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Therapeutics and Sectarianism. The American Therapeutic Contradiction. WE LOVE The most complicated, intrusive, body-transforming technologies, surgeries, and drugs WE ALSO LOVE Nature’s simple laws of health, righteousness, and hygiene. Pathological Presumptions.
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The American Therapeutic Contradiction • WE LOVE • The most complicated, intrusive, body-transforming technologies, surgeries, and drugs • WE ALSO LOVE • Nature’s simple laws of health, righteousness, and hygiene
Pathological Presumptions • The Phenomenological Problem: How do we perceive the bodily interior? • The seat of the soul, emotional life, intellect? • The wandering of the womb • Solid or liquid: the body dead vs the body living • Doctrine of sympathies vs seat of disease • How do you discern health? Primitiveness of diagnostic technology • Humoralism • Solidism – the structures and fibres • Empiricism: the body as a black box • Brunonianism (1790s): sthenic and asthenic states
Classical therapeutics • Individualized medicine • Disease specificity (to the individual), not specific disease – Rosenberg’s “ metabolic gyroscope” • Helping, managing disease: disease as natural process • Place • Season • Life stage • Problem of driving the disease inward • Healing within divine governance; healing as communion
Classical concepts • Naturales • Vis medicatrix naturae • Contranaturalales • poisons • Six things non-natural • Exercise • Diet • Air • Passions of the mind • Excretions and secretions • Sleep
Types of medicines • Supportives • Tonics – bark • Cordials, wine, cod liver oil • Depletetives • Emetics • Cathartics • Alteratives
Therapeutic regimes: physic to operate, ease, and comfort • Herbals • Simples -- lobelia, senna • Compounds -- theriac • Chemicals • Calomel • Tonics, etc. • Wine, bark • Phlebotomy • Venesection, leeching, scarification, cupping • blisters, poultices
Heroic therapy – Benjamin Rush (1745-1813), 1790s • The power of the American constitution • 100 leeches, 75 grains opium, 1 pound calomel • Heavy venesection • 40-50 oz. Blood • Bleed to syncope, then leech • WHY? • Cultural unity: exhibition of the medicine • What is our modern heroic therapy?
Sources of therapeutic nihilism • Pathological-anatomical correlation and the doctrine of disease universality (specific diseases) • The numerical method (therapeutic statistics and the presumption of universalism) • Physiology (pathology) at the expense of therapy • From medical communion to elite (Calvinist?) exclusivity • Holmes: damning of medicines, health (or death) through nature • The faith of the placebo • “The principal influence … of materia medica …drugs supply material upon which to rest the mind while other agencies are at work in eliminating disease from the system.” (quoted in Rosernberg, 19) • 2007: the attractiveness of clinical trials
Natural to Normal:The rise of universalism • We are all the same; if the standard dose doesn’t work, whose fault is that? • “In a sense, almost all drugs now act as placebos, [ex. Diuretics, etc.]… the patient experiences no perceptible physiological effect.” (Rosenberg, 21)
Sectarianism: the first wave To 1870
Reasons for sectarianism • Triumph of medical Licensing by 1830; the fall of medical licensing by 1850 • The period: “know nothingism,” millenarian (slavery) issues; the “great disappointment” • Pleasure over pain; health-orientation vs disease-orientation • Evidence of regular-induced deaths • Jacksonian populism • Religious expression • Medicine as cultural style • Medicine as existential statement
Sects or Quacks? • Empricism vs. “exclusive dogma” • “nature speaks to me alone” • Single cures • Single secret cures • Antinomian character – in a sinful world, only through me… • The AMA’s 1847 consultation clause
Thompsonianism • Samuel Thompson 1769-1843 • Indian pukeweed lobelia • Pyramid scheme and family licensing system: $20 • The problem of a democratic medicine • Can there be progress in botanic medicine? • Can there be expertise in botanic medicine? • Beechite and Eclectic versions Image: http://commons.wikimedia.org/wiki/File:Koeh-218.jpg
homeopathy • Samuel Hahnemann (1755-1843) • The doctrine of similars • The analogy of similars • Vaccine? • The theory of similars • The doctrine of potentization • Proofing as a clinical science • Constituency • German Americans, the Boston elite • Opposition: fraudulent? Unproved? Implausible? Image: http://commons.wikimedia.org/wiki/File:Samuel_Hahnemann_1841.jpg
hydropathy • Vincent Priessnitz (1799-1851) • Water as • cold, force, solvent, diluent • + exercise, vegetarianism • Mens sana corpore sano • Water as the essence of purity • European spas and hydropathy vs American hydropathy • Joel Shew, Russell Trall The Water Cure Journal • Harsh water or harsh regimen Image: http://commons.wikimedia.org/wiki/File:Vincenz_Priessnitz,_supporter_of_hydrotherapy.jpg
Grahamism • Sylvester Graham (1794-1851) and his cracker • No booze, no smokes, no meat, no sex, and NO WHITE BREAD • If a little moderation is good, a lot of moderation is better • No pain, no gain • Galen + Calvinism = Grahamism • Original sin can be overcome; all can be saved; eternal life is at hand • Attraction to the reformist left • Emancipation and social renewal • The narrow road of righteousness • Women’s health and (sexual) freedom • Amelia Bloomer and the dress reform movement
Sylvester Graham Mary Gove Nichols hygieotherapist Image: http://en.wikipedia.org/wiki/File:Graham.JPG Image: http://www.soilandhealth.org/02/0201hyglibcat/020125shelton.pristine/020125ch52.htm Page images courtesy of The Open Library.
Hoop skirts and tight lacing Image: http://en.wikipedia.org/wiki/File:Bloomer.gif Image: http://commons.wikimedia.org/wiki/File:Ball-Gowns-Pauqet-early-1860s.jpg Bloomers (the American costume) Nature’s waist?
High tech intervention Quick cures Botanical Thompsonian Allopaths 1800 1870s Eclectics Beachites 2nd generation, Osteopathy, chiropractic profession lay hygeiotherapy 1870s hydropaths Grahamite Christian Science Adventism homeopaths 1920s Nature: Slow, constitutional, health cultivation
The influence of the sects • Assimilation of Homeopathy into the AMA, 1882 (NY Medical Assn) to 1903 (AMA acceptance) • Ohio State – Beechite • Hahnemann Hospital and Medical School (now Drexel Med Sch) – homeopathic • University of Michigan Medical School – partially homeopathic • Emergence of new sects 1870s-1880s: Christian Science, chiropractic, osteopathy