Bulletin of the History of Medicine

Practitioners outside the medical mainstream are being taken much more seriously these days—by the NIH, by health insurance companies, and by historians. John Haller’s study of a small group of nineteenth-century American alternative practitioners and their schools, a continuation of his 1994 Medical Protestants: The Eclectics in American Medicine, 1825–1939, is an expression of this growing interest in the “other voices” that criticized orthodox practice and theory in ways that seem somehow familiar to recent health-care debates.

Physio-medicals were an offshoot of the better-known botanic movement Thomsonianism. By the 1830s some Thomsonian followers, calling themselves Reformers or Eclectics, began to replace founder Samuel Thomson’s antielitist rejection of heroic therapies like bloodletting and of formal medical institutions with a practice, taught in M.D.-degree-granting schools, that purportedly incorporated the best of every system’s therapeutic armamentarium. Physio-medicals were a group of Eclectics who felt that these reforms were straying too far from the original principles of Thomsonian “kindly medicine”; they became eclecticism’s conservative wing, and designated mainstream eclecticism as a “diluted form of allopathy” (p. 133).

Nine physio-medical schools were founded before the Civil War, three more in the 1880s and 1890s, and the last in 1902. The movement flourished in Ohio, Indiana, Illinois, and Iowa, with short-lived schools in Georgia, Alabama, Tennessee, Virginia, Massachusetts, New York, and New Hampshire; it gained enough public backing to open public hospitals to practitioners and students, and even to finance physio-medical hospitals. Physio-medical schools—like regular and homeopathic ones—were constantly splitting and merging, but Haller identifies three pivotal institutions. The Botanico-Medical College in Columbus, founded in 1836 by Alva Curtis, the father of independent Thomsonians, became in 1839 the second alternative medical school in the United States to gain a state charter (the Eclectic Medical Department of Worthington College in Ohio was first, in 1830). The college in Columbus was renamed the Physio-Medical College and moved to Cincinnati, where it lasted until 1880. In Indianapolis the Physio-Medical College of Indiana, founded in 1873 by George Hasty (an 1860 graduate of Curtis’s Cincinnati school), lasted for thirty-six years. The Physio-Medical Institute (later College) in Chicago was established in 1885 by William Henry Cook, a former professor at the Cincinnati school. Cook’s college was the only physio-medical school examined by Abraham Flexner; it was absorbed in 1911 into an Eclectic school that six years later was bought by the Loyola University School of Medicine.

This study is a fluently written multi-institutional history. Haller takes seriously the group’s intellectual framework and principles, exploring, for example, its leaders’ reaction to serum therapy and the germ theory (the latter derided in 1907 by an Indianapolis professor as “the greatest romanticism of the age” [p. 110]). He also points out that some pharmacy companies, such as Eli Lilly, took [End Page 328] the movement seriously enough to market explicitly physio-medical drugs. But in this medical history there is almost no social history: there is no class, no ethnicity, no race, and barely any gender. Florence Dressler, for example—a practitioner, faculty member, and secretary of Chicago’s Physio-Medical College of Medicine and Surgery in the 1900s—is relegated to a footnote.

Nor does the index have listings for “students” or “patients.” In part this reflects the sources—textbooks and medical journals—on which Haller has relied; he uses no diaries, medical theses, or newspaper commentaries, and almost no letters. As a result we have little sense of what kinds of students were attracted to this movement, or what happened to them when they graduated; what kinds of men (and occasionally women) made up the schools’ faculties; or what kinds of patients physio-medicals treated. Haller calls physio-medicals family practitioners—but we do not really know what kind of medicine they practiced. What about Cook, who worked in Chicago as a specialist in nervous diseases and the disorders of women?

Without a depiction of the workaday realities of physio-medical culture, Haller’s explanation of the movement’s decline is not fully convincing. Clearly a number of schools floundered due to their “fragile financial structure” (p. 149) and their inability to appeal to a public attracted by the new sciences. Still, a new physio-medical school was founded in Dallas in 1902, which by 1905 had thirty-nine students (including six women). And in 1895 Cook’s Chicago school, which had its own hospital and nurse training school, received a rank of “good standing” from the reformist Illinois State Board of Health. Haller points to increasingly restrictive state examining boards in the 1880s and 1890s that forced physio-medicals seeking a license to pretend to be homeopaths or Eclectics; yet in 1890, he mentions, Washington State’s mixed board had a physio-medical as treasurer, a homeopath as president, and a regular as secretary. Haller’s explanations for decline rely on an older historiography that drew uncritically on Flexner’s 1910 report as a source for understanding alternative medical education. I would prefer a more critical view of this reformist polemic that epitomized the Progressive pose of objectivity.

The history of alternative medicine in America can tell us with new voices and in new ways much about patients, disease, gender and social relations in healing, and the interactions between medicine and the state. Haller’s work is helpful in laying out some of the basic story of botanic medical groups after the 1830s, and it hints at some of these intriguing issues. But most remain to be explored, and readers will be left wanting more.