A Profile in Alternative Medicine

The Eclectic Medical College of Cincinnati, 1835-1942

John S. Haller, Jr.

• Publisher: The Kent State University Press
• Year: 2012
• eBook ISBN: 9781612771885
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

The Eclectic Medical Institute was an American institution in origin, concept, and practice. For nearly a century, EMI was known as the "mecca of eclectic thinking" and the "Mother Institute" of reformed medicine. A Profile of Alternative Medicine recounts the history of eclectic medicine which, along with hydropathy, homeopathy, physiomedicalism, chiropractic, and osteopathy, competed with regular medicine (allopathy) in the nineteenth century.

This history of EMI is set within the broader context of American medicine and recounts the internal feuds, successes, adversity, and ultimate failure of this bastion of freedom in medical thought.

– CHAPTER ONE –

Cincinnati’s Medical
Establishment

THE CITY OF CINCINNATI, situated halfway between Pittsburgh at the head of the Ohio River and Cairo at its junction with the Mississippi, is part of the Miami country explored in 1751 by Christopher Gist, an agent for the Ohio Company. The original settlement, surrounded by a well-defined circle of hills, commenced in December 1788 with a population of eleven families and twenty-four unmarried men. A year later, the newly formed United States built Fort Washington on a site that is today Third Street. Threatened by Indians and disease during its early years, the settlement grew quickly as peace and security came to the region. By 1795, the town contained ninety-four cabins, ten frame houses, and five hundred inhabitants. With the boundaries of Ohio determined in 1802, two significant events occurred the following year: the town of Cincinnati was incorporated by the territorial legislature, and state government began operation. By 1805, the population had increased to 960 inhabitants and, in 1819, the state legislature granted a charter incorporating Cincinnati as a city.¹

The nickname “Queen City” appears to have been given to Cincinnati before 1834, but the actual origin will probably never be known. In all likelihood, it derived from the city’s strategic river location for moving merchandise and raw materials along the nation’s principal water routes. Early in the city’s history, large grocery houses, wholesale dry-goods stores, and pork-packing plants lined Front, Broadway, and Main Streets, which crowded close to the public landing. The city’s waterfront teemed with boats and passengers while roustabouts moved cotton, barrels, and other goods across gangplanks. Beyond the landing, flatboats, barges, and other craft transported people and cargo up and down the river. Steamboats appeared in growing numbers in the 1820s, and by midcentury the city had become a center of commerce and industry for the West. After the Civil War, steamboats continued to draw travelers for overnight passenger service, but railroads soon took over the movement of tonnage.²

The early settlers of the city came principally from the middle and northern Atlantic states and secondarily from the South. In later years, they came more directly from Europe, especially Germany, Ireland, England, Scotland, and Wales. From 1825 onward, German migration outstripped all others, with the Irish close behind. Cincinnati became a city of editors, publicists, musicians, scientists, divines, and pork packers. The black population, chiefly emancipated slaves and their offspring, arrived in small but steady numbers from Kentucky and Virginia. Census information reported a population of 24,831 in 1830; 46,338 in 1840; and 115,438 in 1850, including 3,172 blacks.³ Occupations and trades in 1850 included 176 attorneys; 227 barbers; 713 blacksmiths; 1,569 boot and shoe makers; 672 butchers; 327 coffee house keepers; 126 brewers; 533 grocers; 28 policemen; 278 doctors; and 153 druggists.⁴ By then, too, the city touted 91 churches and 3 synagogues; 19 public schools; 3 liberal arts colleges; 4 mercantile colleges; 5 theological schools; I law school; and 4 medical colleges.⁵

EARLY DOCTORS

The earliest medical care for the pioneers of the Queen City came by way of surgeons attached to the regular army of the United States who opened their army hospital chests to sick civilians and who, upon leaving the military, established practices in and around the village. The earliest military surgeons included Richard Allison, John Carmichael, Joseph Phillips, John Elliot, and John Sellman. These were replaced by citizen-physicians, the first of whom was William Burnet in 1789, followed in quick succession by Calvin Morrell, John Hole, John Cramer, John Stites, Jr., John Blackburn, Samuel Ramsey, William Goforth, and his friend and pupil Daniel Drake.⁶

Daniel Drake (1785–1852), who received the first medical diploma awarded west of the Allegheny Mountains, began practicing medicine in May 1804 at the age of nineteen, as partner to his former preceptor. A year later, he traveled to Philadelphia to study medicine more formally at the University of Pennsylvania. In 1807, he returned to Cincinnati to take over Goforth’s practice but went back briefly to Philadelphia in the fall of 1815 to complete the doctor of medicine degree. Over the next several decades, he had a role in the creation of several medical departments, hospitals, and affiliated units, including Transylvania University in Lexington, Kentucky, the first medical school west of the Alleghenies; the Medical College of Ohio, the second medical school of the West, which in 1896 became the Medical Department of the University of Cincinnati; the old Commercial Hospital and Lunatic Asylum, the predecessor to the University of Cincinnati Hospital; the Eye Infirmary of Cincinnati; the Western Museum Society (for which he hired John James Audubon); and the medical department of Cincinnati College, which he founded in 1835 after being expelled from the Medical College of Ohio. He authored Notices Concerning Cincinnati (1810), which provided an account of the town and of plants indigenous to the region; Natural and Statistical View, or Pictures of Cincinnati and the Miami County (1815), which he used to encourage settlement; the Western Journal of the Medical and Physical Sciences (1827–38), which he published and edited; Practical Essays on Medical Education, and the Medical Profession, in the United States (1832); and his most important work, A Systematic Treatise, Historical, Etiological and Practical on the Principal Diseases of the Interior Valley of North America (1850), which he wrote while teaching at the Louisville Medical Institute.⁷

According to Drake, every one of the city’s physicians was also a country practitioner who rode twelve to fifteen miles on bridle paths to visit sick patients. The typical charge was twenty-five cents a mile, “one half being deducted and the other paid in provender for his horse or produce for his family.” Doctors bled and cupped their patients, practiced dentistry, acted as their own apothecaries, and charged patients additional amounts for any personal services performed. For example, they charged twenty-five cents for a bleeding; the same amount for a draught of paregoric and antimonial wine; fifty cents for a vermifuge or blister; seventy-five cents for an ounce of Peruvian bark; and a dollar for sitting up all night with a patient. Although physicians carried medicines with them on their visits, they were just as apt to return home from a visit, compound a special mixture, and send it along to the patient.⁸

MEDICAL DEMOCRACY

Medical education in eighteenth-century America was a relatively simple affair. A student desiring a career in medicine apprenticed himself to a willing physician who served as preceptor and instructed him in the accumulated wisdom and experience of the practice. For a period of four to seven years, the apprentice remained a part of the doctor’s household; kept case books; read from available medical texts; learned how to prepare drugs; followed the doctor on his visits; helped to bleed, blister, and pull teeth; and generally learned the art and science of medicine. As one might imagine, the quality of apprenticeship varied with the educational background of the student, the nature of the preceptor’s practice, the availability of relevant medical texts, and the quality of supervision. American society needed doctors before there was an adequate way of educating them, and apprenticeship afforded a workable solution.⁹

Besides these home-grown physicians, some supplemented their apprenticeship with education abroad—at the University of Leyden in Holland, Hotel Dieu of Paris, Guy’s or St. Thomas’s Hospital in London, Dublin’s Meath Hospital, or the Edinburgh Royal Infirmary. There they took private courses (such as William Hunter’s theater in Covent Garden), enrolled for a medical degree, walked the hospital wards witnessing operations and dissections, and, in general, observed and studied a greater variety of diseases than were seen in a preceptor’s private practice. Upon returning to America, many of these same young men, inspired by what they saw and did abroad, organized medical schools patterned on European models. By 1800, ten medical departments, in conjunction with hospitals and established universities, provided the eastern seaboard states with a high level of clinical and didactic instruction.¹⁰

The system of apprenticeship adapted comfortably to the establishment of medical departments. The term of apprenticeship shortened to three years, with the understanding that the aspiring young doctor would divide his time between a preceptor and a didactic education. The faculty of these early schools gave lectures in anatomy, chemistry, theory and practice of medicine, surgery, medical jurisprudence, materia medica and botany, midwifery, and diseases of women and children. To overcome the lack of textbooks, medical training included two terms of the same subject matter, the rationale being that students who found it difficult to cover the prescribed material in the first term had the opportunity to complete their studies in the second.¹¹

Along with the salutary quality of university affiliation, the faculty in these medical departments enjoyed a high degree of autonomy; in terms of financial responsibility and supervision they had only nominal contact with the academic institution. Having received authority from a university to grant degrees, doctors operated a virtual imperium in imperio, setting their own salaries, tuition, and curriculum. The income for the faculty derived mainly from lecture tickets, although occasionally state legislatures permitted the use of lotteries to raise funds. Because of their heavy dependence on lecture fees, faculty were sometimes tempted to admit candidates on the basis of their ability to pay rather than on their potential as doctors.

The founding of the proprietary College of Medicine of Maryland in 1807 led to a new indigenous model of American medical education that spawned dozens of imitators in the states and territories west of the Appalachians. Unlike the Maryland college, which was actually well managed, many imitators lacked equipment, books, and qualified teachers, and only a few could boast even a nominal hospital affiliation. Except for occasional dissections, which some schools treated as optional, the curriculum was wholly didactic. Organized on a for-profit basis, these colleges operated as stock companies and paid an annual dividend to shareholders. Faculty brought and sold their teaching chairs, which were sources of both status and income, and relied on former students to send consultations their way out of school loyalty. By 1877, fewer than twenty of the sixty-five medical colleges in existence were connected with institutions of higher learning.¹²

As these proprietary schools proliferated and competition increased, faculties chose to capture their share of the student market through a combination of minimal entrance requirements, shortened curricula and terms, reduced matriculation and lecture fees, and lowered graduation expectations. In the absence of clinical facilities and with two ungraded school sessions lasting sixteen to twenty weeks each, the medical education system developed a profile that was deficient in many particulars. Certainly, bright, capable, dedicated teachers worked within this structure to produce remarkably brilliant physicians and surgeons. But these successes were achieved in spite of a weakened apprenticeship system, an overreliance on didactic learning, the lack of clinical and demonstrative teaching, lax licensing requirements, and a competitive spirit that matriculated students with little regard to their qualifications or competence.

Perhaps too much has been said in criticism of the early separation of medical schools from the university. Unlike their European counterparts, American universities were devoted principally to instruction in the classics, mathematics, and philosophy and had little connection with professional schools. Indeed, until the introduction of laboratory science into the medical school curriculum, there was little substantive advantage in integrating the medical school into the university. Besides, the rapid expansion of the frontier after 1800 demanded the training of large numbers of practitioners and this need was efficiently and effectively accomplished through the ingenious combination of apprenticeship and proprietary medical schools. Admittedly, the requirements for admission to these schools were minimal, but they produced a cadre of physicians who, while lacking in depth of scientific knowledge, provided a modicum of health care to the sprawling young republic.

For those young men who could afford the expense, Paris became the mecca for modern scientific medicine. There, enterprising young men sought practical training, learned the statistical and analytical study of disease, and, in the process, repaired many of the deficiencies of their didactic education. Postgraduate medical study took on new meaning as Pierre Louis (1787–1872) and other clinical teachers demonstrated the possibility of disease identification on the basis of extensive clinical and postmortem examinations. While short on experimental research, the Paris school of medicine represented a triumph of medical empiricism over metaphysical concepts of disease that had reigned unchallenged for centuries.¹³

To add to the challenge of maintaining medical standards, various state legislatures abandoned their meager licensing regulations that, when combined with the overseeing efforts of medical societies and university governing boards, had ensured some degree of regulatory control over the profession. The reasons for this shift are several, but, in the main, they reflected the egalitarian nature of American culture and its aversion to monopoly, elitism, intellectualism, and restraint of trade. The spirit of democracy ran high as legislatures chose to see little difference between proprietary and university-affiliated medical schools, between regular and irregular practitioners, and between the claims of one medical system and another. In rapid succession, states repealed what medical legislation existed: Illinois in 1826; Ohio in 1833; Mississippi in 1834; the District of Columbia, Maryland, Massachusetts, Maine, Connecticut, and South Carolina in 1838; New York in 1844; Te...

Table of contents

• Cover page
• Halftitle Page
• Title Page
• Copyright Page
• Dedication
• Contents
• Illustrations
• Acknowledgments
• Introduction
• 1. Cincinnati’s Medical Establishment
• 2. All the Dean’s Men
• 3. Academics
• 4. Student Life
• 5. Presiding over Change
• 6. Denouement
• Appendix: Women Graduates of the Eclectic Medical College, 1853-1939
• Notes
• Selected Bibliography
• Index