When the United States was first founded, the urban centres from New England to the Southern Coast line boasted a small numbers of doctors who would have been trained in Europe and, more specifically, in England. Americans journeyed to European medical centres to study medicine and over time American?born European?trained doctors worked in the emerging American cities. This early medical community led to what would become the American medical establishment ? one rooted in European medical theory and practices and European remedies. During the Renaissance, in 15th century Europe, ancient Greco?Roman works came alive again along with their ideas and remedies. Two types of medical practices developed: the old world herbal tradition that nurtured vitality, and a tradition that relied on contraries for cures. Hippocrates had said, “All diseases which proceed from repletion are cured by evacuation; and those which proceed from evacuation are cured by repletion. And so in the rest, contraries are the remedies of contraries.” The 15th century medical axiom contraria contrariis opponenda in which medicines oppose the symptoms of disease grew out of Hippocrates? idea. Proponents of this tradition used blood letting to reduce body temperature and pulse, purgatives to end constipation, and treated hot inflammations with cold applications. (22) Paracelsius, born in 1506, discovered that minerals could be used to counteract symptoms. He found that substances like mercury, given in high doses, would bring down a temperature and a rapid pulse associated with an infection. With this discovery, lead, arsenic, gold, and other toxic minerals came into common medical practice. (23) Indeed, opposing symptoms with medicines became the dominant medical tradition in Europe, and then in America. By the mid 19th century, the American medical establishment felt disease was caused by an excess of vitality and, if vitality could be reduced, diminished, or drained off, health would return. To diminish vitality physicians bled, purged, burned, leeched, and poisoned patients with mercury, arsenic, and lead. For example, when body temperature rose due to a bacterial infection, blood letting was “the Magnum Bonum Die, The Great Gift of God”(1); it efficiently reduced body temperature. Indeed, bleeding a patient to the point of heart failure was an acceptable means of reducing body temperature according to the established medical practices of the time. Though most 19th century American physicians believed that excess vitality was the cause of disease, a small group of New York physicians did not. This band of medical doctors, organised by Wooster Beach, felt the theory was flawed and treatments based upon it harmed more than they helped. One of Beach’s early followers said this of the medical establishment’s philosophy and treatments based therein: “The results of this practice, and the theory upon which it was based, were very unsatisfactory, especially to the people who had to suffer the penalty?in many cases loss of useful lives, in others constitutions broken down, the patient being but the wreck of his former self.” (2) In fact, these renegade doctors rejected more than the medical establishment’s theory of disease. They rejected the practices that sprang from the theory. “We reject, in Toto, the most pernicious features of old school practice. The habitual internal use of certain intensely poisonous metals, as mercury, antimony, arsenic, lead, copper, etc., we consider a gross violation of the dictates of medical philosophy and experience?an egregious delusion which has bought millions to a premature grave, and which, at the present time, maintain an immense amount of human suffering among the living.” (2) Poisoning patients, with the aim of depleting vitality, was unacceptable to the Eclectics and they made this clear to anyone who would listen. As the American population moved westward, and pioneer settlements developed, formally educated doctors were in short supply. The vast majority of doctoring was undertaken by men and women with an interest or a talent in healing. Some had been to school, most had not. Lay doctors and European doctors alike had to work with indigenous plants when the European medical supplies ran out or were unavailable. Frontier doctors interacted with Native Americans, who had vast knowledge of the medicinal properties of local plants, and came away with valuable knowledge of their pharmacopoeia. Moreover, exposure to a different people who saw and descried the world and its workings in a different way changed the face of frontier medicine. New ideas entered the practice of medicine. Without the confines of organised society, there was intellectual freedom on the frontier. The dissenting physicians of the East Coast, shunned by the medical community after publicly accusing the establishment of murdering patients with their harmful practices, chose to abandon the establishment’s theory of disease and their treatments. They left the “civilised” world for the frontier territories where they could practice their form of medicine in relative peace. These physicians became known as the Eclectics or the “ones that chose.” They called themselves Eclectics because they chose a different disease theory and different remedies: “The term Eclectic, is derived from a Greek word which signifies to chose; we use it, however, in both the past and present tense?we have chosen, we are constantly choosing.” (2) The free?thinking Eclectics called themselves new school and reformers. The medical establishment became known as allopath?s, regulars, orthodox, old school, and majority school; they referred to Eclectic physicians as sectarians, quacks, pretenders, irregulars, and unorthodox. (17) For some time these two groups co?existed. The reformed form of medicine, known as the Eclectic medical movement, existed, in various forms, from 1825 and until 1939. The Eclectics opened “The Eclectic Institute of Medicine” in the frontier territory of Ohio, near a growing town called Cincinnati. It operated from 1848 until 1930. The Eclectic Institute trained physicians in the application of tonics of botanical origin and researched and studied botanical drugs. They encouraged their students and practitioners to continually choose the best remedies based on evidence at hand. The Eclectics had access to hundreds, if not thousands, of American medicinal plants, many of which they learned of from Native Americans and some of which they discovered by accident. In fact, the Eclectics conducted a significant screening of the medicinal plants of North America. King’s Dispensatory, the Eclectic pharmaceutical bible, contains thousands of listings of medicinal plants along with what the Eclectics found to be true for these botanical drugs. John S. Haller Jr., PhD, an American medical historian and professor of history at Southern Illinois University at Carbondale, has spent his career documenting the medical experiments that took place in America. Dr. Haller has researched and written on the free thinking medical movements that flourished in the unrestrained American landscape, the Homeopaths, Eclectics, Osteopaths, and Thomasonians included. Among his many other titles, Dr. Haller is author of American Medicine in Transition, 1830?1910, Medical Protestants: The Eclectics in American Medicine, 1825? 1939, Kindly Medicine: The History of Physio?Medicalism in America, 1836?1911, A Portrait in Alternative Medicine: The Eclectic Medical College of Cincinnati, 1845?1942, and The People?s Doctors: Samuel Thomson and the American Botanical Movement, 1790?1860. In his book, Medical Protestants: the Eclectics in American Medicine, 1825?1939, Haller has these introductory words to say about the Eclectic medical movement: “In the freshness of its youth, the eclectic school of reform medicine stood as a symbol of America’s optimism, imagination, enthusiasms, and eccentricities. Of solid Yankee inheritance, the school represented a powerful statement of the fraternity that its adherents felt with the great world movements of thought. In their writings, the eclectics portrayed themselves as authentic Protestants, saving therapeutics from the errors and extravagances of orthodox medicine. Along with homeopaths, they saw themselves as offering a viable alternative to those in the early decades of the nineteenth century who had wearied of allopathy’s pretensions and failures. Having fostered a revolutionary challenge, they hoped to redress the shortcomings of orthodox practice with proof of their botanic successes, directing attention to the simpler and less drastic form of medicine. Although scornfully rejected by regulars, the eclectics imitated their magisterial air, for a score of years and in two dozen colleges and more than sixty? five journals, they asserted the wisdom of their theory and maxins of reform practice.” (18) Over its one hundred year span, many doctors were trained in and practiced Eclectic medicine. Indeed, as the following graphs indicate, the Eclectic movement was not an insignificant movement nor was it comprised of a insignificant number of physicians. Likewise, the data left behind by the physicians is rich in knowledge and plentiful.
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Orthodox medicine practiced heroic medicine. As mentioned earlier, the treatments for “excessive vitality” were often more frightening than the disease. Not surprisingly, these practices did not often yield favourable results. Indeed, the general public began to seek out the services of the non?orthodox medical providers who offered an alternative to allopathic practice. Michael Flannery, former Library director of the Lloyd Library and adjunct professor at Northern Kentucky University, has studied the Eclectics extensively. Flannery writes: “Eclecticism can be briefly described as a nineteenth century sectarian medical movement emerging out of Americans dissatisfaction with the harsh heroic therapies characteristic of regular (also referred to as allopathic) practitioners. Distrustful of European ideas and institutions, eclectics promoted botanical remedies drawn primarily from America’s fields and forests rather than the chemical and mineral concoctions that formed much of the allopath’s armamentarium.”(19) Dr. Haller, speaking of the core values of Eclectic reform movement in Medical Protestants, writes, “At the heart of the sectarian medicine was its refusal to submit to the beliefs and pretenses of allopathy.” (20) First and foremost, the Eclectics believed that the practice of medicine should work with the body and never against. In contrast to the allopath’s, the Eclectics believed the object of the practice of medicine was to harness the bodies’ own intrinsic healing capacity and to augment that capacity with remedies. “As we are taught to observe and follow nature’s footsteps in these things, we use our remedies to facilitate what nature might accomplish without our aid. We do the things that she does. We do them in the same order, and we endeavour to do them in the same quiet way. In so far as we work with the vital powers, we are successful; when we oppose them we had better not practice medicine.” (3). In fact, to the Eclectics, injuring a patient with health damaging procedures was a crime. John Milton Scudder, one of the leading Eclectics and author of numerous Eclectic textbooks, writes: “Tartar Emetic, though not resorted to as frequently as calomel, was guilty many times of manslaughter. Thus in the days that I speak of, it was thought that inflammation of the lungs could not be treated without the use of this agent. In proof that it is clearly chargeable with murder, let us examine the statement of Dr. Deitl. In order to show the comparative value of treatment, he reports three hundred and eighty cases of inflammation of the lungs. Eighty five were treated with by blood letting, one hundred and six by large doses of tartar emetic, and one hundred and eighty nine by diet and bed rest alone. Of those treated by blood letting, seventeen or 20.4 % died, of those treated with large doses of tartar emetic, twenty two or 20.7% died; while those treated with by diet and rest, only 15, or 7.4%, terminated fatally. These were cases of similar character and yet we see that the cases being as one hundred and six tatar?emetic to one hundred and eighty nine diet and rest, this agent is chargeable directly with the lives of at least ten persons. We therefore choose to discard this agent.” (21)
The core of the Eclectic’s philosophy was the belief that the body had within it the capacity to heal itself. Called the “Vis conservatrix,” this capacity was variously described as vitality, vital powers, life force and conservative power. The Eclectics felt that if one observed the body and it operations, manifestations of the Vis conservatrix were apparent. One of the early Eclectics wrote: “There is, in organised beings a certain conservative power which opposes the operation of noxious agents, and labors to expel them when they are introduced. The existence of this power has long been recognised and in former days it was impersonated. It was the archaeus of Van Helmont; the anima of Stahl. The Vis medicatrix of Cullen… We see its frequent operation in the common performance of excretion; in the careful manner in which noxious products of the body and offending substances in food are ejected from the system; in the flow of tears to wash a grain of dust from the eye; in the act of coughing and sneezing to discharge irritating matters from the air passages, and in the slower more complicated, but not less obvious example of inflammation, effusion of lymph and suppuration, by which a thorn or other extraneous object is removed from the flesh. This Vis conservatrix is alive to the exciting causes of disease, and in person in full health it is generally competent to resist them. How it resists them will depend upon what they are. For instance, is cold the cause? This throws the blood inwardly, which, by increasing the internal secretions and exciting the heart to increased action establishes a calorific process that removes the cold. Is the cause improper food? The preserving power operates by discharging this speedily, by vomiting or by stool. Is it a malarious or contagious poison? It is carried off by an increase of some of the secretions.” (4) Whether the threat to the body was a grain of dust in the eye or a bacterium invading the tissue, the Eclectics believed the body was capable of neutralising threats to well being. Moreover, this innate power gave the body ability to resist the forces of death and decay. Indeed, the Eclectics believed that the Vis conservatrix was the power behind all the basic physiological functions of which the resistive capacity was merely one. In fact, according to their beliefs, problems with the Vis conservatrix could spell problems with all the basic physiological processes. The Eclectics postulated that disease occurred in one of two circumstances. The first was when the Vis conservatrix was diminished and unable to neutralise a threat to well being. For example, a person in a run down state, encountering an infectious disease, is unable to fight it off. The second circumstance was when the Vis conservatrix was overwhelmed by an unnaturally great threat to well being. For example, a person thrown into sub?zero water will succumb to the cold. “But if this resisting power be weakened, locally or generally, or if the exciting cause be too strong for it, then the cause acts, and disease begins.” (5) In essence, the Eclectics felt that disease occurred when the Vis conservatrix was inadequate to counter the challenge confronting the body. When disease resulted from inadequate Vis conservatrix, the Eclectics’ solution was to administer remedies that would boost the body’s intrinsic healing capacity. By augmenting vitality, the real root of disease was removed. “If we can see clearly that the condition of disease is one of depression, that in proportion as a man is sick, his vitality is lessened, such means as will increase the power to live, or the resistance of the body to death, will be suggested.” (6) Another Eclectic author echoes the same sentiment. “We choose to believe and teach, that a person labouring under disease is actually debilitated from the commencement?that the disease itself is an evidence of depressed vitality… we carefully husband the strength of the patient, until by appropriate remedies we remove the cause of the disease.” (2) The Eclectics were convinced that only remedies that augmented the Vis conservatrix should be used in disease. “The influence of all remedies upon the system must be vital in its nature, though it may depend in some part of its action on its physical condition, or on it chemical properties, its major action is such only as could be exerted in a living body. The class of vegetable remedies exert the least physical or chemical effect upon the system; they appear to act directly upon the vital force of the entire system, or on some particular organ or parts.” (7) They rejected any medical treatment that depressed the Vis conservatrix believing the administration of such remedies was likely to cause or worsen disease. “It is a cardinal principle of the Eclectic system, that no medical treatment should be allowed which permanently impairs or injures the vital powers; that no such treatment is, in any case, necessary or proper, and that in the choice of remedies, we should prefer those which are safest, and calculated to act most nearly in accordance with the laws of health.” (2)
The Eclectics called drugs that increased the Vis conservatrix “tonics.” One Eclectic defined tonics as those agents that heightened or augmented vital action. (3) Indeed, tonics became the pillars of Eclectic medicine. A good description of a “tonic” can be found in an 1858 text of Dr. John Scudder who was largely responsible for the isolation of botanical tonics. He writes, “we may say in reference to this class of agents, that their use is indicated whenever the system is depressed below its normal level. They act directly in support of the vital force, and not as is the case with stimulants to produce merely nervous excitation; they therefore assist nature in the removal of the disease. ‘Tonics,’ says Headland, ‘are among the most useful of all medicines. And it is certainly not the least of their recommendations that we can seldom or never do harm by their use. They are remedies, but not poisons. Many a man has been killed by opium, many a constitution ruined by mercury, but it has never been known that quinine has done the one or the other.’” (8) The Eclectics felt that tonics had an almost universal applicability—whenever the healing capacity of the body was needed, tonics could be used to stimulate the process. And, very importantly, they did no harm in the process. When a patient was displaying a deficiency of Vis conservatrix, as in general debility or in the debility following an acute illness, tonics were used to boost the recuperative capacity. “In all cases of asthenia they are indicated, unless it be connected with some local inflammatory affection that would be aggravated by their use. They become important agents in the advanced stages of most of the acute diseases, after fever has subsided, and when high inflammatory action no longer exists; in such cases they enable the system to throw off the disease; and render convalescence much shorter.” (8) In other words, tonics were used to boost the Vis conservatrix when the body was resisting infectious disease be it bacterial, viral, or protozoan. When an infectious agent represented a force greater than the Vis conservatrix, life was threatened. Again, tonics were used to boost the preservative force so that it was sufficient to overcome the infectious agent. “In adynamic fevers, as typhus gravior, scarlatina maligna, gangrenous erysipelas, or in any case where there is a tendency to gangrene or putrescency, they are agents of the first importance. In small pox, where the vital powers are much prostrated, in carbuncle, scorbutis, scrofula, and other similar affections, their employment constitutes an important part of the treatment.” (8) Tonics were used to boost the Vis conservatrix in chronic infectious disease as well. As in the case of Malaria, once acquired, the infection would revisit the patient. “In diseases marked by a periodic character the most powerful tonics are administered. Some of them are supposed to possess antiperiodic in addition to their “tonic” properties, and are therefore called anti?periodics. The cinchona and its alkaloids principles are examples of this kind… Why certain agents of this class exert this peculiar anti?periodic property we are unable to explain, any more than we are why some causes produce periodic fever; the fact, however, is evident that some of them possess a power over this form of disease that is not possessed by others of the class.” (8) Tonics were also used to reduce susceptibility to a secondary disease when a patient was already resisting a disease. The Eclectics felt that while the Vis conservatrix was resisting one outside force, the body had less resistance to other outside forces. For example, when infected with the influenza virus, the body produces excess mucous, which in turn makes a person more susceptible to bacterial infections (tonsillitis, bronchitis, pneumonia, etc.) In fact, most people do not die from influenza but rather from one of these secondary infections. Indeed, the Eclectics found that diseased people were less vulnerable to secondary disease when tonics were used. “Debility of a single organ or of the entire system, predisposes to the morbid influences of surrounding causes of disease, as the infection of certain contagious diseases, changes of temperature causing the retention of a customary secretion, the morbid effects of miasmata, etc. Tonics aid the enfeebled energies of the system in warding off these extraneous causes of disease.” (8) Tonics were also prescribed to increase the power and force of all basic body functions. The Eclectics had observed that when the Vis conservatrix ran low, the basic body functions become weak; the pulse weakens, the body temperature decreases, nervous energy is poor, digestive function becomes marginal, and the muscles grow weak. In the case of extreme debility, the pulse becomes weaker and weaker until it disappears. When tonics were administered, the Eclectics noticed, basic body functions became more forceful and powerful and displayed increased vitality and renewed vigour; the pulse became strong, the body temperature normal, nervous and muscular strength returned. To wit: “Tonics are medicines which produce a permanent exaltation of the energies of the general system, without materially increasing the vital manifestation in any particular organ. They give tone to the muscular system without increasing the temperature of the body or rapidity of the circulation, producing no immediate and marked excitement like stimulants. Their influence is manifested by a very slow and permanent exaltation of organic action, evinced by an increased force of the circulation, and increased muscular power. The heart contracts with more force, but its contractions are not increased in frequency; the pulse acquires fullness and firmness, and loses that soft, flaccid, and atonic character which is a manifestation of debility. They increased energy which they impart to the nervous system, the impetus which they give to the circulation and the improvement in the digestive functions, together with the increased secretion and absorption which they effect, are among the many evidences of their sanative powers.” (8) The Eclectics noted that the stimulating effect of tonics extended beyond stimulating the basic body functions. Once absorbed and released into circulation, the Eclectics found tonics had the capacity to stimulate vital action in every cell, tissue, and organ of the body. “All of this class of agents are readily soluble in the fluids of the body, and hence are absorbed into the circulation, and act from it upon every part of the system. We have already seen that they exert a “tonic” and strengthening influence when topically applied to the stomach; and we may notice a similar influence, from the application to indolent ulcers, wounds, etc., when applied so that we can notice their effects. If this is the case then, that they impart strength and “tonic” when brought into contact with the tissues, as it undoubtedly is, we have a solution of their effects after absorption. The circulation conveys them to every part of the system, they are brought into contact with every fibre and every cell; and if they act in the circulation as they do when topically applied, they give new energy and tone to every part.” (8) The Eclectics had also observed that when the body was labouring under the stress of a destructive force (infection, cold, hardship, etc.), physiological functions often displayed excesses or shortfalls. They noticed that tonics had the ability to normalise these excesses or shortfalls regardless of which direction the abnormality took. “Very peculiar, and apparently very dissimilar effects upon the secretory organs and tissues follow from the use of tonics, under different pathological conditions of these organs and tissues.” (8) For example, tonics could be used to arrest excessive secretion when the organs and tissues were in a state of over activity or production. “When the secretions become abnormal and super?abundant, from an atonic state of the secretory organs, this class of agents have the power to restrain and control them. Thus, if the cutaneous exhaltation becomes superabundant from debility, as is the case in the advanced stages of phthisis, typhus, and typhoid fever, etc., tonics often promptly restore the tone of the system and arrest it. Also, in phthisis and other diseases of the respiratory apparatus, when the secretion from the lungs becomes excessive from debility, and when this discharge would tend to increase that debility, tonics, combined with astringents, are of much value in arresting the secretions. The same remarks apply to diabetes, chronic diarrhoea, leucorrhea, menorrhagia, passive haemorrhages and passive dropsies; in all of which cases tonics will be found important auxiliary agents in restraining the morbid discharges. In the ‘night sweats’ of debilitating diseases, they are often of much advantage, strengthening the skin, and checking the morbid secretions” (8) Alternatively, tonics could be used to stimulate normal activity when organs and tissues were under active or had stopped secreting necessary secretions. “When, on the contrary, the secretions are lessened or arrested from torpor or atony of the organs, or from a languid or enfeebled state of the circulation, or of the general system, tonics are by no means an unimportant class of agents in aiding in the reestablishment of them. If the kidneys, skin, uterus, or lungs, fail to furnish their due secretion, from a torpid state of the organ, or from an enfeebled state of the general system, tonics are of much importance in restoring them; in such cases they exert a diuretic, diaphoretic, emmenagogue, and expectorant influence.” (8)
The Eclectics also noted that when a person was mounting a challenge to an aggressive acute
disease (scarlet fever/Streptococcal infection) or a chronic disease (Malaria, Syphilis, and
Tuberculosis), physiological function could become perverted. When severe acute or chronic
disease exhausted the Vis conservatrix, and perverted function resulted, a specialised class of
tonics was used. Drugs the Eclectics called “Alteratives.”
To the Eclectics “perverted function” meant body functions that had lost normal, orderly
function. For example, when a splinter enters into the skin, it is quickly surrounded by
inflammation. It is through inflammation the site is kept infection free and the splinter is ejected
from the skin. An example of perverted inflammation can be found with rheumatoid arthritis. In
this case, inflammation occurs around a joint when there is no foreign or offending agent that
needs to be removed. Orderly inflammation has been lost and in its place stands unnecessary
inflammation.
“’Alteratives’ are defined to be agents which change, in some insensible and inexplicable way, certain
morbid actions and conditions of particular organs, or of the general system. They produce no sensible
evacuation, or modification of function, by which we can in any way judge of their mode of operation. They
are administered to counteract certain morbid habits of the body, or cachectic states of the constitution, and
to re?establish the healthy functions of deranged organs. As to their general application, they are employed
in all chronic diseases in which there is a depraved or vitiated condition of either the solids or the fluids.
Thus, they are used in scrophula, syphilis, scorbutis, tabes mesenterica, chronic hepatitis, dyspepsia,
chlorosis, chronic rheumatism, chronic cutaneous diseases, etc.” (9)
The Eclectics found that alteratives, like other tonic remedies, had the capacity to restore normal
function in the Vis conservatrix depleted patient. “Administered in small and continuous doses they
improve the blood in quality, the appetite is increased, digestion promoted, and the process of elimination
accelerated. Alteratives improve the nutrition of the nerve centres, and greater and healthier activity to the
circulatory and breathing organs.” (10) In other words, alterative tonics normalised function by
augmenting the Vis conservatrix.
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What about the Eclectics
The Eclectic Medical Movement