Cayenne Pepper Enemas and Other Developments in Early Medicine

From applying leeches to mapping the shape of the human skull, Erik Janik describes a drama of medical history in Marketplace of the Marvelous.

Marketplace of the Marvelous: The Strange Origins of Modern Medicine

Publisher: Beacon
Length: 352 pages
Author: Erika Janik
Price: $28.95
Format: Hardcover
Publication date: 2014-01

Erika Janik delivers a densely written tome littered with nuggets of medicinal history in Marketplace of the Marvelous. Be prepared to immerse yourself, because this is no casual dip into the homeopathic healing waters of modern medicine. Before modern healthcare as we know it came a wide range of homeopathic and "irregular" cures and treatments, vying for their places with “heroic”, or more traditional medical treatments. Some of the irregular treatments seem ludicrous today, and yet Janik presents a surprising number of therapies that are quite familiar.

Janik describes the frightening effects of heroic medicine in the United States’ early days, the type of treatments where the goal was to elicit extreme responses and force out infections or ill humours. You may be familiar with treatments such as invasive bloodletting and induced sweating. In their own way, each tried to force illness to leave the body. When so little was understood about what various compounds and treatments actually did to our insides, it was a relief to see some sort of response, no matter how scary and violent. Or life-threatening. Any change in the state of sickness was deemed a success, and families were happy to pony up the coin to engage doctors, even if it might ultimate kill their loved ones.

From exotic cures to commonplace woodland herbs, from leeches to mapping the shape of the human skull to read your fortune, Janik has a complex journey to describe. She uses her research on early medical practice in the US to anchor the story, but frequently detours to Western and Central Europe to profile the individuals who launched some of the treatments that gained large followings and spread westward as they grew in popularity.

There are some major surprises along the way. That standard image we see of Victorian ladies and gentleman lounging about, paragons of inactivity and tea-sipping? Turns out that once upon a time, people had no idea that staying active was a good idea. Slowly, gently, exercise crept into the general public awareness as a notion that staying active made your body stronger. It gained acceptance under the name, "medical gymnastics" for a time. Exercise is one example of a wacko therapy that later gained widespread acceptance, and today is a fairly standard part of a healthy regimen.

Janik spends time in the realms of botany, phrenology, hydropathy, hypnotism and more, in her Marketplace of the Marvelous. Some types of treatment and theory still known as ‘alternative medicine’ by contemporary insurance brokers were gaining ground in the 19th century, such as homeopathy, osteopathy, and chiropractic care. And as her excerpted article in Slate puts it, we owe our habit of trying to drink eight glasses of water a day to “a bunch of revolutionary 19th century quacks”. Other alternative treatments have become mainstream: the first person to recommend nitroglycerin for chest pain was a homeopath in 1849.

A great facet of Janik's research is her manner of placing these "irregular" practitioners within their wider context. She documents well-known historical personalities of the time who held strong opinions about specific types of treatment, or perhaps became dedicated followers of one practitioner or another. Mark Twain, for example, spoke critically about irregular medicine but didn't hesitate to experiment with it on himself and his family.

Janik’s writing really comes to life when when discussing female heroines in these therapy streams. Mary Gove Nichols is one example. Nicholas was a rare early female lecturer on the health of women and discussion of their bodies, passionate and very well received on her circuit. In the 19th century when female doctors were incredibly rare (traditionally trained ones, anyway), few conversations were happening about how to take care of the female body and its differing needs from those of men and children. Janik teases out the stories of a number of female healthcare providers, documenting the shifting tide of public opinion where it became acceptable to consider how the female body differed from the male, and where women started to feel they could take charge of some measure of their own health.

In each area of medicine, Janik describes its rise, usually with a specific single practitioner and perhaps a dedicated assistant or spouse at his or her side, and then the way practice changed, often with a new proponent stepping forward and proposing a shift in the treatment. Strong personalities were involved, as introducing and supporting the spread of irregular treatments meant a healthy dose of a salesman or preacher-type personality was needed to convince the general public about the benefits of the new approach.

It's no surprise that once upon a time, little or no education was required to bill oneself a doctor. Janik lays out the background for the growth of the medical education industry, once open only to men from relatively wealthy backgrounds. The first medical school in the US opened in Philadelphia over 100 years after Harvard was founded. Early remedies touted by doctors were generally imported from Europe, and unsurprisingly, these same practitioners were not happy with irregular medicine's growing hold on the healthcare market.

As the US was settled from east to west by European pioneers, settlers made use of local knowledge from native populations and tried out all the different plants and herbs they encountered. Some treatment must be better than no treatment at all for many ills, and the nearest doctor could be many miles away when sickness took hold.

Janik itemizes and describes some uses of irregular medicine that now seem incredibly odd. For example, at the height of the popularity of phrenology, some employers required that job applicants provide evidence of a head reading. Employers thought those readings could predict compatibility with the position. Clara Barton, founder of the American Red Cross, was apparently taken to have a reading done by her mother when she was just a teenager. The result was a prediction that Barton had a natural predilection for teaching and leadership. We also owe phrases like “highbrow” and “lowbrow” to phrenology’s popularity.

At the end of the day, Janik's descriptions of parts of the journey that irregular, “marvelous” medicine has taken to gain acceptance from some (and derision from others) culminates with the sense that it may never be possible to understand everything there is to know about the human body, and how what we do to it and what we put into it changes our health. Times have changed, but not all that much.

A dedicated history buff with a keen sense of curiosity on a larger scale, Janik’s earlier works include several histories about the state of Wisconsin, and Apple: A Global History. You can learn more about her on her eponymous website, Erika







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