Examine the discourse of any alternative medicine and you will encounter a surprisingly homogenous set of themes: that their methods are natural, simple, available to all, and are based on ancient and traditional knowledge. Cures for disease are freely available from nature and we do not need the intermediation of a medical elite to provide us with them. These cures have been known for generations and we have lost sight of them through an unwarranted fixation with science and progress.
Advocates of alternative medicine frequency position themselves against ‘conventional’ medicine by describing it as narrowly focussed on a scientific view of people, lacking in a personal approach and corrupted by the status, money and greed of physicians and drug companies. Such views would appear to be recent reactions to the often dehumanising experience of modern medicine where people appear to be treated like machines, and where doctors are accused of neglecting their patients’ spiritual and emotional needs. Alternative medicine is a call for a more human and personal medicine. However, these themes are not new. Such accusations have deeper roots in history and date back long before the emergence of current medical practice.
John Wesley is best known for his theological activities and the founding of the Methodists. He gave rise to a religious movement with tens of millions of followers. However, his best selling book was not a religious book. He was not just concerned with saving people souls; he also had keen interests in healing their bodies. In 1747 he published a book, Primitive Physic, that listed the ‘easy and natural cures for most diseases’. His medicinal beliefs followed quite closely his religious beliefs. He rejects the authority of the medical ‘priests’, the doctors, and embraces the authority of Nature, just as he called for people to seek a personal understanding of their faith through scripture and not the priesthood. As his theology taught that the Bible was the one reliable source of truth and that we could individually understand it through personal experience, his medicinal approach stated that nature was the source of healing remedies and we could understand what was effective through direct experience of such treatments.
The book is a list of ailments and their corresponding cures, listed in priority. Try the first, and only if that did not work, move onto the second and third. The emphasis is on cures that could be readily available to most. So, we have honey as a cure for bee stings and, most delightfully, holding a puppy against the stomach as a cure for stomach pains. We find nettles, and cinnamon and onion as staples of the first aid kit. There are prunes, lemonade and liquorice. A few cures stand out as having many uses – most obviously Wesley had a belief that cold water baths were a near panacea.
For consumption, or TB as we would call it now, his highest priority cure is ‘cold bathing’. Then he advised patents to drink nothing but water and eat nothing but white bread. If that fails, drink milk and sugar candy, or boiled sorrel. Then try milk and beer, ivy leaves, ginger, or even breathing the smell of fresh cut turf. Frankincense next, or beeswax, honey and water cress.
And finally we are told,
In the last stage, fuck a healthy woman daily. This cured my Father.
What more marvellous natural cures could we wish for. And from a Methodist. Wesley does not state if this cure applies to female consumptives too.
(* See comments below for how we might interpret this quote.)
His preface to the cures, evolved through many reprints of the book, outlining his general philosophy of health. Illnesses existed because of our fall from grace. Primitive peoples did not suffer as they had natural cures for all ailments. The newly discovered Americans lived in harmony with their surroundings,
Their diseases are exceedingly few; nor do they often occur by reason of their continual exercise, and (till of late) universal temperance. But if any are sick, or bit by a serpent, or torn by a wild beast, the fathers immediately tell their children what remedy to apply. And ’tis rare that the patient suffers long; those medicines being quick, as well as, generally, infallible.
Wesley is keen to emphasis that a correctly led lifestyle is crucial to a healthy body. Avoid seasoned food and drink lots of water. Avoid coffee and tea, but you may have a small beer. Get plenty of exercise and fresh air. Eat more vegetables than meat. Read standing up, not sitting down, and do not wear too many clothes.
To John Wesley, the medical elite of the day had gone astray. They were rejecting the natural cures and instead embracing new theories of the mind, body and illness. They were embarking on unfruitful enquiries to find out how the body worked,
As theories increased, simple medicines were more and more disregarded and disused, till, in a course of years, the greater part of them were forgotten, at least in the more polite nations. In the room of these, new ones were introduced, by reasoning, speculative men, and those more and more difficult to be applied, as being more remote from common observation. Hence rules for the application of these, and medical books were immensely multiplied, till at length physic became an abstruse science, quite out of the reach of ordinary men.
And then the accusations of arrogance and profiteering are bound to follow,
Physicians now began to be held In admiration, as persons who were something more than human, and profit attended their employ, as well as honour, so that they had now two weighty reasons for keeping the bulk of mankind at a distance, that they might not pry into the mysteries of their profession. To this end they increased those difficulties by design, which were, in a manner, by accident. They filled their writings with abundance of technical terms, utterly unintelligible to plain men.
Those who understood only how to restore the sick to health, they branded with the name of Empirics. They introduced into practice abundance of compound medicines, consisting of so many ingredients, that it was scarce possible for common people to know which it was that wrought the cure— abundance of exotics, neither the nature nor names of which their own countrymen understood.
Is this the first recorded tirade against Big Pharma? Wesley continues,
Experience shows that one thing will cure most disorders, at least as well as twenty put together. Then why do you add the other nineteen? Only to swell the apothecary’s bill: nay, possibly, to prolong the distemper, that the doctor and he may divide the spoil.
And he then accuses the doctors of producing mixtures of medicines that become useless through their opposite interactions that “joined together destroy life”.
These are strong accusations of corruption and deliberate harm from doctors to their patients in pursuit of profit.
Similar philosophies and views can be found today on many leading alternative health sites and discussion boards. Prince Charles espouses a philosophy healthy lifestyle and personal responsibility with his Foundation for Integrated Health. He tells us,
Responsibility for our health isn’t something we can simply delegate to doctors and medicine.
Factors like fulfilling work, strong communities, the buildings we live in, our relationship with the natural world and the food we eat directly affect our wellbeing. So the first step in integrated health is helping people to make choices that keep them well and out of the healthcare system. But once somebody is ill, treating their problem with an integrated approach means bringing together mainstream medical science with the best of other traditions. Complementary interventions may range from stress reduction techniques to therapies like acupuncture or nutritional therapy.
Devonshire GP, Dr Michael Dixon,is one of the main advocates of Charles’s views, and says we must ‘return the soul to medicine’. The “biomedical model based upon stringent definitions of evidence-based medicine” has a focus on
rapid treatment of symptoms and diseases and identification and treatment of risk factors. However this approach is often not patient-centred and takes little account of the patient’s background, culture, and health beliefs.
The Foundation calls for a ‘Natural Health Service’ and says that “Evidence is at hand to suggest that healthy natural environment around us is as important as drinking pure water and breathing clean air.”
What is quite fascinating is how both Wesley and his modern counterparts quickly appear to undermine themselves with some of the treatments they actually espouse. Natural, they are not. Availability to the common man takes a back seat. And safety is questionable. Wesley’s favourite treatment, and one he recommends for many ailments, is the process of electrifying patients. Electrification is said to be able to cure a host of problems, including blindness, deafness, gout, leprosy and and the “King’s Evil” (scrofula). Wesley says,
Nor have I have yet known one single instance, wherein it has done harm; so that I cannot but doubt the veracity of those who have affirmed the contrary.
So, it would appear that this was a controversial new therapy based on the recent discoveries of electricity. Obviously a few people had been hurt by this method, a fact that Wesley tries to deny. It is not unsurprising that people were getting hurt by electrifying, as,
The best method is to give fifty, or even hundred small shocks, each time; but let them be so gentle as not to terrify the patient in the least.
Electricity was a new plaything. Quite how a person could control the amount of shock with such limited equipment and understanding is unclear. But, importantly, it is difficult to see how using the latest electric shock treatment on one hand and turnips on the other can both be described as ‘natural’. Natural must be defined in such a way so not as to reflect some sort of ‘state of of natural world’ but merely in opposition to what conventional doctors do.
We see the same thing going in in today’s “Natural Health” movement. The Alliance of Natural Health campaigns for what they say is the right for people to have access to natural remedies,
The use of nature in healthcare is one of our fundamental human rights and we argue that governments should not be able to deprive us of this right.
Our healthy survival depends on us having nutritious foods, clean water, healthy working environments and the ability to take adequate exercise. On top of this we need to manage stress and have good quality social interactions with the people around us. These are the key requirements for good or optimal health – not pharmaceutical drugs
Behind the rhetorical force of the call for healthy lifestyle, it quickly becomes apparent that the Alliance of Natural Health is really a lobby group for the manufacturers of vitamin supplement pills who fear legislation will restrict their rights to sell pills with huge doses of vitamins in them. It is difficult to see how vitamin pills can be described as natural. They are undoubtedly the most highly processed and manufactured way of getting vitamins into people. The campaign tries to frighten people into believing that real natural diets, say consisting of turnips, are not enough for people to get the unnaturally high levels of vitamins the pill sellers say we need.
The Foundation for Integrated Health, again despite its wholesome lifestyle rhetoric, is again a lobby group that has the payload of attempting to deliver a whole range of disproven and nonsensical treatments into the public health care system. The Foundation lobbies for the unnatural theories of homeopaths, acupuncturists and vitamin sales people to be provided at tax payers cost.
It would be tempting to dismiss John Wesley and his Primitive Psychic as just one more form of Eighteenth century quackery, railing at the newly emerging professionalism of the medical world that is embracing enlightenment thinking and rejecting superstition in medicine. It is not that straightforward though. It would be simplistic to see the ‘natural philosopher’ doctors as the fathers of modern medicine and the Empiriks as the unenlightened quacks.
Indeed, it is quite possible to defend Wesley as embracing his own vision of the enlightenment and to be one of the proto-practitioners of evidence based medicine. Strip away the theology and natural rhetoric and you are left with a pragmatic medicine based on a commitment to empirical verification. Wesley is keen to present cures that have been proven in some way. In his preface to the 1760 edition, he adds the word Tried to those cures that he has found to be ‘of the greatest efficacy’. Whilst we may see with our modern eyes little attention to the the many ways that simple observation may deceive us, we should at least respect his desire to underpin his suggestions with some evidence.
There are several reasons why it is not wise to jump straight to declaring Wesley a quack. Firstly, Wesley is quite justified in declaring the theorising of the doctors as being of little value. Today, the mantra of evidence based medicine is that it does not matter what the mechanism of action might be, we must first show that the medicine works. It is an empirical approach that Wesley would have approved of. Furthermore, the theorising of the the late eighteenth century gave rise to one of the most enduring forms of quackery in the Western world. Just a few years after Wesley’s death, Samuel Hahnemann would theorise that miasms were the cause of all illness and that disease could be treated by applying poisons that gave rise to the same symptoms that were displayed by the patient. Homeopathy was a vastly over ambitious attempt to replicate the success of enlightenment physics into the world of medicine. Just as Newton gave us a handful of laws that could explain the movements of all objects in the universe, so Hahnemann hugely over-extrapolated from a single observation of a supposed cure for malaria to hypothesise his law of similars. This is exactly the ‘abstruse science’ that so worried Wesley,
“Men of learning began to set experience aside; to build physic upon hypothesis; to form theories of disease and their cure, and to substitute these in the place of experiment.”
Of course, we cannot know what Wesley would have made of Hahnemann and homeopathy. Hahnemann indeed tried to place homeopathy on a empirical footing with his theories of remedy provings. But these were a very indirect method to test cures and heavily dependent on the core homeopathic theories being correct. Even contemporary critics could see that provings were prone to subjective bias and delusion.
The second reason not to quickly dismiss Primitive Physic as complete quackery is that some cures might have been effective with one or two remarkably so. Wesley lists several cures for Scurvy, first is to “Live on turnips for a month”. He follows this with tar-water (used to prevent rot on ships), nettle-juice (Tried), boiled Burdock root, goose grass and then Seville Orange or even a teaspoon of lemon juice (well Tried), and scurvy grass.
According to Wesley’s insistence that cures should be effective and available to the poorest, then his priority given to turnips would indeed have been good advice. Turnips are indeed a good source of vitamin C and would have worked well. More expensive citrus fruit might have not been so available. Within a few years of publication, James Lind would be doing his famous trials onboard Navy ships. It would appear that cures such as turnips and lemons were well known as cures for scurvy with the first colonisers of Newfoundland growing turnips in 1601 to beat the disease. Lind is of course credited with the discovery of the cure because he took the naive empirical observation of Wesley onto the next step of a simple comparative trial. Lind would have been able to tell Wesley, with high confidence, which of his scurvy cures were sound and which were not worth pursuing.
Of course, much of Wesley’s cures are fantasy and absurd. He would have been subject to the same observational biases that ensures quackery survives today: an over-reliance on testimony, post hoc reasoning after a self-limiting condition improves and no doubt a good dollop of wishful thinking. But we should recognise that his insistence on observation is important and that an over reliance on hypotheses, no matter how plausible, is no guarantee of effective medicine.
The modern natural health movement appears to have adopted the rhetoric of Wesley, and maintained his simplistic empiricism. They have dropped the real natural cures, such as nettles, cold bathing and onions (and fucking healthy women), and instead embraced modern quackery from vitamin pills to oriental inspired placebo therapies such as reiki and acupuncture. A strong opposition to doctor’s medicine survives with deep suspicions of vaccines and ‘chemical’ drugs. The conspiratorial accusations thrive on sites such as Natural News and What Doctors Don’t Tell You.
Modern medicine took almost two more centuries to emerge into a form we recognise today. In that time, the rationalist movement struggled to find new cures and understand illness. It became very good at diagnosis, but its success in finding effective treatments was a long time coming. The empirical approach thrived and in many ways still does. A strong modern theoretical understanding of illness provides sound hypothesis for testing in a way that the current promoters of natural medicine cannot, but evidence based medicine still of necessity privileges the conclusions of trials.
There are though thoughts that the best reliable medicine can only come from interpreting our empirical results within a framework of scientific theory. These ideas are well discussed on the Science Based Medicine blog. It argues that we should dispense with trials of implausible claims, such as homeopathy, as a priori we can know that they are nonsense. In a world of limited resources for research into medicine, our efforts should be directed to hypothesis that have sound plausibility.
Wesley, understandably for his time, did not trust the emerging science of medicine and trusted his own accounts of cured cases. He saw the new electricity and took the reports of cures at face value – even though I am sure many people would happily proclaim they were cured after being subject to repeat electric shocks. In darker, modern times, such ‘treatments’ are used to extract favourable statements against the will.
Wesley’s stance appeared to be a honest reaction, inspired by his religious faith, against the emerging professionalisation of medicine and its removal from the hands of the ordinary person, whether that be a family member or wise elder. Modern advocates of Natural Health appear to use the same arguments more as marketing; as a differentiator from conventional medicine. The Natural Health products are just as modern, contrived and artificial as any – but wrapped in the language of naturalness, personal experience and free from corrupting influence. The promise of personal, easy and natural cures is a highly alluring concept that draws people in from the rather more stark reality of disease, illness, pain and the sometimes difficult treatments that must be endured.
You can buy Primitive Physic from the Quackometer Bookstore.
As you can see from the comments, the quote about “fuck a healthy woman” has caused some deserved scepticism.
The text I took my quote from reads as follows:
Google books facsimile from 1858 reads thus,
It would appear to be almost certain, on reflection, that ‘suck’ is the correct interpretation. However, I have written to the Methodist New Rooms in Bristol (the oldest Methodist Chapel in the world where my copy was published) to see if Wesley preferred fucking or sucking. (Got to be a first.)