Nature Cures The History of Alternative Medicine in America doc

Nature Cures
Also by James C. Whorton
Crusaders for Fitness: A History of American Health Reformers
Inner Hygiene: Constipation and the Pursuit of Health in Modern Society
Nature Cures
The History of Alternative Medicine in America
James C. Whorton
1
2002
1
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Library of Congress Cataloging-in-Publication Data
Whorton, James C., 1942–
Nature cures : the history of alternative medicine
in America / James C. Whorton.

p. cm. Includes bibliographical references and index.
ISBN 0-19-514071-0
1. Alternative medicine—United States—History. 2. Alternative
medicine—United States—History—20th century.
I. Title.
R733.W495 2002 615.5'0973—dc21 2002022023
135798642
Printed in the United States of America
on acid-free paper
For Jackie

vii
Contents
Preface ix
Part I The Nineteenth Century: Natural Healing 1
1. The Hippocratic Heresy: Alternative Medicine’s Worldview 3
2. Every Man His Own Physician: Thomsonianism 25
3. Dilutions of Grandeur: Homeopathy 49
4. Physical Puritanism: Hygeiotherapy 77
5. Magnetism and Mind: From Mesmerism to Christian Science 103
Part II The Early Twentieth Century: Drugless Healing 131
6. The Licensing Question: The Campaign for Medical Freedom 133
7. The Rule of the Artery: Osteopathy 141
8. Innate Intelligence: Chiropractic 165
9. Therapeutic Universalism: Naturopathy 191
Part III The Late Twentieth Century: Holistic Healing 219
10. From Medical Cultism to Alternative Medicine 221
11. The Holistic Health Explosion: Acupuncture 245
12. From Alternative Medicine to Complementary Medicine 271
Conclusion The Twenty-first Century: The Age of Curapathy? 297

Abbreviations 308
Notes 311
Index 360

ix
Preface
I
n the autumn of 1994, a New Yorker cartoonist imagined a clinical scene
in which a patient who is literally radiant with health, his body throwing
off a nearly blinding aura of wellness, is nevertheless being sternly ad-
monished by his physician because he has achieved his health the wrong way:
“You’ve been fooling around with alternative medicines, haven’t you?” the
doctor scolds.
1
New Yorker cartoons constitute the most sensitive of barometers to shift-
ing currents in America’s cultural atmosphere. And in truth, whatever one
chooses to call it—alternative medicine, unconventional medicine, holistic
medicine, complementary medicine, integrative medicine (some even like the
term vernacular medicine)—a lot of people have been fooling around with
unorthodox forms of therapy in recent years. In a now legendary survey
published in 1993, Harvard’s David Eisenberg reported that one in three
Americans had used one or more forms of alternative medicine in 1990, and
expressed surprise at the “enormous presence” of healing alternatives in Amer-
ican society. When Eisenberg and colleagues repeated the survey in 1997,
furthermore, they found that “alternative medicine use and expenditures have
increased dramatically” since the first study: now 40 percent of the population
employed such procedures.
2
That alternative methods were so widespread in the presumably enlight-
ened 1990s was a startling realization for the medical profession. It shouldn’t

have been, for there’s nothing at all new in the current enthusiasm for un-
conventional therapies. Comparable levels of support have been the norm for
most of the last two centuries: Americans, in short, have been fooling around
with alternative medicine for a long time.
That such activity has been mere foolishness has been the opinion, of
course, of orthodox practitioners. From the start, MDs have scorned alternative
x Preface
systems of treatment as a grab-bag of inert (when not dangerous) therapies
foisted upon gullible hypochondriacs by scientifically uncritical quacks. Alter-
native doctors, Spalding Gray has joked on behalf of physicians, believe that
“everything gives you cancer,” but there’s no need to worry, because they also
believe that “everything else heals you of it.” (The emphasis is Gray’s; itali-
cized words in quoted passages throughout this book were italicized in the
original.)
3
Yet in just the few years since the publication of that New Yorker cartoon,
mainstream medicine’s historic disdain for alternative medicine has softened
remarkably. The decision by the U.S. Congress in 1991 to establish an Office
of Alternative Medicine at the National Institutes of Health was, to be sure,
a political act, and one that enraged many MDs. Nevertheless, the founding
of the OAM, followed by Eisenberg’s study (1993), the opening of the first
publicly funded natural medicine clinic in the country (King County, Wash-
ington, 1996), and other revelations of public support for non-standard ther-
apies forced physicians to pay closer attention to their alternative counterparts.
At first, attention was motivated primarily by the recognition that practitioners
needed to know more about unconventional systems of care in order to engage
their alternatively inclined patients in open discussion of their habit (in contrast
to shaming them in the manner of the cartoon physician). Eisenberg had found
in 1990 that 72 percent of patients who received treatment from unconventional
practitioners did not inform their medical doctor of that fact, suggesting “a

deficiency in current patient-doctor relations” that could be harmful to patients.
To remedy the deficiency, Eisenberg urged that physicians begin to ask pa-
tients about their use of alternative therapies and that medical schools intro-
duce instruction on alternative medicine into their curricula. Since then, more
than half the medical schools in the country have established courses on un-
conventional medicine, and the remainder seem likely to follow.
4
In the process, the forced familiarity with alternative systems has bred a
lessening of the contempt of past times, as physicians have discovered an
unexpected level of professionalism among their alternative counterparts, as
well as evidence of effectiveness for several popular alternative therapies. In
December 1997 the editorial board of the Journal of the American Medical
Association announced that unconventional medicine had been ranked third
among eighty-six subjects in terms of interest and importance for readers, and
that the topic would be the focus of a special issue of the journal. That issue
appeared in November 1998. It included reports on clinical trials of seven
different alternative therapies (including chiropractic, acupuncture, yoga, and
herbs); four of the seven trials found positive benefits from the tested treat-
ment.
5
Now, it would seem, conventional physicians were going to start fool-
ing around with alternative medicine themselves.
Preface xi
Even so, the past will not be left behind without a struggle. Wounds
from historic conflicts between mainstream and marginal practitioners have
not fully healed and are easily reopened. Since 1986 I have given an elective
course on alternative approaches to healing to students at the University of
Washington School of Medicine. Initially, the project seemed a bit like teach-
ing druidism in a Christian Sunday school, although my object never was to
convert students to unconventional medicine. (Indeed, except for a monthly

indulgence in therapeutic massage, I personally have never patronized an al-
ternative practitioner.) Nor have I been interested in using the class as a forum
for attacking alternative medicine. My intent, rather, has been simply to alert
medical (as well as nursing, pharmacy, and other health profession) students
to the prominence of alternative therapies in the American health care envi-
ronment and to provide them with at least an introduction to the treatments,
theories, and claims of the most popular alternative systems. The latter is
accomplished primarily through presentations made by prominent local prac-
titioners of naturopathic medicine, homeopathy, chiropractic, and other un-
orthodox methods. The first year I offered the class, the very first guest
speaker was an osteopathic physician (I elected to begin with the most familiar
and accepted alternative) who was respectfully asked by a medical student if
the generally lower grade point average and medical school admission test
scores of osteopathic medical students meant that osteopathic schools placed
more emphasis on non-academic qualities in selecting their classes. “Most
definitely,” was the answer; “for example, we like for our students to be human
beings.”
So confrontational a beginning to my consciousness-raising project was
an unsettling reminder to me, as a medical historian, that the long record of
interprofessional warfare continues to strain interactions between the two sides.
Time is in the process of relieving the tension, but the change can be quick-
ened by mainstream health professionals acquiring some awareness of the
mistreatment that alternative practitioners feel they have suffered over the
years at the hands of the medical establishment; similarly, alternative doctors
can benefit from a deeper understanding of why the orthodox profession has
tried to suppress their activities.
A second way that an appreciation of the history of unconventional
medicine might assist in the process of conciliation is to acquaint mainstream
doctors with the culture of natural healing. It will not be enough for physicians
to learn more about the treatments and theories of alternative practitioners

and about what evidence exists for the efficacy of their therapies. They must
also learn more about the practitioners themselves. I am thinking here not of
the individual relationships that MDs might establish with NDs, DCs, and
other unconventional healers as they coordinate the care their patients receive.
xii Preface
I have in mind instead the need to appreciate the philosophical outlook com-
mon to alternative doctors of all persuasions. For while the dozens of different
alternative systems are quite distinct from one another with respect to therapies
and theories, they are united at the level of values. All share a certain per-
ception of themselves, and of conventional medicine, that has been forged
over two centuries of effort to define the ways in which they differ from
medical orthodoxy. This alternative interpretation of healing will be discussed
in Chapter 1.
The importance of this philosophical foundation shared by all systems
of alternative medicine can hardly be overstated. When the leaders of natur-
opathy today aver that their medicine is “more than simply a health care
system; it is a way of life,” they are stating that they think of human beings,
their relation to their environment, and their responses to environment and
therapy in fundamentally different ways than mainstream physicians do. It is
an orientation that since the 1970s has been called “holistic medicine,” but
long before the word “holistic” had been coined and glorified as a “new
paradigm” for healing, alternative practitioners were advocating a philosophy
of healing that was nothing if not “holistic.”
6
“Nature cures” is another term for describing the various medical alter-
natives. The phrase “nature cure” has long been used by naturopaths to iden-
tify their system as one that relies on the body’s own natural healing mech-
anisms to restore the sick to health. But in truth, alternative therapists of every
denomination have always claimed to heal by supporting and stimulating na-
ture; they have all been purveyors of nature cures. Further, by virtue of

subscribing to the principle that whenever recovery takes place, nature rather
than the doctor is ultimately responsible, all would gladly accept as their credo
“Nature cures!”
Historically, the ranks of nature cure have been thicker than is generally
appreciated. In the 1850s a New York physician concluded his volume on
Quackery Unmasked with an accounting of the “most prominent” unconven-
tional practitioners that cited homeopaths, hydropaths, eclectics, botanics,
chrono-thermalists, clairvoyants, natural bone-setters, mesmerists, galvanic
doctors, astrologic doctors, magnetic doctors, uriscopic doctors, blowpipe doc-
tors, the less than a decade old plague of “Female Physicians” (that is, women
MDs), and “etc. etc. etc.” The etceteras included Baunscheidtism, physio-
medicalism, and yet other medical isms: and this was only the antebellum
generation of natural healers. Following the Civil War, Christian Science,
osteopathy, chiropractic, naturopathy, and new etceteras made their appear-
ance. Still more approaches have become established in the United States
during the twentieth century, particularly as Asian healing traditions have been
Preface xiii
brought into the country. By the end of the century, the census of alternative
therapeutic and diagnostic methods had surpassed three hundred.
7
The entries on the list enjoy varying degrees of recognition and accep-
tance from the orthodox profession. Some are thought of as silly, others re-
garded as at best alternatives one might try in place of conventional treatments
for a particular condition. A few, however, are coming to be looked upon as
complements to be used in conjunction with conventional care, and the term
“complementary medicine” has gained much currency in recent years. More
than a few readers might feel this book should therefore be subtitled The
History of Complementary Medicine, or even The History of CAM, the widely
used acronym for “complementary and alternative medicine.” I nevertheless
have elected to use “alternative,” as it is still a more widely recognized term

with the general public and a more suitable description of how unorthodox
medicine has been perceived historically.
There are surely other readers who believe The History of Quackery
would be the proper subtitle. The quackery label has in fact been consistently
applied to unconventional medical systems from the outset. An English visitor
to this country in the mid-1800s, astonished by the sheer number of unortho-
dox systems of cure, despaired that “daily some poor unfortunate falls a victim
to these murderous quacks. Their deeds of darkness and iniquity fairly out-
herods [sic] Herod.” In truth, many alternative methods of the last two cen-
turies surely were inert or positively dangerous. Nevertheless, historically the
word “quackery” has been used less to mean ineffective therapy and more to
connote fraudulent intent on the part of the therapist. “Charlatanism,” a re-
spected orthodox practitioner of the mid-1800s remarked, “consists not so
much in ignorance, as in dishonesty and deception.” “The distinction between
quacks and respectable practitioners,” a British contemporary added, “is one,
not so much of remedies used, as of skill and honesty in using them.”
8
Prac-
titioners of the systems of healing covered in this book have by and large
been every bit as honest as orthodox physicians in their belief in their methods,
and just as sincere in their desire to restore sick people to health.
In any event, my object is not to separate the quacks from the consci-
entious but rather to unearth the roots of a contemporary stage of medical
evolution that has profound implications for the future of health care. Thus
while I hope this book will be of interest to fellow historians, my greater
concern is to provide a perspective on the past that will serve health profes-
sionals of all affiliations in their interactions today. I would wish as well that
lay people interested in questions of health and healing find in this work some
enlightenment on a subject as important for patients as for physicians.
In exploring the evolution of alternative medicine, I will not attempt to

xiv Preface
detail the development of every single unconventional system of therapy that
has established a foothold at some point in America’s past. Rather, I will select
a few of the most significant programs of treatment to illustrate different modes
of healing and to dramatize battles with mainstream medicine that had to be
fought by all systems. Finally, as with my medical school course on alternative
medicine, I intend the book to be neither a recommendation of individual
programs of natural healing nor a condemnation of any. If I am taking a
position, it is simply that of the first director of the Office of Alternative
Medicine, speaking “not as an advocate of alternative medicine, but as an
advocate for its fair evaluation.” I would urge upon readers the same spirit
of tolerance that was solicited by Walter Johnson, a nineteenth-century MD
who converted to homeopathic practice. “If among those who cast a glance
at these pages,” he began his 1852 Exposition and Defence of homeopathy,
“there be any who would fain subjugate reason to authority—who would
impose upon the conscience of the many the dogmas of a few—who would
empower halls and senates to fine and imprison, and to disqualify from public
trusts all who dissent from their doctrines and repudiate their practice; if,
among my readers, there be any who, in their hatred of medical heresy, scruple
not to calumniate the moral character of the so-called heretics, and openly to
term them pests of society—to all such I say, this work is not for you.”
9
Historians are heavily dependent upon the goodwill of librarians, and I feel
blessed to have had three extraordinarily goodwilled custodians of books and
documents to work with. First is Colleen Weum, acquisitions and collection
management librarian for the University of Washington Health Sciences Li-
brary. I long ago lost count of the times Colleen has uncomplainingly set
aside her own work to help me track down some book or periodical or to let
me into the locked catacombs in which the library’s older journals are stored.
Without Colleen’s help, I would no doubt be working on this book for some

time to come, and I am deeply grateful for her assistance. Jan Todd, curator
of the Todd-McClean Physical Culture Collection at the University of Texas,
also made my task much easier during a week’s research stay in Austin.
Finally, Jane Saxton, director of the Bastyr University Library, was most
generous with time and expertise on my research visits to her institution.
Other library staff have also gone extra lengths for me. I would partic-
ularly like to thank Kathleen Sisak, of the University of Washington; Susan
Banks, of Bastyr University; Margaret Kaiser, of the National Library of Med-
icine; and Jane Brown, of the Medical University of South Carolina.
I have benefited as well, of course, from ideas and advice from fellow
historians and from health professionals, both mainstream and alternative. I
am indebted in various ways to Christina An, Bob Anderson, Pat Archer, the
Preface xv
late John Bastyr, Kim Beckwith, Jack Berryman, Christian Bonah, Dan Cher-
kin, George Cody, Dean Crothers, Gary Elmer, Norman Gevitz, Greg Higby,
Ron Hobbs, Rosalie Houston, Jennifer Jacobs, Mara Jeffress, David Kailin,
Brenda Loew, James McCormick, Laurin McElheran, Ronald Numbers, Mary
Jo Nye, Robert Nye, Melissa Oliver, John Parascandola, Joe Pizzorno, Lynd-
sey Rasmussen, Ron Schneeweis, Tom Shepherd, Lenore Small, Pam Snider,
Mark Tonelli, Wendy Valentine, Lisa Vincler, and Susan Vlasuk.
I would also like to express appreciation to my editors at Oxford Uni-
versity Press: Jeffrey House, Edith Barry, Joellyn Ausanka, and especially
copy editor India Cooper, whose painstaking reading of the manuscript elim-
inated more than a few errors and contributed a number of stylistic
improvements.
Above all, I wish to thank my wife. Jackie has endured more than a
year of books and papers piled and scattered about our shared office without
protesting once (at least not within earshot). More, she has brought patience
and understanding and love to our shared life. Without the fulfillment I find
with her, writing this book would have been a far less satisfying endeavor.

k
PART I
The Nineteenth Century:
Natural Healing
Physicians of the highest rank—To pay whose fees would need a bank—
Have pressed their science, art, and skill Into a dose of calomel.
Whate’er the patient may complain Of head, or heart, or nerve, or brain,
Of fever high, or parts that swell—The remedy is calomel.
When Mr. A. or B. is sick, “Go for the doctor; and be quick.”
The Doctor comes with right good will, And ne’er forgets his calomel.
He turns unto the patient’s wife, And asks for paper, spoon, and knife;
“I think your husband will do well To take a dose of calomel.”
He then deals out the fatal grain, “This, ma’am, will surely ease the pain,
Once in three hours, at chime of bell, Give him a dose of calomel.”
The man grows worse quite fast indeed, A council’s called. They ride with speed.
They crowd around his bed, and tell The man to take more calomel.
The man in death begins to groan, The fatal job for him is done.
His falt’ring voice in death doth tell His friends to shun all calomel.
Now, when I must yield up my breath, Pray let me die a natural death,
And bid you all the long farewell Without the use of calomel.
“Calomel,” a mid-nineteenth-century song

3
k
1
The Hippocratic Heresy:
Alternative Medicine’s
Worldview
W

alter Johnson, the homeopath quoted at the close of the preface,
referred to his practice as a “medical heresy” and his colleagues as
“so-called heretics.” In fact, the members of all alternative schools
of treatment have regarded themselves as heretics, as dissenters from the es-
tablished gospel of medical theory and practice subjected to castigation and
persecution for their heterodox beliefs. They thought of their heresy as “so-
called,” however, because all were confident that they possessed the one gen-
uine gospel of health. Even so, each of the alternative systems has paid homage
to the same source of inspiration revered by orthodox medicine, looking back
to Hippocrates, the Greek physician of the fourth century b.c.e., as their
doctrinal father. Indeed, so strong has this attachment been, one might think
of alternative systems of medicine collectively as so many Hippocratic heresies.
For MDs, Hippocrates is the “father of medicine” primarily because of
his introduction of a consistently naturalistic orientation to thinking about
disease and cure, banishing gods and demons as agents of sickness and re-
covery. For alternative medicine’s heretics, Hippocrates has been more impor-
tant for his advocacy of certain other principles, principles that have persisted
in alternative medical philosophy to the present. These principles are evident
in particularly concise form in another alternative medicine cartoon, this one
dating from the early 1800s. In 1834 The Thomsonian Botanic Watchman,a
fledgling literary organ for a scheme of herbal healing known as Thomsoni-
anism, spiced its inaugural issue with “An Illustration of the Difference Be-
tween the Regular and Thomsonian Systems of Practice.” (Surviving copies
of the cartoon, unfortunately, are too faded to reproduce clearly.) There a
4
THE NINETEENTH CENTURY: NATURAL HEALING
patient is shown mired in the Slough of Disease despite the ministrations of
a “regular” doctor, as orthodox physicians styled themselves. The doctor is
depicted standing upon the banks of the slough, with his left hand upon the
patient’s head, holding him in place, and his right raised and poised to descend

with a club labeled “calomel.” Clearly intent on bludgeoning the disease into
submission with regular medicine’s favorite drug, he assures the patient that
“You must be reduced, Sir!” The MD’s meaning is that calomel, the most
commonly employed purgative in nineteenth-century practice, will reduce the
disease by cleaning out the intestinal tract. The patient, contrarily, fears that
he is the one being reduced, reduced all the way to the grave: “The Doctor
knows best,” he moans facetiously, “but send for the Parson.” In the middle
of the picture, an observer attempts to get the doctor’s attention, to show him
there is a better way: the way of the Thomsonian healer to the right, who
rescues a second patient by pulling him up the Steps of Common Sense.
1
Heroic Therapy Versus Reliance on Nature
This cartoon is a nutshell presentation not just of Thomsonians’ views but of
the core philosophy of all alternative systems of practice over the past two
centuries. Specifically, it highlights three fundamental tenets of the Hippocratic
heresy. First, by portraying the physician as one who treats the sick by beating
them, the artist suggests that conventional medicine attacks disease so brashly
as to indiscriminately overwhelm the patient too. Thomsonian remedies, on
the other hand, are indicated to be gentle and, more than that, to be “natural,”
to support and enhance the body’s own innate recuperative powers: “I will
help you out,” the Thomsonian doctor tells his patient, “with the blessing of
God.” He might just as well say “with the blessing of nature,” since God and
nature were implicitly one in nineteenth-century thought. Thomsonians did
often state the matter explicitly, however: “The old school physician lifts his
fatal club and strikes at random,” one wrote a few years after the cartoon’s
publication, “the force of which oftener comes on the head of the only healing
principle that exists in man, termed nature, than on his enemy, disease.”
2
Thomson’s characterization of standard therapy as an assault on nature
embodied a considerable amount of truth. Calomel, one of the most frequently

prescribed drugs at that time, was a powerfully acting cathartic that physicians
believed would flush morbid material from the body while also stimulating
the liver to greater action. But as a mercury compound (mercurous chloride),
calomel was toxic, and when given in repeated doses over a period of days
or weeks it made the patient’s mouth painfully swollen, causing cheeks and
gums to bleed and ulcerate and teeth to become loose and fall out. In severe
cases, the sufferer’s jawbone could be destroyed. All too often, critics charged,
The Hippocratic Heresy: Alternative Medicine’s Worldview 5
“the mercurial treatment” left the sick “maimed and disfigured,” subjects “of
pity and horror pitiable objects with distorted features.” Such injuries were
compounded by ptyalism, a profuse flow of viscous and foul-smelling saliva
(“his tongue is protruded out of the mouth and the saliva streaming out
at the rate of from a pint to a quart in 24 hours”). But since salivation and
its attendant oral damages were “the only index of the degree to which the
mercurial impregnation of the blood is carried”—in effect constituted the
proof that an adequate dose had been given—“this mark [salivation] is usually
aimed at.” Doctors then rationalized the side effects as necessary evils, much
as oncologists today justify the damages done by cancer chemotherapy. “Sal-
ivation was a trifling evil,” one argued, “compared with the benefit which was
derived from it.” Patients, understandably, dreaded a course of calomel treat-
ment and “submitted to it,” one doctor observed, “as an evil almost as for-
midable as the disease for which it was administered.”
3
Yet the great majority did submit, even as the size of calomel doses
increased through the first half of the nineteenth century. This “Samson of
the Materia Medica,” as it was hailed, came in for particularly heavy use in
the epidemics of Asiatic cholera that swept the country in the mid-1800s, by
which time calomel prescribing had become virtually a reflex for physicians.
The drug was often given, physician-litterateur Oliver Wendell Holmes joked,
“on the same principle as that upon which a landlord occasionally prescribes

bacon and eggs,—because he cannot think of anything else quite so handy.”
When doctors are “in doubt as to correct treatment,” another skeptic sug-
gested, they behave like card players—“they play trumps.”
4
Calomel was
trumps.
Doctors nevertheless had lots of other cards in their therapeutic pack.
Calomel was just one of a host of violent purgatives employed to scour the
intestines, while the upper alimentary tract was cleaned just as thoroughly
through the use of vomitive drugs. The most popular, tartar emetic, produced
evacuations that one doctor described as “cyclonic” in action, while at the
same time frequently resulting in antimony poisoning. The physical system in
general, furthermore, was relieved of excess or unwholesome blood by ven-
esection, or phlebotomy—Latin and Greek respectively for the cutting open
of a vein. Incised veins were allowed to release a pint or more of blood at a
time, and bleedings were repeated if improvement was not soon manifest.
5
In most cases, improvement did occur. The great majority of patients
recovered notwithstanding their treatment, and their survival only confirmed
in physicians’ minds that the therapies they administered, therapies that were
suggested by medical theory, were actually being demonstrated to be effective
by clinical experience. Even so, doctors often acknowledged the rigorousness
of their treatments (which included more than a few other assaults, such as
6
THE NINETEENTH CENTURY: NATURAL HEALING
the application of blood-sucking leeches and the raising of blisters on the skin)
by referring to them as “heroic therapy.” Therapeutic heroism was the norm
through the first half of the 1800s. “The practice of that time was heroic; it
was murderous,” an aging southern physician recalled of his novice days in
the 1830s; “I knew nothing about medicine, but I had sense enough to see

that doctors were killing their patients, andthat it would be better to trust
to Nature than to the hazardous skills of the doctors.”
6
Trusting in nature was, in fact, a policy that a number of America’s
orthodox physicians adopted during the first half of the century. For reasons
beyond present purposes, a minority of doctors, mostly younger members of
the profession, came to doubt the efficacy of the traditional depletive therapies.
“Boast as doctors will of their cures,” a leader of the American profession
wrote in the 1840s, the “vis medicatrix naturae is the chief doctor after all.”
Vis medicatrix naturae—the healing power of nature—was the Latin phrase
that had been used for centuries to signify the agency first identified by Hip-
pocrates, the inborn ability of the human body to respond to the insult of
illness or injury and restore itself to health in most episodes of disease or
trauma. Among the hallmarks of Hippocratic medicine, in fact, had been trust
in the sick person’s power to recover, without aggressive medication, and
avoidance of treatments that might inhibit the vis medicatrix. The self-
reparative powers of the body had ever since been held in high regard by
physicians, though by 1800 that regard had become largely theoretical. Prac-
titioners’ true enthusiasm was for the heroic interventions that took the work
of cure out of nature’s hands and placed it in physicians’. Students of Uni-
versity of Pennsylvania medical professor Benjamin Rush, that most heroic of
practitioners, recorded in their notebooks his advice to “always treat nature
in a sick room as you would a noisy dog or cat drive her out at the door and
lock it upon her.”
7
The early nineteenth-century revolt against the excesses of therapeutic
heroism saw more than a few mainstream practitioners denouncing “the abom-
inable atrocities of wholesale and indiscriminate drugging” and otherwise ex-
pressing their displeasure with the profession’s neglect of the body’s restorative
power. Nature, in the eyes of these therapeutic reformers, was a “good, kind

angel, hovering over the bed of sickness, without fee, and often without even
any acknowledgment of her services,” an angel who regularly saved “the life
of many a poor patient, who is near being drugged to death by some ignorant
quack, or some over-dosing doctor.” In conjunction with such sentiments,
there was developed the concept of “self-limited” diseases, conditions that
would run their course for better or worse whether treated or not (much as
the common cold will last a week if no medication is taken but be cured in
seven days if drugs are used). In most cases, the advocates of nature main-
The Hippocratic Heresy: Alternative Medicine’s Worldview 7
tained, the patient’s best hope was in being given basic nursing care: nourish-
ment, rest, and warmth—but little or no medicine.
8
The resultant debate of “nature versus art” (“art” denoting the doctor’s
pharmaceutical armamentarium) was a hotly contested issue among America’s
regular physicians from the 1830s into the 1860s. But the fact that Oliver
Wendell Holmes, the profession’s most articulate spokesman for therapeutic
humility, described “nature-trusting” as a “heresy” indicates that the majority
of doctors denied nature’s power to heal unassisted, and stayed on the side of
active intervention. Some of the orthodox actually denied there was any such
thing as the vis medicatrix naturae. (“Obscure and incomprehensible,” one
doctor called it; “only an inference—a theory,” stated another.) Most ac-
knowledged that when the body was attacked by disease it did make efforts
to reverse the injury and reclaim health but believed that generally the aid of
the physician was required nonetheless. To have concluded otherwise would
have been a form of professional suicide, an admission that the doctor was
redundant. Even Holmes and other nature-trusters hardly abandoned drugs
altogether. They simply called for a more moderate and discriminating use of
those that seemed to have some clinical evidence in their favor, rationalizing
their use as agents that removed obstacles to nature’s reparative activity.
Judged that way, even calomel could be identified as a friend of nature; used

judiciously, the purgative eliminated constipation, which might otherwise cause
discomfort, weakness, and sleeplessness.
9
Regular physicians of the first half of the nineteenth century maintained
allegiance to their traditional drugs for other reasons as well. Doing something
active in place of waiting for nature instilled confidence in patients that the
doctor had power, and confidence stimulated recovery. Indeed, if the doctor
did not take action, more often than not the patient or his family demanded
it. “How often,” one physician complained, was he “forced by patients and
their friends to give medicine when it is not plainly indicated He must
cure quickly,orgive place to a rival.” Finally, calomel, bleeding, and other
heroic treatments were the very things that gave the profession its distinc-
tiveness vis a` vis unconventional healers. As these enemies became ever more
strident in their attacks on traditional medicine, it was only natural for MDs
to close ranks and cling more tightly to that tradition as a badge of professional
identity, making depletive therapy the core of their self-image as medical
orthodoxy. In brief, a fair amount of lip service was paid to nature by phy-
sicians of the mid-1800s, but when it came down to practice instead of phi-
losophy, they sided with art.
10
8
THE NINETEENTH CENTURY: NATURAL HEALING
The Emergence of “Irregular Medicine”
Claiming to side with nature instead was the distinguishing therapeutic phi-
losophy of those first alternative systems of practice that appeared in America
in the early 1800s. Systems of practice is specified because while there had
been a variety of methods available as alternatives to conventional medicine
before the nineteenth century, the practitioners of folk medicine, the so-called
root-and-herb doctors, the purveyors of Native American remedies, and other
informally trained medicos had not been professionalized to any significant

degree. They were often paid for their ministrations, to be sure, but they
generally practiced alone, using what knowledge they had acquired in their
individual ways. They did not band together with people of like mind to
prescribe the same drugs and to swear allegiance to the same theory. They
did not establish schools to train the next generation of practitioners, organize
professional societies, or publish journals. The alternative healers who came
onto the scene in the early nineteenth century did all those things, and that
is what made their practices stand out as systems.
Siding with nature meant that the new systems of treatment that cropped
up in the early 1800s were openly hostile to traditional depletive therapies and
to the profession that employed them. The new breed of doctors boldly placed
themselves outside the boundaries of conventional practice, defiantly proclaim-
ing their independence from a pharmaceutical orientation they believed to be
discredited by common sense and experience. From their vantage point, drugs
were poisons, and one could never help the sick by poisoning them. “To walk
through the streets of any great town,” a homeopath reflected, “and ob-
serve the green and red lamps [of apothecary shops] with the idea that each
is a perennial fountain of physic [drugs], whence the sick and suffering derive
not solace and restoration, but aggravation of their misery,” was an exercise
to “make a humane man shudder, and read the sage another lesson upon the
perversity of mankind!” Every drug shop, he remonstrated, and every drug
therein “is an independent focus of disease which radiates through the entrails
of humanity.” A Thomsonian concurred, summarizing the history of orthodox
medicine as “a series of blind experiments with the most deadly poisons,”
experiments whose only result was that “millions sleep beneath the clods of
the valley.”
11
The point would be made again and again over ensuing decades; an
osteopath of the early twentieth century, for example, shamed MDs for claim-
ing descent from Hippocrates. “Hippocrates has a perfect right to deny the

parentage imposed upon him by these children who so little resemble him,”
she objected; “modern medicine is more like a descendant of the Borgias than
of Hippocrates.” The first rule of the Greek healer, after all, had been to do