Brian Altonen, MPH, MS

 The Research of American Doctors

Introduction

Understanding a physician requires a sufficient background knowledge in cultural and religious upbringing, and clues to what personal viewpoints someone had who was practicing medicine.  These traits are the result of personal, family, social and cultural upbringing.  The philosophy and means by which an individual comes to be a practitioner can be any of numerous ways due to the nature of medicine in the United States and its colonial predecessor.  Some practitioners are informally trained and have a fairly superficial understanding of health and disease and the related cause-effect relationships that exist between disease and health.  Other practitioners have a fairly completely understanding of health and medicine so far as this expertise was defined by the society or people teaching the basics of medicine at the time it was learned.   In many cases, a practitioner may be trained by a friend, other family member or neighbor as an official or unofficial apprentice.  In other cases, a practitioners is trained by self-engagement in a series of medical writings designed for those with the wish of becoming a doctor.  The remaining practitioners learned medicine the traditional way, they travelled to Europe and attanded a school and/or were apprenticed, or they attended one of the fairly young schools set up in the United States.  Even these remaining choices were never the same in terms of their requirements and philosophy from one place to the next.

Time is also a very important factor in understanding the type of medicine being practiced.  In New England for example, there is one family in which the grandfather was a colonial physician practicing either some form of vitalism (belief in energy and the body), or brunonianism (aka brownism, belief in perpetual movement of very small particles, much like the atomic theory), or William Thacher’s old classic solidism (belief in the mechanistic manner in which the body works and has diseases erupt).   This individual’s son could learn and become a believer of the philosophy of climate and disease, the notion that we have some internal factors and inherited temperament that may be the cause for our illnesses, but also are victims of nature and if we are strongly religious, God’s choices and actions, factors we may have little control of.  Still a generation later, this same family could have physician devoted to electric cure philosophy, with the electricity produced in some theoretical way relying upon two different metals and based on the galvanism theory just developed (metallic tractors philosophy).  A generation or two more in sequence could result in an individual so strongly devoted to electrogalvanism, that he/she made use of real sources for electricity, like the chemical cell or battery, or static electric generator.  Meanwhile, a family residing next door might be completely into food and health, another into the use of purgatives and laxatives and diaphoretics (sweat-inducing medicines) to induced a cure [Thomsonians]. and yet another into some new fangled German vital force concept that made its way into this country via the German communities (Hahnemannism or Homeopathy].  Medicine never was a stable profession with a single range of philosophies taught at any given time throughout most of the nineteenth century.

Due to the continuous changes that science and medicine have gone through over time, medicine cannot be the same from one generation to the next.    Even when we try to beak the history down into 10 year periods of time, there are enough new changes made during a single decade alone, almost on a yearly basis, that it becomes a difficult process trying to define a particular form of medicine for a particular period of time based on the contemporary knowledge and medical school information available during an individual’s period of training.   At best, we can make a number of assumptions regardin beliefs and methods of practice put to youth by a past physician, but to be accurate as these conclusions are being drawn, a numberof temporal and geographic geatures have to be considered along with the already mentioned characteristics related to religious and cultural upbringing for anyone who is a practitioner.

Over the years, I have found a number of obstacles to be the reasons for many of the problems we have when we are learning about past family members who are doctors.

• First, the type of medicine an individual practiced is never fully known–a practitioner could be an unofficially trained, and a self-defined specialist in medicine, or he/she could have a significant amount of documentation out there detailing the type of medical practice he/she was engaged in and the requirements to engage in such a practice.
• Second, the field of medicine is forever changing over time politically and intellectually.   So too is the underlying philosophy of physicians undergoing constant change.  This always results in some form of “new age” philosophy, an ideology that exists before science can confirm whether or not the claims are true or not.  This means that a person treating a particular illness during one decade could have a totally different reason for engaging in that same practice a decade or two later.   As the time between two periods increases, so too do the reasons for a particular drug that was in use.  For example, the traditional reason opium was administered during the late 1700s and early 1800s was to stop diarrhea from continuing, particularly in cases of dysentery.  By the late 1800s opium drugs served to relieve pain but their primary use related to some form of psychological distress and addiction.
• Third, how do these different types of practices vary over place and time in the colonies and within the United States?   Prior to the Civil War, medicine was very much regional in nature, with Midwest practices significantly different from Northwest, Northeast and even Southeast forms of practicing medicine.   Due to the unstable nature of the medical profession from 1783, the end of the Revolutionary War, to the 1850s, the period when professional organizations became well defined and established, we could find different parts of even a single state varying from one city to the next.  This was due to the establishment of one form of medical school in one urban setting, and another school with a completely different philosophy established in the town or city next door or at a some location (Missouri, 1850s) that was well distanced from its professional and political competition (Iowa, 1870s).  This ongoing change in medicine and its legalities would not begin to stabilize until the period after the Civil War, and even then, this profession went through changes in philosophy and treatment forms due to differing opinions regarding the germ theory for disease, whether or not electricity played an important role in the healing process, whether or not herbal medicines were healthier than mineral drugs being used, whether or not some philosophy of medicine that seemed very naturally-based was more or less important, efficient or healthy than the standard much more toxic regular medical practices.

Having spent most of my time researching 19th century doctors, I came to understand the nature of the healers in a direction reverse of that typically employed by genealogists.  Usually a genealogist is looking up some past family member, and as a part of this research trying to better understand the belief systems harbored by the past family member who practiced some sort of medicine, and as the family legends put it was some sort of a root doctor, and not at all a “bone-breaker.”  Where does one go with this piece of family history to define what kind of physician this great grandparent, aunt or uncle was?  To answer that question, time is the first issue that has to be resolved.  What year exactly did he/she learn the skill?  Where did this take place?  What religion and/or natural philosophy did he/she believe and incorporate into the practice of health and healing?  Were there any neighbors who could have been of some important influence on the traditions at hand in terms of medicine and disease cause?  What school was opened next door, if any?  Who did he/she learn under and why?

Medicine is not a field of study that was as attractive as it is today for particular reasons.  Until the Civil War, there was no money promised by becoming a physician.  There were the few elite doctors who earned plenty, often residing in or near cities to make this sort of income with their work, but over the generations, having a medical degree had status, not reputation.   The MD degree gave someone the intellectual background needed to back a personal claim about one’s skill at being a politician.  It provided some individuals with the background needed to engage in certain fairly lucrative investment industries.   It gave you a skill that you could fall back on if necessary, to make more money when times were tough, and when times weren’t that tough, have the investments needed to engage in all sorts of entrepreneural activities like investing in land in some rural or distant setting, taking a trip to India in order to establish some new local industry devoted to a certain style of clothing or music, or even taking “time off” to pursue the events related to dreams of becoming an argonaut fully engaged in some mythical gold hunting fantasy.

Once the Civil War was over, medicine became more a science, and for the first time became an occupation in an official sense, acting and behaving much like it is today.  Post-bellum medicine had more solid practice-related requirements.  The medical profession solidified the form and progress of its professional groups, which formed since the 1850s but were of limited value and highly competitive with one another prior to the war.  During the first decade after the Civil War, the various specialities of medicine and its “irregulars” were reborn, perfected and defined further, such that economic progress became its major stabilizer and philosophy and ideology its major drawing point.  Why become a doctor devoted to surgery and the use of lancet and opium if you had the choice of becoming some sort of climate cure or mineral springs specialist?  Ten years into this period in medical history, medicine suddenly had more control of itself at some regulatory, government-driven level.  State laws were finally being supported and enforced.  State governments with a Board of Medicine were formed.  The bacterial cause for disease had been discovered, the one philosophy that countered every other philosophy that non-regularly trained physicians believed in.  As this philosophy took about twenty years to finally stabilize and become the new “Truth” in regular medicine, the old believers died off or faded away.  Some became family doctors practicing just on family members.  Others retired.  Still others died off.  Between 1876 and 1896, the types of doctors allowed to practice by any given state became just one of three forms–regular, eclectics and homeopaths.  All the remaining philosophies of practice died off, even though some were trying to revitalize their former movements.  Thomsonianism, Physiomedicine, Electrotherapy, Naturopathy were all reborn during this time, only the latter maintained its existence well into the 20th century.

A number of pages at this blogsite have pages devoted to the various forms of schools and philosophies out there.   The schools in particular are reviewed in detail at several of these pages, with an emphasis more on the pre-Civil War period than the Post-War period.  The attempt here is to establish a series ofwork that are more applicable to just the genealogists’ approach to learning about some past physician.

The following topics are to be reviewed for exploring the past history of a family member who is a healer, practitioner or other form of doctor or physician.

1. The Philosophy of the Doctor you are Researching
2. Learning Place and Practice Type
3. Primary and Secondary References and Journals
4. Overview of Training and Learning
5. Unofficial Training and Practices
6. European Schools and Apprenticeships
7. Colonial and Early Post-colonial United States Apprenticeships
8. American Apprenticeships and Lectureships
9. Military medical training and the Wars
10. Regular or Allopathic Medical Schooling in America
11. Irregular or Non-allopathic Medical Schooling in America, Introduction
12. Thomsonians and allies
13. Eclectics
14. Homeopaths
15. Water Cure, hydropathy and hydrotherapy
16. Midwifery
17. Early Nutrition Therapy (Grahamism)
18. Chiropractic
19. Chiropody or Podiatry
20. Osteopathy
21. Drugless Medicine and Naturopathy
22. Other Non-schooled professions, introduction
23. Basic Herbalists, Herbalist-Midwifes
24. Indian Root Doctoring
25. Mountainman-Trapper Medicine
26. Chronothermalism and Climate therapy
27. Gymnastics and Exercise or Movement Therapy
28. Physical Therapy
29. Electrotherapy and galvanotherapy
30. Early Psychological Therapy and the BodyMind to MindBody traditions
31. Christian Science and others

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Chronology Diagram

The following is a chronological overview of the medical philosophies and traditions mostly of European and early Euro-American birth.  This is a fairly simplistic illustration, but provides enough detail to introduce the development of what was often called sectarian medicine during the late 1700s and early to mid-1800s in North American history.

Nearly all of medicine during these years practiced according to a philosophy and a tradition.  Some writers have referred to regular medicine during this time as representative of the earliest examples of experimental science.  Some of medicine was practiced based on experimental results, but most of it was fairly limited in the amount of this evidence set forth for review, and so remained classical or traditional in nature up to the Civil War.  Both regular medicine and “irregular” medicine based their practices mostly of theory, which in turn required a well-defined philosophy to substantiate any claims being made.  The more circumstantial evidence that appeared in support of the profession’s claims, the stronger that philosophy was in the public eye, and the more trusting the physician was who abided by these “proven” claims.   As noted elsewhere in my work on the formation of medical schools between 1783 and 1860, the history of the schools indicates that the majority of news medical schools that formed between 1810 and 1850 were those teaching reformed medicine or some other alternative to regular medicine.  The public was becoming increasingly disinterested in regular physicians, their philosophical claims, and their very distressing, and sometimes fatal, ways of practicing.

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