What homeopathy had become
- 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)
In 1899, while doing his rounds in a homeopathic hospital with a junior resident from Hahnemann University, Martin observed a patient who was suffering from typhoid fever. He had been given a certain homeopathic remedy by the student doctor, which gave no improvement for two weeks. The doctor had noticed an observation written on the patient's chart by a nurse. The patient was showing a keynote symptom that indicated an entirely different remedy. The resident did not recognize the symptom nor the remedy. The doctor prescribed the proper remedy and the patient was soon discharged. The doctor claimed that the medical students from Hahnemann were well-acquainted with the methods and techniques of regular medicine, but did not know the basics of homeopathic medicine.
Martin pointed out that the ignorance of homeopathy did not end with the medical students. He noted the meetings of homeopathic medical societies were indistinguishable from other medical clubs. He went on to mention the meeting of the AIH, when the Hahnemann monument was dedicated. The meeting had been covered by the Medical Journal, an allopathic publication from Philadelphia, but there was no mention that Hahnemann was a homeopath.
Martin continued that the week-long transactions of the AIH meeting that surrounded the monument had included readings of medical papers that did not differ from those read before other medical bodies. He paraphrased Dr. Price of Baltimore: "The treatment of disease allopathically...[is] right and proper under certain circumstances, i.e. , upon the failure of homeopathic remedies." Martin pointed out that "he was very unfortunate in using this expression-an expression that never should have been made use of-for homeopathic remedies do not fail; their failures are due to the fact the remedies used were not the homeopathic ones."lxxiv
The liberal homeopaths had adopted a scientific identity, they used non-homeopathic methods and drugs. They had not become better physicians; they only created a modern appearance for themselves. In fact by 1900 the scientific trends within medicine in general did little to impact therapeutics. Many physicians at the time used methods and techniques that were antiquated. These physicians were also reluctant to use modern technology as medical tools. Liberal homeopaths, as well as physicians in general, had little to show from their modern identity.
Conclusion
While President McKinley was spending the late afternoon in Scott Circle with the homeopaths on the first day of summer in 1900, an international crisis erupted half way across the world: the Boxer Rebellion in China. The Spanish American War of 1898, the Boxer Rebellion of 1900, and a coal miners' strike in November of 1900 were crises that at first blush could have ruined the President. However, at their successful conclusion, the country soared to new heights of imperialism and prosperity, and the President, to new heights of popularity.
The allopaths used science to organize their profession and to train their students. Homeopaths allowed science to displace their Hahnemannian identity.
President William McKinley had come to symbolize the modern era to most Americans. He won re-election against William Jennings Bryan by a landslide, in November of 1900. McKinley stood for big business and American imperialism. His appearance at ceremonies and state events signaled progress, prominence and prosperity to the crowds. The AIH wanted to identify with these attributes and augmented their Hahnemann monument dedication ceremony with the presidential presence. Other groups had also invited the President to appear and speak at public functions. He later praised science and technology at the Pan-Am Exposition in Buffalo, New York in September 1901. The Pan-Am Exposition showcased the most recent of technology that the world could offer. On display, for example, were an x-ray machine, electric lights, phonographs and moving pictures.
McKinley's trip to Buffalo proved to be fatal. On September 6, 1901, while at a public reception he was shot twice in the abdomen by anarchist Leon Czolgosz. The President lingered for eight days until he finally died on September 14th. He had been attended by fourteen allopathic physicians. The medical treatment, the autopsy of the President and the subsequent criticism of the doctors' efforts were indicative of the medical practice of the time. Against the backdrop of modern science and the technology of the Pan-Am Exposition, the surgery and drugs used to treat the President appeared antiquated.
The actual practice of medicine when compared to the science of the time showed what medical historians have recently claimed: "that physicians took up science as an ideal before it offered much to help them allay the ills of the sick."lxxv In the President's case, the attending physicians were reluctant to use the modern technology that was available to them.
The President was shot at 4:00 PM. He was immediately taken to the Exhibition hospital in an automobile ambulance. Dr. M. B. Mann, a gynecologist, was summoned along with other doctors in the area. Mann and all the other physicians who attended to the President were educated in allopathic medical schools. Mann needed to take advantage of the natural light. He etherized the President at 5:20 PM, gave him an injection of morphine and performed a hasty laparotomy. After suturing the stomach's two entrance and exit wounds with silk thread, the doctor probed for the bullet in the muscle of the back, to no avail.
By this time, the President's personal physician Dr. P. M. Rixey had arrived and tried to improve the lighting in the room with an electric light. Mann abandoned the search for the bullet, and gave the President an injection of brandy. He cleaned the peritoneal cavity with a salt solution and then sutured the abdomen. Mann ordered the ether stopped at 6:50 PM. The doctors issued their first report that night at 10:40 PM, stating that the President is "rallying satisfactory and is resting comfortably." The report set off a vigil for the country and voices of concern and questions from physicians.
The lack of adequate lighting in the operating room is indicative of a failure to adopt new technologies and incorporate them into standard procedure. The surgeons appreciated the value of the electric light as Rixey held one over the President's incision in the twilight of the evening. The handheld light was an ad hoc accommodation. It was not, however, a standard implement like the brandy injection.
The New York Times began publishing the opinions of prominent surgeons in New York. They all agreed that the President's prognosis was good due to the promptness of the surgery. Most surgeons expressed concern for the danger of peritonitis. One surgeon wondered why the x-ray machine was not used to find the bullet, knowing there was one at the Exhibition. lxxvi This reluctance to use available technology such as electric lights and the x-ray machine is indicative of the reluctance to use science and technology in the actual practice of medicine.
Dr. Rosewell Park, a physician in attendance claimed, "I feel certain President McKinley will get well. This is not 1881, but 1901, and great strides have been made in surgery in the past twenty years."lxxvii The New York Times speculated that the comment was an allusion to President Garfield's case and the difficulties surgeons had with his fatal wound after an assassination attempt.
The New York Times continued issuing the doctors' bulletins and interviews that gave complete details of the President's case. His temperature and pulse remained high. These vitals were considered normal for his condition; there was no need for alarm. The doctors were vigilant of symptoms of blood poisoning and peritonitis. The dispatches stated that if the President did not show signs of these complications by Tuesday, he would have a very good prognosis. It was made clear that the bullet was not a danger to the President as there was no evidence of pus forming in the wound. Thomas Edison made available an x-ray machine with a "skilled and trusted operator." The batteries were charged and ready for instant use. The machine would be used if the bullet caused complications.
By Sunday, September 8th, the President was given nourishment by an enema of beef broth. By Wednesday the wound was showing irritation. The physicians believed that the cause was a piece of fabric from the President's coat that had been torn off by the bullet and entered the wound. The wound was reopened and rinsed with antiseptic. The following day, still vigilant of peritonitis and blood poisoning, the doctors took a blood sample, analyzed the red blood cell to white blood cell ratio, and determined that there was no sign of blood poisoning. The doctors stated that no arrangements to move the President to Washington would be made until the threat of an October heat wave had passed.
Thursday morning, the President ate a breakfast of chicken broth, toast and coffee. The doctors felt that "the experiment of nourishing the President through the mouth was forced on [them] earlier than they had intended to try it."lxxviii The President could not at this point take rectal nourishment, forcing the doctors to give him food by mouth.
The President had developed acute abdominal distress. By 3:00 p.m. doctors gave him calomel. Calomel was an old heroic drug made from mercury. It was used as a purgative and cathartic. In this case, doctors gave it to clean out his bowels. His condition was ruled intestinal toxemia. Friday's New York Times carried an announcement at 2:00 a.m. by the doctors, authorizing the Associated Press to report the President had become critically ill. His pulse had become weak and rapid. The doctors gave him digitalis to slow his heart.
On Friday, the doctors continued with digitalis and calomel. During the day the President was heard to say parts of the hymn, "Nearer, My God, To Thee." At 8:30 p.m. , he was unconscious. By 2:00 a.m. Saturday morning, his heart was fluttering. Doctors gave him injections of saline, digitalis and strychnia as restoratives. He woke and muttered, "Goodbye all, goodbye. It is God's way. His will be done not ours."lxxix He was pronounced dead at 2:15 a.m. by Dr. Rixey.
The Sunday New York Times carried a statement signed by the attending physicians who had performed an autopsy declaring, "Death was unavoidable by any surgical or medical treatment and was the direct result of the bullet wound."lxxx The doctors determined that the entire tract of the bullet was gangrenous. "The President had died of toxaemia [sic] due to necrosis of tissue in abdominal cavity."lxxxi The bullet was never found even during the autopsy.
Doctors Wasdin, Park, Mynter and Mann-all in attendance at the sick bed and during the autopsy-voiced their opinions, agreeing that nothing could have been done to save the President. Wasdin stated that there had been no indication of an internal infection and that the bullet was poisoned. Park disagreed that the bullet was poisoned, but agreed that there was no indication of gangrene, and the complications on Tuesday were a mere irritation. He believed that the cause of death was from secretion from the pancreas that was damaged by the bullet. Mynter disagreed, stating that the pancreas was untouched by the bullet but was infected with gangrene. He also felt that the cause of gangrene was a total mystery. He agreed that Tuesday's problem gave no indication of gangrene. Mann believed the pancreas was untouched by the bullet, but believed that the wound on Tuesday had shown signs of gangrene. Mann dismissed the theory of the poisoned bullet after talking with an organic chemist. The chemist did not know of a toxin that would cause such a reaction. lxxxii
The disagreement among these doctors that either there was not a standardization of procedure for a post-mortem, or if there was, it was not followed. They could not agree if the bullet had damaged the pancreas or what was the cause of the gangrene. Their opinions were speculative at best. The poison bullet theory was not grounded in any science of toxicology. They also could not agree as to whether there were signs of a gangrene infection as early as Tuesday. A well thought-out, scientific approach would have resulted in few if any differences in opinion, and most likely, consensus. They had checked the President's blood for elevated level of white blood cells, could they not have checked the wound site as well? There is a demonstration of applied science; however, the applications are rather inconsistent.
A month after the President's death, a homeopathic medical journal, the New England Medical Gazzette, carried a critical editorial. The editor, AIH member Dr. Conrad Wesselhoft, had given $105 to the Hahnemann Monument. lxxxiii The editorial claimed that the grief of the President's death fell "more poignantly...upon our profession, for upon it rested the responsibility of the attempt to save his life. The attempt failed; and because it failed the profession has the right, we believe, to examine and review the case as managed by its representatives."lxxxiv The language of the editorial establishes homeopaths as colleagues of the allopaths. The criticisms did not have the rhetoric that historically characterized the antagonistic relationship homeopaths had with allopaths. There is no mention of homeopathic remedies that could have been used in the treatment of the President. Nor is there mention of how the chosen drugs administered to the President could have worsened the case.
The editorial has the tone of professional courtesy while calling the attending physicians to the President to task:
While it would be unjust in the extreme to pass judgement on the case until all available data are at hand, and while no one can doubt for an instant that those in attendance put their best effort and skill into the management of the case, there are certain questions that continually arise in the medical mind which for the honor of the profession we hope in the near future will be satisfactorily answered. lxxxv
The editorial by Wesselhoft went on to question the unfounded and optimistic assumption that the bullet was innocuous. He criticized the doctors' refusal to use the x-ray to locate the bullet, to remove the bullet, and to drain the wound properly. Furthermore, he questioned why food had been given only six days after a laparotomy. And lastly, he asked why had the bullet not been found during the autopsy.
The editorial was written by a homeopath who felt that he and his audience were brethren of the allopathic physicians who attended the assassinated president. Many homeopaths at this time considered themselves to be regular doctors with a therapeutic specialty. It is clear that there had been erosion of homeopathic identity and an alignment with the regulars.
Although science had failed to offer anything new in the way of therapeutics for medicine in general at the close of the 19th century, many allopathic physicians and liberal homeopaths had adopted science as a way to appear modern and to stay on the cutting edge of medicine. The allopaths used science to organize their profession and to train their students.
Homeopaths, on the other hand, allowed science to displace their Hahnemannian identity. After losing their distinctive character, homeopaths went to the brink of extinction in spite of their best efforts to maintain a homeopathic appearance.
Endnotes
i Bittinger, B.F. Historic Sketch of the Monument Erected in Washington City Under the Auspices of the American Institute of Homeopathy to the Honor of Samuel Hahnemann, 1900. New York: Nicjerbocjer Press. 77.
ii Ibid. 61.
iii Kaufman, Martin. Homeopathy in America: The Rise and Fall of a Medical Heresy. Johns Hopkins Press. 1971. 173.
iv Kaufman, Martin. "Homeopathy in America: The Rise and Fall and Persistence of a Medical Heresy." In Other Healers. Ed Norman Gevitz. Johns Hopkins Press. 1988. 123.
v Coulter, Harris. Divided Legacy: The Conflict Between Homeopathy and the American Medical Association. Berkeley: North Atlantic Books. 1982. 102.
vi Proceedings of the American Institute of Homeopathy, (1846), p5. Quoted from Coulter. 125.
vii Coulter. 103.
viii Warner, John Harley. "Orthodoxy and Otherness: Homeopathy and Regular Medicine In Nineteenth Century America; In Culture, Knowledge and Healing. Perspectives of Homeopathic Medicine in Europe and North America. Ed. R. Jütte, et al. Sheffield: European Association for the History of Medicine and Health Publications. 1998. 6.
ix Ibid. 13.
x Warner, John Harley. "Ideals Of Science and Their Discontents in Late Nineteenth Century American Medicine." Isis 82 (1991): 454-478.
xi Coulter. 328.
xii Haehl, R. The Life and Works of Hahnemann, Vol. I. London: Homeopathic Publishing Company. 1922. 187.
xiii North American Journal of Homeopathy, XXII (1873): 217-219. Quoted in Coulter. 392.
xiv Hahnemann, Samuel. The Chronic Diseases. Second Edition, 1835. New Delhi: B. Jain Publishers. 1998. 8.
xv King, William Harvey, History of Homeopathy and its Institutions in America. Vol. III. New York: The Lewis Publishing Company. 1905. 255.
xvi See Coulter and Kaufman.
xvii Coulter. 328.
xviii Ibid. 330.
xix King, William Harvey. History of Homeopathy. 271.
xx Transactions of the American Institute of Homeopathy. (1870):570-589. Quoted in Coulter. 383.
xxi Holcombe, William H. What is Homeopathy? A New Exposition of a Great Truth. Philadelphia: Boericke and Tafel. 1874. iv.
xxii Ibid. 10.
xxiii Ibid. 10.
xxiv Ibid. 11.
xxv Ibid. 7.
xxvi Ibid. 24.
xxvii Ibid. 25.
xxviii Usadi, M.M. E. The Homeopathic Practice of a Nineteenth Century Southern Physician. Thesis submitted at the University of North Carolina at Chapel Hill. 1995. 14.
xxix Coulter. 328.
xxx Warren, Ira. Warren's Household Physician for the Use of Physicians, Families, Mariners and Miners of all the Diseases of Men Women and Children. Boston: E. and Co. 1889. iii.
xxxi Ibid. 5.
xxxii Ibid. 6.
xxxiii Ibid. 7.
xxxiv Ibid. 7.
xxxv Numbers, Ronald L. "The Rise and Fall of the Medical Profession." Sickness and Health in America. Ed. Judith Walzer Leavitt and Ronald Numbers. The University Wisconsin Press. 1985. 188.
xxxvi Warner, John Harley. "Science, Healing, and the Physicians Identity: A Problem of Professional Character in Nineteenth Century America." Essays in the History of Therapeutics. Ed. W. F. Bynum and V. Nutton. Clio Medica. 22 (1991): 73.
xxxvii Rogers. An Alternative path. 24.
xxxviii Ibid.
xxxix Ibid. 41.
xl King II. 49-50.
xli Announcement of the Hahnemann Medical College of Philadelphia, Session 1867-68. Philadelphia: King and Baird, Printers. 9.
xlii Ibid. 10.
xliii Announcement of the Hahnemann Medical College of Philadelphia, Session 1867- 68.
xliv King II. 51.
xlv Hahnemann. Organon. 32.
xlvi Raue, CG. Special Pathology and Diagnostics, With Therapeutic Hints. Philadelphia: F. E. Boericke. 1874. XXIII
xlvii American Institute of Homeopathy, 1888. From Bradford Scrapbook. Manuscript MCP, Hahnemann Archives.
xlviii Bradford Scrapbook.
xlix Proceedings of the Lippé Society of Philadelphia. 1880. Manuscript MCP, Hahnemann Archives.
l Ibid. 10-14.
li Pearson, C. "History of the Society" History and Proceedings of the International Hahnemannian Association for the Years 1881-'82,'83. Published by the Association. 1884. 5.
lii Ibid. 6.
liii Ibid. 6.
liv Ibid. 6-7.
lv Ibid. 8.
lvi Clinical Reporter. February 1888. Clipping in the Bradford Scrapbook. Hahnemann University Archives.
lvii Kent, James Tyler. Lectures on Homoeopathic Philosophy. 1900. 13.
lviii Kent, James Tyler. New Remedies, Clinical Cases, Lesser Writings, Aphorisms and Precepts. 1925. 471.
lix Morse, B. O. "The Limitations of Homoeopathy." The Hahnemannian Monthly. 36 (November 1901): 686-690.
lx Bittinger, B. F. 18.
lxi House of Representatives. 54th Congress, Report No. 2131. June 2, 1896.
lxii Coulter. 298.
lxiii Rogers, Naomi, The Public Faces of Homeopathy in the United States, 1900-1950. Paper presented at the Second International Conference on the History of Homeopathy, Bosch Institute, Stuttgart, July 1999. 3.
lxiv See Gillis, John R. Commemerations: The Politics of National Identity. 4.
lxv Martin, W.J. "Is Our Materia Medica Becoming a Lost Art?" The Hahnemannian Monthly. Vol. 35 (November 1900): 679-685.
lxvi Ibid. 679-685.
lxvii Ibid. 679-685.
lxiii Ibid. 679-685.
lxix Bigler, W. H. and W. W. Van Baun. The Hahnemannian Monthly. Vol. 35 (December 1900): 780-782.
lxx Ibid. 780-782.
lxxi Ibid.
lxxii Ibid.
lxxiii Martin, W. J. 679-685.
lxxiv Ibid.
lxxv Warner, John Harley. "Ideals of Science and Their Discontents in Late Nineteenth Century American Medicine." Isis 82 (1991): 454-478.
lxxvi "Surgeons Have Hope For the President." New York Times, September 8, 1901.
lxxvii "Great Hope For The President." New York Times, September 9, 1901.
lxxviii "Mr. M'Kinley Has Sinking Spell." New York Times, September 13,1901.
lxxix "Mr. M'Kinley Dies after Brave Fight." New York Times, September 14, 1901.
lxxx "The President Died of Gangrene Poison." New York Times, September 15, 1901.
lxxxi Ibid.
lxxxii "Mr. M'Kinley's Doctors Disagree on the Case." New York Times, September 16, 1901.
lxxxiii Bittinger. 150.
lxxxiv "The Case of the Late President." The New England Medical Gazette. No. 10, Vol. XXXVI (October 1901): 507.
lxxxv Ibid.
Craig Repasz graduated from Yale University with a degree in History of Science and History of Medicine and is currently pursuing a homeopathic education at the School of Homeopathy, New York. He is employed as a bio-analyist in a Connecticut based company. This article is a revision of his college thesis. He can be reached via e-mail at: crepaszhotmail. com
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