Marketplace of the Marvelous (4 page)

Regular doctors were not ignorant of the shortcomings of their therapies. Harvard professor and regular physician Oliver Wendell Holmes, one of the century's most outspoken, shrewd, and witty critics of irregular medicine, demonstrated a surprising evenhandedness in his assessments of his own brand of medicine. He despaired of the lack of progress and innovation in medical science. In 1843, Holmes ignited fierce controversy among regulars for his contention, contrary to popular belief, that physicians often transmitted the contagion of puerperal fever, a deadly infection now known as postpartum endometritis and contracted by women during or shortly after childbirth, to their patients. He also decried the overuse and abuse of drugs by regulars. He placed some of the blame, though, on patients who pressured their doctors to do something with big effects as well as the particularly grandiose American character found in doctors and patients alike. “How could a people which has a revolution once in four years, which has contributed the Bowie-knife and the revolver, which has chewed the juice out of all the superlatives of language in Fourth of July orations, and so used up its epithets in the rhetoric of abuse that it takes two great quarto dictionaries to supply the demand; which insists in sending out yachts and horses and boys to out-sail, out-run, out-fight, and checkmate all the rest of creation,” asked Holmes, “how could such a people be content with any but ‘heroic' practice? What wonder that the Stars and Stripes wave over doses of ninety grains of sulphate of quinine, and that the American eagle screams with delight to see three drachms of calomel given at a single mouthful?”
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The
American Journal of the Medical Sciences
acknowledged that “the majority of physicians over-medicate” despite “all that has been written on this subject,” and more than a few regulars denounced their field's neglect of nature's healing power.
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Nature, according to physician Worthington Hooker, was a “good, kind angel, hovering over the bed of sickness, without fee, and often without even any acknowledgement of her services” as she “saves the life of many a poor patient, who is near being drugged to death by some ignorant quack, or some over-dosing doctor.”
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Until the second half of the nineteenth century, though, most
regular doctors did not seriously question the efficacy of their remedies and even fewer experimented with anything other than increasing the dose or expanding the range of ills a remedy could treat. Regulars maintained their commitment to heroic therapies for many reasons. Primarily concerned with asserting and consolidating its power as a profession, regular medicine as a whole tended to be less open to new ideas, particularly those that might diminish confidence in its power in the eyes of patients. Heroic treatments caused big effects that emphasized a doctor's authority and control over the situation. Heroic therapies also made regular medicine distinct, a point that became more important as irregular healers grew more numerous and medicine more competitive. As irregular medicine grew in strength and size, it was only natural for regular doctors to rally around their depletive therapies as a mark of cohesiveness and group identity.
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From the perspective of the average American and despite protests to the contrary from regular doctors, regular and irregular medicine were often indistinguishable. The professional and educational qualifications for both were minimal and the scientific proof for any treatment virtually nonexistent, so people made choices based on their common sense, convenience, finances, and personal experience. They cared only who made them feel better. For most patients, the decision to seek care rested on a multitude of factors, such as cost, expediency, and their personal relationship with the healer. The sick paid close attention to their own illnesses and actively chose among the burgeoning marketplace of healers, regular and irregular. People often tried one and then another and another. An implicit trust in doctors and medicine was not common before the mid-twentieth century. Whether a doctor earned a degree or completed an apprenticeship mattered less to most people than his ability to instill hope and practice confidently. Americans wanted results, and when regular medicine failed to deliver cures as quickly, easily, or cheaply as they sought, they were not afraid to turn elsewhere.
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Regular and irregular doctors differed most dramatically on one issue: women. Since colonial days, women had performed nearly all of the tasks that professionally trained doctors, nurses, and pharmacists later assumed. But as regular medicine became more organized in the nineteenth century, many regular doctors dismissed traditional female healing practices as ineffective, irrational, and even dangerous. Prevailing ideas about women's health and anatomy also worked to
exclude women from practicing medicine. The common theory of female anatomy and physiology placed responsibility for all female physical and mental symptoms on a woman's reproductive organs. Ruled by reproduction, women were deemed too irrational, emotional, and intellectually inferior to pursue professional careers. Some regulars may also have feared that female doctors would steal their business. Even more, the very image of a professional person seemed to challenge women's acceptance in medicine. In the early nineteenth century, a professional was by definition a man and medicine a profession of gentlemen; a professional female physician thus represented a contradiction in terms.
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As a result, nearly all regular medical schools and medical societies barred women from entry until the late nineteenth century and many into the twentieth century.

Those women who did pursue a career in regular medicine faced discrimination and outright hostility. One of the most egregious incidents occurred in 1869 when students from the Woman's Medical College of Pennsylvania received permission to attend the Saturday morning surgical clinics at the all-male Pennsylvania Hospital in Philadelphia. When the women arrived, the male students greeted them with angry jeers, whistles, and groans. Some men even threw stones. “Ranging themselves in line, these gallant gentlemen assailed the young ladies, as they passed out, with insolent and offensive language, and then followed them into the street, where the whole gang, with the fluency of long practice, joined in insulting them,” reported Philadelphia's
Evening Bulletin
. “During the last hour missiles of paper, tinfoil, tobacco-quid, etc., were thrown upon the ladies, while some of these men defiled the dresses of the ladies near them with tobacco juice.”
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Though opposition to female doctors rarely became violent, women, nevertheless, faced a discouraging path in their chosen field.

Irregular healers tended to take a different view. Many welcomed women practitioners and established coeducational medical schools. For some, welcoming women served the practical purpose of building market share. Others championed a woman-positive message that celebrated women's unique skills and intelligence. Healing highlighted the “feminine virtues” of nurture, altruism, and morality that made women good wives and mothers. Most women physicians shared that view, believing they were better positioned to protect and improve the health of women and children. They saw themselves as a link between the practice of medicine and women's everyday lives.
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Like their male
counterparts, female doctors treated patients, presented case reports, debated therapeutic methods and innovations, and read medical journals.

Allowing women to participate in medicine also solved a very real health problem. Modesty and propriety kept many women from seeking medical care from male doctors. Even when they did, some doctors declined to perform physical examinations, particularly for gynecological issues, out of respect for the delicate sensibilities of their patients. Women could easily find themselves suffering from a dangerous or inappropriate treatment—or no treatment at all—without the benefit of a thorough analysis. But with female doctors, women could get the medical attention they needed. Next to teaching, medicine attracted more women than any other profession in the nineteenth century, the majority in irregular health systems.

Prejudice kept many African Americans out of organized medicine, both regular and irregular alike. While folk and herbal healers as well as midwives and other local healers were common in black communities, many medical schools and medical societies refused to admit black physicians, and many white doctors refused to treat black patients. Even so, David Jones Peck and Rebecca Lee Crumpler became the first African Americans in the United States to earn MD degrees, in 1847 and 1864 respectively, and eight black doctors served in the Army Medical Corps during the Civil War. But more common was the experience of Daniel Laing Jr., Martin Delany, and Isaac H. Snowden, who were expelled from Harvard Medical School in 1851 by Oliver Wendell Holmes in the face of intense pressure and opposition to their presence from white students. Even among otherwise liberal healers, discrimination was common. In 1870, homeopaths in Washington, DC, opposed admitting black candidates to the Washington Homeopathic Medical Society. Black medical schools and medical societies did form, but most were short-lived and underfunded. During the Civil War, the Freedman's Bureau began providing medical care to freed slaves and promoting education, but most African Americans faced intense racism and struggled to find and receive adequate medical care throughout the nineteenth century.
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By the 1830s, irregular systems had grown so numerous and successful that regular doctors increasingly found themselves facing a precarious and uncertain future. “Why are we sick? Why cannot the doctors cure us,” asked health reformer Mary Gove Nichols. “We are
tired of professions and promises.”
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Nichols was not the only one. Many Americans began asking themselves, and their doctors, the very same question.

The list of those who used and advocated for irregular health treatments, and likely contributed to their popularity, includes many of the nineteenth century's boldface names: Thomas Edison, Margaret Fuller, James Fenimore Cooper, Nathaniel Hawthorne, John D. Rockefeller, Mark Twain, Henry David Thoreau, Harriet Beecher Stowe, Edgar Allan Poe, P. T. Barnum, Abraham Lincoln, Susan B. Anthony, and Ralph Waldo Emerson. Some became outspoken supporters of one system, while others dabbled among the marvels on offer in the medical marketplace. Intrigued and hopeful, Americans, the famous and anonymous alike, came to irregular medicine seeking to make themselves happier, healthier, and more successful.

This is their story.

Samuel Thomson grew up with a love of herbs, experimenting as a boy with the plant remedies that would eventually form the foundation of his entire healing system. (National Library of Medicine, Bethesda, MD)

 

Samuel Thomson believed poetry could heal. In 1812, he published his first medical poem, “Seamen's Directions,” which combined ideological cheerleading with instructions for use of his remedies:

Th' Emetic number ONE's design'd

A gen'ral med'cine for mankind … Let number TWO be used as bold,

To clear the stomach of the cold;

Next steep the coffee,

number THREE,

and keep as warm as you can be ... My system's founded on this truth,

Man's Air and Water, Fire and Earth,

And death is cold, and life is heat,

These temper'd well, your health's complete.
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This mnemonic poem was one of dozens composed by Thomson and his followers, who urged patients and practitioners to memorize one or more of them for proper results.

Instructional poems were not the whole of Thomson's poetic offerings, though. He also used verse to deride the excesses of regular medicine and to celebrate the health benefits of herbs and other plants. One 1845 poem read:

They use [lobelia] in tincture, in powders and pills,

The patient it cures, but it never him kills;

It is first rate to cure in all cases of fevers,

But is hated and feared by the regular deceivers.
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Thomson's poetic fervor sometimes spread to his patients, too, who couldn't help but proclaim their devotion to Thomson and the healing power of his favorite remedy in couplets and quatrains.

Then LOBELIA, thou great Deliverer, come!

Purge from my eye this ochre hue …

Make me benevolent and true …

I'll own, O LOBELIA! My virtue is from you.
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Poetry was popular entertainment in the decades before the Civil War. People of all classes read poetry, composed their own verse, and entertained each other with recitations of favorite poems. Poems on love, marriage, courtship, death, passion, and piety, most of which were penned by women, appeared regularly in popular newspapers and magazines. Men wrote most Thomsonian poems, on the other hand, and they tended toward the instructional rather than the moral or flowery messages that characterized the era's other poetic outpourings. Thomson's medical poems did fit the literary and cultural flavor of the era, however, providing both amusement as well as a passionate argument for the reform of medicine.
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