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Lotions, Potions, Pills, and Magic: Health Care in Early America
Health in early America was generally good. The food was plentiful, the air and water were clean, and people tended to enjoy strong constitutions as a result of this environment. Practitioners of traditional forms of health care enjoyed high social status, and the cures they offered—from purging to mere palliatives—carried a powerful authority. Consequently, most American doctors felt little need to keep up with Europe’s medical advances relying heavily on their traditional depletion methods. However, in the years following the American Revolution as poverty increased and America’s water and air became more polluted, people grew sicker. Traditional medicine became increasingly ineffective. Instead, Americans sought out both older and newer forms of alternative medicine and people who embraced these midwives, folk healers, Native American shamans, African obeahs and the new botanical and water cure advocates.
In this overview of health and healing in early America, Elaine G. Breslaw describes the evolution of public health crises and solutions. Breslaw examines “ethnic borrowings” (of both disease and treatment) of early American medicine and the tension between trained doctors and the lay public. While orthodox medicine never fully lost its authority, Lotions, Potions, Pills, and Magic argues that their ascendance over other healers didn’t begin until the early twentieth century, as germ theory finally migrated from Europe to the United States and American medical education achieved professional standing.
In this overview of health and healing in early America, Elaine G. Breslaw describes the evolution of public health crises and solutions. Breslaw examines “ethnic borrowings” (of both disease and treatment) of early American medicine and the tension between trained doctors and the lay public. While orthodox medicine never fully lost its authority, Lotions, Potions, Pills, and Magic argues that their ascendance over other healers didn’t begin until the early twentieth century, as germ theory finally migrated from Europe to the United States and American medical education achieved professional standing.
251 pages, Paperback
First published September 1, 2012
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Displaying 1 - 5 of 5 reviews
December 31, 2019
One might think that the "magic" of the title refers to the active ingredient in the prescriptions of Native American shamans or West African obeahs, or even Northern European folk healers and herbalists, all of whom the residents of colonial America and the early republic called upon when sick. In reality, the magic refers to the mystique surrounding elite physicians of that time, what we might today call the "white coat" of the doctor, that assures the patient that this professional can heal. A main theme of Breslaw's incredibly informative book is that if the professional physician healed at all it was only by the power of that mystique, rather than by the methods employed.
Indeed, by Breslaw's account, all of the healers of the era employed essentially the same "regime of depletion, bleeding and purging to remove the infected matter." (p. 37) In other words, the prevailing theory of medicine at the time was that the healer needed to get the sickness out of the patient by getting them to poop, pee, throw up, sweat or--more aggressively---bleed. Of all the healers consulted by early Americans, only the physician, however, employed the most aggressive treatments. Good thing, then, that the "informal health system was more important in the lives of colonial peoples" (p. 52) than the professional one. Elites were the only exceptions to this trend.
Breslaw makes a convincing case that the methods of physicians, trained by either fledgling medical schools or as apprentices, did more harm than good. Moreover wrong beliefs such as the "miasmic" origin of disease proved intractable, even in the face of scientific theories of disease emerging in Europe in the late 18th and early 19th centuries.
Case in point, the guiding light of American medicine Benjamin Rush argued that his bleeding and purging cured yellow fever during an epidemic in Philadelphia in 1793, even after his opponents proved the disease spread by contagion from the Caribbean. This founding father of psychiatry invented a "tranquilizing chair" in which the afflicted person would be strapped and blind-folded for hours at a time, to be a more humane "cure" for insanity than a straight jacket or chains. Breslaw writes that "[t]he peculiar role of Benjamin Rush in American history cannot be explained on the basis of his remedies, which were often fatal." (p. 100) In fact his "heroic" measures, she argues, may have set back American medicine for generations, as professional physicians employed his methods to demonstrate they were taking powerful and decisive action. The ugly stuff coming out of people seemed to prove the efficacy of such interventions. If the patient didn't recover, it was in spite and not because of them.
Breslaw builds on the work of David Wooten in Bad Medicine: Doctors Doing Harm Since Hippocrates, who called the period 1830-1850 the "dark age" of American medicine, although Lotions is more even-handed, less polemical, and therefore more convincing than Wooten's account. Even as American medicine embraced empiricism and scientifically-based medicine in the years following the Civil War, the mystique of the white coat lives on, and still shrouds bad and even predatory medicine. Breslaw's valuable book cautions us not to let it cloud our judgement, neither of the past nor when seeking treatment ourselves.
Indeed, by Breslaw's account, all of the healers of the era employed essentially the same "regime of depletion, bleeding and purging to remove the infected matter." (p. 37) In other words, the prevailing theory of medicine at the time was that the healer needed to get the sickness out of the patient by getting them to poop, pee, throw up, sweat or--more aggressively---bleed. Of all the healers consulted by early Americans, only the physician, however, employed the most aggressive treatments. Good thing, then, that the "informal health system was more important in the lives of colonial peoples" (p. 52) than the professional one. Elites were the only exceptions to this trend.
Breslaw makes a convincing case that the methods of physicians, trained by either fledgling medical schools or as apprentices, did more harm than good. Moreover wrong beliefs such as the "miasmic" origin of disease proved intractable, even in the face of scientific theories of disease emerging in Europe in the late 18th and early 19th centuries.
Case in point, the guiding light of American medicine Benjamin Rush argued that his bleeding and purging cured yellow fever during an epidemic in Philadelphia in 1793, even after his opponents proved the disease spread by contagion from the Caribbean. This founding father of psychiatry invented a "tranquilizing chair" in which the afflicted person would be strapped and blind-folded for hours at a time, to be a more humane "cure" for insanity than a straight jacket or chains. Breslaw writes that "[t]he peculiar role of Benjamin Rush in American history cannot be explained on the basis of his remedies, which were often fatal." (p. 100) In fact his "heroic" measures, she argues, may have set back American medicine for generations, as professional physicians employed his methods to demonstrate they were taking powerful and decisive action. The ugly stuff coming out of people seemed to prove the efficacy of such interventions. If the patient didn't recover, it was in spite and not because of them.
Breslaw builds on the work of David Wooten in Bad Medicine: Doctors Doing Harm Since Hippocrates, who called the period 1830-1850 the "dark age" of American medicine, although Lotions is more even-handed, less polemical, and therefore more convincing than Wooten's account. Even as American medicine embraced empiricism and scientifically-based medicine in the years following the Civil War, the mystique of the white coat lives on, and still shrouds bad and even predatory medicine. Breslaw's valuable book cautions us not to let it cloud our judgement, neither of the past nor when seeking treatment ourselves.
March 6, 2020
Lots of good info. Not sure why the author was surprised by Americans leaning away from doctors and going more into self care and alternative medicine since modern doctors are pretty much owned by the pharmaceutical companies.
March 7, 2017
This was a pretty great book! As a Health Services Administration major, it was really interesting to look into the history and nature of health care in Colonial America. Unfortunately, I was required to read this for class and had to answer questions over specific points, so it took out the holistic reading experience for me. I'll probably give it a read after term is over to get more out of it.
December 15, 2013
If you've ever wondered how this country's healthcare situation got so screwed up, this slim volume reveals the roots of our deep divide over how, why, and to whom quality medical care should be provided.
American exceptionalism leading American doctors to dismiss new theories championed by European healthcare providers? Distrust by many Americans of vaccines? Poor people's bad health being blamed on moral failings rather than on the unsafe and sometimes unsanitary environment in which they live? Religious leaders seeking absolute control over women's reproductive health? Shocking disparity in the quality of care provided to white and nonwhite patients? It all started here, in the early days of the United States, and the decisions made in those early days still reverberate today.
I absolutely recommend this book to anyone interested in the history of medicine in the United States, and it should be required reading for every politician on any healthcare task force.
American exceptionalism leading American doctors to dismiss new theories championed by European healthcare providers? Distrust by many Americans of vaccines? Poor people's bad health being blamed on moral failings rather than on the unsafe and sometimes unsanitary environment in which they live? Religious leaders seeking absolute control over women's reproductive health? Shocking disparity in the quality of care provided to white and nonwhite patients? It all started here, in the early days of the United States, and the decisions made in those early days still reverberate today.
I absolutely recommend this book to anyone interested in the history of medicine in the United States, and it should be required reading for every politician on any healthcare task force.
May 3, 2014
A must read for anyone entering or in the medical profession. But also eye opening for this who wonder why other developed countries like America have a better healthcare system.
Displaying 1 - 5 of 5 reviews