Read an Excerpt
Excerpt from A Vital Force: Women in American Homeopathy by Anne Taylor Kirschmann
Copyright information: http://rutgerspress.rutgers.edu/press_copyright_and_disclaimer/default.html
Homeopathy, a medical system developed by the German physician Samuel Hahnemann in the late 1700s, made steady gains geographically, economically, and institutionally throughout the nineteenth century in the United States. Introduced in the 1820s by German-speaking immigrant physicians, homeopathy attracted advocates among patients and physicians throughout the country, but especially in the urban areas of New York, Pennsylvania, Massachusetts, Ohio, and Illinois. Enthusiastic converts to the profession established medical schools, medical societies, asylums, dispensaries, and hospitals, which published popular and professional texts introducing and explaining the new system to patients and physicians.1
In 1860, homeopaths were 3 or 4 percent of the 55,000 physicians in the United States.2 By the 1890s, homeopaths numbered over nine thousand, were 8 percent of all medical practitioners, and counted among their patients some of the most elite and affluent families.3 Women figured prominently in the rapid growth of the new school of medicine. Children's dislike of nauseating and disagreeable doses of drugs prescribed by regular physicians contrasted with their positive reactions to the small, pleasant tasting doses of homeopathic remedies, which provided an "entering wedge" for the system.4 Mothers' enthusiasm spurred the acceptance of homeopathy as families and entire communities embraced its benign therapeutics.
As homeopathy's popularity grew, it became animportant route to a medical career for women. Between 1852 and 1900, around 1,690 women graduated from homeopathic medical colleges. During the last two decades of the nineteenth century, they were 15 percent of all homeopathic medical school graduates and assumed active roles in homeopathic institutions and organizations.5 And laywomen, who had played an important role in homeopathy's popularity and growth in the nineteenth century, became partners with physicians to preserve homeopathy in the twentieth century.
Of the various competing medical systems popular during the early part of the nineteenth century, homeopathy posed the clearest institutional and economic threat to the regular medical profession. Although alternative systems such as Thomsonism, eclecticism, and hydropathy were important means to self-doctoring and/or a career as a practitioner, homeopathy, like regular medicine, originated within the learned European medical tradition. Although they differed in their methods, both groups employed drugs in treating disease. Both valued formal medical education and knowledge and developed parallel institutional structures. And unlike anti-professional alternatives such as Thomsonism, homeopaths were interested in and aware of developments in medical science.
Although the term "scientific medicine" usually applies to the period after 1870 when German laboratory medicine influenced the thinking of many leading physicians, doctors before that time did not consider their systems of healing unscientific. Throughout history, proponents of various medical systems claimed their methods of cure rested solidly on scientific principles, with the definition of science and its meaning to patients and physicians in specific places changing over time.6 What then comprised homeopathic science, and how did it differ from the science of the regular school? How did physicians and patients understand the changing definition of homeopathy-what meaning did it have for them? And to what extent did changing ideas of science influence opportunities for women in the homeopathic profession?
Beginnings
When homeopathy arrived on the American scene, the country's medical marketplace was among the most varied in the industrializing Western world. People relied on local midwives, granny midwives in slave communities, lay healers, mental healers, and "Indian Doctors" skilled in the use of herbs, roots, and other plants. Domestic medical manuals guided middle- and upper-class patients in ministering to themselves and family members. Popular health crusades such as those led by William Andrus Alcott (1798-1859) and Sylvester Graham (1794-1851) promoted dietary and hygenic principles, encouraging individuals to learn the structure and function of the body. Botanical movements such as that led by Samuel Thomson (1769-1843), who urged "Every Man His Own Physician," originated as a self-help movement, disdaining formal medical knowledge and training. Botanical practi- tioners of the physio-medical sect sought to compete with regular practitioners by becoming physicians themselves, while eclectics or reformers established formal institutions for education and training beginning in the 1830s.
Through hygenic living, proper diet, and the use of cold water (internally and externally), hydropathy, or the water-cure movement, held out the promise of individual perfectibility, and by extension, the perfectibility of society as a whole.7 By the middle of the nineteenth century, spurred by the antiauthoritarian, egalitarian ethos of Jacksonian democracy, regular physicians' claims to exclusive, arcane medical knowledge were challenged by a myriad of health reformers and sectarian practitioners who attacked, not only the debilitating therapeutics of physicians, but also the exclusivity of medical knowledge. Within mainstream medicine during the early decades of the nineteenth century, practitioners were primarily unschooled and became doctors by apprenticing themselves to practicing physicians. A small number attended medical schools in the United States. Fewer still studied at elite medical schools in Europe. No licensing system required demonstration of the principles and practice of medicine. And although they were an important means of continuing education for practitioners in rural areas or small towns, medical journals and medical societies were not yet the instruments of professional association they later became.
Early nineteenth-century theories of disease and maintenance of health emerged primarily from European centers of medical education. The Hippocratic doctrine of humoralism had eroded, replaced by mechanistic views of illness. Iatromathematicians held that the human body functioned by quantifiable numbers, weights, and measures. The eminent Dutch physician Herman Boerhaave (1668-1738) posited a hydraulic model of the body, viewing disease as an imbalance of internal fluid pressures. The work of Giovanni Battista Morgagni (1682-1771) in Italy fueled interest in pathological anatomy, correlating symptoms with localized lesions in specific organs found on autopsy. Others like Georg Ernst Stahl (1659-1734) from the famous Prussian medical school, Halle, subscribed to various theories of vitalism in which an unseen, nonmaterial anima or soul guided the body's physiological functions. All assumed diet, hygiene, climate, local atmospheric states, and hereditarian influences affected various general states of fevers, fluxes, and inflammations. But the disease framework developed by the eminent Scottish physician and educator William Cullen (1710-1790) had special influence throughout the English-speaking world, shaping the practices of most American physicians by the early nineteenth century.8
Cullen, chair of the Institutes of Medicine at Edinburgh in 1766, integrated earlier theories of Herman Boerhaave (1668-1738), with those of Friedrich Hoffmann (1660-1742), and Albrecht von Haller (1708-1777), who emphasized physico-mechanical principles and the centrality of the nerves, respectively. Rejecting humoralism, Cullen theorized that all pathology originated in a disordered action of the nervous system caused by such external influences as climate, food, and humidity, and that those same factors produced different diseases in individuals. Although he agreed autopsy findings were "one of the best means of improving us in the distinction of diseases," he made little use of anatomical pathology in his own system of disease classification, a nosology categorizing an extraordinary number of different diseases according to the state of the "nerves" and clinical signs or symptoms- a system similar to those developed for plants by naturalists.9
Two of Cullen's pupils were particularly relevant to American medicine. Scottish physician John Brown (1735-1788) and American Benjamin Rush (1746-1813) typified the excesses of systematists who claimed their theories were based solidly on natural law. According to Brown, disease was caused either by an excess or deficiency of nervous "excitability,"-the body's capacity to react to external stimuli. Too much reaction resulted in sthenic diseases, requiring depletive techniques such as bloodletting, emetics, and cathartics. Too little produced asthenic conditions requiring the administration of opium, alcohol, and other stimulants. Brunonian medicine found willing converts in German-speaking Europe and Italy, while in the United States Benjamin Rush combined Brown's system with theories of hematological excitability, recommending massive bloodletting and other depletive therapies such as calomel-a purgative compounded of mercury.10
For Cullen, the treatment of disease-the correction of imbalances-was a delicate art requiring the proper timing, sequence, and dosage of medicines. But for Brown, Rush, and their followers, bloodletting to the point of unconsciousness and large doses of noxious drugs were the treatments of choice, which initiated the "heroic" age of medicine, and, in turn, stimulated the rise of alternative medical systems opposed to harsh therapeutics. In the United States, eclecticism, hydropathy, homeopathy, and the botanical systems of Thomsonism and physio-medicalism enjoyed wide popularity by the middle of the century. But unlike the populist orientation and origins of other movements, homeopathy had been developed by a German scholar and physician trained in the learned European medical tradition, reflecting the mainstream medicine of his day.11 His new school of medicine appeared as a rational alternative to the debilitating, depletive, and stimulating therapeutics in use by regulars and attracted a number of American physicians and patients from select circles to the rival profession.
