Ode to an
icon of 19th century medical reform and his contributions to the
culture of Physiomedicalism.
“Some are in the belief, and are free to express that
belief, that the name of Samuel Thomson will live in all future ages, and
continue to brighten in proportion to the circulation and development of the
full extent of his medical discoveries…For, if the future age should receive
his character from the present, loaded with slander, it will nevertheless,
place a due estimate upon that practice of medicine which he originated amidst
the persecution and calumny of the present generation; and they will do justice
to his name, and to his medical discovery…” - David Tower, Four Lectures on the Thomsonian Practice of Medicine, 18281
Introduction: the Battlefield of American Medicine
Regulars,
Allopaths, Homeopaths, Root Doctors, Thomsonians, Neo-Thomsonians, Eclectics,
Physios. Diving into the subject of 19th century American Medicine
requires a suit of armored protection for unbiased inquiry and historical
fact-checking prowess (to neither of which I lay claim). It is a messy, brutal warscape, writhing with
the confusion, complexity, and accusatory tone typical of conflict-driven sectarianism.
Jacksonian era politics and social norms ensured that the laws that regulated
the practice of medicine rapidly disappeared, and within this context, medical
anarchy ensued.2-4 Different factions of therapeutic philosophy
began to appear and publish literary arguments about the cause and more
specifically the treatment of disease. They also argued internally about what
to call themselves and their principles of practice and therapeutic strategy, about
the nature and form of medical education, and about who should be qualified to
receive the illustrious title of ‘Physician’ (or the acrimonious distinction of
‘Quack’). This hot bed of reformation also targeted elitism and classism as symptoms
of an anti-democratic plague thereby empowering a common ‘do-it-yourself’
population.3 (p443) The concept of ‘self-help’ became the booming
timpani within medical reform by challenging the perception that the role of
physician was necessary for the healing of disease and more aggressively, that
the ‘Regular’ practice of medicine was actually safe and efficacious.2(p15),5
There
are a few historians that have attempted to traverse this hostile territory,
many focusing on the merited evolution of modern allopathic medical practice
out of an otherwise barbaric history.6-10 Even more to the point,
there have been some medical historians that have looked into the face of what has
been termed America’s Botanico-medical movement4 in an attempt to
reiterate the foundations of therapeutic strategy for the ever-growing herbal
medicine movement of modern times. Their attempts have been to reconnect practitioners
of herbal medicine to a system of medical therapeutics that continues to be central
to its present-day practice.11-15 Their work succeeds in
reconstructing the long-lost tangibility of Western herbal medicine theory and
practicum that many of us modern herbal medicine practitioners may feel is
missing within our clinical practice. I take my hat off to them, for they are
warriors in their own right.
The
following essay is an investigation into Samuel Thomson, a true icon of 19th
century medical reform, and his system of therapeutics (Thomsonianism) that
spread like wild-fire across a violent and sickly landscape, creating fertile
ground for the development of botanical medicine in America and abroad. The nature of life and the human body and how
to define disease and its causation, form the basis of the once widely utilized
Thomsonian system of therapeutics.14
These foundational concepts, although metamorphic in nature, remain
intact philosophies within the principles and practice of modern Physiomedicalism
whose primary therapeutic objective is support of the ‘vital force’.13(p11),14(p7)
However,
these fundamental Thomsonian concepts, as outlined below, were not novel
ideas. Although Samuel Thomson himself
readily admits to being ‘uneducated’, there is little doubt that he was privy
to the legacies of Galen and Hippocrates, as well as larger philosophical
debates taking place within medicine and the neighboring fields of chemistry
and physics during his time. What made
Thomsonian medicine unique however, was that it was the first system whose
materia medica was solely based on medicinal plants (refusing the use of
mineral preparations), and that brought the following larger concepts together
to form a concrete therapeutic system with reproducible results (and had enough
fortitude to publicly upset the entire practice of allopathy and even perhaps
inform its evolution.)2(p17-18),5
 |
Samuel
Thomson (1769-1843), the father of Western herbal medicine. Holding his beloved
No. 1, Lobelia inflata. Photo compliments of Center for the History of
Medicine.
|
Planting
the Seed of Vitalism
Thomsonian medicine was born within an era of opposing
views regarding the nature of ‘life phenomena’17(p18), an academic, philosophical,
and religious debate which was deeply influencing late 18th century
and 19th century scientific research into the laws of organic and
inorganic chemistry and physics, and hence the fields of physiology and
medicine.17-19 One side of
this vitalism vs. mechanism debate found its ancestry in Georg Ernst Stahl’s
(1660-1734) principles of anima,2(p91)
which declared that even though the living and the nonliving are both composed
of matter, the difference between them is the presence of an immaterial vital
principle (anima). This anima could only be described or studied
within the context and understanding that living matter is endeavoring towards
a particular goal or purpose and this endeavor, or goal-seeking effort, is
driven by the directive agency of anima over
the mechanical manifestations within living matter.20 Anima was endowed with intelligence and
represented a ‘finite portion of the universal spirit that actuates all
creation’.21(p531)
Samuel
Thomson was revered by medical reformers for rekindling the concept of anima, or vitalism, in governance of
physiology and hence medical therapeutics.2(p91) This concept was
later termed ‘vital force’ by the Physiomedicalists,22 but Thomson
himself never specifically referred to it as such. Instead, the presence of
this concept within Thomson’s theory and practice is inferred from his explanations
of the constitution of life and the body, the cause and treatment of disease, and
his objections to the employment of blood-letting and the use of ‘depletive
remedies’, such as mercury, arsenic and opium, by allopathic or ‘regular’
physicians.5(p191) Thomson states:
“For there are but two great principles in the
constitution of things, the principle of life and the principle of death. That which contains the principle of life,
can never be tortured into an administration of death. If, then, a medicine is good in any case, it
is because it is agreeable to nature, or this principle of life, the very
opposite of disease.”5(p188)
 |
Lobelia inflata. From
Vegetable Materia Medica of the U.S. William Barton, 1818. Thomson claimed to
have discovered the medicinal value of this species as a child. It is by far the most important medicinal
plant found in his New Guide to Health, for an entire system of medicine was
built around its use.
|
This
concept of animism or vitalsim is
often directly stated by Thomson’s contemporaries under various and sundry titles
and explanations.23-26 A clear example of this can be found in Four Lectures on the Thomsonian Practice of
Medicine,1 whereby Tower embarks upon the clarification of what
he calls ‘the active power’ with the premise that the organization of the human
body and all its elements was proof in and of itself that it was designed for
such animation. He states:
“The great point with us, as physicians, is, to know
what principles are active, and what passive, in animal motion. The nature of the active power, and the
nature of that on which it is exerted. For there must be such an agent as
active power, and this active power acts on material substances. It is necessary for the physician to have
correct views of the active power, for in diseases the active power is weakened
and diminished by inanimate matter, and it must be assisted…”1(p42)
Heat,
or the Determining Power and the Vital Flame
Samuel
Thomson actively called upon and quoted aspects of Galenic and Hippocratic
medical philosophy in the formation of his system of medicine. For example, he believed that the human body
was comprised of the four elements (earth, air, fire and water), whereby earth
and water constituted the ‘solids’, and air and fire (or heat) were the cause
of life and motion.5(p185) In addition, Thomson quotes the
Hippocratic sentiment of ‘nature is heat’,5(p190) forming his entire
system of therapeutics around the axiom ‘heat is life, and cold is death’,
whereby adding or diminishing heat could promote either health or disease.5(p43)
Thomson described his theory of this vital heat as ‘the determining power’5(186)
which flowed outward from a ‘fountain’5(p188), the stomach, having
been fueled by the digestion of food and nourishing substances. This is not dissimilar to the concept of Agni (its various types and functions)
of Ayurvedic (Indian) medicine.27 Thomson writes:
“Our life depends on heat; food is the fuel that
kindles and continues that heat…The stomach is the deposit from which the whole
body is supported. The heat is
maintained in the stomach by consuming the food; and all the body and limbs
receive their proportion of nourishment and heat from that source; as a whole
room is warmed by the fire which is consumed in the fire-place.”5(p186)
We
see many similar metaphors regarding this subject in the writing of Thomson’s
contemporaries, all of which suggest that Thomson was not alone in his
vitalistic argument of heat as the great animator of life. Often referred to as
the ‘caloric’, it was evidenced from the observation of heat in the natural world,
that it must play a role in the animism of the human body. This argument was
based upon the seasons as observed within northern hemisphere, whereby the
heated time of year brought forth the flourishing of movement and life just as
the winter yielded stillness and death.1(p41-42) This comparison was further indulged by the
admiration of the sun as ultimate regulator of life which sits at the center of
all known things, perpetually exerting an omnipotent energy outward into the
universe.21(pvi) Although
this particular Romanesque argument venerated the heart as the seat of ‘calor
vitalis’ and compared it as such to the Sun21(p530) (unlike Thomson
who recognized the stomach and digestion as the source of vital heat), nonetheless
it expresses inherent support for Thomson’s axiom and his concept of the ‘vital
flame’.5(p188) These literary examples are furthermore fortified by
discussions regarding the role of heat as a catalyst in chemical reactions,21
its effects on water in the creation of steam,1(p43) and many others.
Defining
Disease and its Causation: an inherent philosophy of Vitalism
Building
upon the apothegmatic construct of heat as the source of life, Thomson’s
definition of disease and his views on its causation also speak to an inherent
philosophy of Vitalism. Although his
sentiments were described differently by various Thomsonian authors, according
to their doctrine there was one singular cause of disease and in describing
this cause one could define disease in simple terms. There was no need for the various and sundry
names and titles denoted by the ‘Regular faculty’ in the differentiation of
disease states.5(pg191), 24(p12)
To
Thomson, the human body being made up of the aforementioned elements of earth,
air, fire, and water, was only able to achieve a perfect state of health when
each of these elements were in balance with one another5(p185). When these elements were thrown off balance
(for whatever reason), the imbalance created a diminution or absence of fire,
or ‘heat’, and in this absence of heat the body would be proportionally
affected by ‘cold’.5(p186) ‘Cold’ was henceforth the cause of
‘obstructions to perspiration’, and these ‘obstructions’ manifest themselves as
symptoms of disease, often referred to by Thomson as ‘canker’ and
‘putrification’. It was ‘cold’, therefore, that was at the seat of all disease,
being opposite to all that supported life. This was the singular cause of all
of human suffering.5(p185-189) Thomson himself was adamant about this
singular causation:
“And I found that all disorders which the human family
are afflicted with, however various the symptoms, and different the names by
which they are called, arise directly from obstructed perspiration, which is
always caused by cold, or want of heat.”5(p43)
 |
Sorry...couldn't help
myself. This picture definitely represents the epitome of both 'cold' and
'ill'. Jack Nicholson in The Shining.
|
This
approach to defining disease from a physiological perspective (albeit
potentially limited), rather than defining disease based upon its symptomatic
presentation, represents support for the larger concept of vitalism present in
Thomsonian medicine, as well as in its evolved state of Physiomedicalism.13-14,28-29
In this regard, Thomson often describes what could be interpreted as an epic
battle between inward heat, or the determining power, and the external forces
applied by ‘cold’ in the causation of disease. He likened this determining power,
which originated in the stomach, to a fountain whose outward flow could be
easily overpowered by the influence of the stream (the cold). He writes:
“The inward heat is the fountain of life, and as much
as that has the power above the outward heat, so much we have life and
strength, and when we lose this power of heat, our strength and faculties decay
in proportion; and it is immaterial whether we lose this power by losing the
inward heat or raising the outward heat above it, as the effect is the same...When
the outward heat becomes equal with the inward…cold assumes the power and death
takes place.”5(p193)
We
see different variations of these sentiments throughout Thomsonian literature.2(p25-43)
Although narrowed down to a singular causation, the explanation of pathology,
or the effects of an overpowering ‘cold’, sometimes shifted between concepts
such as canker and putrification,5 obstructions as caused by canker
and putrification,5,25,30 or in some perspectives ‘loss of tone to
the organs’.24(p8) By and
large however, there was a general agreement within Thomsonian medicine that a
singular cause and hence therapeutic strategy was clear. Countering cold, or supporting
heat as the living power of the system (vital flame), was the primary
therapeutic objective.
Thomsonian
Therapeutics: In support of the Determining Power
As
all disease within the human body was believed to be caused by cold and its
obstructions, it was very evident to Thomson and his followers that this
general causation need only be countered by a general remedy. The Thomsonians were clear, however, that one
general remedy did not mean a single therapeutic agent, but rather a single
therapeutic approach.5,23-24,26 Thomson’s patented system, or the
general cure, sought first and foremost to rekindle the vital flame, or
determining power, by raising internal heat to clear obstructions, followed by a
cleansing of the stomach and bowels so digestion, or ‘the fountain’, could once
again maintain the determining power on its own:
“There is no mystery in it, the whole plan consists of
keeping the determining power to the surface from the fountain of the body,
which is the stomach; from which all the limbs receive their support and
warmth, and when you cannot raise their support and warmth, and when you cannot
raise the fountain sufficient to give nature its proper course, you must lower
the stream, or outward heat, by keeping the heat down on the limbs and raising
the inward heat, when there can no mortification ever return from the limbs to
the body, any more than a log can float against the stream.”5(p138-139
Surprisingly,
this sentiment of ‘general cause, general remedy’ was shared by different
therapeutic philosophies even within the practice of allopathic or Regular
medicine.2(p16-17),4,31 In this regard, there was also at times
agreement between Thomsonians and Regulars about their respective therapeutic
mechanisms as outlined in the following statement:
“Dr. Thomson by considering disease as the general
effect of a general cause, obstruction, fixed
his remedy, like the others. Remove the obstruction is his cure. Remove the debility is Dr. Brown’s cure [referring to Dr. John Brown and his
Brunonian system]. Remove the morbid
excitement is Dr. Rush’s cure [Dr. Benjamin Rush of Philadelphia who heavily
employed the practice of blood-letting].
And all done by diffusive stimulants. The debility is to be removed by diffusive
stimulants. The morbid excitement
by diffusive stimulants. The obstruction by diffusive stimulants.”26(p29)
Therefore,
the mechanics of Thomsonian therapeutics did not differ much from the
popularized heroic32 practices of Regular medicine, both of which
sought to effect a cure through stimulating secretions from the body.2,4
However, even with the employment of strong emetics, purgatives, and
diaphoretics, Thomson believed his practice was superior, safer, and more
efficacious than that of allopathic practice because his system worked with the
body rather than against it. He used steam baths and botanicals as the
therapeutic agents, rather then what he called ‘depletive remedies’ or
‘instruments of death’,5(p187) such as mercury and arsenic, and the
practice of blood-letting. These en vogue agents of the Regulars, Thomson
argued, worked against nature and the determining power, by promoting cold and
therefore death.5(p188) A
good example of this is present in Thomson’s opinions about the role of fevers:
“I have found by experience, that the learned doctors
are wrong in considering fever a disease or enemy; the fever is a friend, and
cold the enemy…it is the struggle of nature to throw off disease…If cold, which
is the commonly received opinion, (and which is true) is the cause of fever, to
repeatedly bleed that patient, and administer mercury, opium, nitre, and other
refrigerents to restore him to health, is as though a man should, to increase a
fire in his room, throw a part of it out of the house, and to increase the
remainder, put on water, snow, and ice!”5(p191)
 |
Breathing a Vein. James Gillray, published by H. Humphrey, St James’s Street, London,
January 28, 1804. Thomson was adamantly opposed to the popular heroics of
bloodletting as practiced by the Regular physicians of his time.
|
In
reading Thomson’s New Guide to Health5 it becomes apparently clear that the
primary objective in the treatment of disease was to support the body’s own
recuperative agenda. This approach of supporting physiology, honoring the vital
force by working with the body rather than against it, has become an essential
feature in the practice of present-day Western herbal medicine.12,33
There is an emphasis placed upon the importance of investigating the
physiology, rather than the symptoms of disease, prior to the application of a
therapeutic strategy.14(p8),33 There is still present a belief or
faith in the self-affirming and self-regulating power of nature, and the
unprecedented importance of supporting this power in the negotiation for
wellness.
Conclusions:
Vix Medicatrix Naturae
The
irony of modern day historical investigation into the heart of turbulent 19th
century medicine lies in an apparently biased interpretation of historical
literature. The side you are
investigating from (because yes, there are still sides), modern orthodoxy or
the holistic paradigm, continues to dictate the outcomes of our perceptions of
history. However, in my days of studying
linguistic anthropology I learned that one must speak the language if they are
hopeful of ever even attempting to understand a culture. Therefore, it is in the language of the
Thomsonian approach to the treatment of disease where the present day
practitioner of Western herbal medicine can begin to appreciate the culture of Physiomedicalism.
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Thomsonianism
promoted the principle of supporting the vital force that became the
cornerstone of the practice of past and present-day Physiomedicalism.13-14,22,28-29
Physiomedicalism is therefore an evolution of a system of medicine that seeks
to work with the physiology of the body (vital force) rather that against
it. There is an underlying respect for
the intelligence of the anima, the
immaterial essence of nature that was designed to moderate itself, the vix medicatrix naturae, or healing power
of nature.2(p94) Physiomedicalism is then a culture that lives
within the foundations of the present-day theory and practicum of Western
herbal medicine and its holistic paradigm, which also seeks to celebrate this
intelligence and support of the vitality of the human body, rather than
medicate against it.12.33
In
addition, Thomson believed that every person should have access to the
knowledge of how to heal themselves and be their own doctor.2,5,16
This, as an inalienable human right, is very much upheld in the present-day
practice of Western herbal medicine. As Western herbalists we are trained to empower
those individuals plagued by illness and disease to reclaim their
responsibility for their health and educate themselves about the promotion
thereof. It is an echo of a larger
democratic appeal not dissimilar to that of Samuel Thomson’s time, a concept
know deeply engendered in the struggle for health sovereignty taking place on the
battlefields of the present-day American healthcare system.
In
closing, Samuel Thomson is indeed an icon of 19th century medical
reform and who has rightfully been knighted as the father of present-day Western
herbal medicine. It was out of his
determination that the philosophies of Physiomedicalism were born, giving rise
to a culture and system of medicine that was, and continues to be, “of the
people, by the people, and for the people”.
Footnotes
1.
Tower, D. Four Lectures on the Practice of Thomsonian
Medicine. By David Tower Physician at Avon Mineral Springs. Canandaigua:
Bemis, Morse and Ward; 1828.
2.
Haller Jr., JS. Kindly Medicine. Physio-medicalism in
America, 1836-1911. Kent, OH: The Kent State University Press; 1997.
3.
Flannery, MA. The
early botanical medical movement as a reflection of life, liberty, and literacy
in Jacksonian America. J Med Libr Assoc.
2002; (90)4: 442-454.
4.
Berman, A,
Flannery, MA. America’s Botanico-Medical
Movements Vox Populi. New York, NY: Pharmaceutical Products Press; 2001.
5.
Thomson, S. New Guide to Health; or, Botanic Family
Physician, containing a Complete System of Practice, upon a plan entirely new;
with a description of the vegetables made use of, and directions for preparing
and administering them to cure disease, to which is Prefixed a Narrative of the
Life and Medical Discoveries of the Author. Boston: E.G. House; 1822.
6.
Starr, P. The Social Transformation of American
Medicine: The rise of a sovereign profession and the making of a vast industry.
New York: Basic Books; 1984.
7.
Starr, P. Remedy and the Reaction: The Peculiar
American Struggle over Health Care Reform. Revised Edition. New Haven, CT:
Yale University Press; 2013.
8.
Warner, JH. The Therapeutic Perspective: Medical
Practice, Knowledge, and Identity in America, 1820-1885. Reprint edition.
Princeton, NJ: Princeton University Press; 1997.
9.
Shortt, SED.
Physicians, science, and status: issues in the professionalization of
Anglo-American medicine in the nineteenth century. Medical History. 1983; 27:51-68.
10.
Numbers, RL. The
history of American medicine: a field in ferment. Reviews in American History. 1982; December: 245-263.
11.
Griggs, B. Green Pharmacy: The History and Evolution of
Western Herbal Medicine. Second edition. Rochester, VT: Healing Arts Press;
1997.
12.
Wood, M. The Practice of Traditional Western
Herbalism. Berkeley, CA: North Atlantic Books; 2004.
13.
Menzies-Trull, C.
Herbal Medicine: Keys to Physiomedicalism
including Pharmacopoeia. Second edition. New Castle: Faculty of
Physiomedical Herbal Medicine Publications; 2013.
14.
Priest, AW,
Priest, LR. Herbal Medication: A Clinical
and Dispensary Handbook. London: LN Fowler & Co; 1983.
15.
Winston, D.
American botanic medicine from Thomson to the Eclectics. 1999. Available at: https://www.herbaltherapeutics.net/_media/american_botanic_medicine.pdf.
Accessed January 28, 2015.
16.
Haller Jr., JS. The People’s Doctor: Samuel Thomson and the
American Botanical Movement, 1790-1860. Carbondale, IL: Southern Illinois
University Press; 2001.
17.
Melzer, SJ.
Vitalism and Mechanism in Biology and Medicine. Science, New Series. 1904; 19(470): 18-22.
18.
Sawyer, ME. An Inaugural Dissertation: Contain an
enquiry into the Existence of the Living Principle and Causes of Animal Life.
Philadelphia: T Dobson; 1793.
19.
Payne, MD., M. Essays on the Philosophy of Vitality as
Contradistinguished from Chemical and Mechanical Philosophy and on the Modus
Operandi of Remedial Agents. New York: Hopkins & Jennings; 1842.
20.
King, LS. Stahl, Georg
Ernst. In Complete Dictionary of
Scientific Biography. 2008. Encyclopedia.com. Available at: http://www.encyclopedia.com/topic/Georg_Ernst_Stahl.aspx.
Accessed February 5, 2015.
21.
Metcalfe, SL. Caloric: its mechanical, chemical, and vital agencies in the phenomena
of nature. Vol. 1. Philadelphia: Lippincott; 1859.
22.
Thurston, MD.,
JM. The Philosophy of Physiomedicalism,
its theorem, corollary, and laws of application for the cure of disease. Richmond,
IN: Nicholson Printing & Mfg Co; 1900.
23.
Thomson, J. A vindication of the Thomsonian System of
the practice of medicine on botanical principles, as originated by Samuel
Thomson, and continued by his coadjutors. Albany, NY: Webster & Wood;
1825.
24.
Howard, H. An improved system of botanic medicine,
founded upon correct physiological principles; Comprising of a complete
treatise on the practice of medicine. New edition. Cincinnati: OH: Kost,
Bigger & Hart; 1854.
25.
Mattson, M. The American vegetable practice, or, a new
and improved guide to health, designed for the use of families. 2 vols.
Boston: Daniel L Hale; 1841.
26.
Stevens, J. Medical reform; or physiology and botanic
practice for the people. London: Whittaker; 1848.
27.
Agrawal AK, Yadav
CR, Meena MS. Physiological aspects of Agni. AYU. 2010; 31(3): 395–398.
28.
Curtis, A. A fair examination and criticism of all the
medical systems in vogue. Second ed. Cincinnati: Printer for the
proprietor; 1865.
29.
Cook, W. The Physio-medical dispensary: a treatise on
therapeutics, materia medica, and pharmacy, in accordance with the principles
of physiological medicine. Cincinnati: By Author; 1869.
30.
Smith, E. The botanic physician; being a compendium of
the practice of physic, upon botanical principles. New York: Murphy and
Bingham; 1830.
31.
Wood, M. Study
guide to the six tissue states. 2010. Available at: http://www.portlandherbalschool.com/wp-content/uploads/2010/03/Study-Guide-to-the-Six-Tissue-States.pdf.
Accessed January 5, 2015.
32.
Berman, A. Heroic
approach in 19th century medical practice. Bulletin of the American Society of Hospital Pharmacists. 1954; 11:
321-327.
33.
Mills, S. The Essential Book of Herbal Medicine. London:
Penguin; 1991.
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