On the The Reckless Physicking of Amateur Females.

It would appear to be important for homeopaths to show how the rich, blue blooded and famous are supporters of homeopathy. One might suggest that in lieu of meaningful scientific evidence for homeopathy, appeals to the beliefs of the influential and celebrities are all that are left.

Dana Ullman, America’s chief propagandist for homeopathy, takes this approach to its zenith with his book, The Homeopathic Revolution: Famous People and Cultural Heroes Who Chose Homeopathy. Bloggers such as Sue Young also use the associations of the notable with homeopathy to promote her views. Young’s approach is usually to attempt to demonstrate support through association with homeopaths – the “their father met a man down the pub who knew a homeopath” approach. Ullman just blusters through poor scholarship and innuendo, most offensively realised through his attempts to show Charles Darwin was a supporter of homeopathy, whilst Hitler, a documented user, was not.

Both Young and Ullman are quick to jump on Nightingale as a supporter of homeopathy. After, all she is widely regarded as one of the most influential Victorians in the world of medicine. She would indeed be a powerful advocate for their cause.

Living the sort of life she did, Nightingale mixed with many supporters of homeopathy. We are told she was treated by James Manby Gully, who was known to use homeopathy. However, Gully was a prominent advocate of the hydrotherapy cure – and even Darwin was an enthusiast for this water treatment. But just as Darwin thought Gully’s use of homeopathy was absurd and “which is a subject which makes me more wrath, even than does Clairvoyance”, there is no evidence that Nightingale approved of his use of such treatments.

The main passage that homeopaths leap on was written in her famous Notes on Nursing,

Homoeopathy has introduced one essential amelioration in the practice of physic by amateur females; for its rules are excellent, its physicking comparatively harmless–the “globule” is the one grain of folly which appears to be necessary to make any good thing acceptable. Let then women, if they will give medicine, give homeopathic medicine. It won’t do any harm.

Here, it is quite clear that Nightingale appears to be advocating the use of homeopathy amongst ‘amateur females’. And homeopaths leap on this passage to prove she was a supporter.

But can it be as simple as that? There are at least three odd things about this passage.

If she was such an advocate, why did she not promote it more thoroughly?

Firstly, this is the only mention of homeopathy in her professional writings. If she was such an advocate, why did she not promote it more thoroughly? Secondly, why is she suggesting that ‘amateur females’ be the administers of homeopathy and not physicians? And thirdly, what are we to make of her description of the ‘globules’ as being folly?

As always, we need to look at the context of this paragraph. (I am quite convinced that homeopaths never check sources. As soon as something appears to support their beliefs they will not actually risk losing that nugget by critically appraising its source.)

So, I did check the source.

The above paragraph appears in a footnote to a discussion on the problems of women getting involved in medicine. Of course, Nightingale was a woman of her time and, even more so than now, doctors were men and nurses were women. What Nightingale did, nonetheless, was remarkable in taking the neglected role of the woman in the hospital and professionalising it by insisting that their purpose was to create a well run hospital that emphasised cleanliness, care and compassion. These were not side issues to her, but central to restoring patients back to health.

Quacks are keen to jump on this philosophy as being ‘holistic’ and thus alternative medicine, also being ‘holistic’, is the natural end point of her revolution. But this is a distortion, as we shall see. Nightingale was advocating such changes in the heart of what was then mainstream medicine. She had little time for fringe and superstitious forms of medicine.

One of the problems that she saw was the interference of women in the dispensing of medicines to patients. Nightingale was well aware that the drugs in use at the time were highly dangerous and that amateurs should be discouraged from getting involved in giving them to sick people.

Her views might prickle modern sensibilities,

It is often said by men, that it is unwise to teach women anything about these laws of health, because they will take to physicking [dispensing medicines],—that there is a great deal too much of amateur physicking as it is, which is indeed true.

There is nothing ever seen in any professional practice like the reckless physicking by amateur females.* But this is just what the really experienced and observing nurse does not do; she neither physics herself nor others.

And this is where the homeopaths’ favourite passage kicks in as a foot note to the starred point.

Nightingale starts with a stern warning to women thinking of dabbling in medicine,

If women will take or give physic, by far the safest plan is to send for “the doctor” every time—for I have known ladies who both gave and took physic, who would not take the pains to learn the names of the commonest medicines, and confounded, e.g., colocynth with colchicum. This is playing with sharp-edged tools “with a vengeance.”

There is no doubt that Nightingale sees that the best route is to have a doctor do what they do. But she goes on to say that homeopathy has provided “one essential amelioration in the practice of physic by amateur females”. And it is in this context that we can understand what she means.

Florence Nightingale is simply advocating that if women must dabble in physic, then let them use the harmless pills of homeopaths. She notes that the pills or ‘globules’ are a folly, but that this is a price worth paying if it allows women to pretend to dispense without risking the patient.

In this context, it is clear that Florence Nightingale was well aware of the essential nature of homeopathic remedies – they are inert and harmless globules of sugar.

We should not be surprised by this. Nightingale was a sharp intellect. Her contributions to science were not just in nursing but also in statistics, being elected the first female member of the Royal Statistical Society.

“Almost all superstitions are owing to bad observation, to the post hoc, ergo propter hoc, and bad observers are almost all superstitious.”

She also makes clear in her Notes on Nursing, that nurses should be acutely aware of the post hoc, ergo propter hoc fallacy. That is, just because one event follows another, does not mean that the first event caused the other. Just because a patient gets better after a particular treatment does not mean the treatment caused the improvement. This is the central fallacy that all homeopaths are guilty of.

She says,

Almost all superstitions are owing to bad observation, to the post hoc, ergo propter hoc, and bad observers are almost all superstitious. Farmers used to attribute disease among cattle to witchcraft; weddings have been attributed to seeing one magpie, deaths to seeing three ; and I have heard the most highly educated now-a-days draw consequences for the sick closely resembling these.

In examining this problem, Florence was criticising the craze of Physiognomy where disease could be revealed by features of the face. It was a false claim likely to mislead the public.

It is for her insights such as this, that Florence Nightingale makes such a good figurehead for the newly formed Nightingale Collaboration. This cooperative venture will seek to challenge the misleading claims that are so rife in the world of alternative medicine. I am quite convinced she would approve.

29 comments for “On the The Reckless Physicking of Amateur Females.

  1. Mojo
    November 17, 2010 at 2:30 am

    “One grain of folly” is a splendid description of a homoeopathic remedy, even if it would, an many cases, grossly overstate the does.

  2. Micko
    November 17, 2010 at 3:11 am

    Apart from the excellent antiquity of the language, this quote seems to me to show clearly that Nightingale was a supreme pragmatist. I work in a large public hospital and I meet lots of nurses who are enthusiastic amateur practitioners of various healing ‘arts’ whose nursing work is compromised by their ideology or mistaken private beliefs. Health professionals need to be secular, naturalistic and scientific if they are to be effective, as we are all as prone to folly and hubris as any people.

    Except for Dana Ullman, apparently he’s perfect.

  3. Michael Power
    November 17, 2010 at 7:41 am

    Fascinating, and a nice piece of work.

    Thanks very much.

  4. Dana Ullman
    November 19, 2010 at 3:47 am

    Mr. Duck…That’s a nice piece of fiction and sloppy scholarship. Your “documented” evidence that Hitler used homeopathic medicine is that he was prescribed “nux vomica” and “belladonna,” and yet, you neglect to mention that he was prescribed EXTRACTS, not “homeopathic potencies” of these medicines by a doctor who had NO training or certification in homeopathy (actually, he was a specialist in syphilis, a condition that Hitler most probably had).

    As for Florence Nightingale, your piss-poor scholarship rears its head (or something) again. Your quote from her is from a book in 1860…and you then neglect to mention the well-referenced information about her efforts to get her father AND her sister to go to a homeopathic physician. And the fact that Nightingale also sought out the care of Darwin’s physician who specialized in water-cure AND homeopathy, Dr. James Manby Gully.

    If readers out there are seriously interested in this and other factual information about Florence Nightingale, Sue Young’s website has a good body of facts on her at:
    http://homeopathy.wildfalcon.com/archives/2007/11/22/florence-nightingale-and-homeopathy/

    But of course, Mr. Duck and his blinded mice followers will prefer to baste in their worldview that conveniently lacks evidence, scholarship, accuracy, and reality…

    There is major irony in having an organization “medical fundamentalists” call themselves the Nightingale Collaboration, especially in the light of her appreciation of real healing, not orthodox medicine of that day (or any other day).

    When you consider the connections that many of the “medical fundamentalists” have to Trotsky, perhaps the organization should be called the TROTSKY COLLABORATION…and death to anyone who disagrees with this organization

    • Mojo
      November 19, 2010 at 11:55 pm

      When you consider the connections that many of the “medical fundamentalists” have to Trotsky, perhaps the organization should be called the TROTSKY COLLABORATION…and death to anyone who disagrees with this organization

      Trotsky and Homeopathy

      “The poor mystic homeopaths feel like petted house-cats thrown at high flood on the breaking ice.” Trotsky: Literature and Revolution (1924)

      “He was a homeopath of the pre-revolutionary politics. His methods and mediums had something of the character of the apothecary shop, of the laboratory. The quantities with which he worked were always very small; the societies with which he had to do he could measure with the finest scales. Not without reason did Deutsch consider Axelrod like Spinoza, and not in vain was Spinoza a diamond cutter; a work that requires a magnifying glass. Lenin, on the contrary, looked upon the events and conditions as a whole and understood how to grasp the social complex in his thought; so he wagered on the approaching revolution, which burst upon Plechanof, as well as Axelrod, all of a sudden.” Trotsky: Lenin (1925)

      “No, I shall remain with my own family, the masses are not pure enough for me; I shall wait until the masses dribble into our party in little homeopathic doses.” Trotsky: The First Five Years of the Communist International Volume I (1924)

      “Seeking to escape from the consequences of their own policy the Centrists have pushed to the fore the homeopathy of “self-criticism.” Stalin unexpectedly referred himself to Marx who had spoken of “self-criticism as a method of strengthening the proletarian revolution.”” Trotsky: The Third International
      After Lenin (1928)

      “A good many prophets of “new morals” are preparing to regenerate the labor movement with the help of ethical homeopathy. The majority of these apostles have succeeded in becoming themselves moral invalids before arriving on the field of battle.” Trotsky: The Transitional Program (1938)

  5. Andy Lewis
    November 19, 2010 at 8:05 am

    Dana

    The usual games.

    Let me put the challenge to you. Now, I am quite ready to change my mind about Nightingale. I am neutral about her beliefs here. What my article is really about is how homeopaths like to appropriate the support of historical characters based on the flimsiest interpretations of the documentation. The question is, can you justify your position that she was a genuine supporter of homeopathy?

    So, how do you interpret the above passage from her nursing book?

    How do you explain my three issues with the quote…
    1) This is her only professional mention of homeopathy. If she was not a supporter of ‘orthodox’ medicine, why does she not support homeopathy more?
    2) Why does she direct her supposed support of homeopathy only at ‘amateur females’?
    3) What do you make of her statement that the globules of homeopathy are ‘folly’?

    If you can answer these questions convincingly, I may change my mind.

  6. Jin-Shei
    November 19, 2010 at 8:33 am

    Having read those references and links, Nightingale referred to the homeopathic practitioner as “that quack” in the original text, and wished to use him to send a report to the physician. This does not suggest to me that she felt he would be any good for her sister but would be able to monitor the situation.

    Nursing is a holistic profession and Nightingale was someone with uncommon sense, a statistician who believed in evidence based medicine and professional nurses.

    Having read the original text to which Andy refers, she is obviously suggesting that allowing the type of women who must both share their medications without understanding their function or action and be their own prescribers should be given a harmless toy to use for this benefit. Or perhaps placebo is a better term.

    Her appreciation for holistic practice is the foundation for modern day nursing, but she also hugely valued evidence, hence the interest in statistics.

  7. Mojo
    November 19, 2010 at 1:17 pm

    @Dana

    …you then neglect to mention the well-referenced information about her efforts to get her father AND her sister to go to a homeopathic physician.

    Can you provide references to this “well-referenced information,” please?

  8. hod
    November 19, 2010 at 4:08 pm

    @Dana

    It’s all gone quiet over there

  9. davidh
    November 19, 2010 at 5:14 pm

    Given that Florence was a classic ME case (in bed all day, writing long asertive letters), it is all the more intereasting that in the usual ME-shoparound for help, she did not bring in a homeopath at some point.

  10. Dana Ullman
    November 19, 2010 at 6:33 pm

    Mr. Duck, you and your ilk do not seem to get that it takes a certain courage to advocate for homeopathy, then and now.

    “I believe what prevents men from accepting the homeopathic principles is ignorance, but ignorance is criminal when human lives are at stake. No honest man faced with the facts of homeopathy can refuse to accept it. He has no choice. When I had to face it, I had to become a follower. There was no choice if I were to continue to be an honest man. … Truth always demands adherence and offers no alternative.”
    Sir John Weir, physician to six monarchs, including four generations of British monarchs

    Orthdox physicians in the 19th century were not allowed to refer patients to homeopaths or even treat a “homeopathic patient.” The degree of social ostracism was also considerable, though the homeopathic community maintained its dignity and has its own powerful community…but involvement in homeopathy sometimes split families and friends.

    Nightingale may not have wanted to go “public” with her appreciation for homeopathy, but she certainly wanted homeopathy for her father and sister…a fact that you “conveniently” chose not to mention. Whooops.

    As for the “folly” of homeopathic globules…I am STILL amazed at the frequent miracles that homeopathic medicines create, and I am humbled by it. These medicines may seem to be folly UNTIL and UNLESS you experience it yourself and/or review the overall body of evidence that exists for their biological activity and clinical efficacy.

    One question to you: Why did Nightingale refer to Gully as a “genius”?

    • Michael5MacKay
      November 20, 2010 at 2:35 am

      Why does it take a certain courage to advocate homeopathy now? Are homeopaths being incarcerated for their beliefs? Don’t think so. All it takes now is ignorance, or a deliberate ignoring, of 200 years of science and medicine.

      The argument that Nightingale advocated homeopathy — not publicly, mind you, where there would be evidence of it — but to her relatives is the type of argument that C.S. Lewis described thus:

      “The very lack of evidence is thus treated as evidence: the absence of smoke proves that the fire is very carefully hidden.” Such arguments are effectively impossible to refute, as Lewis noted. “A belief in invisible cats cannot be logically disproved,” although it does “tell us a good deal about those who hold it.”

      • dt
        November 23, 2010 at 5:59 pm

        Rather in the same way that one cannot see the invisible pink unicorn is solid evidence that it is invisible.

  11. Badly Shaved Monkey
    November 19, 2010 at 6:56 pm

    @Dana
    …you then neglect to mention the well-referenced information about her efforts to get her father AND her sister to go to a homeopathic physician.
    Can you provide references to this “well-referenced information,” please?

  12. Mojo
    November 19, 2010 at 7:22 pm

    @Dana

    Why did Nightingale refer to Gully as a “genius”?

    Who knows. Can you provide the context (and a reference for it)?

  13. Badly Shaved Monkey
    November 19, 2010 at 7:37 pm
  14. nobby
    November 20, 2010 at 10:09 am

    The famous Dr Gully who uses water cure AND homeopathy….or does he?

    We have already had Dana quote from his 1846 edition where Dr Gully says “, ‘although I might be induced to try to subdue a passing but troublesome symptom, I could not trust to remove the essential nature of a chronic malady by homeopathic means’” (p48)

    But then in 1848 Dr Gully became a formal member of the British Society of Homeopathy and apparently his view of homeopathy changed. So much so in the 5th edition in 1856 he had this to say.

    ‘although I might be induced to try to subdue a passing but troublesome symptom, I could not trust to remove the essential nature of a chronic malady by homeopathic means’”(p48)

    Not much change there is there?

    But more interestingly he says this in the 5th edition in 1856:

    “To alleviate this symptom without interfering “with the general curative process is great gain, both to patient and practitioner; and it is readily effected by homoeopathic means. In these and many other cognate instances I hold the application of homoeopathy in the course of water-treatment, to be not only justifiable but desirable; although I should by no means employ it in all cases.” (p48)

    Although I should by no means employ it in all cases? He has so much faith in homeopathy but again chooses to not use it all the time. Of course Dr Gully then goes on about how its best to use both and people who don’t are bigots, blind and charlatans etc. But still he does not use both all the time himself by his own admission.

    I more fitting description for what he does in terms of treatments would be that:

    Dr Gully specialised in water cure and not in every case homeopathy

    http://books.google.com/books?id=SBYDAAAAQAAJ&printsec=frontcover&dq=editions:07WVDaI0nAaUeMi6&lr#v=onepage&q&f=false

    • Mojo
      November 21, 2010 at 1:27 am

      Not only does he seem to have had such little regard for homoeopathy that he only thought it worth mentioning in a footnote to his book, but he is also on record as stating, “It may shock the homœopathic world when I say that I never much cared for the doctrine of “like curing like”; and that I do not believe it to be of the universal application that they suppose” (BMJ, Nov. 16, 1861).

      • nobby
        November 21, 2010 at 5:39 pm

        i think you have to remeber he was only a member of the british society of homeopathy for at least 23 years. everyone knows you need to be a member of a homeopathic society for about 24 years before you become experienced in homeopathy. if only Dr.Gully had more time..sigh

  15. Andy Lewis
    November 20, 2010 at 9:59 pm

    So Dana resorts to the same trick he tried to pull with Charles Darwin. Basically, both Darwin and Nightingale were intellectual cowards who were too afraid to speak out about their true belief in homeopathy. Instead, the disparaged it to try to fit in with their peers.

    Except you do not have the slightest evidence for this. If fact, both characters are well known for taking positions that may will have been against accepted wisdom and even been offensive.

    The only intellectual coward is of course Ullman who can never bring himself to admit that he got it wrong.

    So, the letter you hang your hopes on is in this archive.

    http://encore.wellcome.ac.uk/iii/encore/record/C%7CRb1605294%7CSnightingale+8993%7COrightresult%7CX1?lang=eng&suite=pearl

    If it supports your view, then I suggest you make available its contents in full (you did cite it in your book). For we will find the letter and if it is found not support your view, you will once again be exposed as a charlatan.

  16. Badly Shaved Monkey
    November 21, 2010 at 8:37 am

    Where’s Dana?

    • dt
      November 23, 2010 at 6:04 pm

      Where’s Wally? more like.

  17. Mojo
    December 22, 2010 at 11:12 am

    Well, it doesn’t look as if Dana is going to come back, which is a shame because I managed to track down the letter referred to above, and another source he uses.

    Dana asks,

    Why did Nightingale refer to Gully as a “genius”?

    I asked him for a reference for this but he hasn’t been back since.

    Dana’s book states, on page 216 (Google books didn’t have a preview available for this page, but I managed to reconstruct the passage from the snippets given in search results):

    “She referred to him as a “genius” (Jenkins, 1972, vii). Although Florence Nightingale became an advocate of water cures, she was never known to advocate or write about homeopathy in her public writings; in her private letters, though, she once wrote to her mother that she hoped her father would try homeopathic treatment for an eye problem he was experiencing (Nightingale, 1852).”

    Looking at the “genius” comment, according to a search on Google Books the Jenkins book says, on its seventh page, “Florence Nightingale said he had genius”, which of course doesn’t quite support Dana’s claim: “having genius” isn’t the same as being a genius. I managed to get hold of a UK edition of this book, which unfortunately doesn’t include the foreword Dana cites. I was hoping that the book would include some further content and sources to back up Dana’s claim about Nightingale and Gully, but unfortunately it doesn’t have an index or a list of references. This may be explained by the book’s subtitle: “A Novel”.

    I think I’ve tracked down the original source for this though. It is a letter dated 8 September 1860. Here’s what it says about Gully:

    “I have seen a good deal of all the hydropathic doctors. Dr Gully of Malvern has the most genius, but his practice is so large, his fortune so assured, that I have known him go away for weeks and leave his patients to a third-rate practitioner. And I have known him keep cases of phthisis (not from self-interest but from mere carelessness) to die at a miserable little lodging at Malvern, instead of sending them away to an easier death at home, or in a warmer climate.”

    Note that this waters down Dana’s claim even further than the Jenkins book: having started out described as “a genius”, then having been said to “have genius”, now he only “has the most genius” of the hydropathic doctors. The rest of Nightingale’s comments about him hardly amount to an unqualified recommendation.

    As for the letter, I’ve tracked down the text, and it would appear that Dana has a hit on his hands, but it is really rather trivial. In a four page letter there is a single sentence paragraph, saying “I wonder whether Papa would try homoeopathy for his eyes”. This is sandwiched between gossip about a baby (“I never saw such a child. He seems to have swallowed up the vitality of two generations on both sides”) and a description of a local drought (“The poor little Derwent has dwindled to a thread…”). That’s it. There is no suggestion as to why she thinks he should try it, no indication that she knew anything much about homoeopathy at this stage of her career (it was a fashionable treatment in the mid 19th century), and no recommendation of any particular doctors. It really is rather thin evidence on which to base a claim of support for homoeopathy, especially given her later writings.

    • Le Canard Noir
      December 22, 2010 at 11:49 am

      Thank you Mojo.

      Thin evidence is all Dana Ullman needs to create the most extravagant claims.

      • Mojo
        December 22, 2010 at 12:19 pm

        Well it certainly doesn’t support Dana’s claim of “well-referenced information about her efforts to get her father … to go to a homeopathic physician”. There’s not much in the way of effort here, just a single throwaway remark, and no mention of any “homeopathic physician”.

  18. February 6, 2011 at 4:01 pm

    Being a nurse – and one being worried by the amount of woo in the profession – I cannot say how much I appreciate this piece of work.

    I wonder if there still are miasma-believers, because they would’ve got something going with Nightingale.

  19. Jenny
    December 3, 2011 at 11:57 am

    I really don’t care whether or not she approved of Homeopathy. However clever she was, she was basing her opinion on the amount of information available in her era. I will base mine on current evidence, which is lacking.

    The longer the history of people seriously pursuing homeopathy, and the more respectable those involved, the more suspicious it is that no solid evidence has emerged.

  20. December 3, 2011 at 12:58 pm

    Ah, miasma. Yes, there are still believers and it’s still taught. I actually found a reference to these on the Faculty of Homeopathy website, albeit well-hidden in a bit about homeopathy for animals. But it’s there.

    Brilliant piece, Andy. I’m forwarding this to my nurse of a daughter. So kind of Dana to step in and actually illustrate your point, too.

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