Marketplace of the Marvelous (42 page)

But in the 1970s, perhaps influenced by the resurgence of irregular health, some regular doctors began to show interest in holistic medicine. In 1979 a group of regulars organized the American Holistic Medical Association and announced themselves “dedicated to the concept of medicine of the whole person,” which may “demand combination of both orthodox and non-damaging unorthodox approaches.”
³⁶
That some regulars accepted the idea of holistic medicine was not news by the late 1970s, nor had it been in the past, as many regulars had never taken the hard line against irregulars or their therapies that the AMA demanded. But the establishment of a professional organization of regulars dedicated to the integration of body, mind, and spirit certainly was. Even more arresting, these regular doctors envisioned a possible collaborative future for irregular and regular health. The organization's
Journal of Holistic Medicine
soon included a list of acceptable topics for publication in its pages, a list that included homeopathy. Rarely, if ever, had regulars discussed homeopathy as anything other than a fraud. Now it could be featured and studied in a regular medical journal? Not every regular was sold on the idea of holistic medicine, though, and many of its advocates met with the skepticism and sometimes harsh rebuke of colleagues.
³⁷

Public enthusiasm for holistic and alternative remedies only continued to intensify, though. Drugstores and health food stores began to carry nonprescription homeopathic remedies as well as other botanical remedies and mesmeric-like medical magnets in the 1980s. By the late 1990s, consumers could actually purchase homeopathic kits just as they had been able to in the past, and sales of homeopathic remedies grew 20 percent annually. Alongside these well-established remedies, though, came an explosion of products labeled “holistic” and “natural” that sought to cash in on the potential marketing bonanza, just as medical entrepreneurs had in the past. Dr. Arnold Rellman, editor of the
New England Journal of Medicine
, complained that the valuable message of the holistic movement was “ill served by those who seek quick solutions to the ills of mankind through the abandonment of science and rationality in favor of mystical cults.”
³⁸

Then in the 1980s, concerns about the nation's rising health-care costs led to an even more remarkable endorsement of alternative medicine—one nearly unthinkable only a few decades earlier. In 1991, the US Senate Appropriations Committee instructed the National Institutes of Health to develop a research program in alternative medicine. Championed by Senators Tom Harkin of Iowa and Orrin Hatch of Utah, the Office of Alternative Medicine (now known as the National Center for Complementary and Alternative Medicine) was hailed by some as a victory for irregular medicine while others denounced it as tax dollars wasted on snake oil.
³⁹

Skepticism about government funding for alternative medicine has not stopped major academic medical centers from establishing integrative clinics combining irregular and regular health—Harvard, Yale, Duke, and the Mayo Clinic are among more than forty across the United States. Irregular medicine is more accepted in Europe, where a relatively large number of regular doctors either recognize or practice some form of irregular therapeutics. The emergence of these centers in the United States seems to indicate the willingness of regular medicine to consider or at least tolerate the merits of their competitors, an almost unimaginable idea less than a century ago. While a cynic could attribute integrative clinics to a heedless grab for precious research dollars, it's not hard to find true believers on the ground. Even outside integrative medicine clinics, many doctors now recommend meditation, discuss exercise habits, and emphasize good nutrition to patients. Among the nation's most widely read and popular doctors today are Deepak Chopra and Andrew Weil, regular doctors who champion integrative health. The Harvard-educated Weil emphasizes diet, botanicals, and mind-body techniques in his practice. Chopra uses the Indian Ayurvedic system and focuses on the spiritual nearly as much as the physical in his teaching. Millions of Americans read their books, watch them on television, visit their websites, and pay close attention to what they teach. Their followers are not ignorant or uneducated, the reflexive explanation some regulars have put forth to explain the popularity of irregular medicine. Several studies have shown that those Americans with more education, including 50 percent of those with graduate degrees, and a higher economic status are more likely to use alternative medicine than those less educated and less affluent. They share much the same demographic profile as the well-educated, middle- and upper-class white Americans
who found irregular medicine so attractive in the nineteenth century. Many of these Americans turned to irregular medicine for help and found it effective. That personal experience goes a long way toward explaining the long history and popularity of irregular medicine in the United States, even if popular lore and historical thinking tends to tell a different story.
⁴⁰

Irregular medicine often gets blamed for the problems that were, in many ways, the problems of the larger nineteenth-century American culture in which they arose, practiced, and prospered. It's far easier to make fun or to hold up irregular health systems as a bizarre specimen of the past than to try to understand what they meant and the very real problems they sought to address and continue to address to this day.

Irregular health resonated with concerns about the moral implications of the inventions and technologies revolutionizing American society in the nineteenth century. The democratic spirit of the century coupled with the emerging capitalist marketplace fostered a climate conducive to the proliferation of reform movements seeking to change all aspects of life. Social movements tend to arise during times of unrest and change, as people become more open to new
ideas because of problems they perceive with the status quo.
Irregular healers tapped into cultural yearnings for simplicity and a way of life that emphasized hard work, self-improvement, and common sense. They advocated for direct competition and empowered patients to become arbiters of a healer's merit and efficacy.
⁴¹

During their heyday, irregular healers amassed an impressive record of testimonial success and drew millions of followers. They had a pervasive influence on American cultural trends in areas ranging from egalitarianism and women's rights to philosophy, religion, literature, linguistics, and science. Stories about phrenological readings, homeopathic remedies, and trips to the water cure filled newspapers and magazines. Irregular therapies became part of storylines in novels and their jargon was used in everyday conversation. The very existence of irregular health, even if most regulars saw it as a profound negative, fostered an atmosphere ripe for contemplating new research and theories both within and outside medicine.

Regular medicine in the nineteenth century demonstrated an unwillingness to innovate and take risks. Irregulars, on the other hand, wanted something better and proposed new solutions to old medical
problems. Irregulars suggested novel and creative theories about what caused disease and constituted healthy living at a time when medical advancement appeared stalled.

In hindsight, many questions can be raised about the legitimacy of the cures or experiences associated with some nineteenth-century irregular healers just as they can with regular medicine. Why would anyone believe that cold pure water—and nothing else—could cure everything as the hydropaths believed? Or for that matter that bleeding could relieve a fever?

Facing an explanatory void and without the tools needed to understand disease and human physiology, people developed theories and stories to make sense of the world. It's a perfectly human response. We want health to be predictable and our symptoms contained within reassuring frameworks that offer both meaning and action steps to resolution. Regular and irregular doctors alike conjured animal magnetism, spiritual essences, miasmas, and humors to make sense of a world barraged with illnesses that disabled, maimed, and killed. Just like today, Americans sought answers to their problems and the powerful medicine that comes from the comfort and reassurance of a promised cure.

Irregular medicine's gains and criticisms transformed regular medical practice. Most of heroic medicine's most violent measures gave way to new drug therapies after the Civil War. These therapies were in many ways, though, just as vigorous as those they replaced, at least until the advent of antibiotics in the twentieth century. It was not scientific advances that caused this change so much as the continual criticism and pressure doctors faced from irregulars and the general public. Not that they admitted as much. A few claimed that industrialization had changed the body's composition and that cures thus required new therapies. Others trusted more in nature while a still larger group abandoned their old ways without clear explanation.
⁴²

Irregular ideas did find their way into regular medicine. Regular doctors investigating the irregular theories they found so ridiculous and sought to prove wrong sometimes ended up discovering something new and useful in the process. Other aspects of irregular medicine were simply absorbed into the practices of regular medicine. Both tactics profoundly influenced the shape of modern medicine. Phrenology's suggestion that the brain consisted of a mosaic of functional
organs pushed scientists to examine the organization of the brain and its relationship to the mind. Mesmerism's revolutionary discovery of the unconscious opened a new realm for human exploration and encouraged the scientific study of hypnosis. Both mesmerism and phrenology laid the foundation for modern psychology and psychiatry. Hydropathy's advocacy of good hygiene—exercise, diet, water, sanitation—provided the foundation for public health campaigns to improve urban living conditions as well as the core principles of health and nutritional campaigns to this day. Homeopathy challenged the idea that healing had to hurt and helped condition patients to expect medicines with few side effects; few Americans today would likely accept the vomiting, headaches, and crushing pain of standard nineteenth-century care. In all these cases, an irregular idea was refined, molded, and reshaped into something beneficial to regular medicine and integral to modern ideas of health and wellness.

No one pushed for preventative care and health hygiene as much as irregulars. Many sought to eliminate disease before it could even
take hold rather than respond to disease, as was common in regular medicine. Irregulars viewed health as a goal to strive for and one that was attainable through certain actions and activities. Attention to diet, exercise, and other lifestyle concerns is now a standard part of a visit to a primary care physician, in part because many of the most costly and common chronic diseases today, including diabetes and heart disease, are at least somewhat preventable with lifestyle and behavior modifications.
⁴³
Irregulars recognized this and incorporated it into their systems with far more attention and emphasis than regular medicine. It certainly helped that Americans liked having a system to follow that seemed to promise rich reward; the urge continues to drive the diet, health, and self-help industry today. In the nineteenth century, irregulars seized on this impulse more voraciously than regulars, crafting a health regimen that gave individuals control and self-determination in the face of broader uncertainty.

Despite protests to the contrary from both sides, regular and irregular medicine had much in common. Both employed distinctive treatments based on the subjective selection of symptoms. Both tended to be dogmatic in their assertions and to have bombastic leaders and spokespeople. Both had journals, medical schools, and professional societies. And both appropriated the authority of science
before any therapy could be reasonably judged scientific, as the term is used today. Nearly everyone could agree that science was fundamental to medical practice, but before the twentieth century, science had many meanings and included a wide range of disciplines, such as philosophy, unlikely to be called scientific today. To do science generally meant to make observations and classify them in such a way as to discern natural laws. Regulars and irregulars acquired this knowledge by examining and treating thousands of patients. The multiplicity of meanings attached to science made it easier for people to claim scientific status and to benefit from its social and cultural authority.
⁴⁴
Only in the 1890s did the laboratory techniques and clinical measurement associated with science today begin to make inroads into regular medical practice in the United States and to shape and limit the modern meaning of the word.
⁴⁵

Both regular and irregular medicine also recognized the importance of organization and leadership to success. Charismatic leaders like Samuel Thomson and Daniel David Palmer could grow movements and keep them together for a time, but many irregular systems were done in by internal struggles between those with different visions and strategies for the future. The democratic nature of the irregular health movements encouraged the multiple interpretations that come from broad participation but also brought with it all the difficulties of forging consensus and understanding. The uncompromising personalities of many irregular health leaders only made this more challenging. Despite their own internal differences, regular healers managed to create and sustain a unified front by the late nineteenth century, largely behind the increasing power of the American Medical Association, that allowed them to benefit from irregular medicine's disarray.

Regular doctors proved in many ways to be better chameleons than irregulars. They incorporated scientific advances as well as the most popular theories and therapies of their rivals and modified their treatments in response to criticism, all without relinquishing their fundamental beliefs. Take the germ theory, a discovery that both regulars and irregulars struggled to interpret through their philosophical frameworks. Until late in the nineteenth century, regulars tended to be skeptical of the germ theory's validity. Many ignored it and continued to credit disease to miasmas, atmospheric factors, and spontaneously generated pathogens. After much debate and accumulating
evidence, regulars finally came to terms with germs by asserting that they had always believed disease came from outside the body even if they had previously not known the specifics of the actual entity that caused it. Accepting germs gave regulars a new basis for prescribing drugs and a powerful response to their antidrug opponents. Science now seemed to prove that drugs were, in fact, an effective means of destroying disease-causing germs, even though regulars still had no more idea which drugs worked against specific germs than they had before: those discoveries had not yet come.
⁴⁶