A History of Allopathy

Allopathy, when used properly, refers to the conventional medical practices in use during one specific era of history. Allopathy is a historical term that is widely used "as a referent to harsh medical practices of ... [a specific] era which included bleeding, purging, vomiting and the administration of highly toxic drugs."[12] This article covers the history of allopathy as it was practiced in America from the period of the American Revolutionary War till about 1876, which marks the start of preventive medicine.

Contents of a History of Allopathy

• Introduction
• Allopathic Conception of Disease
• Benjamin Rush, the Allopath
• Allopathic Methods of Treatment
• Allopathic Practices of Hygiene
• Famous People Killed by Allopathy
• Historical Conclusions
• References

Introduction

This article covers the history of allopathy as it was practiced in America from the period of the American Revolutionary War till about 1876, which marks the start of preventive medicine. It can, also, be described as regular medicine,[14] the practice of conventional medicine during the 19th century, the Age of Heroic Medicine (1780-1850), the Era of Miasmas, and the Sanitation Reform Movement in America. "Two parallel threads run through 19th century American medicine: one of evolving medical theory and expanding knowledge that eventually furthered the profession; and the other of the daily practice of medicine in the field."[18] This article emphases the daily practice of allopathy because in the real world, that is the only thing that counts.

"Scientific medicine at the beginning of the [19th] century was heroic medicine."[18] So, modern conventional medicine historically developed out of allopathy or regular medicine.[14]

While use of the term allopathy is consider offensive by some people, its use is no more offensive than Dr. Benjamin Rush's (referred to below) use of the word quack in 1798 to describe a competitor (i.e., "an itinerant and popular quack"[13]). Allopathy is a historical term that is widely used "as a referent to harsh medical practices of ... [a specific] era which included bleeding, purging, vomiting and the administration of highly toxic drugs."[12] R. T. Trall, M.D. in a famous speech delivered on February 4, 1862 at the Smithsonian Institute in Washington D.C.repeatedly used allopathy in order to reference the then current practice of conventional medicine. Further, Trall quoted the American Medical Association as follows: "It is wholly incontestable that there exists a widespread dissatisfaction with what is called the regular or old allopathic system of medical practice."[3] Allopathy, thus, is no more a misnomer than the use of the word quack or quackery is. Allopathy, when used properly, refers to the conventional medical practices in use during one specific era of history.

Allopathic Conception of Disease[1]

Four Humors Theory -- The ancient Four Humors theory "attributed disease to an imbalance of four humors (i.e., blood, phlegm, and black and yellow bile) and four bodily conditions (i.e, hot, cold, wet and dry) that corresponded to four elements (earth, air, fire, and water). Physicians following the Hippocratic tradition attempted to balance the humors by treating symptoms with 'opposites.' For instance, fever (hot) was believed due to excess blood because patients were flush; therefore, balance was sought by blood-letting in order to 'cool' the patient."[12]

Era of Miasmas -- During the 18th century, the Four Humors explanation of disease was starting to lose ground to several new and conflicting systems that attempted to reveal one or two basic causes for all disease. Further, an effort was being made to develop a fundamental theory that would de-emphasized the importance of the diagnosis of specific diseases. But, allopathic medical treatment regardless of theory continued to consist largely of the traditional heroic medical treatment methods: bleeding, leeching, cupping, blistering, purging, puking, poulticing and rubbing with toxic ointments.

The system of medicine prevailing in the Colonies in the years immediately preceding the American Revolution, was that of the Dutch physician and teacher Hermann Boerhaave (1668-1738). The Boerhaavian theory of disease explained it in terms of chemical and physical qualities, such as acidity and alkalinity, or tension and relaxation. The Boerhaavian system was increasingly being challenged in the second half of the 18th century by the theories of William Cullen (1710-1790), a Scottish physician and teacher. Cullen held that an excess or an insufficiency of nervous tension was the cause of all disease. Too much tension was often characterized by a fever, to be treated by a depleting regiment including bleeding, a restricted diet, purging, and rest and sedation. A cold or chill, on the other hand, indicated too much relaxation and called for restorative measures.

Allopathic theorists of the 18th century did not generally include in their systems an explanation for disease epidemics. There were many discussions of possible sources of disease carried by the air. Sir John Pringle (1707-1782), Surgeon General of the British Army (1742-1758) and friend of Benjamin Franklin, wrote that putrefaction was the greatest cause of fatal illness in armies. These physicians attributed the primary cause of disease to miasmas emanating from sewage, cesspools, or rotting vegetable matter. The word infection (including references to infectious tempers) was actually used during this time period, but was used in connection with foul air, or poisonous atmosphere, or miasmas.[2] The allopathic theory of miasmas was an obvious reference to the horrific smells of urban life experienced by all during this time period. The theory of the atmosphere being a cause of many types of fevers was still maintained as late as 1812. Many also blamed sudden changes in the weather for causing outbreaks of disease, as well as believing in the injurious effects of cold and wet climates.

Specific types of therapy for specific diseases was not too common in the 18th century, as the same heroic remedies were used for almost all diseased conditions. Bleeding was popular, the amount and frequency varying with the individual physician and the system he followed. A moderate bleeding was considered to be one taking 8 to 12 ounces of blood at a time, a heavy one was 16 to 20 ounces. Cleansing the digestive tract was another generalized remedy followed with or without much caution, using such purgatives as rhubarb, manna with tincture of serma, and enemas of varying formulation.

Among the newer ideas in medicine was the belief in the general wholesomeness of fresh air. Fresh air was obviously thought to dissipate miasmas, the causative agent for all diseases. Benjamin Franklin was one of the most ardent supporters of the miasma theory of diseases. Allied with this belief was the newly popular cooling regimen in fevers, involving not only cool fresh air but also the bathing of fever patients in cold water. Yet another generalized remedy of recent origin was mercury (a well known poison), used earlier against venereal disease and as a purgative, but now also used as an alterative to treat many diseases, often in the form of calomel or the reputedly better tasting but more nauseating corrosive sublimate. The poison Mercury was increasingly prescribed after 1750 for diseases classified as inflammatory.

Interestingly, Pringle also believed that excessive sleep enervated the body, and rendered it more subject to disease. Poor diet was not generally considered by allopaths as an important cause of illness. Further, it was widely believed that water was made safe to drink by either boiling it or treating it with spirits, wine, vinegar, or cream of tartar.[2]

Although the germ theory of disease was very old, it became generally discounted between 1800 and 1850. Through verbal dialectics, the anti-contagionists got the upper hand over the contagionists, and the beliefs that miasmas, filth, and environmental factors were the chief causes of communicable diseases became firmly implanted in the lay and medical mind, although a few diseases, such as venereal diseases, measles, and smallpox were believed by allopaths to be contagious.[2]

"By mid century scientific medicine took a back seat to ... [alternative medicine]. Scientific medicine was hampered by poor training, the continued practice of heroic medicine despite patient protests, and quarreling among the brightest physicians. Proprietary medical schools and their common practice of grave robbing to obtain dissection specimens did little to improve the public's image of the medical profession."[18]

Therapeutic Nihilism Movement --R. T. Trall, M.D. in a famous speech delivered in 1862 quoted numerous allopathic physicians who were voicing themes of the therapeutic nihilism movement in America.[3]

"It was well known to the physicians of the period that their drugs were damaging. For example, the celebrated Charles D. Meigs, M.D., of Philadelphia said in his work, Observations on Certain of the Diseases of Children (edition of 1850, p. 73): 'It appears to me to be an outrage to give a child a dose of castor-oil, or rhubarb, or magnesia, when it is not required; for such articles cannot be taken into the stomach without exciting the beginning of trains of actions whose end no man can foretell.' The reader will be quick to understand that when these drugs are administered to children when they are supposed to be 'required,' no man can foretell the results. James Stewart, M.D., wrote in his Practical Treatise on the Diseases of Children (second edition, 1846, p. 220): 'The use of any medicine must, as a general rule, be regarded as injurious, as the object of medicine is but to create a temporary disease for removal of another; and only applicable when the disease demanding it is itself the greatest source of danger.' This expressed the old fallacy contained in the choice of the lesser of two evils, except that in this case one chooses both evils. The theory that a serious disease can be removed by creating a temporary and less serious one must have been invented in a mad house.'"[3]

Era of Preventive Medicine -- Preventive medicine, or the bacteriological era, is arbitrarily dated from Robert Koch's (1843-1910) demonstration in 1876 of the bacterial cause of anthrax. 1876 marks the start of a revolution in scientific medical thought through the discovery of the bacteriological agents responsible for causing infectious diseases. Prior to 1876, scientific medical emphasis was placed on hygiene and sanitation. After 1876, it was all about preventive medicine or the use of bacteriological weapons to prevent disease.[2]

Benjamin Rush, the Allopath [2]

Born in Byberry, now a part of Philadelphia, he graduated from the College of New Jersey, now Princeton University, in 1760, and studied for six years in the office of a Philadelphia physician as well as at the University of Edinburgh, Scotland, from which he graduated in 1768 with an M.D. degree. He practiced medicine in London and Paris before returning to Philadelphia in 1769. Returning to Philadelphia, Rush started his medical practice. Dr. Rush entered the Continental Army Medical Service just before the battle of Trenton in December 1776. In April 1777, he became surgeon and later physician of the Middle Department. In 1778 Rush wrote a pamphlet called Directions for Preserving the Health of Soldiers. Rush's hygienic recommendations in his Directions for Preserving the Health of Soldiers. were amazingly similar to those advocated during the American Health Reform Movement. Following Rush's criticism of General Washington in the Conway Cabal affair, he resigned from the Army on 30 January 1778, but he remained a member of the Medical Committee of Congress which was concerned with the regulation of the Medical Department of the military. At the medical school of the College of Philadelphia, Rush taught courses on the theory and practice of medicine as well as lectures on chemistry. All told, Benjamin Rush lectured more than three thousand medical students on his medical theories and heroic methods of treatment.

In Edinburgh, Rush embraced a new explanation of disease being offered by Dr. William Cullen (referred to above). Rejecting the older humoral theory, based upon the balancing of the four humors, Rush believed that the root cause of disease was related to tension in the blood vessels. And, Dr. Benjamin Rush ended up being responsible for a revival of bloodletting in America.[16] The method of treatment upon which Rush insisted with increasing arrogance called for a low diet, vigorous purges with calomel and jalap, and repeated bleedings until the patient fainted. Rush did not hesitate to remove a quart of blood at a time, or, should unfavorable symptoms continue, to repeat such a bleedings two or three times within a two to three day period, it being permissible in his opinion to drain as much as four-fifths of the body's total blood supply.

In an account of the Bilious Yellow Fever written in a Philadelphia newspaper in 1798, Rush commented upon his methods of treatment. Bloodletting was used twice on a child, Isaac Pisso, who was only six weeks old, with success. Children were cured with "gentle pukes, purges of calomel, and blood-letting." In most cases of yellow fever "the pulse flagged after two or three bleedings." But, in the cases of "Dr. Mease it called for the loss of 162 ounces of blood, and in Mr. J. C. Warren for the loss of 200 ounces, by successive bleedings, before it was subdued." In this account, Rush also claimed that "the origin of this fever was from the exhalations of gutters, docks, cellars, common sewers, ponds of stagnating water, and from the foul air," an obvious reference to belief in miasmas, rather than from the correct source of mosquitos.[13]

Allopathic Methods of Treatment -- Allopaths used bleeding, leeching, cupping, blistering, purging, puking, poulticing and rubbing with toxic ointments to treat their patients.[4] All of these allopathic treatment methods were thought to be cleansing, purifying, and balancing treatments which sought to re-establish humoral harmony of the four humors.

Bleeding -- "Bleeding was usually the initial treatment."[18] There were a few different methods of bleeding a person. Bleeding was said to reduce the patient. It was believed that the use of bleeding released bad blood which contained disease from a person's body. "Physicians used to bleed for congestion of the brain, sore eyes, spinal disease, sore throat or swelled tonsils, asthma, inflammation of the lungs, pulmonary consumption, diseases of the heart, dyspepsia, liver complaint, enlargement of the spleen, inflammation of the bowels, piles, genital diseases, rheumatism, neuralgia, in all cases of fever, such as intermittent fever, remittant fever, typhoid fever, typhus fever, yellow fever, ship fever, black tongue, dysentery, dengue and, in fact, for every particular and special morbid condition which could be found."[4]

Blood-Letting -- A patient's vein was directly cut with a lancet (venesection).

Leeching -- Leeching is a method of bleeding with leeches. "A leech was placed in a thin tube while the patient's skin was washed and shaved. To encourage the leech to bite, a drop of blood or milk was placed on the area of a vein. Then the tube with the leech in it was inverted over the spot, and the leech sucked blood from the vein. When it was felt that the leech had taken enough blood, salt was sprinkled on the leech, causing the leech to stop sucking and to let go of the skin."[4]

Cupping -- A treatment in which evacuated glass cups are applied to cut skin in order to draw blood. Cupping was usually used in combination with blood-letting. After one or two aggressive bleedings, a patient's blood pressure would drop to the point where blood would no longer spurt out, so heated cups were placed over cuts to help draw more blood. Special cups were heated and placed over the cuts, creating a vacuum, allowing the blood to freely flow from the vein.

Blistering -- It was believed that the pain of blistering caused the patient to focus on a new pain, taking their minds away from the more serious pain from which they suffered. The practice of blistering was performed by deliberately giving the patient a second degree burn and then draining the resulting sore. "Blistering was a common method of treating the following diseases: congestion of the brain, inflammation of the brain, sore eyes, sore throat, inflammation of the stomach and lungs, of the liver, of the spleen, spinal irritation, bilious, typhus and typhoid fevers, and a great many other diseases too numerous to mention."[4] The practiced of blistering, according to James C. Jackson, M.D. had significantly declined by 1862.[3]

Plastering -- Plasters were paste-like mixtures, made from a variety of ingredients, including even substances such as cow manure. They were applied to the chest or back of a person suffering from a chest cold, or an internal pain--even pneumonia. These were often blistering plasters.

Poulticing -- Poultices were made from bread and milk, and sometimes other ingredients were added such as potatoes, onions, herbs, and linseed oil. Poultices were applied to cuts, wounds, bites, and boils.

Puking -- Puking consisted of dosing a patient with emetics in order to produce vomiting. The practice of puking was believed to relieve tension on arteries and to expel poisons from the body.

Sweating -- Sweating is a treatment where patients were made to sweat out the poisons that caused their disease.

Fumigations -- The practice of fumigating was one of drugging the breathing apparatus with everything that could be smoked, solvented, pulverized and gasified. "Among their multitudinous remedies which they recommended to be introduced into the delicate structure of the lungs, through the medium of their multiform poisons, were such wholesome substances as opium, cubebs, deadly nightshade, iodine, calomel, corrosive sublimate, sugar of lead, belladonna, digitalis, hellebore, aconite, dog-bane, tobacco, arsenic, antimony, niter, lobelia, cinebar, etc."[4]

Purging -- Purging is a treatment that induces evacuation of the patient's bowels or intestines with powerful laxatives. Purging, which was done to cleanse the body of toxins or irritants. "The most commonly used purgative was calomel, a form of mercuric chloride"[18]

Ointments -- Ointments containing mercury were topically used against venereal diseases. Sulfur was quited commonly used to treat itching.

Dehydration -- "During most of the last century, it was standard medical practice to withhold water from the acutely ill and thousands of patients literally died of dehydration. ... It was contrary to the teachings of the allopathic school of medicine to give water, inside or out, to a fever patient. Often the dying, when being granted their 'last wish,' were given the previously denied water and recovered. The sick body called for water, which was needed, and would have received it with gratitude and benefited from it, but the physicians denied it."[4]

Allopathic Practices of Hygiene

"It was not until the late 1880s that American surgeon Dr. William Mayo began practicing antiseptic surgery in his clinics in Rochester, Minnesota, and won converts among colleagues."[18]

How the military implemented the basics of hygiene and sanitation during the various wars of this time period has been well documented.

During the Revolutionary War (1775-1783) ten men died of disease to every one whose life was taken by the enemy. During the Mexican War (1846-1848) a ratio of 7 deaths from diseases of the camp (chiefly dysentery) to every death caused by battle injury took place.[2]

In 1854, Florence Nightingale (1820-1910) organized and directed a unit of field nurses during the Crimean War in Europe. Nightingale tried during the Crimean War to implement hygineic reform in the military hospitals. Nightingale was, also, hired as a consultant by the American Civil War Sanitary Commission.

Two Civil War soldiers died of disease for every one killed in battle, or some 560,000 soldiers died from disease during the Civil War.[18] About half of the deaths from disease during the Civil War were caused by intestinal disorders, mainly typhoid fever, diarrhea, and dysentery. Malaria struck approximately one quarter of all servicemen. The remainder died from pneumonia and tuberculosis. Outbreaks of these diseases were caused by overcrowded and unsanitary conditions in the field. Risks from surgery were great. Doctors in the field hospitals had no notion of antiseptic surgery, resulting in extremely high death rates from post-operative infection.[20]

Famous People Killed by Allopathy

George Washington (1732-1799), the first president of the United States died on December 14, 1799. Washington was prematurely bleed and poisoned to death. His death has been very well documented right down to the attending physicians responsible for his death. Washington caught cold while riding on his estate and developed pneumonia. As Washington's condition declined, Doctor James Craik called on fellow physicians Elisha Dick and Gustavus Brown for help. Washington's doctors bled, blistered, and purged him. He did not respond to these treatments and died. Today, doctors believe George Washington was dying from an acute streptococchal infection of the larynx, which caused a painful swelling of the interior of the larynx resulting in suffocation. A tracheostomy would probably have saved his life, and indeed one was suggested by the youngest doctor in attendance, Elisha Dick, but the technique was new and considered unsafe by the elder physicians.[6],[7],[9]

William Harrison (1773-1841), was the 9th President of the United States, and held the shortest term as President. He served only 31 days. He was also the first US President to die in office. And, was 68 years old. Harrison gave a two hour inaugural speech on a cold, wet, and blustery March 4th; he caught a severe cold that developed quickly into pneumonia. The President's attending physicians tried blistering the right side of his chest. But, Harrison did not improve. Next, the doctors tried cupping. Then ipecac was given to induce vomiting. They also gave him calomel and castor oil to purge his bowels. Sedatives were administered to the fast-weakening President in the form of opium and brandy. They concluded their treatment with Virginia Snakeweed, a Seneca Indian remedy.[7],[8]

Zachary Taylor (1784-1850), was the 12th President of the United States. Taylor became ill after attending a July 4th celebration at the Washington Monument for several hours. Afterwards, he took a long walk along the Potomac River. Upon returning to the White House, the President drank large amounts of cold water and chilled milk, and ate fruit. The President was diagnosed as having cholera morbus, a term then used for intestinal ailments, or acute gastroenteritis. His condition declined over the next two days and a regimen of ipecac, calomel, opium, and quinine did little to relieve him. Blisters, bleeding, and purging were also used. On July 8th, after suffering through four days of sharp abdominal pains, diarrhea, and vomiting, President Taylor died. Here with Zachary Taylor, we have a documented case of a U.S. President dying in 1850 from indigestion caused from eating Blackberries and milk after having received the finest allopathic treatment of the day![7],[10]

Dr. Trall alluded to the fact that Prince Albert (1819-1861) had been taking some type of alcoholic based medicine. Trall claimed that the English newspapers at the time reported that Prince Albert was "'kept up on stimulants' for five or six days." He further claimed that allopathic treatments, such as this, weaken the patient which allowed typhoid to set in. Going on Trall said: "So inexplicable and mysterious was the death of Prince Albert, that suspicions were entertained of foul play for political considerations. My own opinion is that the treatment is sufficient to account for the death. ... The London Lancet, of Feb. 1862, in allusion to the death of Prince Albert, makes a very significant remark: 'The disease was typhoid fever, not very severe in its early stages. But this is a disease which has inevitably proved far more fatal to sufferers of the upper classes of life than to patients of the poorer kind.'" Thus, according to Trall, Prince Albert died in 1861 indirectly from the drug medication that he had received. And, according to Lancet had Prince Albert been poor, and thus without access to allopathic care, he would have been more likely to have survived. History tells us that Albert's death was so unexpected that historians long suspected Albert to have been poisoned with arsenic. Trall, thus, offered in 1862 a very plausible explanation of Prince Albert's death in 1861.[3]

Historical Conclusions

Some allopaths, like Rush, used science, but none of them used the scientific method in their practices. During most of the 19th century, if a patient did not die and recovered, it was generally assumed that whatever treatment was given must have been responsible for the cure. The practice of allopathy, or heroic medicine, lasted so long precisely because in spite of being drained of their blood and poisoned with highly toxic drugs by allopaths many patients did in fact recover from serious infectious diseases like yellow fever and cholera. The lesson to be learned here is not just that patients will naturally recover from deadly diseases thanks to vitalism after having received the placebo treatments of alternative medicine, but that they can also recover even after receiving the harmful treatments of allopathy.

What was wrong with the allopath called Benjamin Rush? Rush was an arrogant academic man and believer in science; but was not a practitioner of the scientific method, who had the nerve to call his competitors Quacks while thinking nothing of killing patients in his blind pursuit of science. His brand of medicine was down right lethal and the public was smart enough to figure it out, no matter how much Rush protested. The development of alternative medicine in America during the 19th century owes much to allopaths, like Rush, who were largely responsible for fostering a rebellion against the aristocracy, or the intellectual elite ruling class, in the medical profession. Alternative medicine in America was not a rebellion against science during this time period. It should be viewed historically as an empirical rebellion against the authoritarian, backward, rationalistic, and dehumanized academia that was in fact both killing and torturing their patients. Allopaths were calling their competitors Quacks long before any allopath ever used the scientific method, long before their science was anything but laughable, and long before allopathic treatment methods were anything but bizarre if not down right lethal torture.

In addition, the claim that preventive medicine started in 1876 is totally erroneous from the perspective of the patient, since it had no practical effect outside of antiseptic surgery until some 50 years later when penicillin was discovered in 1928.

What is generally not realized is that the American Health Reform Movement of hygienic systems obviously embraced many of the 18th and 19th century philosophical beliefs of allopathy (ex, health benefits of fresh air, miasmas, enervation as the cause of all disease, belief that a complete diagnosis is unnecessary before treatment begins because there basically is only one disease, and concern with the acidity and alkalinity of the body) while strongly rejecting most, but not all of the allopathy's treatment methods (health benefits of drinking vinegar, importance of cleansing the digestive tract, and use of enemas were adopted by the Health Reform Movement, for example). It is, thus, historical fact that the American Health Reform Movement of hygienic systems embraced many of the 18th and 19th century philosophical beliefs of allopathy and, thus, these forms of alternative medicine started out by embracing the then science of allopathy.

"In time [during the 20th century], through a process of reform [resulting from the Flexner Report], 'scientization' [through creating a standardized curriculum for medical education], and centralization [by the American Medical Association], [allopathic] heroic medicine would become ... biomedicine, ... the dominant Western medical system."[19]

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References

1. Gillett, M. C. The Army Medical Department, 1775-1818. (United States Army historical series) U.S. Government Printing Office, Washington, D.C. 1981. (Online)
2. Bynes-Jones, S. The Evolution of Preventive Medicine in the United States Army, 1607-1939. U.S. Government Printing Office, Washington, D.C., 1968. (Online)
3. R. T. Trall, The True Healing Art: Or, Hygienic vs. Drug Medication, (speech given in 1862). New York, Fowler & Wells, Publishers, Reprinted 1880. (Online)
4. Herbert M. Shelton, Natural Hygiene: Man's Pristine Way Of Life. Dr. Shelton's Health School, San Antonio, Texas, 1968. (Online)
5. John H Warner, The Therapeutic Perspective: Medical Practice, Knowledge and Identity in America, 1828-1885, Cambridge: Harvard Univ. Press, 1986, pages 28, 33.
6. Morens DM. Death of a president. N Engl J Med. 1999 Dec 9;341(24):1845-9. No abstract available. PMID: 10588974
7. Early Presidents and Their Illnesses
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9. Frequently Asked Dead Presidents Questions: How Did Each Dead President Die?
10. Holman Hamilton, Zachary Taylor: Soldier in the White House (Indianapolis and New York: Bobbs-Merrill Co., 1951), pp. 388-93.
11. Allopathy, Webster Dictionary, 1913.
12. William T. Jarvis, Ph.D; Misuse of the Term "Allopathy", 2000.
13. Benjamin Rush, An Account of the Bilious Yellow Fever. Philadelphia, 1798 [Online]
14. Allopathy, Stedman's Online Medical Dictionary, 27th Edition.
15. Allopathy, MedTerms.com Medical Dictionary.
16. Bob Arnebeck, Destroying Angel: Benjamin Rush, Yellow Fever and the Birth of Modern Medicine, 1999.[Online]
17. THE PRIMARY-CARE CRISIS, Part I: The Contribution of Anti-Scientism
18. From Quackery to Bacteriology: The Emergence of Modern Medicine in 19th Century America, University of Toledo Libraries
19. Alternative Medicine and the Appropriation of Scientific Discourse
20. United States Army, Surgeon-General's Office. The Medical and Surgical History of the War of the Rebellion. Washington: Government Printing Office, 1870-1888.