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Wednesday, October 19, 2016

The Early History of Medical Licensing

From: mnwelldir.org


The Constitution of this Republic should make special provision for medical freedom. To restrict the art of healing to one class will constitute the Bastille of medical science. All such laws are un-American and despotic. . . . Unless we put medical freedom into the constitution the time will come when medicine will organize into an undercover dictatorship and force people who wish doctors and treatment of their own choice to submit to only what the dictating outfit offers. [Dr Benjamin Rush, at the Constitutional Convention]

In 1800, all forms of medicine were practiced together. It wasn’t long before medical societies sprung up with the sole purpose of supporting one type of medicine over another.

In 1806 the first licensing laws were passed in the US, in New York, called the Medical Practices Act. This act allowed the state to license practitioners, which meant that only licensed physicians could recover their fees in courts. Unlicensed practitioners were fined $25.00 for practicing without a license. The New York Journal of Medicine candidly published the reasoning behind this new law: “the suppression of empiricism and the encouragement of regular practitioners.”

Empiricism: the application of observation and experiment, rather than theory, in determining something. This is, supposedly, the core of modern science.

It should be noted that when the first medical licensing laws were passed, legalizing only the practice of medicine based on the philosophy of the four humors, that this particular medicine had neither cured nor had it even palliated a single illness. In fact, if you pulled all of the nutritional and herbal medicines out of their pharmacopoeia, there wasn't a single medicine left that could help an ailing patient. Pharmaceutical medicine would have to wait exactly one hundred years from this first licensing laws before it cured an illness. Yet local governments, pressured by the physicians (not the citizens), tried to force bad medicine onto the populace.

America was still very young and many remembered the struggle for freedom and liberty. Many of these early Americans felt this kind of law to be unconscionable and far too restrictive on their rights and freedom. In 1807 the Medical Practices Act was modified to a point just short of its being repealed. The fine was dropped significantly, and the definition of an “irregular” physician was so defined as to hardly include anyone. Even a student of any of the competing practices did not fall under the parameters of this new definition.

Connecticut passed a similar law in 1832. The Thomsonians fought back and had it repealed in 1842. In 1827 the medical societies attempted to put teeth back into the New York laws, but in 1830, much of this new law was reversed, and by 1844 it was completely abolished. Even with laws on the books, the juries often took the side of the irregulars. Coulter’s book, Divided Legacy, tells us of a case in 1843 where a man charged with practicing homeopathy without a license was found guilty by a jury of his peers, but they fined him 3/4 of a cent for every infraction, and when the trial was over, they all donated their fees received for being on the jury to a local homeopathic society.

Early Americans still remembered the price of freedom, and were loath to relinquish theirs.

Massachusetts passed its first licensing laws in 1819, but they were repealed in 1835. Illinois passed their first laws in 1819, which were repealed in 1821, and then reinstated in 1825, but finally abolished the following year. Some of the strictest licensing laws were passed in Ohio in 1810 and in 1816. These were repealed in 1819, with new laws on the books by 1824, though these didn’t last ten years. In the South, where Thomsonians flourished, licensing laws were passed in Alabama restricting practices outside regular medicine, but in 1832 were modified to allow Thomsonians to practice and recover their fees in courts. Georgia passed medical licensing laws in 1825 and established the first Board of Examiners. In 1839 the law was revised to allow herbalists and Thomsonians to practice and in 1847 Georgia even established a Botanic Medical Board of Physicians along with laws allowing only those practitioners who had graduated from proper botanical schools to practice.

Throughout the 1820s and 1830s Delaware, Mississippi, Vermont, Indiana, Maryland, South Carolina, and Maine all repealed their licensing laws to allow irregulars to practice, and by 1850 Rhode Island, Pennsylvania, Virginia, North Carolina, Texas, Tennessee, Kentucky, and Missouri had never regulated medicine. In fact, by 1850 only Louisiana, Michigan, New Jersey, and Washington DC had laws concerning the licensing of regular physicians.

As you can see, the regulars held sway during the 1820s and 1830s. They influenced a lot of legislation, but because laws in any society represent the will of the people, public opinion won out and the network of medical societies collapsed as the competition built up a strong following.

Then something happened that nearly put a stake in the heart of regular medicine: the advent and spread of Homeopathy throughout the land.

Homeopathy

Though developed and codified by 1796 by Samuel Hahnemann (1755-1845), homeopathy didn’t find its way to America until 1825.

Homeopathy was a reaction to “heroic” medicine. Its foundation was nutrition, exercise, minimal medicine, and, interestingly enough, human relationships. You might say that this was America’s first foray into holistic medicine.

For every disorder there was just one medicine needed. Mixing two together made no sense, because no one could know what the two would do together inside the human body (unlike today when we put our seniors on a slew of medicines, and despite the fact that no one could possibly tell us what will happen with the various combinations; yet we are told that today’s medical practice is highly scientific).

Diet meant a “mixed and varied” diet, and exercise was simply movement. Walking was encouraged.

One of the basic foundations of Homeopathy is that the human body, if given a bit of help, can heal itself. Nature was not an enemy to the homeopath as it was to the regular physician. Hahnemann created homeopathy as “the instrument of total reform in therapeutics.”

During the early 1800s the Thomsonians, many of whom practiced with botanicals too, were regular medicine’s greatest competition. In the 1840’s the Thomsonians joined forces with the botanical physicians and formed the Eclectic school of medicine. But by this time, it was Homeopathy that had become traditional medicine’s greatest competition.

One reason that Homeopathy was so successful was that it did not kill the patient. Another reason was that the theory was integrated and coherent. The average citizen of this period could attend lectures at a regular medical school and walk away having learned nothing, whereas the bulk of homeopathy theory was, in comparison, easily comprehended.

There was hardly a visitor to the US during the early 1800s who did not return to Europe with horror stories about the state of the average American’s health. They reported that we had crooked jaws, teeth missing, a grey pallor, a lazy gate, and our overall health dilapidated. Their reports were not good; our cities were filled with weak and tired people. Historians today tend to agree mercury poisoning (from traditional medicine) would be one good explanation for the state of our health.

Dr Rush, being open-minded, would have probably been a proponent of homeopathy had he lived long enough. His career was exemplary, and he was even called upon by President Jefferson in 1803 to work with Lewis and Clark prior to their expedition. Rush furnished them with questions they would ask the natives concerning their remedies, sweats, purges and bleeding. [http://www.geocities.com/bobarnebeck/ch18.html]

Rush had treated patients through a slew of epidemics and fevers. The epidemic of 1804 that affected farmers living in the outskirts brought food shortages to the city dwellers. A nationwide flu epidemic broke out in 1807, and what was called the “Winter Epidemic” lasted from 1812 to 1814; one long winter, wouldn’t you say?

It was at this time, according to historian Bob Arnebeck, that, “Medical science achieved a tone, which it has maintained to the present day, challenging any complacency about health and death.” This was the advent of heroic medicine. Nature was an enemy, and sometimes, even the Creator was the enemy.

Rush, however, did not partake in this philosophy. He kept an open mind and felt that research would eventually find answers. This is why I feel, that had he lived long enough, he would have been a proponent of homeopathy. Rush, though, did have his detractors. (And they might have been right; for Rush's brand of medicine, and the way he practiced it, killed many and helped few, very few.)

It was at this time that the first “germ theory” of medicine had been first proposed, by a Dr John Crawford, who “suggested in 1807 that ‘amiculae’ caused fevers. He even associated insects with the process. Remarking on the incredible ability of insects to multiply over swamps, he drew the analogy with smaller pests multiplying inside the body.” [Arnebeck]

Amiculae were the little creatures discovered in water through the invention of the microscope.

Rush was excited about these new theories, although he was a regular, charged with “remorseless bleeding” by some of his contemporaries, and even challenged to a dual by another physician. Rush, however, believed in empiricism, and in this respect, he was a true scientist bent on learning as much as he could. Ironically, in the end it was regular medicine that eventually caught up with Dr Rush when he became ill and required a physician. He died shortly after being bled and fed calomel.

Homeopathy had no quarrel with nature or with the Creator. This was homeopathy’s greatest philosophical distinction from the heroic tradition of medicine. The next distinguishing facet was that the regulars felt that everything could be known, eventually; that all disease was mechanical. To Hahnemann, disease was not logical, and not always material; that there was a spiritual aspect to disease.

In Chinese medicine, the spiritual aspect to disease is a given. To modern science, if it cannot be measured, it does not play into the equation. The spirit cannot be measured. This is where biophysics separates from biochemistry. It is also where homeopathy separates from allopathy. The only things a homeopath knows are the symptoms. Homeopathy treats according to the symptoms.

We often come down hard on allopathy for treating symptoms, however, there is a distinction here, between homeopathy’s treatment of symptoms and allopathy’s. Take cancer as an example. Modern allopathy treats cancer as a disease, when in fact it is a symptom. Dr Sam Chachoua demonstrates in his lectures time and again that cancer has come about evolutionarily to protect the body from and issue that can become systemic and kill the individual. Allopathy attacks the symptom. Outside of allopathy, cancer is a symptom and localized. To the homeopathy, the distinction, though seemingly slight, is that it treats "according to the symptoms" (cancer in this case), but not by attacking them. To treat cancer, the homeopath gives the body a minute quantity of substance that would normally cause that same cancer.

In an interview with Dr Sam, he pointed out that homeopathy was on the right track because when you give take a patient with cancer and give that person a cancer in another part of the body, the first cancer dies off.

If you have arthritis, allopathy treats the pain, but the arthritis doesn’t go away. If you have high blood pressure, drugs are given that lower your blood pressure, but the problem does not go away. If you go off the blood pressure drugs, your blood pressure shoots up again. Treating symptoms allopathically is different from treating according to the symptoms homeopathically, but to understand thoroughly this exotic theory, it is best to read the article What is Homeopathy?

Hahnemann accepted that we cannot know the body, we cannot know the disease, we cannot know the human spirit, but what we can know are the symptoms. “When the physician has discovered all the observable symptoms of the disease that exist, he has discovered the disease itself, he has attained the complete conception of it requisite to enable him to effect a cure.” [Coulter]

By 1845, homeopathy had become regular medicine’s greatest competition. Its ranks began to swell from regulars leaving behind their educations and taking up this less toxic brand of medicine. Humorists of the latter half of the 19th century, when discussing the subject of medicine were sure to give the standard patter that regular medicine would kill you, but at least with homeopathy, you’d die of the disease.

Hahnemann was attacked for treating symptoms and not the cause of illnesses (not that regular medicine had ever treated the cause of illness, though I’m sure many had thought they had). Hahnemann responded to his critics claiming that, in treating the symptoms with homeopathy, nothing was left to do. The person was off the drug, and the disease was gone.

It is not conceivable, nor can it be proved by any experience in the world, that, after removal of all the symptoms of a disease, and of the entire collection of perceptible phenomena, there should or could remain anything else besides health, or that the morbid alteration of the interior could remain uneradicated. [Organon of the Medical Art, section 8]

There was then, and is today, a difference between treating symptoms to get symptomatic relief, and treating “according to the symptoms” so that the body will repair itself. However, this distinction is often lost on the narrow-minded.

By discovering all the symptoms exhibited, Hahnemann could find the “exact” medicine to deliver, while the orthodoxy wasted far too much time speculating on the various causes that oftentimes got them enwrapped in contradictions and inconsistencies. “It is safe to say that the Solodist [orthodox] doctrine of diseased, causes, and symptoms was never worked out in detail.” [Coulter]

Hahnemann felt that since there were no criteria for distinguishing the unimportant symptoms from the important ones, that all symptoms must be considered.

Orthodox physicians of that time arrived on the scene with a shotgun full of remedies. They bled, purged, blistered, applied mercury, administered bark, etc. For Hahnemann, after determining all the symptoms, there was one and only one medicine to administer:

In no case under treatment is it necessary and therefore not permissible to administer to a patient more than one single, simple medicinal substance at one time…. As the true physician finds in simple medicines, administered singly and uncombined, all that he can be possibly desire … he will, mindful of the wise maxim that “ it is wrong to attempt to employ a complex means when simple means suffice”, never think of giving as a remedy any but a single, simple substance…. [Coulter]

Today, it is hard to find an elderly patient who is on fewer than 3 or 4 medications. No one can tell you what the overall, cumulative effect of those drugs will be. However, we’re beginning to suspect what can happen as cancer, heart disease, osteoporosis, and Alzheimer’s disease seem to be the main diseases suffered by our overly-drugged elderly population. A few renegade physicians are beginning to point to the treatments (drugs) as being the causes of these many illnesses.

Funny, but this was known way back when: “even though the simple medicines were thoroughly proved with respect to their pure peculiar effects on the unimpaired healthy state of man, it is impossible to foresee how two and more medicinal substances might, when compounded, hinder and alter each other’s actions on the human body…” [Organon of the Medical Art, section 274]

The orthodoxy had few medicines. As stated above, their pharmacopoeia was small and most physicians preferred to administer just a handful of medicines (calomel being their favorite). It was the homeopaths (and herbalists, see below) who employed a greater number of medicines at that time, since, according to the tenets of homeopathy; there was only one possible medicine for any disease (considering all the symptoms). Homeopaths were constantly looking for more medicines to classify, prove, and apply.

The rise of homeopathy was not without constraints. In Austria, it was banned by imperial decree shortly after its introduction in 1819, but was still used underground to treat the cholera epidemic of 1831. Statistics published in The Logic of Figures or Comparative Results of Homoeopathic and Other Treatments in 1900 show that cholera patients treated with conventional medicine had a 50% death rate, while those treated homeopathically had less than a 22% rate of death. Understandably, the decree was revoked in 1837.

In Great Britain homeopathy got a similar welcome, was quickly outlawed after its introduction, and then courageously contested, resulting in a repeal of the prohibition and by the 1880s homeopathy prospered handsomely. A homeopathic dispensary had been opened in 1841, a second in 1867, and by 1885 fifteen hundred people a week were being treated with homeopathy.

In France a medical student was expelled for merely expressing interest in homeopathy. According to Coulter’s book, Divided Legacy, when a conventional physician in France evaluated the results of a homeopathy study in a favorable light, no orthodox medical journal would publish the results. So, he published his work in an Homeopathy journal, and was summarily expelled by his medical society.

What few people realize today, is that “the history of nineteenth-century therapeutics is essentially one of the progressive adoption by allopathic physicians of a numerous medicines originally introduced by homeopathy.”  [Coulter]

Homeopathy today is cursed, laughed at, and derided by orthodox medicine, and ironically, if the orthodoxy had not adopted many of the medicines along with the rule that less is more, orthodox medicine would not even be close to what it is today. When they are through attacking homeopathy, perhaps some orthodox physicians will open a history book and rediscover their roots.

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