Medical Geography and the History and Anthropology of Medicine and Public Health

This site is focused on information, information sources and discoveries that I have made over the years trying to promote the study of medical geography. Since medical history is my strength (other than a few science- and public health-related specialities some readers will pick up on), much of what I am writing are essays on my findings during the past 30 years researching the history of medicine, in particular New York and Hudson Valley medicine, and especially irregular, alternative or complementary medicine. (I save the term integrative medicine to refer to something else, not yet fully existing.) I researched and taught this information at Portland State University for nearly 20 years.

And so what have I recently covered and/or published at this blogsite?

The following are some of the new topics just posted or about to be posted:

  • Open Letter to New York State Commissioner of Parks [the need for a Fishkill Revolutionary War Visitor’s Site]
  • A few more historical disease maps.
  • The brilliant ceramic artwork of Huguenot Naturalist and Natural Philosopher Bernard Pallisy (late 1500s)
  • Dr. Robert Todd, Fishkill, and his “Metalic Points”, 1797
  • New York’s Dr. Samuel Mitchell, naturalist and phlogistian (ca. 1800)
  • “The James Way“–the public health and sequent occupance for a local 1940s-1950s Turkey Farm recently revisited (many pictures)
  • From “New Eclectics” (1878) to the modern day practice of Naturopathy (Portland, Oregon)

Speaking of complementary or “non-allopathic” medicine, the following is the basis for a traditional citation often referred to by writers discussing this pop culture topic–the various forms of medicine out there today . . .

And Moses stretched forth his rod over the land of Egypt, and the east wind brought the locust. And the locust went up over all the land of Egypt; before it there was no such locust, and it did eat every herb of the field, and afterwards Moses stretched forth his rod, and the locust was cast into the Red Sea (Exod. 10:12).

I am trying to make sense of a commonly cited reference posed by recent writers about regular and alternative medicine. They probably do not realize that they are referring to the above quote from the Bible whenever they quote an attractive line penned by the famous writer of American Colonial history William Smith in THE HISTORY Of the PROVINCE of N E W-Y O R K, FROM THE First Discovery to the Year MDCCXXXII. To which is annexed, A Description of the Country, with a short Account of the Inhabitants, their Trade, Religious and Political State, and the Constitution of the Courts of Justice in that Colony (Printed for Thomas Wilcox, Bookseller at Virgil’s Head, opposite the New Church in the Strand, in London. M.DCC.LVII (1757)). I am referring to the following phrase that appears in Smith’s writings about the physicians practicing in the colony of New York around 1750.

“Quacks abound like Locusts in Egypt”

This commonly cited phrase comes from the following paragraph in Smith’s text:

There are some phrases or lines we are can be drawn to as writers, like a fly to flypaper one might say, or in the case of writers, a lonely sheep returning to its flock. After several days of constantly finding references to this particular phrase about two months ago, I decided it was time to research the various applications, and misapplications, of this phrase over the years. I was wondering, ‘are these writers citing each other, with little knowledge of what it is that they are citing?’

Samuel Bard

This phrase was originally used by Smith to refer to “doctors” who were for the most part trained or apprenticed in the Colonies, versus what he considered to be “better doctors”–those who were trained either as an apprentice in some office, by a school, and/or by a teaching hospital setting in England. At the time Smith wrote this claim, he failed to mention any of the activities engaged in by one of the most famous physicians for this time in New York–Dr. Samuel Bard of the City of New York. Loyalism had not yet come to bear as an important part of American culture and history, but the Stamp Tax act that resulted in the separation of loyalists from patriots was just a couple of years away once Smith’s book got published. Smith’s comments referred to the superiority of English-trained doctors (and perhap Scottish-trained or even other Western European trained physicians) over American-trained physicians. Apparently, most of the writers citing Smith’s famous line were unaware of this important piece of American medical history, generalizing it to refer to non-allopathic practices in the early US in general, not necessarily “quackery” since allopathy was often at fault just as much as its competitors.

[see http://civilwarmed.blogspot.com/2009/05/medical-department-25-civil-war-snake.html]

By far the most popular time for Smith to be quoted in the medical journals was the early 1900s, and came in reference to the problems of “quackery” stirring around the turn of the 20th century due to Patent Medicines. The most common year that this statement was cited was 1905/1906, the year the Pure Food and Drug act was discussed and passed. The Food and Drug Act was succeeded by the Food, Drug and Cosmetics act in 1915. The purpose for each of these laws was to manage the mislabeling going on since the early 1800s. These acts outlawed the sales of medicines that had certain drugs in them like the various forms of opium (with one or two exceptions, for example “heroin” was still available OTC and not excluded by this bill). It required the labelling of a remedy’s mysterious ingredients, and was an attempt to control the types of claims made on these labels regarding the many diseases a product was claimed to treat. This is like the problem we see today with certain medications claiming they help reduce the risk of heart disease when there is absolutely no statistically proof that taking these medications accomplishes that (i.e. the recent FDA statement about this regarding certain lipid and blood pressure lowering drugs)–it is just something some doctors want to beleive in and pass on down to their patient.

These applications of Smith’s statement had nothing to do with non-allopathic medicine. They had everything to do with regulating over-the-counter pharmacy. Although a controversy concerning non-allopathic training was once again taking main stage around this time, this was never the main attempt of the 1906 law and so William Smith’s 1757 claims had nothing to do with it, even though the writers wanted to think that it did.

In addition to the above finding, my study of the misapplication of Smith’s line also revealed that a number of times that Smith’s phrase was used as a result of a writer “borrowing” or plagiarizing this statement from another writer. They did not necessarily plagiarize Smith’s words. They pulled the statement from the writings of another author, citing neither Smith nor the later authors. To the novice reader, this can make it appear as though these writers were the creators of such a phrase along with its attached meaning and discovery, suggesting as well to these readers that this author deserved some sort of pat on the back for his or her discovery, and for daring to make such an opinionated and political statement about this controversial issue. This serious misuse of another writer’s discoveries begs the questions ‘Can we believe any of the other findings made by the writer?’ and ‘Is everything else this author writes about based on unreviewed resources?’

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Of course, the writing profession does have certain cases where citations are not appropriate or necessary for the particular article they were asked to produce. Setting this matter of “borrowing” and potential plagiarism aside, the reference to “Quacks” still made today in terms of non-allopathic medicine is really old hat. This kind of authorship is a sign of outdated intelligence. Unknowingly, the writer who uses this citation is telling us that he/she is probably not familiar with the non-allopathic profession, but more definitely that he is not read in the classics as much as he should be. This only results in more mis-citations as time passes, which the author is now a new example of. For example, in one such case we can find a citation originally made in 1757 for the first reason (British vs. American), becoming information that is applied by another person in 1906 for a second reason (reference to the over-the-counter drug patents), which several citations later, has lost its original meaning and is misconstrued or misappropriated (herbal medicine is bad). This new application does not at all match the original author’s intent, nor can it even be related truly to the current situations at hand. Today, Smith’s phrase is now being cited in reference to the development of complementary or integrative medicine, a far cry from the original quacksalvers, mountebanks and, oh yeah, American physicians whom Smith was referring to in 1757. True, it is closer to the original intent of 1757 than the popular 1905/6 use was, but do these writers really want their judgments made on non-allopathic medicine to be linked to some Bible quote about Moses? Do they want us readers to think of them as the next Moses, Smith, Young or Fishbein strongly rebelling against “irregular” medicine? (The next P.T. Barnum?)

This continued use of the word “Quacks”, with reference to Smith’s famous line, is something that modern society has outgrown. The words “quack” and “quackery” valid 50 or 75 years ago are very much outdated today. Society has become more mature one might say about this issue. The original cultural constructs for which this this word and cultural statement were intended are long gone. So today, when this historical statement is used, it is most often wrongfully applied to refer anything that is non-allopathic medicine, be it truthful or not. This is particularly the case when the critics don’t have an inkling of an idea about the contents of the philosophy they are talking about. I have to question the intellect of someone who denounces something like the theory that EMF could be a cause for fibromyalgia and acupuncture a possible treatment but cannot tell me whether the energy being produced by his scanner is discrete or sampled, or based on ‘nup’ or ‘sup’ (north up coils or south up coils).

It was different back in 1906 because then the critics were referring to the misuse and mishandling of chemicals, and only in some cases fraudulent claims regarding a physiological or pathological change that could not be made to happen, such as the instant curing of a cancer. When writers today use the terms “quack” or “quackery”, they are also telling us that practicing some form of medicine based on philosophical beliefs such as Vitalism, the balance of the four humors, Chi, Yin and Yang, Vata, Pitta and Kapha, Homeopathy, herb- or crystal-related energies, garden angels, dowsing and channeling with nature for the benefits of our innermost being are wrong. They forget that this also pertains to all non-American, non-allopathic traditions as well, like those practiced by Jewish, African, Carribean, Hoodoo, Hispanic, Hindu, Ayurvedic, Unanic, Chinese, Buddhist, Kampo, Celtic, Aesculapian, Phillipine, Hawaiian, Inuit, Metis, Navajo, Mayan, Scandinavian, or even Viking cultures. Does this mean that since these people are also practicing some sort of medicine which the writers don’t believe in, that it is quackery and shouldn’t be allowed?

James Harvey Young (1915-2006).

In my first days in medical school, I happened to meet the second historian to make the term “quackery” what it still is today for many people–James Harvey Young (for a biography see http://www.historians.org/perspectives/issues/2007/0702/0702mem3.cfm). One of the first readings for the special interest group I was in at medical school was his book on quackery–The Toadstool Millionaires. A Social History of Patent Medicines in America before Federal Regulation.

James Harvey Young’s writings about quackery and their effects on Americans and medicine were preceded and surpassed only by the works of an even more prolific speaker and writer of this field of the early 1900s, someone who represented the AMA and was the original editor of the pop culture trade magazine Hygeia. He was the infamous Morris Fishbein (similarly, see http://educate-yourself.org/cn/morrisfishbein05feb02.shtml). When I first began my work in the field as a student of medicine during the early 1980s, Fishbein’s books were the rage I was told and his books could still be found in nearly every used book store. Of course their presence in the used book world probably meant thay they had outgrown their original owners’ needs and interests of 30 or 40 years ago. But due to Fishbein’s writing style they were still pleasurable waiting room readings during the 1980s, much like they were to the “millions of readers” who decades before me perused Fishbein’s popular magazine Hygeia in much the same way, and in much the same type of physician’s office setting as well as at home.

Morris Fishbein (1889-1976)

The regularly distributed magazine Hygeia was kind of like the Weekly Readers or Highlights magazine one always found hanging around the waiting rooms at doctors’ and dentists’ offices. It was sent to as many people as possible, for free on many occasions. It focused on the importance of preventive medicine, hygienic practices, the value of immunizing, how to engage in the most appropriate exercise programs, developing good dietary behaviors, and all the other skills or lessons a doctor was said to be professed in, the knowledge base for those skills he or she was suppoed to provide to unsuspecting patients. But it is also important to keep in mind that an equal number of articles in Hygeia pertained to the numerous “fallacies” out there about health and hygiene. There was a special topic of this sort covered in each and every number produced, along with a matching editorial section Fishbein was in charge of. In this part of the magazine, the writer provided his reader with a unique and highly opinionated reports on some form of malpractice or “quackery” out there, reviewing such controversial topics as electrotherapy, herbal medicine, astrology and health, hypnotism, religion and medicine, and one of the worst “evils” known to man–homeopathy.

[Published from 1924 on, the current version of this journal can be accessed at http://www.hygeiajournal.com/. For origins and culturally-defined meaning in relationship to this journal title, see http://www.sciencemuseum.org.uk/broughttolife/people/hygeia.aspx.]

At the time Hygeia was first published, the popular practices like homeopathy and eclectics were in their final years, at least for their generation of medical schools branded as “alternative”. The new schools of naturopathy had just been born and were about to blossom (this is reviewed extensively and posted near the end of my lengthy list of topics). Were it not for the hygienic movement taking place in the 1920s and 1930s, naturopathy could have been well on its way to becoming its own self-sustaining practice by the 1950s. Instead, unfortunately, due to lack of financial input and political support, this profession was forced to take the stage alongside chiropractics for a while, terming itself “drugless medicine” while it taught its philosophy at the same schools that taught chiropractic medicine. This “mixed” schooling, as politicians called it, persisted for just a decade or two, and was forced to cease its operations once the problem of defining immunizations as a form of drug delivery came to court. [See Utah studies posted for more on this]. This led various government agencies in charge of overseeing accreditation processes to threaten the chiropractic profession with shutting its doors if this mixed form of schooling and licensure process continued.

Photographer Doug Beghtel/The Oregonian. Article’s author: Andy Dworkin. “New Clinic Opens at Portland College of Natural Medicine.” Published: Wednesday, September 30, 2009. Subtext for photo: “Students Tim Rudowsky (left) and Matt Elliott weigh and mix kun bu, or medicinal kelp, and other Chinese healing herbs in the medicinary of the new clinic at Portland’s National College of Natural Medicine.” Accessed on 3-25-2011 at http://www.oregonlive.com/health/index.ssf/2009/09/new_clinic_opens_at.html.

Time has of course allowed for a total reversal of this age old controversy. Today’s naturopaths have several licensed and accredited schools out there, with federal student loans available for those engaged in this particular form of medical education. This is all due to just the one school that persisted its operations throughout the 1960s and 1970s. Due to the passage of time, and changes in public perception and attitude, naturopathic doctors who earned an official ND status from an accredited school could once again engage in certain clinical practices that they were previously excluded from more than 50 to 60 years ago. (I underscore this because there are many learn at home NDs also out there who learned via mail from a non-accredited institution. For more on this accredited school and its licensed profession see http://www.ncnm.edu/.)

Suffice it to say, the “drugless medicine” of NDs is once again very popular, be it in the form of Chinese medicine, Ayurvedics, some 19th century form of herbal medicine, movement therapy, or even at times practices akin to the most modern products of allopathic pharmacology. Were it not for the invention of bioengineered drugs by allopaths, medicines designed to target specific parts of the body, today’s practice of allopathic care might appear at times to be something more and more like the “pharmacy” of its complementary medical field at times–naturopathic medicine. A number of MDs practice according to their own philosophies on the nature of health, which they either rediscovered or discovered for the first time, a knowledge of the past brought back into the modern era of “reformed” medicine. At times it seems the only differences between some of the more esoteric preachers of allopathy (those “certified” as homeopaths, nutraceuticalists, acupuncturists, environmental medicine specialists, nutrition doctors, sports medicine physicians, physical fitness doctors, some new age psychologists or psychiatrists), and the most traditional forms of naturopathy, are the “religions” or philosophies each of these classes of new physicians base their practices upon. When it comes to health maintenance and helping a patient find his/her best treatment plan, the knowledge of one practitioner can sometimes complement the preachings of the other. It’s funny how they never seem to effectively teach this in regular medical school.

To me this means that relating “quackery” to most of America’s modern alternative medicine is a vision of the past. Of course there is still true “quackery” out there . . . the poorly supported, misaligned claims made by “doctors” of any shape or form. For example, there are still people out there trying to claim they have found the magical cure to remove your skin’s blemishes as well as treat cancer, or claim they can change your appearances into someone who is 20 years younger, and of course there are the healers out there who claim they can manage to tell you all about your medical fate based on some test of the crystallization of your saliva, an analysis of your sweat to determine what substance your body is lacking, a review of your allergy-antigen history by means of a simple muscle test, or use a scan of your entire body’s physical and energy state or “forces” using nuclear magnetic resonance to interpret the “vibrations” produced by its water content (not Kirlian photography, but MRI, the nobel prize winning discovery of one of my chemical teachers at Stony Brook, Paul Lauterbur-see http://en.wikipedia.org/wiki/Paul_Lauterbur). Note: none of these claims are really promoted by any of my writings at this blogsite. So ‘rest in peace’ those of you who are trying to figure out whether or not I am someone who is willing to throw away the baton in the race to medical, political supremacy, or engage in my own form of unique form of the popular health culture. My work is focused on the philosophy of medicine in general, not just alternative, complementary or integrative medicine, but medicine in general.

Perception and prejudice are everything when it comes to formulating and acting upon one’s own opinion about “facts.” I once had this survey I always handed out at the end of the chemotaxonomy/ethnobotany classes I taught at Stony Brook and Portland State Universities. One of these questions asks students to define what side of the field I appear to be on regarding non-allopathic medicine. In other words, ‘Am I for or against these different forms of medicine I am teaching?’ The response options for this question ranged from strongly pro-alternative to strongly pro-allopathic, with the choice of a neutral score placed in the middle of the Likert response scale I provided them with. It always felt good to see that no one really knew where I stood in this matter. All of the possible perspectives of my work were out there.