book, Divided Legacy, tells us of a case in 1843 where a man charged with practicing homeopathy without a license was found guilty by a jury of his peers, but they fined him 3/4 of a cent for every infraction, and when the trial was over, they all donated their fees received for being on the jury to a local homeopathic society.

Early Americans still remembered the price of freedom, and were loath to relinquish theirs.

Massachusetts passed its first licensing laws in 1819, but they were repealed in 1835. Illinois passed their first laws in 1819, which were repealed in 1821, and then reinstated in 1825, but finally abolished the following year. Some of the strictest licensing laws were passed in Ohio in 1810 and in 1816. These were repealed in 1819, with new laws on the books by 1824, though these didn’t last ten years. In the South, where Thomsonians flourished, licensing laws were passed in Alabama restricting practices outside regular medicine, but in 1832 were modified to allow Thomsonians to practice and recover their fees in courts. Georgia passed medical licensing laws in 1825 and established the first Board of Examiners. In 1839 the law was revised to allow herbalists and Thomsonians to practice and in 1847 Georgia even established a Botanic Medical Board of Physicians along with laws allowing only those practitioners who had graduated from proper botanical schools to practice.

Throughout the 1820s and 1830s Delaware, Mississippi, Vermont, Indiana, Maryland, South Carolina, and Maine all repealed their licensing laws to allow irregulars to practice, and by 1850 Rhode Island, Pennsylvania, Virginia, North Carolina, Texas, Tennessee, Kentucky, and Missouri had never regulated medicine. In fact, by 1850 only Louisiana, Michigan, New Jersey, and Washington DC had laws concerning the licensing of regular physicians.

As you can see, the regulars held sway during the 1820s and 1830s. They influenced a lot of legislation, but because laws in any society represent the will of the people, public opinion won out and the network of medical societies collapsed as the competition built up a strong following.

Then something happened that nearly put a stake in the heart of regular medicine: the advent and spread of Homeopathy throughout the land.

Homeopathy

Though developed and codified by 1796 by Samuel Hahnemann (1755-1845), homeopathy didn’t find its way to America until 1825.

Homeopathy was a reaction to “heroic” medicine. Its foundation was nutrition, exercise, minimal medicine, and, interestingly enough, human relationships. You might say that this was America’s first foray into holistic medicine.

For every disorder there was just one medicine needed. Mixing two together made no sense, because no one could know what the two would do together inside the human body (unlike today when we put our seniors on a slew of medicines, and despite the fact that no one could possibly tell us what will happen with the various combinations; yet we are told that today’s medical practice is highly scientific).

Diet meant a “mixed and varied” diet, and exercise was simply movement. Walking was encouraged.

One of the basic foundations of Homeopathy is that the human body, if given a bit of help, can heal itself. Nature was not an enemy to the homeopath as it was to the regular physician. Hahnemann created homeopathy as “the instrument of total reform in therapeutics.”

During the early 1800s the Thomsonians, many of whom practiced with botanicals too, were regular medicine’s greatest competition. In the 1840’s the Thomsonians joined forces with the botanical physicians and formed the Eclectic school of medicine. But by this time, it was Homeopathy that had become traditional medicine’s greatest competition.

One reason that Homeopathy was so successful was that it did not kill the patient. Another reason was that the theory was integrated and coherent. The average citizen of this period could attend lectures at a regular medical school and walk away having learned nothing, whereas the bulk of homeopathy theory was, in comparison, easily comprehended.

There was hardly a visitor to the US during the early 1800s who did not return to Europe with horror stories about the state of the average American’s health. They reported that we had crooked jaws, teeth missing, a grey pallor, a lazy gate, and our overall health dilapidated. Their reports were not good; our cities were filled with weak and tired people. Historians today tend to agree mercury poisoning (from traditional medicine) would be one good explanation for the state of our health.

Dr Rush, being open-minded, would have probably been a proponent of homeopathy had he lived long enough. His career was exemplary, and he was even called upon by President Jefferson in 1803 to work with Lewis and Clark prior to their expedition. Rush furnished them with questions they would ask the natives concerning their remedies, sweats, purges and bleeding. [http://www.geocities.com/bobarnebeck/ch18.html]

Rush had treated patients through a slew of epidemics and fevers. The epidemic of 1804 that affected farmers living in the outskirts brought food shortages to the city dwellers. A nationwide flu epidemic broke out in 1807, and what was called the “Winter Epidemic” lasted from 1812 to 1814; one long winter, wouldn’t you say?

It was at this time, according to historian Bob Arnebeck, that, “Medical science achieved a tone, which it has maintained to the present day, challenging any complacency about health and death.” This was the advent of heroic medicine. Nature was an enemy, and sometimes, even the Creator was the enemy.

Rush, however, did not partake in this philosophy. He kept an open mind and felt that research would eventually find answers. This is why I feel, that had he lived long enough, he would have been a proponent of homeopathy. Rush, though, did have his detractors. (And they might have been right; for Rush's brand of medicine, and the way he practiced it, killed many and helped few, very few.)

It was at this time that the first “germ theory” of medicine had been first proposed, by a Dr John Crawford, who “suggested in 1807 that ‘amiculae’ caused fevers. He even associated insects with the process. Remarking on the incredible ability of insects to multiply over swamps, he drew the analogy with smaller pests multiplying inside the body.” [Arnebeck]

Amiculae were the little creatures discovered in water through the invention of the microscope.

Rush was excited about these new theories, although he was a regular, charged with “remorseless bleeding” by some of his contemporaries, and even challenged to a dual by another physician. Rush, however, believed in empiricism, and in this respect, he was a true scientist bent on learning as much as he could. Ironically, in the end it was regular medicine that eventually caught up with Dr Rush when he became ill and required a physician. He died shortly after being bled and fed calomel.

Homeopathy had no quarrel with nature or with the Creator. This was homeopathy’s greatest philosophical distinction from the heroic tradition of medicine. The next distinguishing facet was that the regulars felt that everything could be known, eventually; that all disease was mechanical. To Hahnemann, disease was not logical, and not always material; that there was a spiritual aspect to disease.

In Chinese medicine, the spiritual aspect to disease is a given. To modern science, if it cannot be measured, it does not play into the equation. The spirit cannot be measured. This is where biophysics separates from biochemistry. It is also where homeopathy separates from allopathy. The only things a homeopath knows are the symptoms. Homeopathy treats according to the symptoms.

We often come down hard on allopathy for treating symptoms, however, there is a distinction here, between homeopathy’s treatment of symptoms and allopathy’s. Take cancer as an example. Modern allopathy treats cancer as a disease, when in fact it is a symptom. Dr Sam Chachoua demonstrates in his lectures time and again that cancer has come about evolutionarily to protect the body from and issue that can become systemic and kill the individual. Allopathy attacks the symptom. Outside of allopathy, cancer is a symptom and localized. To the homeopathy, the distinction, though seemingly slight, is that it treats "according to the symptoms" (cancer in this case), but not by attacking them. To treat cancer, the homeopath gives the body a minute quantity of substance that would normally cause that same cancer.

In an interview with Dr Sam, he pointed out that homeopathy was on the right track because when you give take a patient with cancer and give that person a cancer in another part of the body, the first cancer dies off.

If you have arthritis, allopathy treats the pain, but the arthritis doesn’t go away. If you have high blood pressure, drugs are given that lower your blood pressure, but the problem does not go away. If you go off the blood pressure drugs, your blood pressure shoots up again. Treating symptoms allopathically is different from treating according to the symptoms homeopathically, but to understand thoroughly this exotic theory, it is best to read the article What is Homeopathy?

Hahnemann accepted that we cannot know the body, we cannot know the disease, we cannot know the human spirit, but what we can know are the symptoms. “When the physician has discovered all the observable symptoms of the disease that exist, he has discovered the disease itself, he has attained the complete conception of it requisite to enable him to effect a cure.” [Coulter]

By 1845, homeopathy had become regular medicine’s greatest competition. Its ranks began to swell from regulars leaving behind their educations and taking up this less toxic brand of medicine. Humorists of the latter half of the 19th century, when discussing the subject of medicine were sure to give the standard patter that regular medicine would kill you, but at least with homeopathy, you’d die of the disease.

Hahnemann was attacked for treating symptoms and not the cause of illnesses (not that regular medicine had ever treated the cause of illness, though I’m sure many had thought they had). Hahnemann responded to his critics claiming that, in treating the symptoms with homeopathy, nothing was left to do. The person was off the drug, and the disease was gone.

It is not conceivable, nor can it be proved by any experience in the world, that, after removal of all the symptoms of a disease, and of the entire collection of perceptible phenomena, there should or could remain anything else besides health, or that the morbid alteration of the interior could remain uneradicated. [Organon of the Medical Art, section 8]

There was then, and is today, a difference between treating symptoms to get symptomatic relief, and treating “according to the symptoms” so that the body will repair itself. However, this distinction is often lost on the narrow-minded.

By discovering all the symptoms exhibited, Hahnemann could find the “exact” medicine to deliver, while the orthodoxy wasted far too much time speculating on the various causes that oftentimes got them enwrapped in contradictions and inconsistencies. “It is safe to say that the Solodist [orthodox] doctrine of diseased, causes, and symptoms was never worked out in detail.” [Coulter]

Hahnemann felt that since there were no criteria for distinguishing the unimportant symptoms from the important ones, that all symptoms must be considered.

Orthodox physicians of that time arrived on the scene with a shotgun full of remedies. They bled, purged, blistered, applied mercury, administered bark, etc. For Hahnemann, after determining all the symptoms, there was one and only one medicine to administer:

In no case under treatment is it necessary and therefore not permissible to administer to a patient more than one single, simple medicinal substance at one time…. As the true physician finds in simple medicines, administered singly and uncombined, all that he can be possibly desire … he will, mindful of the wise maxim that “ it is wrong to attempt to employ a complex means when simple means suffice”, never think of giving as a remedy any but a single, simple substance…. [Coulter]

Today, it is hard to find an elderly patient who is on fewer than 3 or 4 medications. No one can tell you what the overall, cumulative effect of those drugs will be. However, we’re beginning to suspect what can happen as cancer, heart disease, osteoporosis, and Alzheimer’s disease seem to be the main diseases suffered by our overly-drugged elderly population. A few renegade physicians are beginning to point to the treatments (drugs) as being the causes of these many illnesses.

Funny, but this was known way back when: “even though the simple medicines were thoroughly proved with respect to their pure peculiar effects on the unimpaired healthy state of man, it is impossible to foresee how two and more medicinal substances might, when compounded, hinder and alter each other’s actions on the human body…” [Organon of the Medical Art, section 274]

The orthodoxy had few medicines. As stated above, their pharmacopoeia was small and most physicians preferred to administer just a handful of medicines (calomel being their favorite). It was the homeopaths (and herbalists, see below) who employed a greater number of medicines at that time, since, according to the tenets of homeopathy; there was only one possible medicine for any disease (considering all the symptoms). Homeopaths were constantly looking for more medicines to classify, prove, and apply.

The rise of homeopathy was not without constraints. In Austria, it was banned by imperial decree shortly after its introduction in 1819, but was still used underground to treat the cholera epidemic of 1831. Statistics published in The Logic of Figures or Comparative Results of Homoeopathic and Other Treatments in 1900 show that cholera patients treated with conventional medicine had a 50% death rate, while those treated homeopathically had less than a 22% rate of death. Understandably, the decree was revoked in 1837.

In Great Britain homeopathy got a similar welcome, was quickly outlawed after its introduction, and then courageously contested, resulting in a repeal of the prohibition and by the 1880s homeopathy prospered handsomely. A homeopathic dispensary had been opened in 1841, a second in 1867, and by 1885 fifteen hundred people a week were being treated with homeopathy.

In France a medical student was expelled for merely expressing interest in homeopathy. According to Coulter’s book, Divided Legacy, when a conventional physician in France evaluated the results of a homeopathy study in a favorable light, no orthodox medical journal would publish the results. So, he published his work in an Homeopathy journal, and was summarily expelled by his medical society.

What few people realize today, is that “the history of nineteenth-century therapeutics is essentially one of the progressive adoption by allopathic physicians of a numerous medicines originally introduced by homeopathy.”  [Coulter]

Homeopathy today is cursed, laughed at, and derided by orthodox medicine, and ironically, if the orthodoxy had not adopted many of the medicines along with the rule that less is more, orthodox medicine would not even be close to what it is today. When they are through attacking homeopathy, perhaps some orthodox physicians will open a history book and rediscover their roots.

Herbalism

The use of foods to heal is as old as the human spirit; it is as natural as breathing. Even today, when we get a cold or flu, we also get a bowl of hot chicken soup. However, the chicken soup we get from a can is hardly related to the chicken soup grandma made from scratch.

Herbs are food. Our medicines of the early 1800s were mostly herbal. What we did not bring from Europe we learned from the Natives, who were far more sophisticated than many give them credit. While surgeons theorized why some patients died of infections and others did not, our natives were very familiar with the role of pathogens in infection (sepsis) and created salves to clean wounds and kill off the pathogens that could cause infections.

The two great names in the early American herbal movement were, Samuel Thomson and Constantine Rafinesque. Rafinesque came to America as a young man, studied botany and herbalism and became a professor of botany. Around 1830 Rafinesque published his book, Medical Flora of the United States, which became the chief reference for herbalists of that period. In his book he described in detail the healing properties of a New World herb, goldenseal. For its immune stimulating properties, the goldenseal was highly prized, and the European communities were soon cultivating seeds they’d received from America. Nothing in the pharmacopoeia could compete with goldenseal, that is until the Natives introduced us to echinacea, the purple coneflower.

Thomson, on the other hand, was not a scholar. He created nothing new, but to his credit, he brought herbal and Native medicines to the common people. He was attacked by the regulars, even found himself facing murder charges for losing a few patients, but was acquitted and went on to publish his New Guide to Health. He is even, according to Ingrid Naiman’s book, Cancer Salves, “credited with the development of a cancer plaster made from red clover blossoms.” Most likely, he learned this too from the Natives, though he was the first to get this procedure on paper. Herbalists today still use this and many other preparations Thomson passed onto us.

At the time of his death, in 1843, his followers numbered around three million. The latter part of his life was spent deflecting criticism from the regulars, though many a regular physician adopted much of Thomsonian medicine as they did Hahnemann’s homeopathy. One constant in history is that when something works, the more liberal minded have a tendency to examine it and eventually incorporate it. 

Mixing “pharmaceuticals,” as noted already, is dangerous. However, herbalists, on the other hand, mixed many herbs together, since herbal medicines, for the most part, did not contradict each other, and worked in harmony. Herbs are food. Together, many herbs act to potentiate [make stronger, better] each other. For instance, adding cayenne pepper to any herbal medicine makes the action of the preparation stronger and faster acting. This is just one example of synergy, where the answer to 2 + 2 is actually greater than four. For a more in depth treatment of this matter, see: An Herb is More Than its Active Ingredient.

Women and Medicine

Surgery during this period killed as many as it cured, mostly due to sepsis. It was in Europe, where the surgical arts were being perfected, at this time, specifically France, and new techniques flourished there and were quickly disseminated among European medical schools. However, even in Europe, sepsis [infection] was still a problem.

Most surgeries in the US involved the treating of wounds, as well as battle wounds. Amputation was most probably the leading surgical procedure performed.

In 1809, Jane Todd Crawford (Lincoln’s wife’s—Mary Todd— cousin) was diagnosed with a very large ovarian cyst which had originally been diagnosed as a pregnancy. At the time, no tumor had ever been removed successfully. However, there was a visiting surgeon from Edinburgh who agreed to do the surgery. According to Gail Collins, he gave her opium and alcohol to ease the pain, and a month later she returned home cured.

Legend has it that an angry crowd surrounded the doctor’s home while he was treating Mrs. Crawford, threatening to kill him for his outrageous assault on a female body. [Collins]

It was not until mid century that anesthesia was being used, as is outlined in our tongue in cheek article, The History of Anesthesia. At this time Dr J Marion Sims began experimenting with his female slaves.

Females of this period had a rough time where medicine was involved, for doctors were determined to treat every facet of female passage, from puberty through menopause as a disease.

Many doctors believed that during their periods, women were deprived of blood to the brain, leaving them “idiotic” or temporarily insane. [Collins]

During childbirth, regulars bled women into unconsciousness, mainly to relieve their own anxiety at hearing the screams and moans accompanying most births. How woman handled menstruation at this time will remain a mystery because it was something that no one mentioned in private or public. Even diaries have no mention of this monthly visitor, though many have theories on the subject, with some guessing that the use of multiple skirts and petticoats was to hide the great variety of “napkins” women had developed and used at the time.

What we do know for sure is that personal hygiene was extremely poor. Diapers were not even washed till just prior to the Civil War. Bathing was considered unhealthy. Magazine articles exhorted people to brush their teeth, but again, accounts of visitors returning to Europe spoke volumes of the poor dental care in Americans of that time. Much of our tooth loss and gum disease, though, was attributable to mercury poisoning from traditional medicine.

Because of modesty, and no regular female physicians, doctors were not allowed to look upon the naked bodies of their female patients. Many palpated (felt around) under the skirts, while others examined women with the aid of a mirror (to avoid looking directly). Collins points out that one of the best obstetricians of that period, a Dr Degorges, was blind. Many a physician exhorted medical students in their care to avoid viewing a half naked woman (even giving birth) under their care for it could result in sexual perversion leading them to adultery and madness. Students had to learn from textbooks and manikins.

Things sexual were strictly taboo, leading to much ignorance on the subject of birth control and sexually transmitted diseases, though an efficient mail system supported our young entrepreneurial spirit in the trade of sexual goods:

… Americans could send away for birth control pamphlets, medical devices like diaphragms and syringes, condoms, spermicides for douching, and pills that promised to induce abortions. Ads for condoms, cures for venereal disease, aphrodisiacs, and abortion services were an economic mainstay of the urban newspapers. Agents distributed ads for birth control devices on street corners and mailed them to newlyweds. “French” was a code for a contraceptive, and “Portuguese” for something that induced abortion . . . .  [Collins]

Abortions, performed early, were a socially accepted form of birth control. Even the Catholic Church looked the other way, as the fetus was not considered human till movement was perceived. Midwives hung flags out their windows signifying that they performed abortions. [Collins]

Infant mortality was high, even though, as Collins points out, “Americans were more likely to live to adulthood than ever before.” With husbands gone most of the time and no easy way to call for help, young wives were left alone to their superstitions. Everyone knew a handful of stories of a happy, bouncing baby struck by a sudden fever and dead before morning.

Traditional medicines at this time did more harm than good (history seems to repeat itself, e.g. Vioxx) and parents began to drug their children.

An 1833 guide used by southern women suggested daily doses of laudanum, an opium derivative—four drops for a nine-month-old and five to six drops for a toddler. [Collins]

American women, according to the European visitors, aged rapidly. Be it due to the ravages of raising a family or poor nutrition or poor medical care, one visitor penned this maxim:

… charming and adorable at fifteen . . . faded at twenty-three, old at thirty-five and decrepit at forty.  [Collins]

It was right around the mid 19th century that our personal hygiene habits began to improve. It became genteel to have a fresh water basin awaiting one’s morning ablutions. Babies where no longer swaddled (very tightly fitting clothing) in unwashed linens, but were loosely clothed and their diapers washed regularly, and not allowed to dry while the baby still wore them. The belief that children were born unsullied sprouted at this time, and since the mother was a child’s main influence, she often took all the blame should her child go astray. Women’s magazines, physicians, clergy, and neighbors offered plenty of unsolicited advice to raising the perfect child, but the perfect child was only to be found in books. The story of young George Washington still finds life in many an elementary school today.

Women were not allowed in medical schools, period. The reasons for this were varied, and today, quite comical. It took the Blackwell sisters to finally breach this barrier, though the barrier still remained sturdy for many, many years.

Elizabeth Blackwell was inspired to go into medicine because women had a hard time discussing their issues with male doctors. She’d had a close friend dying of uterine cancer who told her of her troubles communicating with her physician. Elizabeth applied at nearly every medical school available at that time, and was turned down time after time, with some faculty members even suggesting she disguise herself as a man and try Paris. [Collins]

As luck would have it, the faculty of a small medical school in upstate New York decided to ask the student body about admitting women, and boys being boys, particularly rowdy that day, cheered and hollered and yipped their approval (most assuredly along with gratuitous lewd gestures) and that was that. Wouldn’t you like to have been a fly on the wall the day Elizabeth Blackwell showed up for her first day of class? The student body thought it had been a joke, but, as the saying goes, the joke was on them. “A hush fell over the class as if each member had been stricken by paralysis.” [Jordan Brown, Elizabeth Blackwell, Physician (p.52)].

Emily Blackwell, Elizabeth’s sister, also went on to become a physician. We’ve created a page for Elizabeth Blackwell’s biography.

The AMA Is Formed

Many attempts were made to create medical societies. There is strength in numbers. Most fell by the wayside as competition ate away at their structure, and even forbidding members to consult with, cohort with, purchase from, or even befriend an “irregular” didn’t stop a huge wave of physicians from going over to the other side.

The main purpose of a medical society/association is to provide political pressure to adopt laws that would kill the competition. They also provide entertainment, fellowship, and a safe place to whine about the midwife down the block who makes more money in a week than your average physician in two months.  

Another purpose of the American Medical Association was to raise the standards of medical education in the land. Dr Nathan Smith Davis, a graduate of the Rush Medical College in Chicago, became a driving force in the creation of the American Medical Association. His regard for the general educational standards of the day is clear in the following statement:

All the young man has to do is gain admittance in the office of some physician, where he can have access to a series of ordinary medical text-books, and see a patient perhaps once a month, with perhaps a hasty post-mortem examination once a year; and in the course of three years thus spent, one or two courses of lectures in the medical colleges, where the whole science of medicine, including anatomy, physiology, chemistry, materia medica, pathology, practice of medicine, medical jurisprudence, surgery, and midwivery are all crowded upon his mind in the short space of sixteen weeks...and his education, both primary and medical, is deemed complete. [New York Journal of Medicine, V, 1845, 418]

All in all, the main reasons underpinning the formation of the AMA was that doctors simply could not compete in a free market, and they made little money. A report submitted to the 1847 convention that kicked off the formation of the AMA, stated:

The very large number of physicians in the United States has frequently been the subject of remark.... No wonder that the merest pittance in the way of remuneration is scantily doled out even to the most industrious in our ranks. [Healing the Health-Care System]

 The AMA’s first course of action was to lobby the government for strict licensing laws that would limit the number of doctors practicing medicine. Banning any form of medicine not practiced by the regulars was one sure way to limit the number of practicing physicians.

Historically, all laws pertaining to the practice of medicine have been enacted out of intense pressure by the medical lobbyists, not the public.

But as hard as they tried, their efforts often blew up in their face. This young country was not about to give up the freedoms they’d fought to attain. And when given free choice, most Americans in mid century chose the least toxic options of the Eclectics or homeopaths.

The Sad State of the Art

When the AMA got established, the form of medicine practiced by its members had not yet cured a single disorder, and most of the time sent patients to an early death. Surgery showed promise, but sepsis was not yet understood and doctors with a 50% success rate or higher were rare, in deed.

Scurvy had been cured, but by nutrition, not by medicine. Iodine cured goiters, but again, iodine is an essential nutritional factor.

By 1850, the jury on inoculations is still out, for there were safer homeopathic inoculations being developed, and plagues had a life cycle of their own. They came in spite of everything we did to avoid them, and the usually petered out and went away on their own in spite of heroic medicine claiming victory.

In France, a study on cancer, begun in 1843, had just been published. A physician of the French Academy of Science, Dr Leroy d’Etoilles, gathered together as many statistics as possible at that time from some 170 practitioners who had treated cancer. The reason for the study was to compare survival rates of those who elected to undergo the standard treatments for cancer against those who refused these treatments. According to Dr Naiman in her book Cancer Salves, the standard treatments consisted of surgery, caustics “such as nitric acid; sulfuric acid mixed with saffron; poisonous minerals such as lead, mercury, or arsenic nitrate; or alkaline caustics such as sulfate of zinc. Copper sulfate [mixed with borax], quicklime, or potassium permanganate were also used, evidently with mixed success.”

The conclusion of the study showed that those who avoided traditional cancer therapies outlived those who underwent them. Did this stop anyone from practicing these therapies? Perhaps, but for the most part, these treatment protocols continued on till the advent of Radium therapy that proved to be even more deadly than any previous protocol, but was highly recommended because it was a great money maker.

History, we are told, often repeats itself. A study presented to the American Cancer Society in the nineteen-eighties, concluded much the same as that study in France over a century earlier. Ellen Brown’s book, Forbidden Medicine gives us the following:

One of the few studies ... was conducted by Dr. Hardin Jones, professor of medical physics and physiology at the University of California, Berkeley. He told an ACS panel, "My studies have proven conclusively that untreated cancer victims actually live up to four times longer than treated individuals. For a typical type of cancer, people who refused treatment lived for an average of 12-1/2 years. Those who accepted surgery or other kinds of treatment [chemotherapy, radiation, cobalt] lived an average of only three years. . . . I attribute this to the traumatic effect of surgery on the body's natural defense mechanism. The body has a natural defense against every type of cancer.

Ulrich Able, a German epidemiologist and biostatistician, concluded the same in what can be considered the largest statistical analysis ever conducted on cancer. Irwin Bross, biostatistician for the National Cancer Institute, would have to agree. In a paper on Radiation we already published one of his famous quotations: “Radiation therapy does not improve the survival of patients with breast cancer. Did you know that the mortality rate for breast cancer in women over 55 was about 20% higher in 1995 than in 1970 (so much for mammograms)?”

Sadly, the one lesson we have all learned from history is that we do not learn anything from history. We are condemned to make the same mistakes again and again. As long as the primary focus of medicine is on profits, real healing will always take a back seat.

 

References and Further Reading

Medical Research: an excellent article on women and medicine during this period of history.



Organon of the Medical Art, by Samuel Hahnemann (A variety of volumes, prices, and editors.)


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