The Search For Recognition

John Potter & Steven Soreff, MD. The Search For Recognition: State Support for Homeopathic Psychiatry in Late Nineteenth Century Massachusetts. Presented at the Sixty-Eighth Annual Meeting of the American Association for the History of Medicine, Pittsburgh, PA. May, 1995.

Summary

In 1884, the Massachusetts legislature passed a law founding the Westborough Insane Hospital, in Westborough, Massachusetts on the “principles of homeopathic medicine.” While homeopathy had made many gains, in Massachusetts, since its introduction during the 1830s, this institution represented the first endorsement by the state government that homeopathy had a place in the State’s mental health system. This paper explores how organized homeopathy and its supporters were able to obtain state support for their work in treating the insane. A feat made even more impressive by its occurrence just a decade after the expulsion of homeopaths from the Massachusetts Medical Society, and a mere three years after the denial of visiting privileges at Boston City Hospital to homeopathic physicians. We argue that Massachusetts homeopaths gained this success through a combination of influence, fiscal arguments, and the failures of orthodox treatment. Just as important, however, was the realization by the orthodox medical community in Massachusetts that, regardless of their preference, some tolerance of homeopathy was necessary.

The homeopathic emphasis on the limited use of drugs and gentle treatment had led to it being adopted by an educated, affluent, and influential clientele in Massachusetts. By the 1870s, these adherents had begun to argue that the exclusion of homeopathy from the state hospital system was unfair, and amounted to what the Massachusetts Homeopathic Medical Society called “taxation without representation.” In 1881, they were able to submit petitions signed by several thousand people calling for the establishment of a homeopathic mental hospital by the state. Moreover, the wealth and social status of most adherents to homeopathy not only meant that the homeopathic cause had influential supporters (including high-ranking members of the Republican party), but it also meant that the petitioners could hold out the pleasing prospect to the legislature of attracting private patients to the new state hospital.

This fiscal inducement was highly important at a time when “retrenchment” of government expenses was a major issue in Massachusetts politics. There was increasing displeasure among the state legislature over the cost of the state hospitals for the mentally ill. At the same time, the increasing pessimism among orthodox physicians about the curability of insanity promised only a continued increase in expenditure. In such an atmosphere, the promises by homeopaths of reduced costs of treatment, increased rates of cure, and the prospect of subsidizing the care of the indigent through the treatment of private homeopathic patients proved irresistible to the government.

Finally, the campaign for the establishment of a homeopathic hospital also succeeded, because it attracted little opposition from the orthodox medical community. The bitter fight over the expulsion of the homeopaths from the Massachusetts Medical Society, in 1873, had proved a financial and public relations bonanza for homeopathic medicine. As a result, the majority of the orthodox medical community had adopted an attitude of grudging tolerance towards homeopathy. While they were unwilling to share facilities with homeopaths–as the 1881 controversy at Boston City Hospital had shown–they were willing to accept the existence of separate homeopathic institutions. This attitude was strengthened by the extent to which homeopathic practice, in Massachusetts, had converged with orthodox medicine. While still utilizing homeopathic techniques, Massachusetts homeopaths generally used larger doses of medicines, and ignored the more esoteric doctrines of Hahnemann.

Taken together, all of these factors explain why on December 6, 1886, Westborough State Insane Hospital admitted its first patient.