Allopathy and Homeopathy: Medical Clash in a Philadelphia Home for Aged Blacks

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Philadelphia’s Home for Aged and Infirm Colored Persons was organized after a series of meetings in the fall of 1864, in which both black and white communities showed considerable agreement. In August 1877 the suicide of one of the inmates made the home the scene of controversy between rival philosophies of medical practice, conservative allopathy and the newer homeopathy.

 

Formation of the Home

When Mary Ann Shaw, a Quaker, learned that an elderly black servant, Eliza Perry, whom she had known all her life, was confined in an almshouse, she had Eliza placed in the home of a respectable private family. This was in keeping with Quaker policy toward their own poor, but Eliza had been so shattered by the almshouse experience that she soon died. In an emotional response to the loss of Eliza, Mary Ann Shaw began a campaign that resulted in the founding of the home. Her friend, Maurice Hall, an elderly black leader, recruited contributions by taking people to “the abodes of many colored women, some of whom were living in dilapidated, uncomfortable, unhealthy apartments, the sight of which was enough to move the least sympa­thetic heart.” Quakers, who were prominent among those who founded and governed the home, were already largely acquainted with the general level of poverty among black Philadelphians, but Shaw and Hall pointed them toward the especially tragic state of the elderly.

A building was purchased at 340 South Front Street and, in February 1865, six elderly women were admitted. Stephen Smith, a black businessman, minister, and philanthropist, funded a new building for the home in 1871. Since he was also active in its management and left his estate to its continued operation, the institution now bears the name Stephen Smith Geriatric Center.

The home was intended for “worthy” and “exemplary” blacks “who in their old age, from sickness or infirmity, have become more or less dependent upon the charities of the benevolent.” The Board of Managers held its first annual meeting in January 1865 and adopted rules and regulations. A matron was appointed who had heavy responsibilities. The first appointee, Miliscent Parvin, came well recommended because she was also assistant matron at Pennsylvania Hospital. Physicians served the home gratuitously until 1873 when the board voted to pay one physician $100 per annum. At first (1865) two physicians were appointed annually to “look after the health of the inmates,” but the requirement was altered to “one or more” physicians, in 1868. Until 1896, when a room for physicians was established within the home, the physicians visited once a week and saw each resident in his or her room. An arrangement was made, in 1880, for another physician to be on call nearby for emergencies. The home’s physicians were responsible for all aspects of welfare, from sanitary conditions of the kitchen, infirmary, and other areas, to administering to the real and fancied needs of the residents.

Since residents came to the home on a life-care basis, it was impractical to allow them to choose their own physicians. At first there was a rule against it, but in 1878 this was changed so that residents could make a choice, provided that consent of the home’s physician was ob­tained, and that the home was assured it would be under no obligation for the work done by the outside doctor. Although the residents seem to have had very little money, some were treated by outside physicians and, despite the rule, the home was billed for some of those services.

 

The Clash: Brief Triumph of Homeopathy

When medical services had been provided by volunteer doctors, the home had not cared about their medical theories. Once the physicians were paid it became another matter. In 1847 the American Medical Association had resolved on a “Consultation Clause” which prevented allopaths from conferring with homeopaths, or from adminis­tering to the patients of homeopaths (unless the homeopath was dismissed from the case). The medical profession was emerging from what has been called “the age of heroic medicine,” characterized by excessive blood letting for almost every condition, and huge doses of calomel and other dangerous mineral drugs, as well as purgatives and emetics to cleanse the system of irritants. The homeopaths used remedies known to produce symptoms similar to the patient’s present disease, on the theory that “likes cure like,” but applied them in very small doses. According to the distinction made by homeopathy’s founder, the Ger­man physician Dr. Samuel Hahnemann (1755-1843). traditional medicine, from which homeopaths had defected, was allopathic. Allopaths used remedies producing effects contrary to the patient’s disease and they tended to use large, or “heroic,” doses. In the second half of the nine­teenth century homeopathy was threatening to overshadow allopathy. Having repudiated the homeopaths, the Ameri­can Medical Association, in the 1860’s, had further nar­rowed its membership by casting out blacks and women physicians. Thus it appeared to be an organization that was intolerant both at the theoretical and the personal level.

The home’s physician for many years (1866, 1867, 1872-1877) had been an allopath, Dr. David Roselle. In January 1877 he was not reappointed “owing to the desire of some of the Board of Managers of adopting homeopathy.” The Board appointed an homeopath, Dr. Jessie Thatcher. On July 12, 1877, Thatcher recommended that the inmate Alexander Maxfield, a ninety year-old native of Delaware with tendencies toward violence, be taken to the insane ward of Blackley Almshouse. Since the affidavit for Max­field’s removal required a second signature, Thatcher ob­tained that of another homeopath, Dr. Banks. When the secretary of the home presented the papers to the alms­house authorities, the Guardians of the Poor (a body of public officials at the county level). he learned that they required the signature of their own physician, Dr. Mullen, who was an allopath and the visiting physician of the city ward in which the home was located. Dr. Mullen re­fused to sign because to do so would associate him with homeopaths, but he offered to examine Maxfield and issue a new certificate.

On August 15, 1877, Maxfield jumped to his death from the fourth story of the home and the controversy between the two medical factions was brought out into the open. During the ensuing investigation the press followed the pro­ceedings closely, clearly siding with the homeopaths. They accused the Guardians of the Poor of obtaining a coroner’s inquest solely for the purpose of exonerating Dr. Mullen. State law required “two or more reputable physicians” to attest to the insanity of an individual. The public physi­cian’s signature was required only by the Guardians, not by the law. Thus it was the Guardians, not the state legislators, who were condemning the homeopaths as quacks. The newspapers continually reminded the Guardians that ho­meopaths had graduated from universities chartered by the Commonwealth, that their degrees were therefore as valid as other physicians’ degrees, and that non-recognition was a violation of the law. The Sunday Dispatch called Max­field’s death a “pathy” homicide and suggested that similar situations “furnished the fraternity of undertakers with lots of business.” It also accused the Guardians of running a public institution in the interests of a particular school of medicine.

During the coroner’s hearings the allopaths were clearly on the defensive. One, Dr. Dwight, swore that he had ex­amined Maxfield before admission to the home and at that time found the man suffering from dotage or somnambu­lism, but not from mental illness. The implication was that homeopaths could not properly recognize insanity. Al­though evading the question of whether he himself had ever had any association with homeopaths, Dr. Dwight took the occasion to accuse the home of having inadequate supervision and of desiring to rid itself of Maxfield by what­ever means possible.

The final report of the coroner exonerated Dr. Mullen, and the Guardians’ rules for committing the insane remained unchanged. Since Maxfield was never presented at the almshouse, Dr. Mullen had done nothing wrong. The Sunday Dispatch cried “white wash,” “evasion,” and de­clared the findings “insulting to the community.” For his part, Dr. Mullen revealed in a letter to the Dispatch that he had been busy until ten o’clock the evening of August 14, and therefore had not examined Maxfield. When he had arrived at the home the next day, he contended, the matron informed him of Maxfield’s death. Yet Mullen had come to the newspaper office the day after the first article appeared in the Dispatch, and had displayed a certificate he had com­pleted after such an examination, explaining then that Max­field had died before the required second signature had been obtained. Dr. Mullen, the editor exclaimed, “must be afflicted with a treacherous memory.”

The death of Alexander Maxfield brought medical bigotry to public attention, but did not solve the problem. The press and the managers of the home were generally in favor of homeopathy at this time. Homeopath Thatcher remained the home’s physician. He had been serving since January 1877 without remuneration. In fact, his willingness to serve without pay may have been the reason he had been chosen over the incumbent allopath at that time. He resigned in March 1878 because he could not continue without compensation. In April he was reappointed by the home with assurance that he would be paid $80 per year.

Even though the general medical responsibilities re­mained in the hands of homeopath Thatcher, allopathic medical service was made available to the inmates who preferred it. In 1880 the allopath Dr. Caroline Anderson was appointed for home residents who chose allopathy and to serve in cases of emergency. She was a black woman who worked for the home until July 1884 and several years afterwards served as a member of the board. The Quaker members among the governing body of the home had, no doubt, prevailed in the appointment of Dr. Anderson. They believed that women should practice the professions and that black doctors should attend blacks. The annual report of the home for 1882 noted that “our physicians both Homeopathic and Allopathic have been attentive and ef­ficient in their departments: and the health of the family, for so large a number of aged people, has been, we think, remarkably good.”

 

Repudiation of Homeopathy

In 1885 the reputation of the home’s homeopath was in­directly tarnished during an investigation of cruelty allegedly perpetrated by the matron of the home. Although exonerated of the specific accusations, the matron was censured, and resigned. The censuring committee said of homeopath Thatcher that “while there was not much outspoken opposition to the doctor, we think the majority would prefer the old School (allopath). Edward, the nurse, says those under his care would much prefer the old treatment.” Dr. Thatcher resigned. His replacement was an allo­path and although the managers considered appointing another homeopath to please the older residents, the official documents of the institution do not show that this was ever done.

Ironically, the home began its relationship with homeopathy when the American Medical Association was main­taining an adamant posture against it, and ended its use for inmates in 1885, when homeopathic practice was generally becoming respectable. Across the land homeopathy grew steadily, until 1920, when a decline set in leading eventual­ly to extinction. The battle waged in the Philadelphia Home for Aged and Infirm Colored Persons, between these two schools of medical thought, was repeated in other institu­tions. Homeopaths won a few skirmishes, but allopaths won the war.

 

Sources

Constitution, By-Laws and Rules of The Home for Aged and Infirm Colored Persons, 1864.

“Committee on Management Records” (unpublished manuscript), 1895.

DuBois, W. E. B., The Philadelphia Negro: A Social Study, with introduction by E. Digby Baltzell (1967 reprint).

Friends’ Intelligencer.

Friends, Society of, A Statistical Inquiry into the Condition of the People of Colour of … Philadelphia, 1849.

Kaufman, Martin, Homeopathy in America: The Rise and Fall of a Medical Heresy, 1971.

“Minute Book of the Association” (unpublished manuscript).

Noam, Ernst, Homes for the Aged: Supervision and Standards – A Report of the Legal Situation in European Countries, trans­lated by John S. Monks, 1975.

Philadelphia Public Ledger.

Philadelphia Sunday Dispatch.

 

Dr. Leslie J. Pollard, associate professor of social science at Voorhees College, Denmark, South Carolina, has been teaching history since 1965. Active in planning for the
elderly, his dissertation at Syracuse University was “The Stephen Smith Home for the Aged … 1864-1953.” In 1971 he was voted the Outstanding Young Man of America.