THE THOMSONIAN AND BOTANIC MEDICAL SYSTEMS BY J. BEN NICHOLS, M.D., UNITED STATES SOLDIERS' HOME, WASHINGTON, D. C. FROM THE MEDICAL NEWS, February 2, 1895. [Reprinted from The Medical News, February 2, 1895.] THE THOM SONIAN AND BOTANIC MEDICAL S Y ST EMS. By J. BEN NICHOLS, M.D., UNITED STATES SOLDIERS' HOME, WASHINGTON, D. C. The Thomsonian medical system arose in the United States early in the present century, attained considerable prominence and popularity for a few decades, largely under the name of botanic medicine and is now nearly or quite extinct, with the excep- tion of a slightly modified form known as physio- medicalism, which still survives in a few localities. The prominence and influence which the system in its time attained give it a place in the history of medical sectarianism. The subject seems sufficiently profitable and interesting as a matter of medical history and general medical information to warrant this historic and doctrinal review. Samuel Thomson, the originator of the system, was born in 1769 in Alstead, a country place in Southwestern New Hampshire. He was brought up in the country, had almost no education whatever, and as he grew into manhood engaged in farming. About 1792 he began to doctor, at first in his own family and then among his neighbors. As years passed he developed his medical notions, and his reputation and practice extended. From about 2 1806 he engaged in itinerant medical practice, trav- elling about from town to town in Northern New England. In 1813 he obtained a patent on his sys- tem, by virtue of which he claimed sole proprietor- ship and control of it, and made the " right " to use it a simple article of commerce. Under his man- agement Thomsonism was preeminently a system of family medicine and treatment. He taught that food and medicine are analogous, and, growing side by side in the fields, it is as simple and natural for people to prepare and administer their own medicines in disease as to produce food for hunger. A scheme for doing this and the right to use it was what Thomson had for sale; he charged $20 for each invisible right and a little book of instructions, the purchasers agreeing not to divulge any of the information so obtained, and being organized into the "Friendly Botanic Society." For many years Thomson travelled about, mostly in New England, selling his right, books, and medi- cines, and overseeing the operations of local agents. With the latter Thomson was usually at loggerheads, due to his selfishness, avarice, and jealousy. The profits from the sale of his twenty-dollar patent book must have been something handsome; his agent for the Ohio Valley and the South, for instance, in 1827-30 sold 4000 copies, representing a gross re- turn of $80,000. About 1822 Thomson published two books on his system, by which its extension beyond the limits of his personal management was facilitated. These were a Narrative of the Life and Medical Discoveries of Samuel Thomson, Containing an Account of His System of Practice and the Manner 3 of Curing Disease with Vegetable Medicine upon a Plan Entirely New, partially unfolding the system ; and his New Guide to Health, or Botanic Family Physician, which contained his autobiography and a complete presentation of the system. These books had a large circulation, and went through many editions during the next twenty years. In 1841 The Thomsonian Materia Medica, or Botanic Fam- ily Physician, was published, a larger and more pretentious treatise, nominally by Samuel Thomson, but really written by his son John. Samuel Thom- son died at Boston in 1843. From the testimony of contemporaries, and even followers, it appears, as his autobiography indeed shows, that Thomson was an ignorant, illiterate, narrow man, high-handed with others, and of some financial shrewdness. He had practically no educa- tion whatever, least of all in medicine; he never attended a medical school or studied under a pre- ceptor. His medical knowledge consisted in the notions picked up by a narrow and ignorant man within the small field of observation of a country neighborhood. He says, for instance, that nearly all his instruction in obstetrics consisted in a twenty- minute conversation with a midwife. One would suppose that such an utter lack of education would have entirely discredited all Thomson's pretensions to medical knowledge and authority. The Thomsonian pathologic and therapeutic doctrines, as promulgated by their founder and held by his stricter followers, were essentially as follows: Heat is life and cold is.death. Life depends on heat; food and medicine are the fuel of heat, and therefore of life. The process of digestion causes the consumption of food, and thus supports the heat and vitality of the body. The stomach, therefore, is the organ upon whose proper action depends almost entirely the maintenance of heat and health. When the food is not digested properly the produc- tion of heat diminishes, the vital powers are de- pressed, and this constitutes disease. The main in- dication in the treatment of disease is, accordingly, the clearing out of the stomach and its restoration to proper action; this Thomsonism accomplished by violent emetics. Heat being the basis of life, fever is a friend and cold an enemy to health. Consequently, from the Thomsonian standpoint, antiphlogistic and antipy- retic methods of reducing fever-by bleeding, pur- gatives, cardiac sedatives, application of cold, etc. -were unnatural, inefficacious, and injurious. All fevers are of the same essential nature, consisting of a decrease of internal and disproportionate increase of external heat, a struggle between the cold and the heat. One of the chief indications of Thom- sonian treatment was, accordingly, to promote the fever, or heat, and decrease the cold, for which steam baths and capsicum were the principal agents employed. The influence of torpidity of the excretory func- tions, especially of the perspiration, in causing dis- ease was recognized. That all diseases are of essen- tially the same nature was a doctrine which justified the practice of treating all diseases in essentially the same way. Thomson had other notions concerning "canker," 4 5 the vital power, respiration, medieval ideas of the elements (earth, air, fire, water) composing the body, etc., which are beyond ordinary comprehen- sion or have no practical medical bearing. The Thomsonian therapeutic agencies consisted of a few drugs, mostly arranged in six classes and designated by Thomson (but not so much by his followers) by numbers rather than by name, steam baths, and injections. Thomson's " No. i " was emetic medicine. Vio- lent and repeated emesis was practised in nearly all cases of disease, and to this treatment the most beneficial results were ascribed. For this purpose lobelia, the main drug of Thomsonism, was em- ployed in tremendous doses, as high as one-half ounce of the seeds. In the face of repeated fatal cases of poisoning by the drug, and of numerous legal trials to which many of them were subjected for deaths caused by its use in their practice, the Thomsonians insisted that lobelia was a perfectly harmless, innocuous medicine, not under any circum- stances poisonous ; and they endeavored to explain away the fatalities that occurred under its use, and denounced the assertions of its poisonous nature as malicious slanders. Of this point the following re- markable passage from Wilkinson's Botanico-medical Practice (1845), relating to the attitude and opin- ions of regular physicians concerning lobelia, is a characteristic illustration : "Every particle of honesty, goodness, benevolence, and every other Christian virtue and gentlemanly prin- ciple was wholly disregarded and swallowed up in their determined, combined, formidable, and unceasing oppo- 6 sition to this innocent plant. Every mean, low, base, insignificant, wicked, ungentlemanly, unfair, Heaven- daring, principle-disgusting, and soul-revolting measure was eagerly and promptly made use of to suppress the expanding and deserved fame that lobelia was constantly acquiring." " No. 2 " was stimulants-capsicum and the like. " No. 3 " consisted of astringents, or " canker medi- cine." "No. 4" was "bitters, to correct the bile and restore digestion." " No. 5 " was peach-meats and cherrystones, " syrup for the dysentery, to strengthen the stomach and bowels, and restore weak patients." "No. 6," myrrh, turpentine, and camphor, was "rheumatic drops." Other prepara- tions were nerve-powder, composition, cough-pow- der, cancer plaster, salve, etc. Steam baths were one of the main features of Thomsonian treatment; they were universally used, and the highest importance was laid upon their operation. "Courses of medicine" constituted a prominent method of treatment; these were used as a routine measure in most cases of disease. A course of medi- cine usually consisted of, first, a steam bath; next, profuse emesis with lobelia; third, an injection to open the bowels; fourth, another steam bath. These courses were repeated indefinitely ; they were employed indiscriminately, and extravagant claims were made for their efficacy. Thomsonism made lofty claims of using only innoc uous and gentle medicines, and vigorously denounced bleeding and the use of alleged harsh drugs, like opium, mercury, arsenic, antimony, niter, and other mineral medicines. It styled itself a botanic system, and attempted to create prejudice against the em- ployment of mineral drugs, and cast a slur on regular medicine by calling it the mineral school and charging it with a predilection for using injuri- ous treatment. Thomsonism first attained popular strength in New England under Thomson's personal manage- ment, and was sustained in that region largely by his personal efforts. It achieved a more extensive and more enduring development elsewhere through his agents and the circulation of his books, apart from his personal influence, and by 1830 became widely disseminated through the Atlantic States and Ohio Valley. Thomson held the practice and the followers of his system well under his proprietary control until about 1830. Differences then appeared among his followers, and an element arose which was disposed to renounce his doctrinal and proprie- tary authority. Thenceforth Thomson's personal influence declined greatly, although the sale of the "right" continued at least as late as his death, in 1843. In its fullest development Thomsonism thus became divided into well-marked elements, differing more in ethics, name, and organization than in prin- ciples or practice, namely, (1) strict Thomsonism ; (2) the more liberal section, commonly known as the botanic or botanico-medical system, from which developed (3) physio-medicalism, the only form of Thomsonism which continues in existence in Amer- ica, to any extent at least, at the present time. The strict Thomsonians, while slightly modifying his methods, professed to follow Thomson's teach- 7 8 ings closely, and denounced the innovations and "improvements" of the botanies. The main body of the adherents of the system, however, rejected Thomson's claims to a monopoly of it, and broke from his control. They generally styled their system the botanic or botanico medical system; also (later) the reform medical system, and employed these names rather more commonly than the original designation, Thomsonian. They established the schools and journals and produced most of the literature of the system. The difference between their opinions and practice and those of the so-called strict Thomsonians was exceedingly slight; yet the refinements and innovations which they introduced were vigorously denounced by the latter. The main difference lay in organization and ethical methods, in the fact that original Thom- sonism was a proprietary system for family and lay practice. Thomson bitterly opposed this element, since it injured his vanity, prestige, and profits. This more respectable form of Thomsonism arose about 1830, concurrently with eclecticism, with which it was for a time quite closely associated, and was at its height in the United States for two or three decades following. Its greatest strength was in Ohio (also the headquarters of physio-medicalism and eclecticism), Massachusetts, New York, Penn- sylvania, Georgia, and the adjacent sections, extend- ing also into Canada. Over this wide territory at the time of its prevalence the system was very ex- tensively diffused, and had quite a strong hold upon the people, especially and mostly in the country and among the lower classes. Botanic medicine 9 had some organization for a time, in State societies, etc., but never secured much legal recognition. Considerable literature devoted to the system ap- peared, of which empiricism and illiteracy were prominent characteristics. The periodicals of the system were quite numerous, but mostly ephemeral. Of the five or six schools established to teach the system, all except two were short-lived, or after from two to four years of existence adopted eclecticism; these two were the Botanico-medical College of Ohio (the first botanic school), organized in 1839, which became the chief physio-medical educational institution, and the Southern Botanico-medical Col- lege of Georgia, organized soon after the preceding, which continued under various organizations and names, and finally merged into an eclectic school. Botanic medicine was introduced into England about 1848 by the teachings of A. I. Coffin, after whom his followers received the ominously appro- priate name of Coffinites. In that country it rapidly attained a large following and very many irregular practitioners or "poisoners," and achieved much notoriety from the frequent cases of fatal lobelia- poisoning, and convictions for manslaughter ensu- ing. The system survived there longer than in the United States, and probably still lingers to some extent. By about i860 botanic and Thomsonian medicine in the United States had lost its schools, journals, literary activity, and many of its adherents, and was on the decline. Much of its strength went over into eclecticism. Its last stronghold was Macon, Georgia, where a Thomsonian journal and college 10 continued as late as or later than i860. The system has become virtually extinct in its original form, with few if any genuine stragglers still surviving from the past. Physio-medicalism arose among the botanies about 1840, under the teachings of Alva Curtis; this has continued in existence in some localities under a distinct organization and name. Concerning the merits of the Thomsonian system little need be said. Thomson's commercial motives and methods of promulgating his practice were simply one with the many quack and patent-medi- cine enterprises now in operation, and his system would deserve no more notice than any of these except for its influence and bearings upon medical sectarianism in the United States as a matter of medical history. The Thomsonian theories were the crude, illogical, and frequently absurd notions of an absolutely uneducated man, whose entire observation and experience had been limited to the narrow field of a remote country neighborhood, and who was largely actuated by mercenary motives. The partial degree of truth in some of Thomson's ideas was exalted by narrow ignorance and enthu- siasm to an exaggerated importance, so that the multitude of other and more important medical facts were lost sight of. The fact that theories and methods such as these, and coming from such a source, should have received general and wide ac- ceptance is an instance of the narrowness which the exaltation of one idea always produces and a com- mentary upon the gullibility and pervertibility of the human mind. The final extinction of Thom- 11 sonism throughout the extensive region where once it was a familiar household word, after undergoing the fullest trial by the world, was simply the inevit- able fate of error. The Medical News. Established in 1843. A WEEKLY MEDICAL NEWSPAPER. Subscription, $4.00 per Annum. The American Journal OF THE Medical Sciences. Established in 1820 A MONTHLY MEDICAL MAGAZINE. Subscription, $4.00 per Annum. CO MM VTA TION RA TE, $7.50 PER ANNUM. LEA BROTHERS & CO. PHILADELPHIA.