Medicine, Alternative

MEDICINE, ALTERNATIVE

MEDICINE, ALTERNATIVE. Alternative medical practices have arisen in or have easily been transported to the United States, where social values and political infrastructure have encouraged many forms to flourish. The pervading American value placed in persons having autonomy with respect to making decisions over their own bodies; the skepticism toward any professional group having a monopoly on a given field; and Article 10 of the U.S. Constitution, which reserves to each state the exclusive power to set standards, make rules, and license practitioners in their jurisdictions, have enabled the public and small groups of unorthodox practitioners to shape laws that limit the powers of the dominant orthodox medical profession and protect the interests of alternative minority groups. In Europe and most other countries, licensure and medical policy are centralized, and alternative practitioners and their supporters must win one large battle to gain political recognition or face being marginalized. In the United States, alternative medical movements have been able to fight simultaneous battles in several states, winning some and using those successes to institutionalize, build followings, set standards, and continue their struggles in other jurisdictions.

Although alternative medicine has existed throughout the country's history, the greatest growth of alternative medical movements occurred during three eras, when more broad-based social ideologies nurtured the philosophical premises and political aims of such movements. These ideologies were Jacksonian Democracy (roughly the 1820s to the 1840s), populism (1880s–1910s), and New Age thought (1970s–1990s).

The Era of Jacksonian Democracy

President Andrew Jackson and many of his followers trumpeted the virtues of "the common man, " feared large centralized institutions, and had a distrust of professionals, particularly when the latter sought special privileges or exclusive rights based upon expertise to practice in fields traditionally open to those with or without formal training. Consistent with these beliefs, three large alternative medical movements arose during this time.

Samuel Thomson, a self-trained root doctor from New Hampshire, believed that all disorders were caused by obstructed perspiration. He argued that fever was the body's effort to eliminate disease and that orthodox physicians, with their bleedings, blisterings, and use of drugs like mercury, arsenic, and antimony, were jeopardizing the lives of patients and causing many deaths. Thomson believed anyone could treat disease using six classes of remedies consisting of botanical drugs and the steam bath, all designed to produce great internal heat, eliminate the cold, and allow the body to reestablish its natural balance. Thomson wrote a popular book, prepared kits of his medicine, sold individual rights to his practice, and encouraged followers to defeat or repeal medical licensure laws that restricted the practice of medicine to formally trained physicians. Although Thomson was antiprofessional, other alternative groups that employed a wider range of botanical drugs emerged, including Eclectic Medicine, which established schools, journals, and hospitals and won status for its practitioners as physicians.

The second major group of medical reformers, part of the so-called popular health movement, believed that physicians were largely unnecessary because most diseases could be prevented by individuals adopting healthy habits. The most prominent American lecturer and writer in this movement, Sylvester Graham, maintained that disease resulted from excessive stimulation of the tissues. Any food that caused too much stimulation had to be avoided, including tea, coffee, alcohol, pastries, and all fleshy meats. Graham also used the doctrine of overstimulation to warn of the powerful dangers of too much sexual energy. Eating meat, he argued, produced a heightened sex drive, which was health destroying. One of his innovations was a cracker that still bears his name, which was initially designed in part to discourage overstimulation of this type.

The most significant European import during this era was homeopathy, a system of practice originated by the German physician Samuel Hahnemann. Brought to America in the 1820s, homeopathy encompassed two essential principles. The first principle was that the drug best able to cure a given illness would be that which could produce the symptoms of that illness in a healthy person. The second principle was that the smaller the dose, the more powerful the effect. One active part per hundred was shaken in a vial, and one part of that solution was mixed with another ninety-nine inactive parts, and so on, usually thirty times. By the end of the nineteenth century, homeopaths constituted 10 percent and the eclectics 5 percent of the physician and surgeon population in the United States.

The Era of Populism

Midwestern populism encompassed a distrust of large East Coast–controlled businesses and institutions, a belief that elites had gained too much power, and a sense that common people had too little say in shaping government and law in their own interests. As opposed to Jacksonian Democracy, many populists were not against creating laws governing the professions as long as the interests of competing groups were protected. In the 1870s and 1880s, new medical licensure laws were enacted; however, homeopathic and eclectic physicians were given the same rights as orthodox physicians. Challenging this hegemony were two groups—osteopathy and chiropractic.

Osteopathy was founded by Andrew Taylor Still, an apprenticeship-trained Midwestern physician. Still, who had practiced for a time as a bonesetter, believed that disease was the result of an obstruction or imbalance of the fluids caused by misplaced bones, particularly of the spinal column. These misplacements could be corrected through physical manipulation. He established an infirmary and school in Kirksville, Missouri, in 1892. Still's followers relatively quickly gained some measure of legal protection, established other colleges, and gradually expanded osteopathy's scope of practice to incorporate drugs and surgery. Eventually, D.O.s (doctors of osteopathic medicine) won equal rights along with M.D.s as full-fledged physicians and surgeons in every state and equal recognition by the federal government. As homeopathic and eclectic medicine faded after the beginning of the twentieth century, osteopathy became, and remained, the only equivalent professional rival of allopathic medicine, although the differences between the two groups have faded considerably.

Chiropractic appeared within a decade of the emergence of osteopathy and was founded in Davenport, Iowa, by Daniel David Palmer. Like Still, Palmer believed that diseases were due to misplaced bones. Many early chiropractors or D.C.s (doctors of chiropractic) were initially charged with practicing osteopathy without a license, but they demonstrated to courts and eventually legislatures that their diagnostic and treatment techniques were different. Unlike osteopathic physicians, who grew to encompass the full range of medical training and skills, chiropractors, despite the addition of some adjuncts, continued to center their activities on spinal manipulation and quickly became associated in the public mind with that technique, though osteopathy had historical priority.

"New Age" Thought

Fueled by America's continued participation in the Vietnam War and frustration with the perceived failure of government to produce meaningful change consistent with their own beliefs, a growing number of middle-class Americans in the 1970s shifted their attention from reforming society by legislative action to focusing on the potential for personal improvement. Drawing upon the rich traditions of other cultures, and often incorporating metaphysical and spiritual understandings of the basis and meaning of life, millions of Americans turned to a variety of disparate health beliefs and practices, including traditional Chinese and Ayurvedic medicine; crystals and scented candles; rolfing and other body treatments; imaging and other psychological interventions; alternative diets; herbs, vitamins, and other supplements; and a rediscovery of homeopathic and botanical remedies. By the end of the twentieth century, more money was spent by Americans on alternative practitioners and remedies than on visits to the offices of conventional primary care physicians.

This movement also reflected a growing frustration with the way orthodox medicine was practiced. Too little time was spent listening to patients, and while science had contributed to the treatment of acute diseases, many patients with chronic illnesses wanted more relief from their conditions than conventional physicians could provide. The number of alternative treatments that became available provided patients with new choices and new hopes. Experience by physicians with some of these modalities, and later research indicating value in some forms of alternative treatment, encouraged a growing number of conventionally trained physicians to incorporate these methods under the banner of "holistic" or "integrative" medicine. The continued popularity of these most recent forms of alternative medicine will, as in earlier periods, depend not only on the perceived efficacy of the respective practices over time but also on the broader social trends and ideologies that facilitated the emergence and growth of these practices.

BIBLIOGRAPHY

Berman, Alex, and Michael A. Flannery. America's Botanico-Medical Movements: Vox Populi. New York: Pharmaceutical Products Press, 2001.

Gevitz, Norman. The D.O.'s: Osteopathic Medicine in America. Baltimore: Johns Hopkins University Press, 1991.

———, ed. Other Healers: Unorthodox Medicine in America. Baltimore: Johns Hopkins University Press, 1988.

Haller, John S. Medical Protestants: The Eclectics in American Medicine, 1825–1939. Carbondale: Southern Illinois University Press, 1994.

Kaufman, Martin. Homeopathy in America: The Rise and Fall of a Medical Heresy. Baltimore: Johns Hopkins University Press, 1971.

McGuire, Meredith. Ritual Healing in Suburban America. New Brunswick, N.J.: Rutgers University Press, 1988.

Moore, J. Stuart. Chiropractic in America: The History of a Medical Alternative. Baltimore: Johns Hopkins University Press, 1993.

Whorton, James C. Crusaders for Fitness: The History of American Health Reformers. Princeton, N.J.: Princeton University Press, 1982.

Norman Gevitz

See also Homeopathy ; Medical Profession ; Medicine and Surgery ; New Age Movement .