The History of Alternative Medicine in America

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The History of Alternative Medicine in America

• Hughes Evans

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Alternative Medicine today

• Increasing use
• Increasing visibility
• Increasing research

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19th C Alternative Medicine

• Many medical sects emerged and challenged
  allopathic medicine
• Thomsonianism
• Eclectic movement
• Hydropathy
• Most died out

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Why were 19th C medical sects popular?

• Period of self-reliance
• Jacksonian democracy
• Skepticism about regular or allopathic
  therapeutics
• Flourished in rural areas and on frontier
• Important tradition of using local healers,
  domestic manuals

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Popularity

• Flourished 150-200 yrs ago
• Dramatically decreased in popularity
• Now on upswing
• Why?

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Alternative Medicine Today

• Homeopathy
• 19th century sect w/ resurgence
• Osteopathy
• From sect to parallel profession
• Chiropractic
• others

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Heroic Medicine

• Blood letting
• Purgatives
• Emetics
• Sialogogues

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Homeopathy

• Largest unorthodox sect in 19th c
• Samuel Christian Hahnemann
• German physician
• Translated classical medical texts
• Rejected allopathic medicine
• Brought to US in 1825

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Principles of homeopathy

• Law of similars
• Disease could be cured by drugs that produce
  symptoms found in those who are sick
• Used provings
• Law of infinitessimals
• The smaller the dose the more effective in
  stimulating the bodys vital force
• Succussion
• The vial containing the drug must be struck
  against a leather pad after each dilution

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Homeopathy

• A new system of medicine
• Employed an experimental pharmacology
• Self-experimentation or provings
• Initially popular in Europe
• Spread to USA

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Success of homeopathy

• 1844 1st national homeopathic medical society
• 1848 Homeopathic Medical College of Pennsylvania
  (now Hahnemann)
• 1860 2399 homeopathic physicians in US
• 1880s homeopathic medical schools in most major
  cities

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Who became homeopathic drs?

• Most were once orthodox MDs
• Attracted to scientific approach
• Believed in bodys Vital Force
• Appealed to Transcendentalism and American
  intellectuals
• Opportunity to treat yourself
• Marketed via domestic kits and guides

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• Homeopathic kit

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Challenges to homeopathy

• 1860s and 70s heroic medicine waning
• Hard to be pure homeopath
• Extremely detailed PMH
• Drug and dose tailored to every symptom
• Homeopaths tended to be eclectic
• adopted elements of allopathic medicine,
  naturopathic remedies, etc.
• Early 1900s unification of homeo- and allopaths
• Flexner report led to closure of all but 4
  homeopathic medical schools

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Homeopathy today

• Many practitioners are laymen
• Some are allopaths, naturopaths, chiropractors
• Popularity in Europe, esp. Germany
• Regulation does FDA have jurisdiction over
  homeopathic medicines?
• If so, how to prove effectiveness
• Is something so dilute a drug?
• Marketed differently than allopathic med

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Osteopathy

• Andrew Taylor Still
• Son of pioneer dr and Methodist minister
• Frontier physician
• Kansas
• Apprenticeship
• Children died of meningitis
• 1874 conceives of osteopathy
• Itinerant physician

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• Created alternative to allopathic medicine
• Human body like a machine Ought to function well
  if mechanically sound
• Treat body by improving natural functions

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Osteopathy principles

• Believed drugs were immoral and useless
• Used early on, then condemned use
• Influence of magnetic healing
• Metaphor of man as a machine
• Health as unobstructed flow of fluid
• Magnetism magnetic energy
• Still blood
• Use of spinal manipulation
• Disease due to obstruction/imbalance in fluids
  caused by misplaced bones

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• American School of Osteopathy, 1892
• Kirksville, Missouri

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• American School of Osteopathy

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Osteopathy landmarks

• 1892 American School of Osteopathy founded
• By 1897 700 students enrolled in osteopathic
  schools
• 1897 American Assn for the Advancement of
  Osteopathy
• Becomes American Osteopathic Assn in 1901
• Creates educational standards
• Early 1900s creation of osteopathic hospitals
• From medical sect to parallel profession
• Currently used by gt25 million Americans

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Osteopathic Medicine
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Challenges to osteopathy

• 1920s begin to teach supplementary therapeutics
  (pharmacology)
• Had to integrate new scientific knowledge
• Legitimate medical education requirements
• 1960s and 70s require bachelors degree
• 1950 court decision established DOs right to
  practice medicine in allopathic hospitals
• Full practice rights in all states achieved in
  1973

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Chiropractic Medicine

• 1895
• Daniel David Palmer
• Iowa
• Cheir hand
• praxis practice
• First patient
• Deaf janitor

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Chiropractic Medicine

• Disease joint-oriented nerve interference
• Obstructs flow of innate intelligence
• Innate Intelligence
• Regulates all vital functions as it flows through
  CNS
• Connects man the spiritual to man the
  physical
• Remove nerve interference caused by subluxations
  so that innate intelligence can maintain health
  and bodily equilibrium

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Chiropractic education

• 1896 opened Palmer School and Infirmary of
  Chiropractic
• 6 month course
• Largest training school for health practitioners
  in the US, graduated 1000 in 1921
• Taught anatomy, physiology, pathology,
  toxicology, diagnosis, obstetrics, nerve tracing,
  palpation, chiropractic philosophy
• Many short-lived schools
• Often combined philosophies

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• Palmer School and graduates

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Chiropractic appeal

• Energetic and charismatic leader
• Merchandising skills
• Admitted women and minorities

BJ Palmer, son of DD Palmer
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Chiropractic medicine in 20c

• practitioners grew
• AMA campaign
• Chiropractic must die
• 1930s Demise seemed near
• WWII
• resurgence w/ returning vets
• 1950s 4 year course
• 1965 National boards

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Chiropractic popularity

• Over 7.5 million American used chiropractic in
  last 12 months (1974)
• Strongest in Midwest and West weakest in South
• Middle income adults
• 1972 Congress legislated that Medicare cover
  chiropractic

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AM Increasing popularity

• Used by gt40 Americans
• Usually in conjunction w/ allopathic medicine
• 80 dont tell their doctors
• 1990 425 million AM visits
• More than visits to allopathic MDs
• 1993 1.5 billion spent on herbal remedies
• 1998 NCCAM founded
• Worldwide 80 use herbal medicine
• Ayurvedic, naturopathic, traditional med

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Appeal of Alternative Medicine

• Chronic disease
• Access to worldwide health information
• Decreased tolerance for paternalism
• Emphasis on quality life
• Declining faith in scientific advances
• Availability

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Increasing popularity, contd

• Interest in spiritualism
• Concerns about
• adverse effects of conventional health care
• escalating costs of health care
• Belief that Alternative medicine ministers to
  individual needs

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Are there risks to embracing AM?

• Quality of Care
• Governing of licensure, education, scope of
  practice, certification, etc
• Quality of Products
• Natural products are largely unmonitored and
  uncontrolled
• Dietary supplements outside FDA purview
• Quality of Science
• ?hypothesis driven, peer review, research

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What does AM offer?

• Attend to illness and suffering
• Spend time w/ patients, individualized therapy
• Promote self-care, empowerment, participation in
  healing process
• Minimize adverse effects kinder, gentler
• Focus on self-healing
• Lower costs
• Can convince patients to make lifestyle changes
• Oriented toward health promotion