Posts filed under ‘Philosophy of natural medicine’
“Naturopathy”, as a generally used term, began with the teachings and concepts of Benedict Lust. Naturopathy, or “nature cure”, is both a way of life, and a concept of healing employing various natural means of treating human infirmities and disease states. The earliest mechanisms of healing associated with the term, as utilized by Lust, involved a combination of hygienics and hydropathy (hydrotherapy). The term itself was coined in 1895 by Dr John Scheel of New York City, to describe his method of health care. But earlier forerunners of these concepts had already existed in the history of natural healing, both in America and in the Austro-Germanic European core.
Lust came to this country from Germany in 1892 as a disciple of Father Kneipp and as a missionary dispatched by Kneipp to bring hydrotherapy to America. Lust purchased the term “naturopathy” from Scheel in 1902 to describe the eclectic compilation of doctrines of natural healing that he envisioned to be the future of natural medicine. In January of 1902, Lust, who had been publishing the Kneipp Water Cure Monthly and its German language counterpart in New York since 1896, changed the name of the journal to The Naturopathic and Herald of Health and evoked the dawn of a new health care era with the following editorial:
Naturopathy is a hybrid word. It is purposely so. No single tongue could distinguish a system whose origin, scope and purpose is universal – broad as the world, deep as love, high as heaven. Naturopathy was not born of a sudden or a happen-so. Its progenitors have for eons been projecting thoughts and ideas and ideals whose culminations are crystallized in the new Therapy. Connaro, doling out his few fixed ounces of food and drink each day in his determined exemplification of Dietotherapy; Priessnitz, agonizing, despised and dejected through the long years of Hydropathy’s travail; the Woerishofen priest, laboring lovingly in his little parish home for the thousands who journeyed Germany over for the Kneipp cure; Kuhne, living vicariously and dying a martyr for the sake of Serotherapy; A.T. Still, studying and struggling and enduring for his faith in Osteopathy; Bernarr Macfadden, fired by the will to make Physical Culture popular; Helen Willmans, threading the mazes of Mental Science, and finally emerging triumphant; Orrison Sweet Maraden, throbbing in sympathy with human faults and failures, and longing to realize Success to all mankind – these and hosts of others have brought into being single systems whose focal features are perpetuated in Naturopathy.
Jesus Christ – I say it reverently – knew the possibility of physical immortality. He believed in bodily beauty; He founded Mental Healing; He perfected Spirit-power. And Naturopathy will include ultimately the supreme forces that made the Man of Galilee omnipotent.
The scope of Naturopathy is from the first kiss of the new-found lovers to the burying of the centenarian whose birth was the symbol of their perfected one-ness. It includes ideally every life-phase of the id, the embryo, the foetus, the birth, the babe, the child, the youth, the man, the lover, the husband, the father, the patriarch, the soul.
We believe in strong, pure, beautiful bodies thrilling perpetually with the glorious power of radiating health. We want every man, woman and child in this great land to know and embody and feel the truths of right living that mean conscious mastery. We plead for the renouncing of poisons from the coffee, white flour, glucose, lard, and like venom of the American table to patent medicines, tobacco, liquor and the other inevitable recourse of perverted appetite. We long for the time when an eight-hour day may enable every worker to stop existing long enough to live; when the spirit of universal brotherhood shall animate business and society and the church; when every American may have a little cottage of his own, and a bit of ground where he may combine Aerotherapy, Heliotherapy, Geotherapy, Aristophagy and nature’s other forces with home and peace and happiness and things forbidden to flat-dwellers; when people may stop doing and thinking and being for others and be for themselves; when true love and divine marriage and pre-natal culture and controlled parenthood may fill this world with germ-gods instead of humanized animals.
In a word, Naturopathy stands for the reconciling, harmonizing and unifying of nature, humanity and God.
Fundamentally therapeutic because men need healing; elementally educational because men need teaching; ultimately inspirational because men need empowering, it encompasses the realm of human progress and destiny.
Perhaps a word of appreciation is due Mr. John H. Scheel, who first used the term “Naturopathic” in connection with his Sanitarium “Badekur,” and who has courteously allowed us to share the name. It was chosen out of some 150 submitted, as most comprehensive and enduring. All our present plans are looking forward some five or ten or fifty years when Naturopathy shall be the greatest system in the world.
Actually the present development of Naturopathy is pitifully inadequate, and we shall from time to time present plans and ask suggestions for the surpassing achievement of our world-wide purpose. Dietetics, Physical Culture and Hydropathy are the measures upon which Naturopathy is to build; mental culture is the means, and soul-selfhood is the motive.
If the infinite immensity of plan, plea and purpose of this particular magazine and movement were told you, you would simply smile in your condescendingly superior way and straightway forget. Not having learned as yet what a brain and imagination and a will can do, you consider Naturopathy an ordinarily innocuous affair, with a lukewarm purpose back of it, and an ebbing future ahead of it. Such is the character of the average wishy-washy health movement and tumultuous wave of reform.
Your incredulous smile would not discomfit us – we do not importune your belief, or your help, or your money. Wherein we differ from the orthodox self-labeled reformer, who cries for sympathy and cringes for shekels.
We need money most persistently – a million dollars could be used to advantage in a single branch of the work already definitely planned and awaiting materialization; and we need co-operation in a hundred different ways. But these are not the things we expect or deem best.
Criticism, fair, full and unsparing is the one thing of value you can give this paper. Let me explain. Change is the keynote of this January issue – in form, title, make-up. If it please you, your subscription and a word to your still-benighted friends is ample appreciation. But if you don’t like it, say so. Tell us wherein the paper is inefficient or redundant or ill-advised, how it will more nearly fit into your personal needs, what we can do to make it the broadest, deepest, truest, most inspiring of the mighty host of printed powers. The most salient letter of less than 300 words will be printed in full, and we shall ask to present the writer with a subscription-receipt for life.
By to-morrow you will probably have forgotten this request; by the day after you will have dropped back into your old ways of criminal eating and foolish drinking and sagged standing and congested sitting and narrow thinking and deadly fearing – until the next progress paper of New Thought or Mental Science or Dietetics or Physical Culture prods you into momentary activity.
Between now and December we shall tell you just how to preserve the right attitude, physical and mental, without a single external aid; and how, every moment of every day, to tingle and pulsate and leap with the boundless ecstasy of manhood consciously nearing perfection.
A BRIEF HISTORY OF EARLY AMERICAN MEDICINE WITH AN EMPHASIS ON NATURAL HEALING
To understand the evolutionary history of naturopathic medicine in this country, it is necessary to view the internal development of the profession against the historical, social, and cultural backdrop of American social history.
Medicine in America: 1800–1875
In the America of 1800, although a professional medical class existed, medicine was primarily domestically oriented. When an individual fell ill, he was commonly nursed by a friend or family member who relied upon William Buchan’s Domestic Medicine (1769), John Wesley’s Primitive Physic (1747), or John Gunn’s Domestic Medicine (1830).
Professional medicine transferred from England and Scotland to America in pre-revolutionary days. However, 18th- and early 19th-century America considered the concept of creating a small, elite, learned profession in violation of the political and institutional concepts of early American democracy.
The first medical school in the American colonies was opened in 1765 at what was then the College of Philadelphia (later the University of Pennsylvania) and the school came to be dominated by revolutionary leader and physician Benjamin Rush, a signatory to the Declaration of Independence. The proliferation of medical schools to train the new professional medical class began seriously after the war of 1812. Between 1810 and 1820, new schools were established in Baltimore, Lexington and Cincinnati, and even in rural communities in Vermont and Western New York. Between 1820 and 1850, a substantial number of schools were established in the western rural states. By 1850, there were 42 medical schools recognized in the United States, while there were only three in all of France.
Generally, these schools were started by a group of five to seven local physicians approaching a local college with the idea of establishing a medical school in conjunction with the college’s educational facilities. The schools were largely apprenticeship-based, and the professors received their remuneration directly from fees paid by the students.
The requirements for an MD degree in late 18th- and early 19th-century America were roughly the following:
• knowledge of Latin, natural and experimental philosophy
• 3 years of serving an apprenticeship under practicing physicians
• attending of two terms of lectures and passing of attendant examinations
• a thesis.
Graduating students had to be at least 21 years of age.
The rise of any professional class is gradual and marked by difficulties, and varying concepts existed as to what was the demarcation of a “professional” physician. There were the graduates of medical school versus non-graduates, medical society members versus non-members, and licensed physicians versus unlicensed “doctors”. Licensing statutes came into existence between 1830 and 1850, but were soon repealed, as they were considered “undemocratic” during the apex of Jacksonian democracy.
In 1822, the rise in popularity of Samuel Thomson and his publication of New Guide to Health helped to frustrate the creation of a professional medical class. Thomson’s work was a compilation of his personal view of medical theory and American Indian herbal and medical botanical lore. Thomson espoused the belief that disease had one general cause – “cold” influences on the human body – and that disease had therefore one general remedy – “heat”. Unlike the followers of Benjamin Rush and the American “heroic” medical tradition who advocated blood-letting, leeching, and the substantial use of mineral-based purgatives such as antimony and mercury, Thomson believed that minerals were sources of “cold” because they come from the ground and that vegetation, which grew toward the sun, represented “heat”.As noted in Griggs’ Green Pharmacy (the best history of herbal medicine to date), Thomson’s theory developed as follows:
Instead, he elaborated a theory of his own, of the utmost simplicity: “All diseases … are brought about by a decrease or derangement of the vital fluids by taking cold or the loss of animal warmth … the name of the complaint depends upon what part of the body has become so weak as to be affected. If the lungs, it is consumption, or the pleura, pleurisy; if the limbs, it is rheumatism, or the bowels, colic or cholera morbus … all these different diseases may be removed by a restoration of the vital energy, and removing the obstructions which the disease has generated …
Thus the great object of his treatment was always to raise and restore the body’s vital heat: “All … that medicine can do in the expulsion of disorder, is to kindle up the decaying spark, and restore its energy till it glows in all its wonted vigor.
Thomson’s view was that individuals could be self-treating if they had a sincere understanding of his “new guide to health” philosophy and a copy of his book, New Guide to Health. The right to sell “family franchises” for utilization of the Thomsonian method of healing was the basis of a profound lay movement between 1822 and Thomson’s death in 1843. Thomson adamantly believed that no professional medical class should exist and that democratic medicine was best practiced by lay persons within a Thomsonian “family” unit.
By 1839, Thomson claimed to have sold some 100,000 of these family franchises called “friendly botanic societies”. While he professed to have solely the interests of the individual at heart, his system was sold at a profit under the protection of a patent he had obtained in 1813.
The eclectic school of medicine
Some of the botanics (professional Thomsonian doctors) wanted to separate themselves from the lay movement by creating requirements and standards for the practice of Thomsonian medicine. Thomson, however, was adamantly against a medical school founded on his views. Thus, it was not until the decade after Thomson’s death that independent Thomsonians founded a medical college (in Cincinnati) and began to dominate the Thomsonian movement. These Thomsonian doctors, or “botanics”, were later absorbed into the medical sectarian movement known as the “eclectic school”, which originated with the New Yorker, Wooster Beach.
Wooster Beach was another of medical history’s fascinating characters. From a well-established New England family, he started his medical studies at an early age, apprenticing under an old German herbal doctor, Jacob Tidd, until Tidd died. Beach then enrolled in the Barclay Street Medical University in New York. As noted by Griggs . Beach’s burning ambition was to reform medical practice generally – not to alienate the entire profession by savage attacks from without – and he was convinced that he would be in a stronger position to do so if he were himself a diplomatized doctor. The faculty occasionally listened to criticism from within their own number: against onslaughts of “illiterate quacks” like Samuel Thomson, they simply closed ranks in complacent hostility.
After opening his own practice in New York, Beach set out to win over fellow members of the New York Medical Society (into which he had been warmly introduced by the screening committee) to his point of view that heroic medicine was inherently dangerous to mankind and should be reduced to the gentler theories of herbal medicine. He was summarily ostracized from the medical society.
To Beach this was a bitter blow, but he soon founded his own school in New York, calling the clinic and educational facility “The United States Infirmary”. However, due to continued pressure from the medical society, he was unable to obtain charter authority to issue legitimate diplomas. He then located a financially ailing, but legally chartered, school, Worthington College, in Worthington, Ohio. He opened there a full-scale medical college; out of its classrooms was launched what became known as the eclectic school of medical theory. As Griggs relates Beach had a new name for his practice: while explaining to a friend his notions of combining what was useful in the old practice with what was best in the new, the friend exclaimed, “You are an eclectic!” to which, according to legend, Beach replied, “You have given me the term which I have wanted: I am an eclectic!”
Cincinnati subsequently became the focal point of the eclectic movement and the medical school remained until 1938 (the last eclectic school to exist in America). The philosophies of the sect helped to form the theoretical underpinnings of Benedict Lust’s naturopathic school of medicine.
Despite his criticism of the early allopathic medical movement (although the followers of Benjamin Rush were not as yet known by this term, reputed to have been coined by Samuel Hahnemann) for their “heroic” tendencies, Thomson’s medical theories were “heroic” in their own fashion. While he did not advocate blood-letting, heavy metal poisoning and leeching, botanic purgatives – particularly Lobelia inflata (Indian tobacco) – were a substantial part of the therapy.
The hygienic school of thought
One other forerunner of American naturopathy, also originating as a lay movement, grew into existence at this time. This was the “hygienic” school, which had its genesis in the popular teachings of Sylvester Graham and William Alcott.
Sylvester Graham began preaching the doctrines of temperance and hygiene in 1830, and published, in 1839, Lectures on the Science of Human Life, two hefty volumes that prescribed healthy dietary habits. He emphasized a moderate lifestyle, recommending an anti-flesh diet and bran bread as an alternative to bolted or white bread.
William Alcott dominated the scene in Boston during this same period, and together with Grahm, saw that the American hygienic movement – at least as a lay doctrine – was well-established.
By 1840, the profession of homeopathy had also been transplanted to America from Germany. Homeopathy, the creation of an early German physician, Samuel Hahnemann (1755–1843), had three central doctrines:
• the “law of similars” (that like cures like)
• that the effect of a medication could be heightened by its administration in minute doses (the more diluted the dose, the greater the “dynamic” effect)
• that nearly all diseases were the result of a suppressed itch, or “psora”.
The view was that a patient’s natural symptom-producing disease would be displaced after homeopathic medication by a similar, but much weaker, artificial disease that the body’s immune system could easily overcome.
Originally, most homeopaths in this country were converted orthodox medical men, or “allopaths”. The high rate of conversion made this particular medical sect the arch-enemy of the rising orthodox medical profession. The first homeopathic medical school was founded in 1850 in Cleveland; the last purely homeopathic medical school, based in Philadelphia, survived into the early 1930s.
The rise and fall of the sects
Although these two non-allopathic sects were popular, they never comprised more than one-fifth of the professional medical class in America. Homeopathy at its highest point reached roughly 15%, and the eclectic school roughly 5%. However, their very existence for many years kept the exclusive recognition desired by the orthodox profession from coming within its grasp. Homeopathy was distasteful to the more conventional medical men not only because it resulted in the conversion of a substantial number of their peers, but also because homeopaths generally also made a better income. The rejection of the eclectic school was more fundamental: it had its roots in a lay movement that challenged the validity of a privileged professional medical class.
The existence of three professional medical groups – the orthodox school, the homeopaths, and the eclectics – combined with the Jacksonian view of democracy that prevailed in mid-19th century America, resulted in the repeal of virtually all medical licensing statutes existing prior to 1850. But by the 1870s and 1880s, all three medical groups had begun to voice support for the restoration of medical licensing.
There are differing views as to what caused the homeopathic and eclectic schools to disappear from the medical scene in the 50 years following 1875. One view defines a sect as follows:
A sect consists of a number of physicians, together with their professional institutions, who utilize a distinctive set of medically invalid therapies which are rejected by other sects …
By this definition, the orthodox or allopathic school was just as sectarian as the homeopathic and eclectics. Rothstein’s view is that these two 19th century sects disappeared because, beginning in the 1870s, the orthodox school grasped the European idea of “scientific medicine”. Based on the research of such men as Pasteur and Koch, and the “germ theory”, this approach supposedly proved to be the medically proper view of valid therapy and gained public recognition because of its truth.
Another view is that the convergence of the needs of the three sects for professional medical recognition (which began in the 1870s and continued into the early 1900s), and the “progressive era”, led to a political alliance in which the majority orthodox school ultimately came to be dominant by sheer weight of numbers and internal political authority. As Starr notes :
Both the homeopaths and eclectics wanted to share in the legal privileges of the profession. Only afterward did they lose their popularity. When homeopathic and eclectic doctors were shunned and denounced by the regular profession, they thrived, but the more they gained an access to the privileges of regular physicians, the more their numbers declined. The turn of the century was both the point of acceptance and the moment of incipient disintegration …
In any event, this development was an integral part of the drive toward professional authority and autonomy established during the progressive era (1900–1917). It was acceptable to the homeopaths and the eclectics because they controlled medical schools that continued to teach and maintain their own professional authority and autonomy. However, it was after these professional goals were attained that the lesser schools of medical thought went into rapid decline.
The American influence
From 1850 through 1900, the medical counterculture continued to establish itself in America. From its lay roots in the teachings of the hygienic movement, there grew professional medical recognition, albeit a small minority and “irregular” view, that hygiene and hydropathy were the basis of sound medical thought (much like the Thomsonian transition to botanic and eclectic medicine).
The earliest physician who came to have a significant impact on the later growth of naturopathy as a philosophical movement was Russell Trall MD. As noted in Whorton’s Crusaders for Fitness,  he “passed like a meteor through the American hydropathic and hygienic movement” :
The exemplar of the physical educator-hydropath was Russell Thatcher Trall. Still another physician who had lost his faith in regular therapy, Trall opened the second water cure establishment in America, in New York City in 1844. Immediately he combined the full Preissnitzian armamentarium of baths with regulation of diet, air, exercise and sleep. He would eventually open and or direct any number of other hydropathic institutions around the country, as well as edit the Water-Cure Journal, the Hydropathic Review, and a temperance journal. He authored several books, including popular sex manuals which perpetuated Graham-like concepts into the 1890’s, sold Graham crackers and physiology texts at his New York office, was a charter member (and officer) of the American Vegetarian Society, presided over a short-lived World Health Association, and so on. His crowning accomplishment was the Hygeian Home, a “model Health Institution [which] is beautifully situated on the Delaware River between Trenton and Philadelphia.” A drawing presents it as a palatial establishment with expansive grounds for walking and riding, facilities for rowing, sailing, and swimming, and even a grove for open-air “dancing gymnastics.” It was the grandest of water cures, and lived beyond the Civil War period, which saw the demise of most hydropathic hospitals. True, Trall had to struggle to keep his head above water during the 1860’s, but by the 1870’s he had a firm financial footing (being stabilized by tuition fees from the attached Hygeio-therapeutic College). With Trall’s death in 1877, however, the hydropathic phase of health reform passed.
As will be seen later in this chapter, this plethora of activity is very similar to that engaged in by Benedict Lust between 1896 and his death in 1945, when he worked to establish naturopathic medicine. The Hygeian Home and later “Yungborn” establishments at Butler, New Jersey, and Tangerine, Florida, were very similar to European nature cure sanitariums, such as the original Yungborn founded by Adolph Just and the spa/ sanitarium facilities of Preissnitz, Kneipp and Just.
Trall gave a famous address to the Smithsonian Institution in Washington, DC, in 1862, under the sponsorship of the Washington Lecture Association. “The true healing art: or hygienic vs drug medication”, a 2.5 hour lecture purported to have received rapt attention, was devoted to Trall’s belief in the hygienic system and in hydropathy as the true healing art. The address was reprinted by Fowler and Wells (New York, 1880) with an introduction written by Trall, prior to his death in 1877.
Trall also founded the first school of natural healing arts in this country to have a 4-year curriculum and the authorization to confer the degree of MD. It was founded in 1852 as a “hydropathic and physiological school” and was chartered by the New York State Legislature in 1857 under the name “New York Hygio-Therapeutic College”, with the legislature’s authorization to confer the MD degree.
In 1862, Trall went to Europe to attend the International Temperance Convention. At this meeting of reformers, he took prominent part, specifically relating to the use of alcohol as a beverage and as a medicine. He eventually published more than 25 books on the subjects of physiology, hydropathy, hygiene, vegetarianism, and temperance, among many others.
The most valuable and enduring of these was his Hydropathic Encyclopedia, a volume of nearly 1,000 pages that covered the theory and practice of hydropathy and the philosophy and treatment of diseases advanced by older schools of medicine. At the time of his death, according to the December 1877 Phrenological Journal cover article featuring a lengthy obituary of Trall, this encyclopedia had sold more than 40,000 copies since its original publication in 1851.
For more than 15 years, Trall was editor of the Water-Cure Journal (also published by Fowler and Wells). During this period, the journal went through several name changes including the Hygienic Teacher and The Herald of Health. When Dr Lust originally opened the American School of Naturopathy, an English-language version of Kneipp’s Water-cure (or in German Meine Wasser-kurr) being unavailable, he used only the works and writings of Russell Trall as his texts.
By 1871, Trall had moved from New York to the Hygeian Home on the Delaware River. His water-cure establishment in New York became The New Hygienic Institute. One of the co-proprietors there was Martin Luther Holbrook, who later replaced Trall as the editor of The Herald of Health. As noted by Professor Whorton . But Holbrook’s greatest service to the cause was as an editor. In 1866 he replaced Trall at the head of The Herald of Health, which had descended from the Water-Cure Journal and Herald of Reforms (1845–1861) by the way of the Hygienic Teacher and Water-Cure Journal (1862). Under Holbrook’s direction the periodical would pass through two more name changes (Journal of Hygiene Herald of Health, 1893–1897, and Omega, 1898–1900) before merging with Physical Culture.
Trall and Holbrook both advanced the idea that physicians should teach the maintenance of health rather than simply provide a last resort in times of health crisis. Besides providing a strong editorial voice espousing vegetarianism, the evils of tobacco and drugs, and the value of bathing and exercise, dietetics and nutrition along with personal hygiene were strongly advanced by Holbrook and others of the hygienic movement during this era. As described, again by Whorton.
The orthodox hygienists of the progressive years were equally enthused by the recent progress of nutrition, of course, and exploited it for their own ends, but their utilization of science hardly stopped with dietetics. Medical bacteriology was another area of remarkable discovery, bacteriologists having provided, in the short space of the last quarter of the 19th century, an understanding, at long last, of the nature of infection. This new science’s implications for hygienic ideology were profound – when Holbrook locked horns with female fashion, for example, he did not attack the bulky, ground-length skirts still in style with the crude Grahamite objection that the skirt was too heavy. Rather he forced a gasp from his readers with an account of watching a smartly dressed lady unwittingly drag her skirt “over some virulent, revolting looking sputum, which some unfortunate consumptive had expectorated.”
Holbrook expanded on the work of Graham, Alcott and Trall and, working with an awareness of the European concepts developed by Preissnitz and Kneipp, laid further groundwork for the concepts later advanced by Lust, Lindlahr and others:
For disease to result, the latter had to provide a suitable culture medium, had to be susceptible. As yet, most physicians were still so excited at having discovered the causative agents of infection that they were paying less than adequate notice to the host. Radical hygienists, however, were bent just as far in the other direction. They were inclined to see bacteria as merely impotent organisms that throve only in individuals whose hygienic carelessness had made their body compost heaps. Tuberculosis is contagious, Holbrook acknowledged, but “the degree of vital resistance is the real element of protection. When there is no preparation of the soil by heredity, predisposition or lowered health standard, the individual is amply guarded against the attack.” A theory favored by many others was that germs were the effect of disease rather than its cause; tissues corrupted by poor hygiene offered microbes, all harmless, an environment in which they could thrive. In addition to introducing the works of Father Kneipp and his teachings to the American hygienic health care movement, Holbrook was a leader of the fight against vivisection and vaccination:
Vivisection and vaccination were but two of the practices of medicine criticized in the late 19th century. Therapy also continued to be an object of protest. Although the heroism of standard treatment had declined markedly since mid-century, a prescription was still the reward of any visit to the doctor, and drugless alternatives to healing were appearing in protest. Holbrook published frequent favorable commentaries on the revised water cure system of Germany’s Father Kneipp. A combination of baths, herbal teas, and hardening exercises, the system had some vogue in the 1890’s before flowering into naturopathy. Holbrook’s journal also gave positive notices to osteopathy and “chiropathy” [chiropractic] commending them for not going to the “drugstore or ransack[ing] creation for remedies nor load[ing] the blood with poison.” But though bathing and musculoskeletal manipulation were natural and nonpoisonous, Holbrook preferred to give the body complete responsibility for healing itself. Rest and proper diet were the medicines of this doctor who billed himself as a “hygienic physician” and censured ordinary physicians for being engrossed with disease rather than health.
The beginnings of “scientific medicine”
While the hygienic movement was making its impact, the orthodox medical profession, in alliance with the homeopaths and eclectics, was making significant advances. The orthodox profession, through the political efforts of the AMA, had first tried to remove sectarian and irregular practitioners by segregating them from the medical profession altogether. It did so by formulating and publishing its first national medical code of ethics in 1847. (In 1846, the orthodox profession formed the American Medical Association to represent their professional views.) The code condemned proprietary patents (even carrying over into a physician’s development of surgical or other medical implements, which led to its greatest criticism); encouraged the adoption of uniform rules for payment in geographical areas; condemned the practice of contract work, prohibited advertising and fee-sharing even among specialists and general practitioners; eliminated blacks and women; and, most significantly, prohibited any consultation or contact with irregulars or sectarian practitioners. As the code stated:
… no one can be considered as a regular practitioner, or a fit associate in consultation, whose practice is based on an exclusive dogma, to the rejection of the accumulated experience of the profession, and of the aids actually furnished by anatomy, physiology, pathology, and organic chemistry.
In the late 1870s and into the 1880s, the major sects – the orthodox, or allopathic school, the homeopaths and the eclectics – began to find more reason to cooperate to obtain common professional goals. These included the enactment of new licensing laws and the creation of a “respectable” medical educational system. Also at this time, the concept of “scientific medicine” was brought to America. (Although Starr differs with Rothstein about the cause of the death of the homeopathic and eclectic sectarian schools, he notes that Rothstein clearly documents the transition, during the 19th century, of medicine to a recognized professional class composed of both the minority sects and the orthodox school.)
This transition from conflict between the major sects resulted in the erosion of the implementation of the code of ethics, the cooperation among the sects to revive medical licensing standards, the admission of sectarian physicians to regular medical societies and, ultimately, a structural reorganization of the American Medical Association, which took place between 1875 and 1903.
Once the cooperation between the three medical views had begun, the medical class as dominated by the regular school came fully into power. And the homeopathic and eclectic schools of thought met their demise, which was finally brought about by two significant events: the rapid creation of new medical educational standards between 1900 and 1910, culminating in the publication of the famous “Flexner Report” (1910); and the effective infusion of millions of dollars into selected allopathic medical schools by the newly created capitalistic philanthropic foundations, principally the Carnegie and Rockefeller foundations.
The impact of the monies from the Carnegie and Rockefeller foundations has been clearly documented and is described in detail, albeit for the advancement of a particular political point of view, in Brown’s Rockefeller Medicine Men. The impact of the monies from these foundations, as contributed to medical schools that met the AMA’s view of medical education and philosophy, cannot be underestimated.
This process has been well documented. As discussed by Burrows, this educational reform allowed the AMA to form a new alliance with legislators, and push quickly for medical licensing designed to reward the educational and medical expertise of the new orthodox “scientific medicine”, and the exclusion of all others.
Medical education in transition
Based upon the rising example of scientific medicine and its necessary connection to research, the educational laboratory, and a more thorough scientific education as a preamble to medical practice, Harvard University (under the presidency of Charles Elliott) created a 4-year medical educational program in 1871. The primal modern medical educational curriculum was devised and set in motion over 20 years later at Johns Hopkins University under the leadership of William Osler and William Welch, using the resources from the original endowment of the hospital and university from the estate of Johns Hopkins. Other schools followed suit. By the time the American Medical Association set up its Council on Medical Education in 1904, it was made up of five members from the faculties of schools modeled on the Johns Hopkins prototype. This committee set out to visit and rate each of the (160) medical schools then in operation in the country. The ratings used were class “A” (acceptable), class “B” (doubtful), and class “C” (unacceptable).
Eighty-two schools received a class “A” rating, led by Harvard, Rush (Chicago), Western Reserve, the University of California and, notably, Johns Hopkins. Forty-six received a class “B” rating, and thirty-two a class “C” rating. The class “C” schools were mostly in rural areas and many of them proprietary in nature.
Subsequently to the AMA ratings, the Council on Medical Education applied to the Carnegie Foundation to commission an independent report to verify its work. Abraham Flexner, a young, energetic and noted educator was chosen for this task by the Carnegie Foundation and accompanied by the secretary (Nathan Colwell MD) of the Council on Medical Education, who had participated in all of the committee site visits.
Flexner visited each of the 162 United States medical schools then operating. The publication of the “Flexner Report”, which was widely publicized, put the nails in the coffins of all schools with class “C” ratings and many with class “B” ratings. Significantly, the educational programs of all but one eclectic school (in Cincinnati) and one homeopathic school (in Philadelphia) were eliminated by 1918.
The eclectic medical schools, in particular, were severely affected by the report. According to Griggs (p. 251):
Of the eight Eclectic schools, the Report declared that none had “anything remotely resembling the laboratory equipment which is claimed in their catalogs.” Three of them were under-equipped; the rest “are without exception filthy and almost bare. They have at best grimy little laboratories … a few microscopes, some bottles containing discolored and unlabeled pathological material, in an incubator out of commission, and a horrid dissecting room.” The Report found them more culpable than a regular school for these inadequacies: “… the Eclectics are drug-mad; yet, with the exception of the Cincinnati and New York schools, they are not equipped to teach the drugs or drug therapy which constitutes their sole reason for existence.”
The other regular schools that had conducted homeopathic or eclectic programs had by that time phased them out in the name of “scientific medicine”.
During this same period of time, the American Medical Association, through several of its efforts, began a significant alliance with the organized pharmaceutical industry of the United States, shaping that industry in a manner acceptable to the allopathic profession.
The new “sects”
The period from 1890 through 1905 saw the rise of three new medical sects and several other smaller “irregular” schools which replaced those soon to pass away. In Missouri, Andrew Taylor Still, originally trained as an orthodox practitioner, founded the school of medical thought known as “osteopathy”, and in 1892 opened the American School of Osteopathy in Kirksville, Missouri. In 1895, Daniel David Palmer, originally a magnetic healer from Davenport, Iowa, performed the first spinal manipulation, which gave rise to the school he termed “chiropractic”. He formally published his findings in 1910, after having founded a chiropractic school in Davenport, Iowa. And, in 1902, Benedict Lust founded the American School of Naturopathy in New York.
Although some of the following discussion will be devoted to the schools of healing called osteopathy and chiropractic, only that portion of their histories related to the history of naturopathy will be mentioned. (A full study of osteopathic medicine in America may be found in The D.O.’s by Gevitz , and a reasonable sketch of chiropractic medicine may be found in Ronald Lee Kapling’s chapter in Salmon.
As noted by Starr, these new sects, including Christian Science, formulated by Mary Baker Eddy (see Silberger for further discussion), either rose or fell on their own without ever completely allying with orthodox medicine. Starr theorized that these sects arose late enough that the orthodox profession and its political action arm, the AMA, had no need to ally with them and would rather battle with them publicly. This made these sectarian views separate and distinct from the homeopathic and eclectic schools.