Thursday, May 9, 2013

Homeopathy versus the old school

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- On the cutting edge of extinction : how the quest for modernity led to the erosion of identity in american homeopathy from 1865-Craig Repasz (Craig Repasz)
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Old school of Medicine.
 As homeopathy developed in the United States in the first half of the nineteenth century, it joined the onslaught against old school medicine that was being waged by other medical groups.
 Samuel Thomson had introduced a system of medicine in 1806, based on herbs and the belief that any man could become his own physician. The Thomsonian movement, which gathered momentum in the 1820s and 1830s, embodied the ideals of early democracy in America. The populace at the time abhorred elitism and privilege. While the Thomsonians directly attacked old school medicine, the homeopaths were considered the most bitter rivals to the old school due to the enthusiastic proselytizing of their more educated homeopathic physicians. vii
 A war of rhetoric existed between the homeopaths and the other medical groups on the one side and the old school on the other. The imagery of this war of rhetoric was religious. The old school considered and termed itself orthodox, and its rivals, unorthodox.
 The rival groups were called sects by the old school. Historians have claimed the term allopathy, levied against old school medicine, cemented the imagery of sectarianism. viii By having clearly defined enemies, all camps developed a strong identity and national presence.
 In 1847, physicians of the old school formed the American Medical Association (AMA) in an effort to professionalize themselves and to counter the assault by the other medical groups. For old school medicine, its identity in the public eye was influenced by its enemies. Its tools, like the lancet and harsh drugs, such as the mercury-based calomel, became icons. Homeopaths, on the other hand, held themselves out to be a non-invasive and effective alternative, although they were defined as "sugar doctors" and "effeminates" by the old school.
 But the old school was being forced to change. Pressure by the homeopaths, the advent of the statistical method from the Paris school in the late 1820s and 1830s, and public demand had an impact on the therapeutics of the old school. The large chemical doses that they administered were harmful and ineffective. They eventually lowered the doses and, as a result, the harm done to their patients was lessened.
 By mid-century, the old school had abandoned the rational theories of the 18th century. American physicians were traveling to Paris to learn the statistical method to develop pathology and drug efficacy which would transform rational medicine to empirically-based medicine. The new influences on the old school ushered in changes that blurred the lines that were once very distinct between the old school and homeopathy. ix Homeopathy had defined itself as the non-invasive, safe alternative to the overtly harsh practices of the old school. Now that the old school was changing, and moving away from extreme practices, and toward the middle, it not longer set up the opposite camp which homeopathy had used to help define itself.
 These changes in the old school made the rival schools less distinct in the public eye. During the early 19th century, the public had several different medical groups from which to choose. These groups were very distinct and easily defined. Homeopathy now had to stand on its own merits; it could no longer just be the safe alternative. The shift within the old school from the rational theories of the 18th century toward an empirical basis was also problematic for homeopathy. The old school could now easily hold itself out to the public eye as being modern and accuse homeopathy of being based on a dogmatic system from the past century. The loss of a clearly-defined enemy was not the only assault on homeopathic identity.
 In 1835, Dr. Jacob Bigelow, a Boston physician, published A Discourse on Self-Limiting Diseases. In that piece he stated that a doctor's work was ineffective and did not determine the outcome of the patient. Rather, the patient would have recovered or died according to the "self limiting" aspect of the disease and the healing power of nature, in most cases. He posed that the doctor should simply make the patient comfortable and assist nature.
 The internal conflict within homeopathy was as old as homeopathy itself, historians have argued.
 The impact of Bigelow's article on the old school was to further quell the use of heroic therapies. But it also became ammunition against the homeopaths as well. Since the remedies used for treatment were so highly diluted, the old school doctors viewed homeopathy as the equivalent to doing nothing. According to Bigelow's theory, the patient cured by a homeopath would have recovered anyway by healing power of nature alone.
 While the combined impact of the statistical method from Paris and the concept of self-limiting disease eroded the identities of both the old school and homeopathy, there were new sciences on the horizon-pathology, microscopic physiology and, later on, bacteriology-that would further impact these identities.


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