Kauai Osteopathic Services with doctor of Osteopathy, Lisa R. Chun

E-mail
Lisa R. Chun, D.O.

The History of Medicine
By Dr. Lisa R. Chun
Inspiration Magazine/ May-June 2003

We live in interesting and innovative times. There is a constant state of change. And the changes seem to be coming faster and quicker. Technology, knowledge, understanding, and people have given us the opportunity to improve the quality and longevity of life. Times can be hectic, forcing people to simplify, get down to basics, and to ask what is really important. Our concepts and ideas about what constitutes "health" and how to care for, maintain, strengthen, and recover it have become important. People describe "health" as including physical, mental, emotional, spiritual and social well-being, whatever parameters we use to artificially divide what it means to be human. History has shown that we can learn from previous generations. So, it's interesting to note that present day America in many ways mimics America at the turn of the 19th century. Health care now in many ways reflects the state of health care over a century ago. In order to better understand where we are and where we may be going, it would be beneficial to understand where we've come from.

It should be noted that "health" not only has many relationships but that the spectrum of health and it's care is wide. The terms "Complimentary" and "Alternative" have been used to describe categories which are considered outside mainstream conventional medical thought. Conventional medicine can help in many instances, and the non conventional therapies can help in many others. Medicine has incorporated much of the innovation, technological advances and scientific discoveries, yet it still does not address all the concerns that many people have. It's become accepted that no one category has all the answers. They all have their place. All have common goals: to alleviate pain, suffering, and dis-ease; and to promote health. Now, maybe the time has come to embrace and incorporate the many areas to fill the gaps and deficiencies of each system. Admitting that no one area has all the answers may indeed be the healthiest.

When taking the whole history of medicine in context, ancient cultures such as the Aztecs considered disease as a punishment from an unkind God, lack of cleanliness, extreme temperatures of hot and cold, humidity, meteorological changes, and intemperate eating and drinking. Disease came from wounds or broken bones. The incorporation of the physical with the mystical and religious pervaded many countries and regions of the world- that of early Central and South America, North America, Mesopotamia, Egypt, Greece, Polynesia, the Orient, and even Europe through the Middle Ages. External and internal causes were appreciated. Native peoples to this day integrate and acknowledge Spirit in everyday life.

During the Renaissance, new fields of thought were being explored. The knowledge and workings of the human body were only beginning to be discovered. Care of the mind became separate from the physical body. There was a group of physicians and biologists that reacted to these investigations and ideas saying that this new philosophy was too mechanical and material, and reductionistic. These "vitalists" believed man was more than the sum of his parts. That there is an innate, universal intelligence, a spiritual vital force that pervades Man, and that "health is accessible through…. technologies that activate, evoke, or re-direct universal beneficent healing influences."(Kaptchuk, The Web That Has No Weaver, pg. 35).

In colonial America, there were few formally educated physicians. Many had stayed in the big cities in Europe where the hazards of a sea voyage and unknown situations were of no worries. The colonists knew from experience that the medicine of their day could not help against infection or other serious disease. Keep in mind that the medicine of the day consisted of purging, bleeding, blistering, or the use of toxic substances or quantities. The printing press was not yet in full swing, and the education level of the general populace did not allow many to read or write. Word of mouth, experience and outcomes were the best indicators. Many incorporated what worked and learned by apprenticeship. Health care by non-physician personnel was very common.

By the mid-to-late 1700's, American born physicians could obtain formal education abroad. There was only one American medical school. These formally trained physicians, "regulars", made sporadic attempts to organize the profession. According to one historian, many people resisted licensure essentially because of the threat it posed to their traditional freedom to choose from a broad range of practitioners. This stream of formally trained physicians was interrupted because of the Revolutionary War. It was during and after the War that Americans sought a medical education from countries other than Britain. All other practitioners were considered "irregulars". The grouping of the "regulars" and "irregulars" led to the development of the American Medical Association in 1847.

According to one historian, this "irregular" therapeutic community conducted a loosely organized but effective running attack on regular medicine on the grounds that it wasn't working. A good deal of the appeal of these irregulars may well have derived from a simple desire of citizens for medical change, along with a public perception of the deficiencies of orthodox medicine. The quality and type of care available varied by region. Health care in the cities differed from health care in the more rural areas. Health care in the coastal regions differed from that in the middle or mountainous regions.

Toward the turn of that century, many people were moving into cities from rural areas because of jobs and opportunities. Sanitation and public health measures provided for the greatest contribution of conventional medicine. Antibiotics, anesthesia, antisepsis and other advances that we now take for granted were either not available or were not common. Foods were high in salt or fat. Refrigeration was not common. Consumption of alcohol and fermented products was high because it was safer than drinking the water.

Many people became proponents for change. Nutrition was one area. Sylvester Graham proposed regular exercise, fresh air, weekly bathing, meatless and liquor-free meals. One of his main issues was with unprocessed bread-"put back the bran". These responses were in regard to the frequent adulterants in the food of the time. William Kellogg and John and Harvey Post dealt with "sanatoriums" and the idea of a healthy breakfast. They also proposed abstinence from tea, coffee, and alcohol. There were calorie counts and the use of hypnotherapy and hydrotherapy. The two famous institutions were located in Michigan, The San and La Vita. Horace Fletcher proposed thoroughly chewing and enjoying one's food. Temperance was proposed.

Herbs were used, some of which were derived from Europe, some from the Orient. Many had contempt for, and fear of, the Native Americans and, therefore, of their culture and knowledge. Herb gardens were common, as were almanacs which printed herbal recipes. Samuel Thompson was known for his use of Indian tobacco-lobelia- to induce vomiting. His other health practices included the use of herbs, baths, and sweating.

Much of the rest of the climate can be described as per the following: folk medicine was largely empirical and often improvised; it's early advocates did not trust doctors or could not afford them. Oriental medical thoughts came into recognition. Midwives and women tended to birthing and women's issues when most physicians tended to the wealthier classes. Hydrotherapy, bathing, sweating, enemas and colonics, as well as the ingestion of bottled water, came to the fore even though it's use had been recorded in ancient times. Patent medicines were used. The use of the so-called "miracle " or "quick fix" remedies, snake oils, alcohol and narcotics existed. Medical disciplines encouraging vitalistic thought -Osteopathy, Homeopathy, Naturopathy, and Chiropractic. Eclecticism was a developed branch of medicine, which included not only the conventional thoughts of the day but also tried to incorporate into it's theme that of other thoughts-e.g. acupuncture, herbology, homeopathy. Exercise was brought into public view. Bernard McFadden proposed gymnastics and weight lifting. Anton Mesmer is credited with something which mimics hypnosis. Interest in spirituality and the occult existed.

As you can see, there are many parallels between that time and this. Now, many of these areas are more commonly accepted and used in mainstream thought. They have themselves been refined and expanded upon. Medical knowledge itself has also increased. So, that's where we find ourselves. Not back at the same place but at a similar one…a different turn on the spiral. Another point where it is acknowledged that the inner and outer are related, where the balance of the parts is just as important as the balance of the whole, where East meets West, the old and the new are important, and where there is no one correct path. During these times when we are being asked to be more accountable and responsible for our selves and for others, it is becoming increasingly more important that we take care firstly for ourselves, and then for others. Attention to our health and it's relationships will help strengthen the foundation from where we can truly help others. The distinction between "care taking" and "taking care" will become obvious.