Uneven Paths to Health and Healing: Medicine, Politics and Power in 19th Century America

Abstract

Medicine and healing in the United States in the 19th century was a pluralistic mosaic of allopathic medicine, neoteric systems of homeopathy and osteopathy, faith-based systems of Christian Science and Seventh Day Adventism, Grahamism, water cures, and patent medicines. The therapeutics of allopathic medicine in the 19th century were venesection, purgatives, and heavy metal medicines, which were used in escalating or “heroic” dosages with significant toxicities and limited clinical benefit. The non-allopathic healing systems arose from allopathy’s inability to effectively address the medical needs of the rapidly growing, highly diverse, and geographically dispersed American population. In this pre-scientific age, non-allopathic healing systems arose from the sociocultural environment, health normative values, and religious beliefs of the day and offered less invasive, less injurious, and potentially more efficacious therapeutics than did allopathic care.

This study is a synchronic historiography focusing on a 100-year period in American history, reflecting the scientific knowledge available at that time and based on first-person accounts by key clinicians of the age. Traditional presentist medical histories focus on scientific achievements and historically erases individuals not contributing directly to 21st-century biomedicine. This work, written from a contextualist perspective recognizing the significance of the non-allopathic healing systems, reinserts into the historical medical narrative contributions by all healers, especially women and the marginalized.

The core belief structure and the contribution to healing and wellness are elucidated for each healing system. The evolution of medical pluralism over the century is documented, as is the impact on 21st-century medicine. The major findings of the study challenge the belief that scientific advancements were responsible for the decline of non-allopathic healing systems, as the science of the late 19th century did not translate into the introduction of significant new medicines for another three decades. Rather, the Flexner Report, under the direction of the American Medical Association with funding by the Carnegie and Rockefeller Foundations, created sociocultural, financial, and legislative pressures resulting in closure of non-allopathic medical education facilities as well as women’s and Black allopathic medical schools and led to medicine and healing becoming a White-, male-dominated allopathic profession for the next seven decades.